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Subject: Big Folks Health FAQ

This article was archived around: 8 Jun 1998 11:33:51 GMT

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Archive-name: fat-acceptance-faq/health Posting-Frequency: monthly to *.answers, bi-weekly to soc.support.fat-acceptance and alt.support.big-folks Last-modified: January 2, 1997 Version: 5.1
Frequently Asked Questions (FAQ) about Health and Fat People This document contains information about health issues for fat people. If you don't find what you're looking for here, try one of the related FAQs (see question B1 for a complete list). -------------------------------------------------------------------- Recent Changes: Added a topical (as of Jan 1998) interesting article from the New England Journal of Medicine, see section A7. -------------------------------------------------------------------- Contents SECTION A: FAQ about health for fat people A1) How healthy or unhealthy is fat *really*? A2) What advice do you have on dealing with doctors? A2-1) What if the doctor says my problem is weight-related? A2-2) What if the doctor wants to weigh me? A2-3) Is there any special equipment for large people? A3) What is BMI? A4) What research exists on fat people and health? A5) What specific information is there about fat people and A5-1) Anasthesia A5-2) Arthritis A5-3) Blood Pressure A5-4) Cancer A5-5) Diabetes A5-6) Exercise A5-7) Fertility A5-8) Gallstones A5-9) Gout A5-10) Heart Disease A5-11) Hiatal Hernia A5-12) Menstruation A5-13) Osteoporosis A5-14) PCOS A5-15) Plantar Fasciitis A5-16) Pregnancy A5-17) Sleep Apnea A5-18) Thyroid Problems A5-19) Varicose Veins A5-20) Yo-Yo Dieting A6) Are there any health advantages to being fat? A6-1) Diseases less prevalent amongst fat people A6-2) Diseases where fat people have a better prognosis A7) Are there any informative web pages on health for fat people? SECTION B: Information about this FAQ B1) Are there other related FAQs? B2) Posting information B3) Availability of the FAQ B4) Contributors -------------------------------------------------------------------- -------------------------------------------------------------------- SECTION A: FAQ about health for fat people A1) How healthy or unhealthy is fat *really*? In short, it's very difficult to tell. Filtering out what is real risk or benefit from the over-exaggeration and prejudice is tough. For example, there is the common view that going to the gym and lifting weights is healthy, but when considering fat people who do this permanently, the common attitude is that it is unhealthy. It's difficult to see objectively the health benefits of being fat against the health risks, and these may vary a lot with the individual. Being fat does *not* automatically mean that one is unhealthy. A clearer way to examine the risks is to look at the research. Even then, care must be exercised. There are many studies that show correlations (positive and negative) between many diseases and obesity. But correlation is not the same as cause. Obesity may cause disease X or disease X may cause obesity, or a third factor could be causing them both. Obesity may exacerbate or hurry the onset of an illness that would have happened anyway. To examine how healthy it is for you to be at a certain weight, don't just consider what health risks you may have at that weight, but also consider the effort (and mental happiness) required to change weight, and the effort required to maintain that new weight, the probability that you will rebound to your original weight, the health risks included in the weight change and possible rebound, and the health risks at the new weight (if you manage to stay there - it's difficult to maintain a weight larger or smaller than your body naturally wants to stay at). You might well conclude that you'd be happier and healthier not concentrating energies on weight change. It is unproven that losing weight increase longevity. One anecdote from a.s.b-f even mentions how being fat saved one guy's life. He was on his bike, hit by a car, and thrown some distance into the street. Passersby thought he was dead, but he had only bruises, and it was his fat that saved his life. "But I've heard that obesity gives you a 1200% greater risk of dying!" No, everyone has a 100% chance of dying. The figure comes from a study where 200 obese men were put on a diet for two years, and regained the weight. The number of men in the 25-34 age group who died during the follow-up period was 12 times the expected number for men of this age. Draw your own conclusions as to what the risk was - the reference is in the Research FAQ, [DBSJ]. See the new Research FAQ for relevance references about obesity and health. -------------------------------------------------------------------- A2) What advice do you have on dealing with doctors? The first and