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Is it okay to be fat?

http://www.hulu.com/embed/gpabQ23QRCHrDSAA80er1g

I just came across this Nightline Face-off episode on the concept of "fatness" as it relates to health, government policy, and cultural ideals of beauty. It was really interesting and especially relevant to conversations that have arisen in several different threads on the forums recently. Above you can watch a sort of 20 minute summary with a whole bunch of excerpts from the debate. You can watch the full debate on ABC's website, but it's quite a bit longer and I wanted to post something brief enough that people will have time to watch it and share their thoughts.

So, vegwebbers, what do you think? Is it true, as one panelist claims, that the notion of a person being fat and healthy is an oxymoron? Who (if anyone) should decide where we draw the line that distinguishes "healthy" bodies from "fat" bodies? What do you think about this idea of reclaiming the word fat so it's no longer a dirty word? What's your reaction to the panelists arguments about biological determinism (i.e. you're fat because your genes make you so) versus behavioral control (i.e. your eating habits determine how your body looks)?

One thing that struck me was that it was a debate amongst women. The moderator was female, as well as all four panelists. Uh huh. That's all I'm going to say about that.

I guess I didn't realize we were talking about the population without chronic illness. The yardsticks that are traditionally used to indicate health are body weight and how often you get sick. Autoimmune conditions weaken your immune system and make you more susceptible to common colds and such. Both diabetes (synthetic insulin) and thyroiditis cause you to be heavier. I guess I was just giving more examples of exceptions to the rules.

Thank you for sharing about your situation. As you probably noticed, earlier in the discussion there was the hot topic of being overweight when you are medically inhibited or receiving treatments, and revvie talked about her situation. I do not personally know anybody with type 1 diabetes, and I had no idea how synthetic insulin affects someone. I'm sure it's incredibly frustrating to be on a medication that is saving your life, but the side effects are causing other things you don't like--especially a side effect that can be noticed by other people, such as your weight.

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Soooo, let's just all be the best we can be--our own version of healthy, and our own version of happy! 

I think this is pretty much IT.  ;)b

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Soooo, let's just all be the best we can be--our own version of healthy, and our own version of happy! 

I think this is pretty much IT.  ;)b

agreed

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And while we're at it, stop judging other people based on our perceptions of their health.

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And while we're at it, stop judging other people based on our perceptions of their health.

wait - we still get to judge the meat eaters right?  cus thats my favorite part about being vegan!!

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And while we're at it, stop judging other people based on our perceptions of their health.

wait - we still get to judge the meat eaters right?  cus thats my favorite part about being vegan!!

um, HELL YES :D

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And while we're at it, stop judging other people based on our perceptions of their health.

wait - we still get to judge the meat eaters right?  cus thats my favorite part about being vegan!!

Well, duh! That's in the vegan handbook! Did you not receive your copy?

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And while we're at it, stop judging other people based on our perceptions of their health.

wait - we still get to judge the meat eaters right?  cus thats my favorite part about being vegan!!

Well, duh! That's in the vegan handbook! Did you not receive your copy?

I just got back from Vegas, Health Conscious Capital of the US.  If judging meat eaters to the same degree I was judged in Las "Steak and Deep Fried Twinkies" Vegas is wrong, then I don't want to be right.

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Comment by Courth:

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Healthy people shouldn't be getting colds. I am a type 1 diabetic. Type 1 is not caused by being overweight or unhealthy. When I was a healthy diabetic (good control of blood sugar levels, running every day, eating super well) I still got colds. Diabetes gives you a weaker immune system. I got plenty of vitamins and tried to stay away from people who were visibly ill. I still got colds. At the same time, I was 20 pounds heavier than I am right now.

I was wondering about this comment from Courth.  I was like...wha?  :o

You get a cold if you don't have antibodies to a particular virus or bacteria, simple as that, so that comment confused me.  I have no autoimune disease and I still get colds, who doesn't?  Is there a  person here who can honestly say they  have never had a cold, or the flu?  

I think it boils down to as so many things do: what is the definition of "healthy"?

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I didn't make that comment originally, btw. It was hespedal, and she has a much, much higher standard of health than a lot of people.

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Comment by Courth:

Quote:
Healthy people shouldn't be getting colds. I am a type 1 diabetic. Type 1 is not caused by being overweight or unhealthy. When I was a healthy diabetic (good control of blood sugar levels, running every day, eating super well) I still got colds. Diabetes gives you a weaker immune system. I got plenty of vitamins and tried to stay away from people who were visibly ill. I still got colds. At the same time, I was 20 pounds heavier than I am right now.

I was wondering about this comment from Courth.  I was like...wha?  :o

You get a cold if you don't have antibodies to a particular virus or bacteria, simple as that, so that comment confused me.  I have no autoimune disease and I still get colds, who doesn't?  Is there a  person here who can honestly say they  have never had a cold, or the flu?  

I think it boils down to as so many things do: what is the definition of "healthy"?

