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It's All Around Us - We Can't Escape

I mentioned to a friend the other day that I was still having problems losing the last of the weight I gained when I went on Lyrica, which led me to thinking about all the other common medications that also have weight gain as a side effect, most notably corticosteroids and anti-depressants, two of the most frequently prescribed classes of drugs today.


In a cursory look at the side effects of the most popular drugs, I came up with 14 anti-depressants that have weight gain as a side effect.  There are several anti-anxiety, -seizure, and -psychotic medications that list weight gain as a side effect, and most ironically, there are a few Type-2 Diabetes drugs that cause slow weight gain ("just lose weight", my ass).

In my random Googlings, I also found an abstract of a study documenting weight gain associated with medications (that also recommends that weight gain as a side effect of medication be included as a factor in future medication studies), and a study of anti-psychotics that showed steady weight gain as a factor in medication use.

Add to this the medical conditions that cause weight gain - PCOS, Cushing's, Hypothyroidism, Depression, injuries (especially back, hip, knee and ankle injuries), and (if you believe the current research) Type-2 Diabetes, where weight gain is now being looked at as a side effect, not a cause, of the condition (because of research into errors in insulin production that are echoed in PCOS, which has weight gain as a recognized side-effect), and I do not marvel at the fact that so many people are overweight, but that anyone at all has escaped some form of weight gain as they get older.

New research seems to be indicating that the High Fructose Corn Syrup that saturates our foods is also contributing to weight gain, as it stimulates appetite and depresses the signals that indicate fullness.  How's that for a kick in the pants?  Thanks, corn lobby.

We have so many indicators of the multi-layered issues that surround weight in our culture, and yet people are still frantically trying to reduce (hah) it to "eat less, exercise more" in all cases.  Quite apart from the fact that our cultural perception of an "acceptable" weight is severely underweight (by cultural standards, I, at a size 8 and weighing 140 pounds, am fat), the refusal to accept that people come in all sizes actually contributes to the problem, as people who were never meant to be a size 6 diet themselves into a wrecked metabolism and end up weighing more than when they started.

Yes, some people can lose weight by eating less and moving more (assuming they do not require any of the above listed medications, and do not suffer from a medical condition that prevents diet and exercise - good luck with that!), but I think it's very important to ask ourselves:  What weight are they trying to achieve?  Do we know what's a healthy size?  Do they?  Or is everyone allowing their cultural conditioning to override their natural size, just like we override our natural appetite to conform with an arbitrary cultural ideal?

In both cases, we run a high risk of negatively impacting our bodies, causing harm, not health.

I think until we can actually say "healthy and fit is more important than being a size 4", we cannot, in good conscience, berate people who don't fit into that narrow ideal.  I know people of all sizes, and I also know that the larger people I know are not gluttons; when I was binge eating (oh yes, I have a disordered eating past), I could out-eat any of them, and yet my top weight was 200lbs.  I ate enough to feed four people on a regular basis, didn't exercise, ate terrible foods on top of that (pizza, chips, candy), and still didn't go beyond a set point.

Why?  Well, it wasn't because I wasn't trying; at one point, I was really out of control.  But I think there's a range our bodies want to live in, just like there's a certain length at which our hair will cease to get longer (my ultimate length is butt-level - in ten years of growing, it got no longer than that).  Just like there are some people whose hair never stops growing (I used to know a woman who cut her hair when she started stepping on it), there are people who will never stop gaining weight, but they're rare.  Most people will reach a maximum, and stay there.  It seems reasonable that there's also a minimum set point, and it won't be the same for everyone.

I am 5'3".  The height-weight charts say my minimum weight for my height and frame should be 111lbs.  At 124lbs (the max for a small frame, which I am), I looked sick - and I only got that low because I was anxious, dealing with a bunch of bullshit, and on a painkiller that gave me constant nausea.  My "ideal" weight - i.e., the weight at which I feel most healthy - is 130-135lbs - the mid-range for a large-framed person of my height.  No-one looking at me at that weight would call me fat, yet at that weight, where I feel good and healthy, I am way too fat for Hollywood.