most important thing to remember when dealing with doctors is "You are the customer." If they do not treat you with respect or do not treat you as an adult or keep pushing you to lose weight when you have explained that this is not an option, take your business somewhere else. If necessary, walk out of their offices. And don't pay for services not rendered. If they won't treat the problem you are there for, don't pay them money. With that said, there are good doctors who are not fat-phobic. It's probably worth the hassle of looking around for one. Ask your friends which doctors they like. Interview doctors before making an appointment with them. Tell them that you are a large person and that you are not interested in losing weight. Ask them what they think about large folks, dieting, and so forth. If you've had a history of dieting, and a doctor is recommending weight-loss, then you might wish to say something along the lines of "Let me tell you what happened to me before....do you really want me to go through that cycle again?". A fantastic new resource for fat folks in the US is the Fat Friendly Health Professionals List. This is maintained by Stef Jones, and available at http://www.bayarea.net/~stef/Fat/ffp.html. A2-1) What if the doctor says my problem is weight-related? What can you do if your doctor tells you your problem is weight-related and the only way to treat it is for you to lose weight? If this is clearly not true, i.e., you are there for a sinus infection, you probably want to find another doctor. If it is possibly true, ask them, "Do you mean to tell me that thin people _never_ have this problem?" You are not being obstinate by asking this question. Losing weight is an incredibly energy-intensive process. Losing weight and keeping it off is even more so. If there's any other way to treat whatever condition you have, you want to find it. Besides, being heavy may contribute to your condition. But there are probably other factors that contribute as well. After all, it is not true that every single fat person in the world has whatever problem you do. So start with the other factors, and see if they help. An example. Say your feet hurt all the time, and your doctor tells you you need to lose weight to fix it. Ask your doctor, "Do you mean to tell me that thin people's feet _never_ hurt?" Your doctor will probably admit that some thin people's feet hurt. "And what do you do for thin people whose feet hurt?" you ask. And your doctor will tell you about analyzing how they people walk (to see if they're doing something weird), and applying contrast baths, and getting orthotics and whatnot. And then you tell your doctor that you would like those same things done for you. A2-2) What if the doctor wants to weigh me? What about getting weighed at the doctor's office? There's usually no need for you to be weighed at the doctor's office if you don't want to. Doctors want to weigh you every time you come into the office for two reasons. First, they want to keep track of whether you've had any sudden changes in weight, as this is generally a bad sign. Sudden changes in weight up or down should be reported to your doctor. (Even if you don't weigh yourself regularly, you'll probably notice significant weight changes because your clothing will fit differently.) Unfortunately, some doctors assume that any loss of weight for a large person is positive. If this happens to you, explain to them that you were not dieting and this is not usual for you, and make them look into it. Also, some doctors assume that weight gain by large folks is simply evidence that they're eating too much. Again, insist that this is not the case, and insist they run tests for conditions that could cause it. Second, they want to know your body weight so they can prescribe the correct amount of drugs. However, almost no drug scales linearly with weight, and the dosages for most drugs don't depend on weight at all. If it turns out they need to prescribe you one of the few drugs that they do prescribe differently for different weights, they can weigh you then. Or they can ask you how much you weigh, if you know. So whether you get weighed in a doctor's office or not is totally up to you. Some people on a.s.b-f don't get weighed because they think it is unnecessary, they want to head off possible lectures, or they don't want to know what they weigh. Other people on a.s.b-f think that being weighed is no big deal, provides the doctor with useful information, and they do it without a fuss. How the people in the doctor's office react if you refuse to be weighed may be a good indicator of how a large patient will be treated in that office. If they are not open to being educated, you may want to find another doctor. If you are being weighed, and you have an idea of what you weigh, you may want to set the scale to the correct numbers yourself, rather