An anonymous reader turned me on to a website for “Obesity Advocacy”. There is no way in hell I’m linking to it so don’t ask. It is a website encouraging people to get involved in convincing Congress to recognize obesity as a disease and “support legislation to provide greater access to and acceptance of all effective treatments, including weight-loss surgery.”
The group sponsoring this is called CHOICE – Choosing Health Over Obesity and Inspiring Change Through Empowerment.
Let me check these words against my card…Woo Hoo I just won bullshit bingo!
Let’s get a few things straight. You can’t choose health over obesity for a couple of reasons. First, they are not opposites, they aren’t mutually exclusive. You have your body weight and you have your health, two different things. Secondly neither of those things is just a matter of choice. Both your body size and your health are multi-dimensional and include things that are and are not within our control including things like past behavior, current behavior, genetics, stress, environment, and access.
Calling people’s bodies “diseased” based only on what you can tell by their weight and height is not inspiring or empowering. Sadly, it’s also not change.
So I call shenanigans on their slogan. But let’s look at the meat of their argument:
In their list of the truth about obesity they include:
- People do not choose to be obese — medical research now indicates obesity has more to do with science and the biology of fat, rather than willpower or discipline.
- By dieting alone, many people affected by obesity regain as much as two-thirds of the weight within one year, and almost all of it within five years.
- For adults affected by obesity who have at least one obesity-related health condition, like heart disease or type 2 diabetes, weight-loss surgery, in combination with diet and exercise, may help them overcome obesity and live a longer, healthier life.
True. True. What?
First let’s be clear that “obesity-related” means a condition that has been correlated with obesity – which is to say that it sometimes, but not always, happens at the same time as obesity. This is not to be confused with conditions that are proven to be caused by obesity, of which there are almost none. To give an example: Men who are bald have more heart disease. They are correlated, but they are not causally related: baldness doesn’t cause the heart disease and growing hair won’t prevent it. However, if the people at the CHOICE campaign were working on heart attacks, they would be trying to advocate surgery to grow hair as a way to prevent heart disease and I’m guessing they’d be stumped when it didn’t work.
Also, once again we are saying that we recognize that large bodies are part of human diversity, and yet we want to treat them as a pathology and make them go away. Let’s not forget how well and truly we do suck at making bodies smaller (as they mention in their own material), but somehow it’s still an incredibly lucrative field. Moving on…
Under misconceptions they included:
- People affected by obesity choose to be this way — they’re lazy and they lack willpower.
- Exercise and diet should do the trick for everyone
- Weight-loss surgery is a last resort or a sign of failure.
True. True. Run that last one by me again?
What is with the random surgery references? Oh.. I see, CHOICE is actually Allergan – the makers of the LapBand. And they have signed up over 16,000 people to lobby Congress to create a problem that they will then sell their product to fix. This reminds me of that time when several people who were affilitated with weight loss companies got to lower what the CDC considers a healthy BMI. Then the next day they got to recommend their product to solve the problem that they just created.
Truthfully, nothing that Allergan does surprises me anymore. Let’s look at their greatest hits:
Paying for a study with abhorrent research methods that “shockingly” found that obesity costs the workplace $73 Billion a year, and then using that study to convince health insurance companies that it’s cheaper to pay for lap bands than to have fat employees.
Holding a CONTEST where you could win a lap band which you could take yourself or, I am not kidding, give to a friend or family member.
And this is a big deal because their surgery isn’t that safe. Over one third of patients require follow up surgery. Try to imagine the outrage that would occur if more than 30% of people who had an apendectomy required a second surgery where the doctors went back in to correct potentially life threatening issues, and those people had to pay for the second surgery. And that doesn’t even include the plastic surgery to remove loose skin that often isn’t covered by insurance, or the follow up that often isn’t covered by insurance.
Plus many people who have the lapband regain their weight, and then there are the dangers of slipped band (The Band has to be dissected out, all the sutures removed, and the position of the stomach made right), band erosion (when the band actually erodes into the stomach), concentric pouch dilation, esophogeal dilation, and a host of other complications.
Yet Allergan wants to push Congress to get behind their product while they are also pushing to be able to do the surgery on younger and lighter patients despite all of the side effects we just talked about and the fact that people die from this voluntary, elective procedure. Their stock is down and apparently this is their idea of marketing.
To be clear, I don’t believe in telling anyone how to live so if people want to get a lap band I support their right to do that. However, they can absolutely cut out the “obesity advocacy” message because I don’t want or need these people as my “advocates”, and I would appreciate it if they would refrain from getting my existence declared a “disease” by Congress in the process.