I think it boils down to the fact that if you're healthy then your immune system is going to be much more ready to attack antibodies, send out the signal, recruit macrophages and eat up the virus or invading bacteria. Yes, healthy people do get colds, but you do not sick as often when you're healthy, you're up on your sleep, you're eating well, and you're drinking lots of water. Your body is at the helm, ready to go and fight off the infection before it becomes a problem. If you're not treating your body well, then you're asking for colds and flu viruses to come into your system.

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Viruses don't work that way.  If it is the common cold/flu that cycles around seasonally, than you can take precautions to avoid it.  If it is say a new, aggressive virus, you will get it almost no matter what you do.  Those that are healthy may not have serious consequences.  Still, viruses, bacteria and other communicable diseases can be tricky.  Even very healthy people will surcome to things like staph.

When it comes to health, to me it depends on if it is a preventable lifestyle disease, communicable disease or a genetic disorder.  There are many diseases and disorders that people contract/develop that they have little or no control over.  There are also things like diabetes type 2, heart disease and certain cancers (i.e. lung) that most people develop due to self neglect.  As a whole, these are draging down our country.  The loss of productivity and healthcare costs alone are detremental to our economy.  Also, the human cost is large.  It is a horrible existence to be cronically ill. 

Not that I am purposely pointing fingers.  I understand that society, poverty, ignorance and other things greatly effect how people  can take care of themselves.  However, I don't think that it is prudent to just ignore these issues and say that everyone has a different concept of health.  There are real divisions in terms of health.  Some people need only annual checkups, perhaps a few medications in their golden years and can work a full-time job until the age of retirement.  Others  have to see a doctor several times a month, get one or more operations in their life, take several medications throughout their life and have to draw on public assistance early in their life. 

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On the note of colds/flus... if it's a type you've never been exposed to, it takes a couple weeks to generate the best antibodies against them, even if you're in great shape. If you stay healthy, you may never get sick from the same strain again. But new strains (which happens all the damn time with the flu) will still get you sick; the best way to avoid it is sanitation (washing, masks, avoiding sick people, whatever) if you've yet to be exposed. The severity of your first exposure can depend on your general health though, as well as that particular organism's virulence (like... the initial swine flu versus a 'normal' flu).

As for weight vs health, I guess I come from a different perspective. I've never heard a client argue that their overweight/underweight dog or cat is still healthy (well, that's biased, because people don't tend to bring in healthy animals!). Anyway, I think this 'debate' is taken personally when we see ourselves as a potential "unhealthy" person (based solely on weight). Yeah, I'm overweight, and tests show I'm generally healthy now, but I'm at higher risk for... lots of things, though I like to think I can be this weight and healthy just because I find it so difficult to maintain a "healthy weight." However, if I think about my chubby kitty, I'm not really going to spend the brain power on deciding whether I can keep him heavy but healthy; it's just way easier to put him on a diet and be done with it. My other cat had been underweight for some time, and automatically I wanted to get her assessed/tested for lots of things; I didn't brush it off because it's possible that she's underweight and healthy. On that note, though, everything checked out ok, and she gradually gained weight after that. She was not severely underweight, and I guess that's part of the point... there's a little bit more leeway than some might think, but I don't think that's a reason to ignore under/overweight or a change in weight. For all I know, she could have had transient leukemia and have it come back in some years. In other words, I see weight as a potential "lesion" like dry skin, red skin, constipation, whatnot. None of those things may necessarily be a sign of illness or lead to illness, but it could be, and for that reason they should be resolved if possible.

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The issue is that people are discussing "overweight" differently.  When we started this discussion, I looked up what being unhealthily overweight meant.  The CDC has a link on their site to a weight assessment guide:  http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm

Steps
1.  BMI:  s/b less than 30 (5'5" @ 180 pounds = 29.95)
2.  Waist Circumference:  s/b < 40" for men & < 35" for women
3.  Other Factors:  cholesterol, blood pressure, blood glucose, heart disease, smoking, physical inactivity
4.  Assessment:  2+ risks = should lose weight

There are people who could easily be of a healthy weight following this definition, but whom I think the people in this discussion would consider overweight.  For example, I'm about 5'4".  According to an online BMI calculator, I could have a 30.0 BMI at 175 pounds; my waist would easily be below 35 inches, even at 175 pounds; and let's say my "other factors" would be healthy since I'm vegan and go to the gym.  In that scenario, I wouldn't have any risks.  In reality, I have a small waist and could likely have a waist measurement of <35" at substantially more than 175 pounds and so I would only have 1 risk (BMI) and, according to this guideline, not need to lose weight.  However, with those statistics, I think the people here would would call me unhealthily overweight. 

What is underweight, healthy weight, and overweight?  Not philosophically, but as a working definition.