than weighting for the person weighing you to slowly increment the scale. If you don't want to know what you weigh, there's no need to look at the numbers on the scale. Look in the scales section in the Big Folks Resources FAQ for how to be weighed if you're heavier than the highest number on the scale. (People in doctor's offices should know how to do this, but a surprising number don't.) A2-3) Is there any special equipment for large people? Large-size blood-pressure cuffs: It is vitally important that they use large-size blood pressure cuffs, since conventional-size cuffs give high blood pressure readings when they are used on large arms. It may also be possible to measure blood pressure in the radial or ulnar artery -- use a regular-size blood pressure cuff but put it on your forearm, rather than your upper arm. It's apparently harder to hear, but it can be done. Large-size gowns: Several suggestions. If they don't have them, you could try two gowns, one on the front, and one on the back. They might make you a little hot, but will preserve modesty. If you're nifty with a needle, you could make your own, or you might be able to buy one. An ad in the Spring '95 issues of Radiance declares: Supersize Hospital Gowns - Don't get caught without your own. Check/M.O. for $30 to NAAFA Feminist SIG, c/o Lynn Meletiche, 2065 First Ave., #19-D, Dept. RM, NY, NY 10029, USA (212) 721-8259. Allow 4-6 weeks for delivery. Alternatively, try (again, in the US) NAAFA, P.O. Box 188620, Sacramento, CA 95818, tel. 916/558-6880 (Mon-Thurs). MRI (magnetic resonance imaging) machines: There do exist open-sided machines, where only the head slides under the mechanism. These are for people that are large or claustrophobic. You might need to call around to see where this service is offered. Alternatively, depending on what you need the machine for, it might be possible to look at your body in other ways, for example a CAT scan. The Philips Medical Systems' Gyroscan T5 is designed to handle patients up to approximately 500 pounds and is in use in many hospitals around the US. Give them a call and they can tell you the location of the nearest hospital that has one. Their number is (800) 526-4963. Also see the scales section in the resources FAQ for how to be weighed if you are heavier than the highest number on the scale. -------------------------------------------------------------------- A3) What is BMI? BMI stands for Body Mass Index and is a common rough measure of how relatively large a person is (you may come across it in the literature). To calculate your own BMI, divide your weight in kilograms by the square of your height in metres. 1 kilogram is 2.2 pounds 1 inch is 2.54 centimetres Obesity is usually defined to be a BMI of 30 or more. -------------------------------------------------------------------- A4) What research exists on fat people and health? See the Research FAQ for many studies on fat people and health that seem relevant. References in this FAQ are to the Research FAQ. -------------------------------------------------------------------- A5) What specific information is there about fat people and Specific information (collected so far): A5-1) Anasthesia For years, fat people used to be denied surgery until they lost weight. When weight-loss surgery came along, anesthesiologists had to figure out how to anesthetize fat people. The problem was that common anesthetics are absorbed by fat tissue, so a higher dose is needed to anesthetize a fat person (although not to maintain anesthesia). Nowadays much more is known about anesthesia for fat people and it is much safer. A5-2) Arthritis There are two main types of arthritis, rheumatoid arthritis and osteoarthritis. Osteoarthritis is joint-specific, and involves damage to the cartilage of the joint and inflammation at that site, along with pain, stiffness, yucky grinding noises and sensations, and the like. There is a correlation between being fat and being arthritic. People do have a tendency to gain weight after getting arthritis, and conversely, there are several long-term studies which show that fat people are more likely to go on to develop arthritis, after starting out healthy. Arthritis of the knee is the only disease that can be conclusively linked to increased weight per se. Obesity is positively correlated with osteoarthritis, weight-bearing and non-weight-bearing joints [VVVV]. It is not known whether obesity is a risk factor, or whether there is an unestablished risk factor affecting both [Fel+]. A5-3) Blood Pressure Having high blood pressure is not a disease in itself, but a condition that is a risk factor for such diseases as strokes and heart attacks. Obese people are more likely to get high blood pressure. However obesity does not exacerbate high blood pressue (if you were going to have high blood pressure anyway, being fat isn't making it