Dances With Fat 
I’m having a bit of a struggle with this lately.
1) I’m worried about going in to see my doctor about some things that might be major issues because every time I see my doctor all she says is I have to lose weight. This blog gives me a bit of strength to think I might be able to stand up to her and say, “Okay, but if it’s not the weight, what the hell could it be and do you have a test for it?” I wonder though, how many people in the world avoid going to their doctors to be tested because they don’t need another person to remind them of their fat?
2) Lately, I’m not overeating. I’m eating normal foods that every other person on the planet eats, in a reasonable amount of food per day. I don’t eat more than a recommended allowance as far as I’ve been following. I’m not exercising because I’m sick, and I’m not losing weight. I’m watching friends and relatives around me eat starvation level diets and hearing them say things like I’ll probably be hungry for the rest of my life, but don’t I look great?!”
I don’t know that I’m fit, I’m certainly unhealthy right now (first cold of the season). I’m ambitious to get fit again and try to find active things that I love doing, rather than pounding the pavement or similar mind numbing activities…
The fight against the diet world is exhausting and it’s not helping. I’m feeling defeated, unwell, and like I HAVE to lose weight to get better. It sounds like bullshit when I type it out. If it looks like bullshit and smells like bullshit, it’s probably bullshit.
Sorry to commandeer the rant. Thanks for being out there.
Julie
Hi Julie,
I’m sorry that you’re going through this, you are definitely not alone. When I go to the doctor and get a diagnosis of “fat” and a prescription of “weight loss” I am fond of asking “Do thin people get this issue?” The answer is always yes, if the doctor tries to tell me know I call them out as either uninformed to the point of incompetence or a liar and leave – although that’s only happened once (a doctor told me that thin people don’t get pulled hamstrings and that the only cure was weight loss – seriously?). So after they admit that yes, thin people do get this issue, I ask them to try the treatments that they would give a thin person first and offer to reconsider weight if those treatments don’t work.
Good Luck!
~Ragen�
When I went to the doctor with a skin condition, straight away he told me it could be a symptom of diabetes (because of my weight of course, I’m sure he wouldn’t have leapt straight onto that if I were slim). I said I’d been tested for that last time and blood sugars were fine. I then tried the “thin people get this condition as well you know” and got a lecture about how my weight put me at risk of diabetes etc. But I hadn’t even been talking about diabetes. I’d been talking about the thing I WENT there for. It was like he just forgot why I was even there.
Next time I went because I was having WRIST PAIN and thought it might be RSI. He sent me for a blood test – including blood sugar, thyroid and cholesterol – but didn’t bother checking for any rhematoid antibodies, in case that might be causing my wrist pain. What the hell has cholesterol got to do with it? All results were excellent btw, much to his disappointment.
Hugs to you. I go through it myself all the time. Just know you’re not alone and it isn’t you. Stay strong.
This is so cynical.
Some insurance companies will pay for weight-loss surgery if the patient can prove it’s “medically necessary,” which means she (it’s usually a “she”) can prove she’s got The Death Fat. So she’s got to list a bunch of supposedly related health concerns like high blood pressure, Type II Diabetes, joint problems, &c. on her application, and her PCP has to submit supporting documentation. This is why pharmaceutical and surgical supply companies don’t give a rat’s ass about the difference between correlation and causation. If these conditions are merely correlated with weight, then there’s no funding for surgery. These are trained scientists and they know perfectly well the difference. But it suits their purposes, at present, to pretend that every time they’ve discovered a link they’ve found a problem they can sell you a product to cure.
Surgery is also currently “a sign of failure” insofar as another thing the prospective patient has to prove is that she’s tried a gazillion less- expensive, not-covered-by-insurance things to lose weight. Your insurance company is no fool: They’re not going to pay $30,000 for surgery when they can get you to buy a book on your own hook and try the latest fad diet at no cost to them. There’s actually a form for the screening psychologist to complete that lists every diet she’s ever tried, the dates, the weight she lost, if any, and the regain.
If CHOICE (which doesn’t even work as an acronym good grief) can get fat declared a disease in its own right, then that’s one giant hoop surgeons’ offices won’t have to jump through to get more people qualified for surgery so they can get paid more. Surgery will be, presto chango, medically necessary overnight. Similarly, if they can move surgery up the options ladder by either making it the standard protocol or, failing that, kicking current treatments off the protocol (why try dieting first, since dieting doesn’t work, right?), well, then, more patients will qualify sooner for this lucrative practice.