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Underweight BMI 18.5 or less plain and simple

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a BMI of 25-30 is supposed to be overweight, over 30 is obese. Of course, it depends on body fat too. I think that women are supposed to have around 20-25% body fat (for men it's less... but i forget what...). You could use those parameters, though that seems to be not what the CDC is using. =/

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We were talking about this at lunch yesterday at work, and we decided that the BMI recommendations should be used as a guideline, as a warning that things might not be optimal. If you look at your chart and see you're over/under weight by that definition, then maybe a trip to the doc to check things out is in order. When my boyfriend was in the hospital for a wreck, they checked his height and weight. He is technically underweight, so they sent a dietitian to see him. We told her we were vegetarian (at the time), that we didn't eat refined foods, hydrogenated oils, HFCS, you get the idea, then he told her that he ran, blah blah blah. I know we could have lied about these things, but she took it that he is just naturally skinny, not unhealthy, and signed off on his chart. But his BMI was a warning sign, and they were just checking into it. I appreciated it, and I was glad that they were looking out for extremes on either end.

Also, I really want to share this. I just got the pictures this morning from my marathon last weekend, and there are people in those photos that I guess would be deemed "overweight" by BMI standards, but they ran a full marathon! I think that counts for something (a whole lot of something). So, again, the BMI chart doesn't mean everything, and people should be looked at on a personal basis by their doctor.

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Viruses don't work that way.  If it is the common cold/flu that cycles around seasonally, than you can take precautions to avoid it.  If it is say a new, aggressive virus, you will get it almost no matter what you do.  Those that are healthy may not have serious consequences.  Still, viruses, bacteria and other communicable diseases can be tricky.  Even very healthy people will surcome to things like staph.

Not that I am purposely pointing fingers.  I understand that society, poverty, ignorance and other things greatly effect how people  can take care of themselves.  However, I don't think that it is prudent to just ignore these issues and say that everyone has a different concept of health.  There are real divisions in terms of health.   Some people need only annual checkups, perhaps a few medications in their golden years and can work a full-time job until the age of retirement.  Others  have to see a doctor several times a month, get one or more operations in their life, take several medications throughout their life and have to draw on public assistance early in their life. 

If the virus has not mutated to be completely different, then our bodies can see it and think "hmmm, this looks like something I've seen before" and they can launch the B cells that were used in the similar virus the last time. Think of the H1N1 everyone is freaking out about--the reason older people are not dying in as high numbers as the young is because this virus ever so distantly resembles the 1918 flu virus, and they have some antibodies left over from that. Yes, there are *some* completely novel viruses, but this is very rare. Most are mutated slightly, and our bodies can recognize them as being somewhat familiar. There is a delayed reaction, but it's usually only a day or two, and we might barely feel the effects. This is where a healthy, ready and able immune system will come in handy. If we didn't have this resemblance recognition, every single little virus in the whole world would affect us until we'd built up antibodies to everything (but then the viruses are ever evolving, so this would imply that we'd be sick our entire lives).

I like your second paragraph. I think it's true that we all need to do what is best for our own bodies, but somewhere this is some wide range of factors that determine health. The problem is, who determines these, and how wide is the range? It kind of seems like a sliding scale, like a bell-shaped curve, instead of a switch of yes/no. On VW, we seem to have different definitions of "health," but I'd be curious to hear what a medical professional would outline as healthy in terms of...which factors? So many could be included. Maybe this is where it gets sticky.

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On VW, we seem to have different definitions of "health," but I'd be curious to hear what a medical professional would outline as healthy in terms of...which factors? So many could be included. Maybe this is where it gets sticky.

You would be shocked to find out what a doctor considers healthy.  I can't go into much detail because of privacy laws, but I type for over a dozen doctors on a regular basis from several cities in the Mid West.  Generally they consider a patient healthy if they don't have any uncontrolled medical conditions that limit their activities of daily living (ADLs).  These so-called healthy people commonly have hypertension, hyperlipidema, COPD, type 2 diabetes, assorted cancers in remisssion, etc.  It also seems they are more likely to label someone as healthy who is overweight than underweight. 

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On VW, we seem to have different definitions of "health," but I'd be curious to hear what a medical professional would outline as healthy in terms of...which factors? So many could be included. Maybe this is where it gets sticky.

You would be shocked to find out what a doctor considers healthy.  I can't go into much detail because of privacy laws, but I type for over a dozen doctors on a regular basis from several cities in the Mid West.  Generally they consider a patient healthy if they don't have any uncontrolled medical conditions that limit their activities of daily living (ADLs).  These so-called healthy people commonly have hypertension, hyperlipidema, COPD, type 2 diabetes, assorted cancers in remisssion, etc.  It also seems they are more likely to label someone as healthy who is overweight than underweight. 

I guess that makes some sense, since overweight is now our society norm, not underweight. How can regular people get the straight answers they need to keep themselves in top form when doctors cannot even agree upon a working definition of how our bodies should function? I think this is starting to really get to the root of the problem.

BTW, I would laugh really hard if you've ever typed any of my medical records!

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