worse). And in fact a fat person with high blood pressure is less likely to get a stroke or heart attack than a thin person with high blood pressure. High blood pressure can be easily controlled by taking medication. A5-4) Cancer A quote from [GW]: "Certain types of cancer appear to be more common with obesity (e.g. obese women have higher rates of gallbladder, biliary duct, endometrial, postmenopausal breast and cervical cancer; obese men have higher rates of colon and prostate cancer). But obesity appears to protect against overall cancer death and against death from specific cancer types that are the leading causes of cancer death (e.g. in women, premenopausal breast, lung, stomach, and colon, and in men, lung and stomach" There have also been several anecdotes in a.s.b-f about how fat can protect against cancer. Relevant references include [EH], [NRC], [Wil+]. A5-5) Diabetes In a person with diabetes, the pancreas' production of insulin is affected, which in turn affects the regulation of the level of sugar in the blood. There are different types of diabetes. The bodies of people with Type I diabetes produce no insulin, whereas people with Type II diabetes do some produce some insulin, but it is either not enough, or defective. Type I diabetes is less common in larger people; Type II diabetes is more common in larger people. Most diabetics are Type II. The disease is also genetically linked, and affects and is affected by weight. The Pima Indians have the world's highest incidence of both fatness and diabetes. However, the Pima women with the longest life spans are 200% of "ideal" weight, and the men 145%. Treatment concerns the regulation of insulin levels; this can sometimes be done with injections and sometimes by a combination of exercise and diet (whatever the diabetic's weight): regular activity causes the muscles to use glucose, and counteracts the problem to some extent irregardless of weight loss. Dividing total caloric intake into a larger number of smaller meals also helps to avoid overtaxing your regulatory system. If you get diabetes, you owe it to yourself to find out as much as you can about it, and your body's particular version of it. It is a serious disease that needs careful control, as it is associated with greatly increased risks of cardiovascular disease, strokes and other diseases. There is a mailing list for fat diabetics and hypoglycemics who are looking for a place to discuss their condition and their lives in a fat-accepting atmosphere. To get information about this list, send an email to majordomo@psc.edu with the content: info fa-diab A5-6) Exercise Exercise is beneficial to the health of everyone, be they fat or thin. See for example [Bla+]. It increases flexibility and mobility, provides more energy and muscle tone, and can help to keep blood pressure at normal levels. Also see the FAQs on Fitness Resources, and Sports and Activities, for exercise tips for exercising as a large person. There is a mailing list for those who wish to discuss fitness and healthy eating in a size-accepting atmosphere. Discussion of weight loss for the sake of health is allowed, but it is not assumed you want to lose weight. To subscribe, send mail to listproc@listserv.oit.unc.edu with the content SUBSCRIBE FATANDFIT (your name). A5-7) Fertility A common misconception is that fat women are often infertile and/or don't get their periods. If you are having trouble getting pregnant, have a doctor try to figure out what is going on. Lots of other fat women have become pregnant; almost certainly, a woman who is fatter than you has become pregnant. There are lots of reasons that one might not become pregnant immediately. A reference is [Zaa+], which found that a larger waist-hip ratio had a negative impact on fertility in women. Average-size and obese women had similar conception rates, but underweight and very obese (BMI > 38) women were slower to conceive. A5-8) Gallstones Gallstones are formed from bile crystallizing in the gall bladder. These are very common; many people have them without realising it, and without them causing any problems. Problems can be caused when stones get stuck in the bile duct, possibly blocking the liver, and this causes pain, in the form of gall bladder attacks. Risk factors that can make one more suspectible to gall bladder attacks are: femininity, obesity, stress and crash dieting. The function of the gall bladder is to digest fats, and on a diet very low in calories there is not much fat to digest, and so the gall bladder is not used much, and so the bile can more easily crystallize, forming gallstones. A quote from [CS]: "During rapid loss of weight in obese persons, biliary cholesterol saturation increases consistently and in about 50% of patients leads to formation of cholesterol crystals or gallstones..." The standard procedure when someone is experiencing