Chronic Illness, Diet & Food

TW: Talk of diets, potential weight loss and eating habbits

My BMI is over 30 for a couple of reasons;

  1. I am insulin resistant as a result of PCOS, it makes gaining weight really easy
  2. Because of issues with my digestive system I will frequently go a fortnight where I really struggle to keep any food down which puts my body into starvation mode and slows my metabolism  Then when I can eat again, even if it’s just a little, I put on loads of weight (usually more than I have lost) as a direct result. 
  3. I’m not naturally skinny, never have been and that’s fine by me
  4. I would rather be happy and “overweight” than subject myself to the misery making cycle of diets & self-loathing society keeps directing me towards
I’m pretty happy with my body and my weight. Possibly more so than a lot of people raised in our slender-obsessed society. Unfortunately practically every time I visit a health care professional I have to be weighed and then lectured about my BMI. Regardless of how good my waist to hip ratio is or any other indicators of health. It wasn’t so bad before I became disabled, I didn’t see doctors often enough to care. Now I do see doctors a lot. I think it’s safe to say I’ve had more NHS appointments in the last 4 years than in the first 25 years of my life. 
I’ve hit a point where I’m too tired to fight it any more. The crushing pressure has become too much and given my other health issues it’s just too much extra for me to keep battling on against. I have grudgingly agreed to see the local “Weight Management Services”. Not because I want to loose weight but because I don’t want to spend over half of every appointment I attend talking about my size. I’m sick of it now and I really don’t have the energy to keep fighting them. So as of today I begin a very restrictive 1000 calorie per day diet. Now at 6’2″ I’m told that I should need over 2000 calories just sitting still so I imagine this will have the desired effect. I needed to have a blood test first to check it was suitable for me so I wouldn’t try doing the same unless it’s prescribed. I’m really upset with myself for agreeing to do it. I just keep reminding myself that this is why feminism & fat acceptance are so badly needed.
To try and turn this negative in to a positive I’m going to try and think about body image, weight, normalised health & beauty standards, feminism, disablism and the intersections between them. I’m also going to try to look critically at how people react to the news that I’m starting a “diet” because I suspect that there will be a lot of societal re-enforcing with regards to the “virtues” of weight loss and I’m interested in seeing first hand what it’s like. I also want to see if it effects how doctors, other professionals and strangers view my disability.
I will not talk about how much (if any) weight I loose. I will not extol the virtues of weight loss in my writing, I thoroughly believe in the Health At Every Size approach. I will try to place warnings at the top of posts so that people that want to avoid this stuff can.
I’m talking about this because as we have known for years, Fat is a feminist issue and needs to stay a feminist issue. I think it’s time to talk about how this issue intersects with disability. Many of us have bodies that often already don’t fit the societal “gold standard” of normalised health & beauty, our limbs may look different, we may not be as symmetrical as society would like us to be, we may have higher or lower BMI’s than society says we should have, some of our bodies aren’t as “under-control” as others, we may just simply not look as “healthy” as many non-disabled people. As a result we frequently are made too feel unattractive,  undesirable, morally lax and sometimes just plain grotesque, you can read a bit more here and here. We are also a group of people who often engage heavily with health services which higher exposure to government initiatives to police/concern troll body size & choice on top of it all. There is a lot more to be said on this topic but I’m not able to do it today. I’d appreciate reading your thoughts in the comments or on twitter before I write another post on this subject.
  1. BMI is bullshit for many disabled people because being of restricted growth throws the whole thing out of whack.

    And I'm not just talking about conditions that cause restricted growth in and of themselves (there are several hundred types of dwarfism); but most people who've been mobility-impaired since birth won't grow very tall because walking and weightbearing are essential for growth.

    I think my BMI is about 35. I'm not denying that I'm fat; because I am. But I'm not as fat as my BMI would imply.

    Someone just under 4'9″ (4'8″ and ¾ is my actual height) but without a medical condition (i.e. someone who is “just short”) would normally be petite in every way.

    However because I have a medical condition that restricted my growth upwards but not in other directions I'm a completely different shape to someone that's “just petite”. I have normal width hips for a woman, I have very broad shoulders for a woman (I'm wider at the shoulders than at the hips), and I have a huge rib circumference because a funny-shaped rib cage is a facet of my condition.

    If I was the correct BMI for my height I'd just be a skeleton covered in skin.


  2. I'm really sorry you've been put in this position, Em. I hope that you get what you want from this experiment and that everything goes as smoothly as possible.

    I despair that even medical doctors don't seem to grasp the chicken and egg issue with weight and impairment. Poor mobility, digestive problems, a lot of the drugs we take and disability-related poverty are a recipe for weight gain. This, in turn, can add to the problems our bodies have. But because of the moral dimension to weight, this is treated quite differently from say, muscle wasting or circulation problems related to poor mobility, bowel or liver problems relating to pain-killer use. It's acknowledged that there's little to nothing we can do about those things, but weight? Weight is all about personal responsibility!

    (And that, of course, is before we get onto the question of how much extra weight is actually adding to our problems, which may be significant in some cases, but not at all in others. I've too often heard people suggest that someone with depression would get better, if only they could lose weight.)

    I am writing about body-policing and disability for BADD this year. We exist in a weird hinterland where, on the one hand, we're almost exempted from pressures of beauty (since we simply cannot fit that ideal), but on the other hand, we have to be seen to be doing absolutely everything “right”, lest our limitations be somehow perceived as our fault.

    Before I go, in case you need to hear it:

    The weight you are is not your fault. None of your medical issues are in any way your fault. Both your weight and your health are morally neutral subjects, like the colour of the socks you are wearing. You are lovely and however much weight you could ever lose or gain wouldn't change your value as a human being.

    Same for everyone else.


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