Monday, February 14, 2011

Why This Matters

 Carrie at ED Bites posted the following story as part of her Sunday Smorgasbord this week. It is a heartbreaking read by a woman named Kath, chronicling the mistreatment and lack of treatment she faced for her eating disorder. Kath was diagnosed with EDNOS - Eating Disorder Not Otherwise Specified - which in the context of her post sounds suspiciously like Bulimia While Fat. Kath's story almost reads like a checklist of the things that the FA movement aims to change. It isn't about pigging out on junk food all the time and asking not to be judged (although the non-judgment is part of it), it's not about neglecting exercise in the name of Fat Rights, it's not about encouraging anyone to be fat who wasn't already. It's about making sure what happened to Kath stops happening to anyone.

The link is here; I'll be posting excerpts to go along with my list of what went wrong in this story.

*The idea that fatness is caused, always, exclusively by overeating, and no other possible explanation.
 Despite the fact that Kath's ED behaviors were restrictive eating and purging, "On learning that I am fat, most people assume that my eating disorder is binge eating or overeating because I must have been gorging myself to get this way. Until a few years ago, every single doctor or medical professional I went to diagnosed me with overeating, often without ever asking me what I eat, or if they did and I told them, they didn’t believe me. They said I must be cheating, or lying, or not counting some things that I ate. I simply had to be an overeater to have “let myself get that fat.”"

*A dangerously casual attitude among young women about ED behaviors, or even the disorders themselves. Or a variant; the believe that ED behaviors are less dangerous or more desirable than being fat.
"I started when I was about 13 or 14. Some bullies (girls) forced me to stick my fingers down my throat and make myself vomit because, “That’s what fat ugly bitches like you should do.” A year or so before this incident I had actually been shown what to do by another slightly older girl. I worked with her at an after-school job, and she thought she was being kind to the fat kid. She did it and it kept her slim, so she showed me how to stick my fingers down my throat and how to disguise that I was doing it."

*A tendency in the medical community to focus on weight above and beyond other symptoms; or a refusal to see weight gain AS a symptom more than a cause.
"For 20 years, I kept presenting doctors with the same physical issues: An irregular menstrual cycle that manifested itself as constant bleeding, amenorrhea (absence of menstrual cycle), or dysmenorrhea (pain during menstrual cycle). In my early 30s, I was diagnosed with Polycystic Ovary Syndrome (PCOS); I discovered I had been showing symptoms and characteristics of it since I was 12. I was told yet again that the way to “cure” PCOS is to lose weight."
This deserves more commentary. PCOS is notorious for CAUSING weight gain. Yet her perscription - multiple times - was to lose weight and the pain would go away. It couldn't be that her syndrome had made her gain weight as fast as she had at puberty, or that treating the actual causes might result in both less pain and a return to whatever Kath's natural weight set-point was. Just lose weight to cure the weight-gain-causing illness.

*An unshaking belief in the theory of Calories-In-Calories-Out; that more exercise and less food will never fail to produce weight loss, and can not be unhealthy. In fact, the idea that exercise obsession is virtuous, and never the sign of disordered behavior, especially in someone who may be starving, but is not thin.
"I was exercising between six and eight hours per day. I had lost over 50lbs (about 25kg) and dropped five dress sizes. I was desperately unhappy and my physical health was failing. I was not coping at work and it was suggested that I should see the counseling service through the employee assistance program. I saw a few different psychologists—they all focused on my weight. Eventually, out of desperation I begged one of them to help me, told him of my suicidal thoughts and explained my obsession with diet and exercising. His response was to suggest that I add another half hour to the six to eight hours I told him I was already doing, “To get you over the plateau.”

Kath attempted suicide after multiple doctors refused to see past her weight to her actual emotional emergency and other health issues, and thankfully survived. Her story is brave and painful and heartwrenching, and this is why we're here, why this movement matters. I am lucky as anything that my own issues about food and weight are limited to a few warped ideas and mental blocks.

I'll leave you with Kath's final words, which sum up everything else I meant to say.

"It is important to me to talk about having an eating disorder as a fat person. Where thin or normal weight patients often get sympathy and understanding, and even simple recognition of their disorders, fat patients are ignored, considered lying or “cheating” somehow. So often disordered behavior is sanctioned in fat people simply because there is a belief that fat people must have got that way through inactivity and gluttony.
How many people have to suffer, or even die, because of the belief that no matter what the cost, thinner is always healthier?"

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