repeated gall bladder attacks is the removal of the gall bladder. This can either be done by full abdominal surgery, or by laser surgery (the technical term is laparoscopic cholecystectomy). The laser surgery standardly involves a general anasthetic, and a small number of incisions. The incisions are small so there are no stitches or staples, just butterfly sutures. Some doctors are reluctant to recommend laser surgery for large folks, although some big folks have had the surgery without problems. From anecdotes on the newsgroup, most big folks were enthusiastic about the laser surgery and much better after it, some recovering very quickly, others taking a little longer. Some had standard abdominal surgery and were happy with that option. One was unhappy with the laser surgery, and one was still having problems after the surgery. A5-9) Gout Gout is caused be an excess of uric acid in the blood, and it crystallizes at the joints of the legs and ankles, thus causing inflammation. The cause of the excess is not known, but there is a hereditary component. Precipiating factors include rich foods, alcoholic drinks, a high fat diet, and inadequate exercise, but they are no more than precipitating factors. The disease can occur in vegetarians and teetotallers. Fatness as an independent factor is not known to have any effect. A5-10) Heart Disease Some studies show that heart problems are more prevalent in fat people. This is connected to the fact that high blood pressure is more prevalent. There are studies (trying to find references for these) that look at the risk factors for heart problems that find no relation to weight, after controlling for the effect of smoking, cholesterol levels and blood pressure. References mentioned in the reference section have mixed results. [Wil+] finds no link between BMI and heart disease. [Man+] reports that obesity and weight gain is associated with an increased incidence in coronary heart disease. There also are studies indicating that cardiovascular risk factors decline with weight loss (eg [Blo+]) and increase with weight gain (eg [AK]), but there are few studies that indicate mortality risk is reduced with weight loss, and there are some indeed that suggest that weight loss leads to an increased mortality risk. e.g. see [HG] Of interest might also be [DBSJ], which is primarily concerned with very low calorie dieting, but some of the deaths of the men concerned were from heart disease. A5-11) Hiatal Hernia A hiatal hernia can be 2 types, sliding or paraesophageal. Sliding is more common. In obese persons, especially older persons, the hiatal area is more relaxed and stretched. A piece of the esophageal junction (part of the esophagus) slides up over the diaphragm with a portion of the stomach. The sphinter that closes off your esophagus functions poorly, and gastric juices reflux (back up) and causes heartburn. This gastric juice reflux leads to esophagitis (swelling and inflammation) and can cause a stricture or narrowing as scarring takes place. Early treatment includes a bland diet, antacids, weight reduction, and sleeping in a semi-sitting position to control reflux. More drastic treatment for severe cases include surgery to repair the esophageal junction and replace it below the diaphragm. A5-12) Menstruation Body fat can have an effect on menstruation, in particular because estrogen is produced by fat cells (as well as from the ovaries). Very thin women (e.g. anorexics or very fit athletes) tend to stop ovulating because their production of estrogen is low due to the lack of body fat. In contrast, fat women have plenty of estrogen. In very obese women, this can play havoc with the menstrual cycle, either lack of menstruation, or irregular menstruation. For regularizing menstruation, where pregnancy is not required, oral contraceptives may prove useful. If pregnancy is required, there are drugs or hormones that can be taken to help normal egg production. A5-13) Osteoporosis Osteoporosis is a disease weakening the structure of the bones, and is usually throughout the skeleton (though some bones may weaken faster than others). Bone minerals are gradually lost and the bones turn brittle. Dieting and improper nutrition during fitness training are positively correlated to osteoporosis (that is, people who diet are more likely to get it). Obesity is negatively correlated to osteoporosis; it is thought to be attributed to both mechanical factors (the weight-bearing helps strengthen the bones) and the estrogen from fat. See [RTP]. A5-14) PCOS PCOS stands for Polycystic Ovarian Syndrome. It is called a syndrome as it characterized by a collection of symptoms, and it is not well understood what causes it. Symptoms include: thinning hair, obesity, adult acne, excess facial hair, irregular cycles, brownish skin on the back of the neck, tiny "skin tags", infertility, diabetes, hypertension. It