Saturday, May 31, 2008

Talking about being overweight

In a recent article in my local newspaper, The Morning Call, a doctor talked about the difficult decision he was facing to start talking to patients about their weight. Apparently he finds it easier to bring up drinking and smoking than obesity, but he believes he can no longer justify this reluctance on his part.

In my job as hospital chaplain I see many gentle and beautiful people who are dying in part because of the burden their extra pounds put on their hearts, their backs, their knees and the whole system. I see the suffering of family members - spouses and partners, parents, children. 

I think about the extra pounds that I carry on my small frame - the bones are still strong but I'm getting older. I should lose at least ten pounds - twenty would be better. Recently I've learned that my self-image has changed over the years so that now I see my self as a plump woman with a prominent tummy - cringe, cringe. So I'm working on reconnecting with another image of myself, trying to know in my bones and in my belly that I, Greta, will be myself if I return to the image of my twenties and thirties. I've looked at photos where my waist is slender and then I check some favorite dresses that I was never able to discard and see that same slender waistline. 

Would I welcome my doctor's words about my extra pounds if she decided to raise the issue? I think now I would. Maybe in the past I could have heard her if she stuck to the health consequences of extra weight. Would words from her motivate me? I don't know. But I can think of two motivations that would make sense to me: lower insurance premiums for an improved BMI, and a safe place to post my success for others to see. The costs to individuals, families, communities, the work force, and the health system are huge, and it is in everyone's interest to overcome the obesity epidemic. I don't believe in shaming, but I do think that a stronger public approval for appropriate weight would be a good thing, while maintaining tolerance and compassion for those who are unable to reach the norm. 

In any case, I applaud the doctor in the article and hope that he will find successful approaches as he talks to his patients.  

Wednesday, May 14, 2008

Today's media report that over half of all insured Americans are taking prescribed medications on a regular basis for chronic ailments. (The Morning Call, 5/14/08, p. A4) 

A few years ago I would have counted myself in the other half, and I resented the automatic question by health care providers "What meds are you on?" The assumption that everyone my age would be on medications implied that pharmaceuticals are a normal part of life, a reality that would obviously benefit the companies that produce these medications and spend millions of dollars to relentlessly promote them. 

Then slowly I began to take a few medications regularly, to control my stomach pain and my asthma. Eventually I added prescription pills for hypothyroidism and ointments for lichen sclerosis. I take aspirin for arthritic pain and to keep my blood flowing through plaque-lined vessels.  Frankly I'm thankful for the relief I get, and for the ability to do the things I want to do.

But I'm still very uneasy with the normalcy of 'taking meds.' I would argue that we do not lead normal lives in today's fast-paced, competitive, polluted world, where our food, water and air are compromised in so many ways. Instead of taking medications we would be better served by improving the conditions in which we live, something that we can do to a minor extent individually. However the policies of our government and the lifestyle models that dominate our media must be changed by a larger effort, starting with the dialogue and consciousness- raising that this blog intends.

I know that my medications are at least in part related to my lifestyle. When I went to Brazil for two months this past winter, after six weeks of breathing the air of the high central plateau, walking at least a mile every day, eating closer to the land, including milk, cheese and meat from grass-fed cattle, and living without the pressures and alienation that I've experienced in my US life, I was off most of my medications: no anti-histamines, Advair, aspirin, Prilosec.