The obesity and BMI divide.

Paul Campos has a Daily Beast article ("Michelle Obama's Let's Move Campaign Is Helping Bullies") that puts it very succinctly what our bovine barnmate was trying to illustrate earlier: that contemporary discourse on weight-lose hinged on the Body-Mass Index (BMI) bordering on pseudo-science of pop-psychology, with all the trimmings of statistical conjuring and arbitrary standards buried in formality to make bullshit sound oh-so authoritative, medical but mostly pompous.

If you didn't get Cow's message earlier, here's Campos laying it out for you, which I doubt substantively differs much from Singapore although written in the context of America:

The Centers for Disease Control website offers these definitions of “overweight” and “obesity” in children: (emboldening by me)

· Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex. · Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex.

These definitions raise a couple of obvious questions in a nation that has been bombarded with claims that childhood obesity is skyrocketing. After all, by this standard, aren’t exactly 10 percent of children always overweight by definition, while another 5 percent are obese? And what’s the justification for these statistical cut-points, anyway?

The definitions were created by an expert committee chaired by William Dietz, a CDC bureaucrat who has made a career out of fomenting fat panic. The committee decided that the cut-points for defining “overweight” and “obesity” in children would be determined by height-weight growth chart statistics drawn from the 1960s and 1970s, when children were smaller and childhood malnutrition was more common. The upshot was that the 95th percentile on those charts a generation ago is about the 80th percentile today-hence, the “childhood obesity epidemic.”

These definitions are completely arbitrary. The committee members chose them not on the basis of any demonstrated correlation between the statistical cut-points and increased health risk, but rather because there was no standard definition of overweight and obesity in children, and so they invented one. In other words, the “childhood obesity epidemic” was conjured up by bureaucratic fiat.

The committee did this despite Americans being healthier, by every objective measure, than they’ve ever been: Life expectancy is at an all-time high, and demographers predict it will continue to climb steadily. This isn’t surprising given that mortality rates from the nation’s two biggest killers, heart disease and cancer, are at historical lows and keep declining, while infectious diseases are under better control than ever. There’s no reason to think that today’s children won’t be healthier as adults than their parents, just as today their parents are healthier than their own parents were at the same age, continuing a pattern that has prevailed since public health records began to be kept in the 19th century.

(Hat tip Kate Harding.)

Visiting the Doctor While Fat

It seems like everytime I have something to say, it's because I've read something excellent that Melissa McEwan of Shakesville has written (I do read other blogs, really). This time, it's her post on going to the doctor while fat.

It's very well documented that up to 50% of doctors harbour a widespread bias against fat people. And we also know that men have to be a whole lot fatter than women before they're classed as fat, so this is a problem that disproportionately affects the fairer sex (as if we didn't have enough to deal with). In fact, the folks at Shapely Prose have a whole blog dedicated to collating stories of doctors offering misdiagnoses and all around disastrous advice on account of fat: First, Do No Harm. The stories therein are all from women. Granted that could just be how the blog readers skew, but I find it rather telling nonetheless.

Not one to be left out, here's my story.

I have been on many diets. The first one I embarked on was shortly after I was tagged for the TAF club in primary school and my parents thought they should do something. The last one I was on is the one I want to talk about. Oh, there were many in between, like any good fatty I've gone through periods of "eating well", "lifestyle changes" and even the goddamn Atkins diet (I have never ever wanted a piece of toast quite as badly as I did back then, and I can't even tell about you the mental torture involved in avoiding a lovely hot bowl of chicken porridge when you're sick). But the last one, the last one was the one where I was going to do it right. I wasn't going to be part of the 95% that gain back all the weight and then more. I decided that I would pay for a program that was presided over by healthcare professionals. You may have heard of it - the Dr. Bernstein diet.

Sure, I did the research beforehand. I read the forums where people on "maintenance" talked about gaining back the weight (people I assumed were cheating and just wanted to maintain the veneer of doing well). I read about how some people experienced hair loss and how others stopped getting their period on the diet (but you are monitored throughout the diet by health professionals!). I read all about these things, but I wasn't going to be one of them, it was going to work well for me. Of course it was. I was going on a Diet. This was going to Change My Life.