affects only women (obviously), about 6% of all women. You don't have to be obese to have PCOS. PCOS promotes weight gain and is a symptom rather than a cause. The irregular periods are caused by (and contribute to) an excess of androgen hormones in the body. PCOS is diagnosed in several ways, including a blood test, or through sonogram or a laporascopy. By looking at pictures of ovaries, the doctor can tell if there are cysts on the ovaries. With PCOS, ovulation is not occuring regularly, but egg development is. Thus as eggs develop but are not released, the problem snowballs as each unreleased egg forms a cyst, and as these build up, these can prevent further eggs from escaping. The American Journal Of Medicine published a symposium on PCOS: "Androgens and Women's Health", Volume 98(1A) Jan 16, 1995 Further information can be found from the PCO page at http://www.prairienet.org/~eah/pcopage.html There is also a recently formed newsgroup alt.support.pco, and a mailing list at pco@lists.best.com (open to both men and women, anyone with an interest in the condition). A5-15) Plantar Fasciitis The plantar fascia is a muscle along the underside of the foot, and if it gets inflamed it can cause heel pain. This usually manifests itself as pain at the front of the heel, when getting out of bed in the mornings and also after sitting down for a while. Being large is a risk factor for plantar fasciitis, with a greater proportion of fat folk having it than in the population in general. However this is not a fat person's disease; the primary risk factor is from being athletic and there are plenty of thin active folks with this disease. Also having flat feet is a contributing factor. There are various treatments. The most simple (and usually very effective) include special stretching exercises, rest, heel lifts, shoe inserts, ice, massage. If those don't work, other options such as night splints, orthotics, injections, weightloss and surgery could be tried. Medication and surgery are definitely the last resort. Take care not to go barefoot, or just in stockings/socks. Also, do not bound out of bed in the morning. Give the blood a chance to go to your feet first. If you exercise a lot, you might want to consider changing to non-weight-bearing exercise, like cycling or swimming. Go to a podiatrist, and sort it out early before it gets worse as time goes on. Scott Roberts' excellent web page on plantar fasciitis at http://www.mindspring.com/~scottr/foot.htm is a very good source of further information. A5-16) Pregnancy or... What should I know if I'm fat and pregnant? Some doctors advise their patients to lose weight before attempting to get pregnant. Other doctors simply recommend that patients maintain a stable weight for the last year or so before attempting to get pregnant. Given how difficult it is to lose weight and maintain it (especially when you are trying to eat well and you have morning sickness), the second option is probably more sensible. Many large women (including some who post to a.s.b-f) have had babies without any problems. You may not gain as much weight over the course of your pregnancy as a thin person might. However, it is a very bad idea to deliberately try to lose weight, or deliberately try not to gain weight, while you are pregnant. The baby can't get all the nutrition it needs from your fat stores, and it needs the same amount of food as the baby of a thin person. Large women are more at risk for inadequate weight gain during pregnancy [GSK]. Your doctor should run frequent checks for gestational diabetes, but they should be doing this for all their patients. In general, most of the suggestions about dealing with doctors (above), apply to dealing with your ob-gyn when you're pregnant (or trying). Insist on being treated as a full person. Some common misconceptions: * It's hard to do an ultrasound on a fat woman, so you have to press really, really hard. An ultrasound technician may have to press firmly to get a good picture. But ultrasound should not hurt. If the technician hurts you, tell them to stop, and tell them to find another technician (or your doctor) to do the ultrasound correctly. * You can't hear the heartbeat of a fat woman's baby (or see its picture on ultrasound or whatever) at the same time as you can do these things for thin women's babies. Have them try. They may be surprised. Another generally friendly and knowledgeable resource is misc.kids.pregnancy. You may want to check them out. See the conception and pregnancy section in the Research FAQ for further information. Also the Large-size Maternity Resources FAQ run by katiesmom@vireday.com has a lot of information. You can find this and more information at the Plus-size Pregnancy Web Site, which is at http://www.vireday.com/~rvireday/plus/. A5-17) Sleep Apnea "Apnea" means "lack of breath". It occurs during