Pregnancy, Obesity, And The Lies We Tell

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The diet and weight loss industry benefits from your fear. They literally prey on it, to the tune of $60 billion a year

When reading the news, I often find myself in a perpetual state of rage/anger/sadness/general hopelessness. I’m not proud of it. But can you blame me? That’s rhetorical. The answer is, no. 

And so it was, when I read this, that my head exploded. After I cleaned the blood and grey matter off my laptop, I decided to write about it. Mostly because people need to know it’s fallacious, but also because people need to know it’s fallacious.

I don’t really want to encourage you to read it, but read it. My ranting will be more worthwhile if you understand the source.

Let’s cut right to the chase. “Obesity” is an “epidemic.” About According to the National Institute of Diabetes and Digestive and Kidney Disease, 68% of American adults fall into the “overweight” category, with a BMI of 25-29.9. About one third of us stand firmly in the “obese” category, with a thoroughly humiliating BMI of 30+. And let’s not forget the 1 in 20 adults who are classified as “extremely obese,” with a shameful BMI of 40+.

What’s your BMI? If you aren’t privy to this incredibly useless piece of information, I have provided you with a handy link right over there so you can find out. Then you may promptly discard said information into the bin. Right along with that article.

If I may pose a question: Who exactly created the BMI anyway? Furthermore, who decided what constitutes “obese”? And further furthermore, what arbitrary scale decides that X BMI = Health Risk. And further further furthermore could the BMI be wrong?

In the spirit of both honesty, and illustration of a point, my BMI is 33.6. Let’s not forget the .6. That’s important. I’m 4.6 extra BMI points (?) into the obese category. Which is almost 5. Which is half of 10. Which means as much as the BMI itself.

Where do I even start with this? My BMI plops me solidly in the “obese” category. I am currently “obese” and I was “obese” during my last two pregnancies. As suggested so eloquently by the aforementioned article, I am at an increased risk for gestational diabetes, high blood pressure/preeclampsiashoulder dystocia, and let’s not forget my obese child. When I delivered my last baby, who was 10 and a half gigantic pounds, my blood pressure was 112/65 (enviable), my fasting blood sugar was 72 (good is 70-99), and my baby was born, giant head and all (like really giant head, almost 15 inches. Which is really giant), without complication.

His sister before him was also gigantic, almost 11 pounds, and she got stuck coming out. This is the shoulder dystocia you read of in the aforementioned esteemed article.  Why did she get stuck in the first place? OH NO. It’s because I am so fat. No. Sorry to disappoint, it wasn’t because I weighed 200 pounds. It was far more likely that she couldn’t make her way out with ease because I was pushing in an ill-advised position, one that narrows the pelvis significantly. You know what? I turned to my hands and knees (as is the recommend intervention in such cases) and out she came.

Making blanket statements about obesity and birth is problematic at best.

The rate of cesarean section in obese women is skyrocketing. Oh. Is it really now? Well then. Case closed. Or not. Because guess what, the cesarean rate in ALL WOMEN is skyrocketing. Well that is a weird coincidence. The problem with blanket statistics is that they don’t always take independent variables into consideration. For example, how many of those women had an epidural? The epidural administration rates are also going up. More than 2/3 of women giving birth will receive epidural/spinal anesthesia. In some states that number is more like 80%.

How many of those super fat loathsome women were laboring flat on their backs? How many of these burdens on society were restrained to their bed for continuous fetal monitoring, an intervention that isn’t even evidence based.

I don’t have ready access to all this data. It might be somewhere in some academic study, but that’s A) unlikely and B) wouldn’t work with this ‘fat people are horrible’ agenda. But it just simply is not as cut and dry as you would be lead to believe.

What have you been lead to believe in regards to “obesity”? It’s a valid question. Pause for a moment and ask yourself, what information have you internalized as far as The Fat goes?

*Obese or fat people die sooner.

*Being “overweight” or “obese” places you at a significantly higher health risk.

*If you were just determined, you could lose weight.

*If you lost weight, your life would be prolonged (conversely, if you are fat, your life is shortened)

*Health is in general decline because of the “obesity epidemic”

And what if I told you, that is simply not true. No, really. None of it. Read it for yourself in Health at Every Size. At the risk of sounding like a conspiracy theorist, let me just say, it’s a bunch of nonsense. I know. This challenges literally everything you’ve been told. Every fact that you’ve had shoved in your face like a piece of wedding cake (yum, cake). And for what? Money. Always with the money.

The diet and weight loss industry benefits from your fear. They literally prey on it, to the tune of $60 billion a year

The author of the article in question is an obstetrician, so she’s qualified to make some medical statements, obviously. I don’t begrudge her, neither her education, nor her right to free speech. HOWEVER (all caps) she too has been taught to believe that obesity is the root of all evil. Every bodily problem. Every crisis. Every unfavorable outcome. It can all be traced right back to my disgraceful 33.6 BMI.

What happens when we challenge a so deeply held belief? It freaks people out, that’s what. It’s like saying, “Oh hey, by the way, the sky is actually green. OOPS.” It would freak out Claire A. Putnam too, who presumably went to medical school, what with the whole MD thing.

And in medical school she was presumably taught all the things you’ve been taught. But, instead of a bunch of fear mongering nonsense, what if obstetricians were taught that standing up in labor not only speeds it up, but lead to an easier, less complicated delivery? I know. I know. That’s just crazy talk. Ask Ina May Gaskin about it though. She’ll tell you, the outcomes in her practice, one of midwifery, which employs a hands-on approach, constructed around the ridiculous notion that women are supposed to give birth, that her outcomes are predominantly positive. 

What if instead of metaphorically chaining a laboring mother to a bed, we instead told her, “Oh hey. Did you know that laboring upright, and without intervention, can really significantly decrease complications.” What if instead of assuming she’d be a diabetic/hypertensive health risk, we just took care of her and her baby.

Stop freaking out.

As if this whole ‘you’re so fat you’re killing yourself and your baby’ thing wasn’t bad enough, Dr. Putnam would like doctors to “end the taboo against talking frankly about obesity” and patients to “not take offense, especially when their health, and their children’s health, is at stake.” Well, what a great idea. I am just so humbled by your kindness and understanding Dr. Putnam (and the vast majority of your colleagues). I am profoundly grateful for your willingness to frankly discuss something that is not at all a problem.

You know what’s an epidemic? Making people feel second rate and ashamed, criminalizing them for something that A) isn’t your problem and B) is probably irrelevant anyway. Here’s a radical notion. What if instead of scare tactics and shame we simply dedicated ourselves and our medical practice (I am a RN, after all) to helping people. What if, instead of doctors cornering their patients, to shame and vilify them for something they may not even have control over, they just said, “Oh hey. Did you know that walking 30 minutes a day is the single best thing you can do for your health.” What’s that you say? Your weight isn’t the be all end all predictor of your life expectancy? Radical.

And do not even bother to comment about how fat people wouldn’t be fat if they weren’t lazy. Because I am about as far from lazy as the Earth is from Pluto (which is definitely a planet, by the way). Oh and also, I am fat. I am so so fat. I’m just over here taking up my own zip code and dressing in a trash bag.

What if we stopped shaming, stopped blaming and just let people live. And what if we even told them, you can be healthy and happy just like you are.

What if.

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