You may think that "Hollywood" is not the norm - and it isn't - but it's the "ideal" size that's fed to us every day in the media that surrounds us, and poisons our perception of "normal".  Until we acknowledge that not only is "ideal" actually an intensely personal thing (that should not be dictated by anything/anyone but the person living in that body), it really has nothing to do with size, we're fucked as a society, and we have no hope of getting past the fat hysteria that permeates our culture and allows the scapegoating and ill-treatment of people who fall outside rigid norms.

We don't expect everyone to be the same height, yet we respond with extreme negativity to any suggestion that we approach weight the same way.  It seems silly to me that a 5'9" woman would be expected to be a size 6, but it happens all the time, and people are shamed for not fitting into a narrow range of sizes.  And it's considered acceptable to police and shame fatties - hell, PETA just came out with a billboard that called overweight people whales.  Awesome!  That'll teach them!

I am now at a loss as to why people keep trotting out "eat less, exercise more" as if it's a) a universal solution to everything, and b) something no-one has ever heard before.  Fat people, thanks to the harassment they receive, are probably the most well-informed about diet and nutrition on the planet.  They're also really disciplined - it takes real dedication to lose hundreds of pounds over and over again, and not lose their sanity.  Most people simply aren't meant to be tiny - it's not healthy for them.

If we could only change people's attitudes from "thin is good" to "healthy is good" - oh, wait!  There''s already a group of people trying to do that very thing - the Health at Any/Every Size, and the Fat Acceptance movement.  HAAES focuses on two things - that healthy is not automatically associated with thinness, and that fat people do not deserve to be villified. Fat Acceptance says that Fat is not automatically bad, and loving yourself is healthy.

(FYI:  I edited that slightly for clarity.) 

Makes sense to me, so I support it.  Body shape is not nearly as important as the person who inhabits that body - their feelings, their dreams, their ideas, and their lives are as valuable and as meaningful as anyone else's.

One last mumble before I shut up - if the Lyrica had worked, I would have had to make a choice about whether I wanted to be fat and bald (yes, my hair started falling out, too) than in pain.  I'd like to think my priorities are straight enough that I'd have chosen pain-free, but the cultural conditioning we all go through is so strong, that I might have chosen thin over pain-free, because dealing with pain is easier than dealing with constant fat-hatred and discrimination. 

Tell me, how fucked up does that make society's expectations, and how fucked up does that make me?

This is one of the reasons why I support HAAES.  Because if I prioritize thinness over health, I lose.


Aug. 20th, 2009 02:24 pm (UTC)
I had had a poor body image my whole life. Finally, in my late twenties, I went to the UK to do my MA where, because of sudden financial issues, I was too poor to eat enough. I ate properly - that is, I ate good food, I just didn't have enough to eat. After a year of going to bed with a growling stomach and losing enough weight in my butt that my tail bone stuck (not visibily) out so that sitting (especially in the bath tub) hurt, I resolved never to think I needed to lose weight again. By the time I came back to the US, my ribs stuck out so that even my cat didn't want to sleep on me. Being a little 'over weight' (whatever that is) and healthy/comfortable is a hell of a lot better than in pain because you have nothing between your skin and bones.
Aug. 20th, 2009 03:35 pm (UTC)
Re: Weight
I had the same problem during my undergrad. Not enough money (or time!) means less eating. At 5'4" I was 120 lbs when I graduated and anyone who sees my graduation pictures asks me if I was sick because I was so skinny. Like AL, I feel good around 135 - 140 which I believe makes me obese by the charts. Morons.
Aug. 20th, 2009 05:02 pm (UTC)
Re: Weight
Ha! Yes! I recently saw a picture of myself from my senior year of high school -- a distance runner, I weighed 105 pounds the day I graduated, at 5'3" and change. I looked like a hat rack! I'm not happy with the current 180, but you couldn't pay me to be 105 again.

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