sleep, when the throat closes off and shuts the airway, and the lack of breathing can go on for quite a long time. Since the person is getting little REM sleep, he or she is often very tired during the day, to the point of nodding off. Lack of energy and concentration, morning headaches, and vivid dreams are other symptoms. The condition occurs mostly in heavy middle-aged men; however, after menopause, almost as many women have it in the same age group. Average weight people can get sleep apnea too, however weight can contribute to the condition, as excess tissue in the airway causes obstruction, and excess weight can lead to that. It is true that sometimes losing as little as 20 pounds can alleviate the condition, but there are other ways of treating sleep apnea, such as a CPAP machine. There are a number of sites on the internet for this condition. Check out alt.support.sleep-disorder, and the Sleep Medicine home page on Obstructive Sleep Apnea (URL http://www.cloud9.net/~thorpy/ ) A5-17) Thyroid Problems The thyroid gland is located in the neck, just below the Adam's apple. This produces thyroid hormone. Too much thyroid being produced is hyperthyroidism; too little is hypothyroidism. Symptoms of hyperthyroidism (not all are necessarily experienced) include weight loss, a fast pounding heartbeat, frequent bowel movements, inability to sleep, nervousness, muscle weakness and fine tremors of the fingers and tongue. Symptoms of hypothyroidism (not all are necessarily experienced) include weight gain, tiredness, depression, feeling run-down, skin/hair/nails may grow more slowly and be more brittle, constipation, anemia, fatigue, loss of appetite, irregular or absent menstrual periods, swollen ankles, puffiness about the face, elevated cholesterol and, possibly, hypertension. To put it succinctly, the metabolism is just not working fast enough. Thyroid problems are fairly common, but not everyone with them has been diagnosed. It is estimated that at least 6 or 7 million Americans are hypothyroid. Hypothyroidism is 4 times more common in women than in men. Although a small proportion of large people do have thyroid problems, not every large and/or tired person has a thyroid problem. Diagnosis of hypothyroidism is by a simple blood test, and treatment is with tablets of levothyroxine, a synthetic thyroid hormone. More information can be found on-line, for example at the on-line service provided by the Santa Monica Thyroid Diagnostic Center (URL is http://www.thyroid.com/ ). A5-19) Varicose Veins Varicose veins are those that bulge out. They are hereditary, but can be exacerbated by excess pressure, eg high weight, constant standing (nurses and waitresses are notorious for them) and pregnancy. They do not go away if you lose weight, although if you do lose weight, it might (or might not) stop more from forming. There are surgical and non-surgical ways of getting rid of them. The most common nonsurgical way involves injecting a saline solution into the vein. It then closes up (the blood flow goes through other veins). You then have to wear a bandage around it for six weeks or so, so that it doesn't pop out again. Support stockings may help comfort-wise, although they might not prevent more from forming. A5-20) Yo-Yo Dieting Some relevant references include [EH], [DBSJ], [NE], [Hay], [Ha+]. Particularly the second, as it's often cited (wrongly) as a study showing the dangers of obesity. -------------------------------------------------------------------- A6) Are there any health advantages to being fat? These lists are taken from [EH]: A6-1) Diseases less prevalent amongst fat people Anaemia Atherosclerotic renal artery stenosis Bronchitis (chronic) Cancer: overall incidence, overall mortality, colon cancer, lung cancer, pre-menopausal, breast cancer, stomach cancer, Diabetes type I Eclampsia Hip fracture Hot flashes Infectious diseases (overall fatalities) Intermittant claucidation Meningioma Mitral valve prolapse Obstructive pulmonary disease (chronic) Osteoporosis Peptic Ulcer Premature birth Premature menopause Reno-vascular hypertension due to fibromuscular hyperplasia Scoliosis Suicide Tuberculosis Urinary tract infection Vaginal laceration Vertebral fracture A5-2) Diseases where fat people have a better prognosis Diabetes type II Hypertension Hyperlidemia Rheumatoid arthritis -------------------------------------------------------------------- A7) Are there any informative web pages on health for fat people? Yes, several. Some are fatphobic, others not. Here's a topical (as of Jan 1998) article from the NEJM: -> http://www.nejm.org/public/1998/0338/0001/0052/1.htm Sharon Curtis (the maintainer of this FAQ) also maintains some pages entitled Health Information about Fatness, which can be found at http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/BF/Inf/main.html These pages offer information straight