Wednesday, 4 March 2009

More obesity nonsense

Courtesy of attrice, this. In trying to fit obesity as a disease into a scale of stages of progression they expose what lax standards the 'field' holds itself to.

And these are supposed to be the good guys.

The size of your body, whether fat or thin cannot be described as disease, whether it correlates with worse health outcomes or not. If you compare prognoses across class, ethnicity even religious beliefs results differ between groups.

Virtually none of the symptoms given for obesity are specific to it. Only one, Type II diabetes, could be said to be overly prevalent enough in fat people and even then the causal direction of fatness=the cause has not been convincingly made even though it is often alluded to as if it has.

What is the underlying pathogenesis here? When compared with actual fat people it comes unstuck, the first stage has absolutely no symptoms whatsoever, this takes a cheap shot, implying that this is appearance only and is somehow suspect for thwarting the authors assumption.

Perceiving a disease comes when symptoms appear in common if they don't you have not narrowed in on your target properly. The extent this is missed makes it seem like whoever came up with it either doesn't understand the concept of disease or the course of disease progression or fatness.

It reads like a parody by people who know they've got little but don't care, there is no imperative to make them care, certainly not a thirst for truth or knowledge.That is always disturbing no matter how much one encounters this.

Ditto the dubious use of "psychopathology" meaning pertaining to abnormal behaviour or mental symptoms. How can merely being fat be a diagnosis of mental illness? Technically speaking, how can a fat person claim to be sane under these conditions? Because hey, psychiatrists are well known for being able to tell the difference when they suspect someone is not right in the head aren't they?

I'm shocked at the way mental distress is included as diagnosis when believing exactly what you are told as a fat person produces abnormal psychology even in the sane as a trawl around the 'spher will show. Whether its have no emotional sense of belief to match your reality or the terror that every ache and pain is your death knell along with weight loss diet induced trauma plus disordered eating cause by the same.

If you have none you are liable to be accused of having narcissistic personality disorder or of being arrogant, suicidal, etc., Including a nebulous reference to mental problems as if it is intrinsic to fatness is emotive and underhand. If that is required to formulate part of the "diagnosis", you must be desperately short of actual symptoms.

No mental illness is specific to being fat nor has been shown to be directly caused by it. All sorts have been linked with weight loss dieting which is endlessly recommended for fat people. There's depression which has become more associated with fatness. It's only in the last decade or so that weight gain stopped ruling the person out of a diagnosis. It was insisted that if you were depressed you had to lose weight because you lost your appetite as it became depressed too.

There's an interesting overlap between pronounced anxiety and clinical depression, they are often present and one can lead to or even seem to be the other. The dominant thrust of the crisis rhetoric is to scare unnerve and keep fat people in perpetual self disgust and in a state of high anxiety.

And unless you are going to teach people not to give a damn about what people say which would defeat the object of the bullying, what is the treatment drugs of course. So drug companies as well as 'obesity' doctors end up with a stake in bullying. The more of it occurs the higher their profits, the more fat prognosis matches that of obesity.

Fatness is not ill health in itself, if it is anything it tends to be a sign of something else, of struggle of survival the need for stamina, etc., How can a healthy fat person who's weight levelled in the teens or early 20's be said to relate to someone who's put on many pounds after a course of psychiatric medications? Any more than someone who's naturally thin can be compared to someone thin through being ravaged by cancer?

Speaking of this, that is the attitude towards underweight, strenuous attempts are made to weed out anything which lowers the health of thin people. Warning that link thanks Walter Willett.One of the usual complaints is failure to control for cigarette smoking, but if thin(ner) people tend to smoke more than fatter one's as seems to be the case then that may be part of the overall comparative thinness of the slim population.

I can see how inclusion is problematic, however exclusion so is exclusion. If you wish to zero in on fatness solely on paper fine , however when you lift the results to actual fat or thin people in real life you are measuring theory versus reality.

A cure for conditions these conditions in fat people would be the same for everyone unless we are being told that these conditions differ among differing weights. What is the purpose of this segregation? Unless this is so they can focus intensively on the needs of fat people to create a new engine of medical progress that feeds through to everyone.

Is obesity about weight or about disease?

If there was a remedy for fatness, why would it be any different for someone who's very fat as opposed to someone less fat or slim and wanting to lose 5 Ibs? And if it cured these debilitating conditions, where would that leave thin people with said conditions? A slim person could have as many of the above symptoms and progression mentioned, what would this "relate" to?

It does mention treatment which is laughable as it has nothing, the scale vaguely suggests drugs and behavioural therapy, which cures heart disease how I wonder. That is a novel idea. The stages are thus;

STAGE 0: Patient has no apparent obesity-related risk factors
Why would they be a 'patient' then? Oh yes, because they are fat. Then that would be the obesity related risk factor wouldn't it? Its use of the word "apparent" is churlish.
STAGE 1: Patient has obesity-related subclinical risk factor(s) (e.g., borderline hypertension, impaired fasting glucose, elevated liver enzymes, etc.), mild physical symptoms (e.g., dyspnea on moderate exertion, occasional aches and pains, fatigue, etc.), mild psychopathology, mild functional limitations and/or mild impairment of well being.

If its not related to obesity what is it related to?

STAGE 2: Patient has established obesity-related chronic disease(s) (e.g., hypertension, type 2 diabetes, sleep apnea, osteoarthritis, reflux disease, polycystic ovary syndrome, anxiety disorder, etc.), moderate limitations in activities of daily living and/or well being.

Thank goodness we are told it is related to obesity so that we can tell.

STAGE 3: Patient has established end-organ damage such as myocardial infarction, heart failure, diabetic complications, incapacitating osteoarthritis, significant psychopathology, significant functional limitation(s) and/or impairment of well being.

Is heart disease/ osteoarthritis really combined with mental illness in this way? Are they saying fatness produces psychopathology via the action of fatness or that it is intrinsic to having large fat stores or of having a different ratio of fat to leanness, if so via what route? What if a fat person has the mental symptoms without the physical or vice versa, what would be their stage?

STAGE 4: Patient has severe (potentially end-stage) disability/ies from obesity-related chronic diseases, severe disabling psychopathology, severe functional limitation(s) and/or severe impairment of well being.
Wow, past organ damage, diabetic complications heart attacks/failure and still alive! This is the palliative stage no different from anyone else who is dying.

Treatments are I quote "phramalogical" and "behavioural", which is extraordinary, I'm sure those in fields dealing with actual chronic and potential disease are investigating this behavioural treatment for their own patients.

Who knows, maybe treating behaviour can cure serious disease such as say cancer. Has anyone thought fit to try?

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