The diet involved keeping your caloric intake between 400-900 calories a day. Only that's not how it was framed. Rather, there was a list of foods that you were allowed in the quantities they were allowed in. And there were foods on that list you were discouraged from eating too often (to give you some idea, you weren't allowed things like carrots and peas, and if you wanted an apple, it had to be a small one). I did really well on it, then I ran out of money and couldn't continue the program, and I wasn't comfortable restricting my food intake so drastically once I wasn't under the constant care of health professionals (you get to talk to a nurse for 10 minutes a time three times a week) so I went to the "maintenance" phase. I'd already lost 30kg, so I was feeling pretty good about myself. I still read as "fat" but was probably closer to "plump".

The maintenance phase is where you can start "eating sensibly". Which any good dieter knows involves small amounts of carbs and smaller amounts of fat and lean protein portions the size of your palm. Two months in, I started experiencing episodes of chest pain. Not scary heart attack chest pains, more like I was wearing a bra that had been crossed with a boa constrictor. So I went to my doctor about it and was diagnosed with boobs that were too big. *cough* So I was sent away with a prescription for some massage therapy and was told to work out to strengthen the muscles in my back and chest.

So I did. But the episodic pain kept coming and it was worse each time. Twice I went straight to the emergency room because all I wanted was morphine to stop the pain (and also my partner was pretty freaked out that I was having such severe chest pains). Each time a report was generated, sent to my doctor and each time I was told that they were muscle cramps (obviously the first thing the ED did was to rule out a heart attack). I kept working out (which really helped with carrying the groceries home, I can't recommend it enough if you are able to fit it into your life) and I kept going to those massage appointments that are far less pleasant than you imagine. In fact, they hurt like hell. But not as much as those waves of pain that kept hitting me at random moments.

Eventually I worked out that if I chewed over-the-counter painkillers that contained codeine it'd dull the pain enough that I could just sit around and ride it out without having to keep presenting to the harassed emergency department staff. All for having boobs that were too big. What a burden to bear.

Except it had absolutely nothing to do with my impressive knockers. And I assure you that they are quite impressive.

I'd gone to Canada over school break (God bless the universal health care availabe in Canada...) and I got the now familiar pain again. Only this time it didn't go away. I'd made it through an entire bottle of Mersyndol (not recommended) over three days and it was still there, and more insistent with time. I'd lost my appetite and I was impossibly itchy all over despite the absence of any dermal symptoms. Then one night, like a knife through the fogged pain-haze was a bright, white stabbing pain, unlike anything I'd ever experienced in my life. This time, I called an ambulance.

Some laughing gas and some more morphine later, I was discharged and told to visit the GP the next day. Knowing that this could not possibly be big-booby-itis, and knowing that my original doctor was unlikely to reverse a diagnosis she'd held onto for the past three years, I went to my partner's father's doctor (who came highly recommended). That doctor took one look at me and panicked. He quickly scribbled a report, told me that I was severely jaundiced and made me assure him that my next stop after leaving his office was a hospital emergency room. He told me to stay there till I was admitted.

For the past three years, I had been experiencing gall bladder attacks. This time, the gallstone had moved and by the looks of things (i.e. bright yellow) it had lodged itself in my common bile duct. I was in liver failure (also explains why I was so damn itchy, hyperbilirubinemia would do that to you).

I needed my gallbladder out, and to complicate things, the surgeon also had to look for the stone that was stopping up my pipes. I think I was given the choice between being sliced open end-to-end and a laproscopic procedure. I can't remember, at this point I was on a morphine and benedryl drip. There was something about having to wait longer for laproscopy, I think. So I chose to be gutted. A week later and there was still no improvement. That's how long it took the people at the hospital to realise that instead of being a lazy fatty who was not invested in getting better, there was a second stone that was missed.

I will have you know that once the second stone came out, I did all the rehabilitative things they had me do. Twice and with enthusiasm.

So there's my story. I'm fat, I have large boobs, clearly my body couldn't support it despite having supported it all this time. Obviously the diet I was on was an unmitigated good and couldn't have caused anything like episodic pain consistent with a gallbladder attack (P.S. this is actually the #1 reason for gall bladder issues in young women).