from research articles about how fatness relates to health. The Medical Sciences Bulletin has a page which focuses on obesity: http://pharminfo.com/pubs/msb/obesity.html Although it refers to obesity as a chronic disease, it does contain a lot of useful information and common sense. It tackles several common misconceptions about obesity and considers the social implications too. There is also a page for AHELP (Association for the Health Enrichment of Larger People), at http://www.nrv.net/~ahelp/ -------------------------------------------------------------------- -------------------------------------------------------------------- SECTION B: Information about this FAQ B1) Are there other related FAQs? Yes. The list of them below can be found from the following page: http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/BF/SSFA/faqs.html fat-acceptance-faq/clothing/canada information about clothing for large people in Canada fat-acceptance-faq/clothing/europe information about clothing for large people in Europe (excluding the United Kingdom) fat-acceptance-faq/clothing/uk information about clothing for large people in the UK fat-acceptance-faq/clothing/us information about clothing for large people in the US fat-acceptance-faq/health information about health issues affecting large people fat-acceptance-faq/research information about research concerning large people fat-acceptance-faq/maternity information about large-size maternity resources fat-acceptance-faq/sports information about resources for sports and activities for large people fat-acceptance-faq/fitness information about resources for fitness for large people fat-acceptance-faq/organizations information about organizations for large people fat-acceptance-faq/resources information about resources for large people (that aren't covered in the other resources FAQs) fat-acceptance-faq/physical information about resources for dealing with the physical aspects of being large fat-acceptance-faq/publications information about publications for large people fat-acceptance-faq/size-acceptance information about size-acceptance big-folks-faq general information file for alt.support.big-folks There is some overlap in the topics covered by the FAQs. If you don't find what you're looking for here, try the other FAQs. -------------------------------------------------------------------- B2) Posting information This document is posted monthly to news.answers and alt.answers and posted bi-weekly to soc.support.fat-acceptance and alt.support.big-folks. Sharon Curtis (sharon@comlab.ox.ac.uk) maintains this FAQ. -------------------------------------------------------------------- B3) Availability of the FAQ All FAQs posted to news.answers are archived at rtfm.mit.edu and its mirror sites. You can get any of these FAQs from rtfm.mit.edu via anonymous FTP or via the mail archive server. (To get information about the mail server, send email to mail-server@rtfm.mit.edu with the body of the message containing the word "help", without the quotes.) FAQs posted to news.answers are also available on the Web from: http://www.cis.ohio-state.edu/hypertext/faq/usenet/top.html http://www.cs.ruu.nl/cgi-bin/faqwais You can find this FAQ at the following URLs: ftp://rtfm.mit.edu/pub/usenet/news.answers/fat-acceptance-faq/health http://www.cis.ohio-state.edu/hypertext/faq/usenet/fat-acceptance-faq/health/faq.html http://www.cs.ruu.nl/wais/html/na-dir/fat-acceptance-faq/health.html although the latest version specifically adapted for HTML and maintained by the maintainer can be found at http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/BF/health_FAQ.html -------------------------------------------------------------------- B4) Contributors These are the people who contribute significant chunks to the FAQ. Sharon Curtis (Sharon.Curtis@comlab.ox.ac.uk) Sasha Wood (Sasha.Wood@cs.cmu.edu) Largesse (75773.717@compuserve.com) Elly Jeurissen (obistat@plex.nl) Also, lots and lots of other people (too many to credit) contributed information that appears herein, some via email and some on s.s.f-a or a.s.b-f. Thanks to them all. Suggestions for additions/improvements are always welcome. Copyright 1995 by Sharon Curtis (Sharon.Curtis@comlab.ox.ac.uk). Permission is granted to copy and redistribute this article in its entirety for non-commercial use provided that this copyright notice is not removed or altered. No portion of this work may be sold, either by itself or as part of a larger work, without the express written permission of the author; this restriction covers all publication media, including (but not limited to) CD-ROM. -- http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/ v 3.12 GM/CS d s:++ a-< C++ U+ p L !E W++ N++ o+ K w-- O? M-- V-- PS? PE? Y PGP- t-- !5 X- R- tv--- b+++ DI+ D- G e++++ h- r z+(--) -=- A month is a calendar, a year can be a decade spent alone -=-