I’ll bet every one of those 16,000 who signed up is either a surgeon, a member of the surgeon’s staff/family, an executive/employee of a pharmaceutical/surgical supply company, or some poor potential surgical patient who’s been conned into believing that this is (a) safe, and (b) the solution to all her problems. Here’s hoping Congress won’t be conned: We all need to write, too!
Ragen, your “contest” paragraph cuts off rather abruptly.
I nearly got whiplash reading those lists from the speed of my double takes. Way to out yourselves as industry shills, CHOOICE.
So, if Congress is now in the business of defining diseases, does that make all obesity sufferers fall under the Americans with Disabilities Act? Not sure Allergan thought that particular facet through all the way.
Would you please write more about how it was the CDC came to declare the BMI correlated with lowest overall mortality to be “overweight?”. I have wondered how that happened, and it sound like you have tracked it down. Your blog is so worth reading, and I recommend it to my clients. Thanks! Ann RD
The proliferation of lap band billboards and the underlying assumption that if you zip in and out in a simple forty minute procedure your life will be transformed is so atrocious to me I can barely find the words for it. I wrote about the CHOICE campaign in June and for a couple of weeks there was a flurry of “activistivity” from my readers. (http://www.leftoverstogo.com/2011/06/18/a-matter-of-choice/) I am so glad you mention it now. We must maintain our presence in this arena and voice our dissent. What’s next?…Drive through gastroplasty?
Thank you Ragen!
Maybe it is a spoof site? Oy!
Ugh. You know what they say, “follow the money”. It’s so transparent as to be disgusting. I’m afraid that CHOICE will succeed in its efforts… the snowball does seem to be rolling in that direction. Weightloss surgery is the modern lobotomy, and what else can you expect when the government’s definition of an obesity expert is someone who runs a weight loss clinic?
I am really astounded by this. I know next to nothing about weight loss surgery, but I know they won’t even do the lap band surgery here in Finland anymore since there are too many risks and complications involved. (WLS and who can have it in general have a really tight screening process here too.) So to see that a product which has been practically almost banned in a country is aggressively lobbied for in another country… wow. Quite some “solutions” they’re offering.
This is sort of off-topic but relates to Allergan–I had to do some work for them (one of my clients is a custom publishing company and I’ve told my manager I can’t do weight-loss materials–but she was in a last-minute crunch and empathy for her won out over my ethics and personal concerns) and proofread some of their materials. It struck me how up until a certain point it seemed…almost HAES-friendly. Like, Diets don’t work! Exercise is good for health but won’t necessarily make you lose weight! You should enjoy food! And then, of course, comes the dark side. It’s an interesting co-opting–conscious or not, I don’t know.
Back when I was considering WLS (before I found FA & HAES), I had a doctor offer my depression & anxiety up as the health-related concern to get my referral going. Despite the fact that I have literally suffered from both since I hit puberty. Mkay.
Kind of off topic, but it occurred to me the other day how everything is so linked together. For me, anyway, not claiming any of this to be anyone else’s experience. But pretty much as soon as I hit puberty, I started having PCOS symptoms (that went undiagnosed for another 15 years and now I can no longer have biological children), depression and anxiety issues, and my weight increased dramatically. I wonder if this happened to anyone else that way. And, if this is the norm more often than not, how about we get some researchers looking into THAT?
Well-Rounded Mama is currently writing a series of articles on that very subject on her blog which I recommend. She started it off by doing a survey on unexplained weight gain.
A lot of people are not properly diagnosed for PCOS. In my case I was properly diagnosed, but effective treatments either didn’t exist or were only for the purpose of increasing fertility, which was not something I was interested in.
I’d be curious to know who founded the CHOICE and who is funding it. I’m gonna go out on a limb here guess that they have a vested financial interest in the weight loss industry.
It appears to be founded and funded by Allergan.
~Ragen
Shocking!
I get so angry when I see weight loss companies and other businesses that make money from destroying the self esteem of people co-opting terms and phrases from Fat Acceptance and HaES to push their horrible products and services.
GRRRRRRR!
Hi Ragen,
I’m not a “large” woman in either the weight or height department. And my high blood pressure, let me show you it! Also, the bursitis in my left hip? So awesome!
I’m glad to know that these are diseases that are caused by obesity. I can’t wait to tell my doctor that I don’t really have them after all! Yay!!
*throws HBP meds and Percocet in the trash*
But seriously, geeze. It’s awful that doctors take one look at you and diagnose you as “fat” immediately and don’t bother to hunt for the real problem or recommend treatment plans other than “LOSE WEIGHT NOW BEFORE YOU DIE OF FAT!!!!!”.
Ugh.
PS. Just kidding about trashing the meds. That would be profoundly stupid.