I'll leave you here for today, but do remind me to tell you guys about the time where I presented at a doctor's office because I had violent diarrhea for the past three-four days and was given the "you should lose weight" talk. Oh and that time I went to ask a "family health professional" about whether my birth control pill was adequate contraception for someone of my heft and got a long lecture about health and weight loss instead. And and and and and and and there is so much more where this came from. Buy me a drink and I'll tell you all about it.

2010 Asia Internet MSM Sex Survey

2010 Asia Internet MSM Sex Survey.

Survey closes: 28 February 2010.

Dr Stuart Koe of Fridae.com is now conducting an internet survey on sexual behaviour of gay men (or any man who has sex with other men), transgender and intersex people in Asia. The study seeks to uncover a a better understanding of "social and behavioral factors with regards to HIV knowledge, attitudes, prevention, testing, care and support", which is essential to better address the spread of HIV and other STIs.

The test is available in various languages (English, 简体中文, 台灣繁體, 香港繁體, Tagalog, ภาษาไทย, Bahasa Indonesia, Bahasa Malaysia, 日本語, हिन्दी).

This badly drawn gay pig has already taken the test, and I can assure everyone that it's painless. (And unsurprisingly fast for me because I don't really get out of the barn at all to meet other pigs.) And the results of the survey can be availed to you if you sign up for them.

Do pass this along to your friends who fit the sample descriptives.

2010aimss.com

Those deadly pincers

The Magical observation has previously been made that Family Valuez and Porn Nation are close allies in the war of Bullshit against humanity, and in particular against women.

The battles in this conflict, and other combatants, sometimes take unexpected forms. Consider this case from Zambia:

The trial of a news editor in Zambia, accused of distributing obscene material, is coming to an end. Chansa Kabwela says she sent photos of a woman giving birth without medical help to senior government officials to highlight the effects of a nurses' strike. [...]

So far, it has amounted to a succession of trembling ministerial secretaries expressing their humiliation and shock that a woman in childbirth, the most private moment of her life, had been photographed.

Shock, not over the fact that she had given birth in a hospital car park. Or that her baby had suffocated. But that the pictures had been seen by men - an absolute taboo.

This is not to say the photographs are not terrible. When I saw them, it took me several seconds to focus, as though my brain was refusing to process the images.

The most graphic shows a woman from the waist down, lying on a plastic sheet, with the bloodied torso of a baby between her thighs. The head is still inside her.

This is what Zambia's President, Rupiah Banda, declared pornographic, when he called for the photographer to be arrested. [...]

Fred Mmembe is the editor-in-chief of The Post newspaper. He hates the government and his paper shouts it loud and clear.

Stage whispers hint that he is the real target.

On the one hand, the idea that pictures of a woman giving birth are "obscene" or "pornographic" is unmitigated bullshit. You can only consider these visual images obscene, in the sense that traditional obscenity law means the term, if you consider the female body obscene - if, addled by dietary and atmospheric sexism, you are unable to look upon the vulva without reading it as sex.

The vulva is not sex. It is sometimes used by the woman to whom it belongs, in sex. But it is not, itself, sex.

So the dehumanising characterisation of pictures of childbirth as necessitating suppression because somehow of prurient interest and corrupting tendency is an anti-woman act, performed by a government - a familiar entity in the pantheon of oppressors - seemingly in order to suppress criticism of women's healthcare and the state of healthcare workers' rights. This is not intuitively difficult to grasp as potential institutional misogyny.

But wait a minute. On the other hand, these bold governmental critics, with their noble aims of spreading awareness of a vital political issue, and asserting their freedom of speech against the heavy arms of the state: surely they don't hate women too?

One issue which appears to have gone largely unreported in major newspapers is whether the woman whose suffering was to be the subject of this burning crusade for justice actually consented to the pictures being taken, or to their subsequent circulation.

If this was done against her will or without consultation, what the world has witnessed is the objectifying exploitation of her body, in a private moment, for a political cause. However well-intended that cause may be in principle, this Magical Chicken cannot help but wonder if it is making gains at the expense of a woman's dignity, or by positioning her as a pawn.