Privilege v. Entitlement

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Unfortunately, much of the discussion of privilege focuses around shaming those who are perceived to have it, rather than trying to strategize about how to empower those who may not. – Octogalore, “Entitlement”

Even before the latest dustup, I wanted to write about privilege versus entitlement (that is, a feeling of entitlement). So what better time than now, since we’re sick of it already?

Octogalore’s post is an old one, but she made me think about some things that I think sometimes get lost in discussions of privilege. Namely, that feeling entitled to success (i.e. what you want out of life) is something that isn’t so neatly distributed along “privileged”/”not privileged” lines. Some people with fewer advantages on paper experience more feelings of entitlement, and some people who seem to have more advantages are held back by the feeling that they not only don’t deserve success, but actually deserve abuse. (I’m not going to claim that everyone who is abused believes they deserve abuse, but it’s a pretty safe bet that everyone who thinks they deserve abuse is bound to get plenty of it.)

How much entitlement you feel, in fact, probably doesn’t come down to a formula of any kind, but a lot depends on upbringing, environment, neurobiology, and how all those things cook together over the years. Like Octo says, too much entitlement can curdle into arrogance, which can not only make an intractable pain in the ass of you, but it can actually backfire when it comes to getting what you want (e.g. you think the traffic laws, metaphorical and actual, don’t apply to you because you rule). Does feeling entitled to success trump privilege? I don’t think so, and Octo doesn’t either. (Seriously, that post is amazing, I highly recommend it.) In fact, privilege often reinforces entitlement; if you expect characteristic X to help you in the future because it has in the past, you are less likely to sandbag your future efforts because you don’t want to deal with the roadblocks. (“Why bother applying for that job? They won’t like me.”)

Do I think it’s possible to accomplish things even if you think you’re a useless dirtbag? Yeah, I do. But I’m going to guess that people who succeed despite feeling little or no entitlement don’t enjoy it a whole lot. And aside from relief to have survived, can anything beyond that be considered “success” if you don’t really enjoy it?

I have always had a serious entitlement deficit. Okay, that’s an understatement; I have had serious problems my whole life maintaining a feeling that I deserved to exist. In fact, the way I found fat acceptance, as I’ve said before, was that my therapist in the mid-’90s recommended I get myself a book on self-esteem, figuring I’d live longer if I actually had some. And I wound up with this one. I’d heard of FA principles before, but post medication weight gain, what Carol Johnson said just made way too much sense. “No, it really IS totally illogical to discriminate against people because of their weight! Yes, it really IS about more than calories calories calories! Yes, I really SHOULD dump the boyfriend who’s been acting like I’m corroded because of my newly Zoloft-padded tush!” I had to be feeling at least some sense of entitlement to get that message, yes? I believed, at last, that I was entitled to eat what I was hungry for, to not weigh myself, to actually live and pursue the goals that were important to me, whether I lost an ounce or not.

This was seismic. We all know that most fat people don’t feel entitled to those things, right? (And probably even more so in 1996, when I bought the book, than now that there’s a Fatosphere and everything.) So you’d think that acceptance of my outsides would soon lead to feeling more entitlement about my insides — in other words, that who I was on the inside deserved my respect as much as my outsides did, that I should feel perfectly free to go after exactly what I wanted in life.

Hooboy would you ever be mistaken about that.

Don’t get me wrong, I’m glad I didn’t have to deal any longer with hating myself for being fat on top of hating myself for everything else. That combination might have killed me. But I still could not, for the life of me, figure out why I did or said certain things the way I did, why people just stopped talking to me and told me “you should know, everyone knows” when I asked what the problem was, why I kept getting booted out of homes, jobs, lives, so unceremoniously. Here’s where neurotypical unprivilege comes in and how complicated that can be, folks. Until two years ago, I didn’t have the privilege of having a diagnosis of Asperger’s, partly because such a diagnosis didn’t exist until 1994, and partly because none of the shrinks I saw after that knew jackall about it. So all I could think was what’s wrong with me? what’s wrong with me? what’s wrong with me? on an endless goddamn repeating loop. When you feel that way, you don’t persevere through rejections; you get one rejection, or maybe two if you’re feeling feisty, and then go hide under the bed for a few years, until the pain of not having what you want becomes so severe you try again, and it’s the same damn thing all over. They said no. That proves I suck.

Maybe self-esteem is privilege too, in a way.

Believe me, I’m not going to be all smug about understanding the whole privilege issue better than some people do. I had a terrible time with it, actually. Because I didn’t have a handle on my basic right to exist, when I first started reading about it, it sent me into a terrible downward spiral. How can having privilege not make me a bad person? If I’m costing other people their safety and health and dignity just because I exist, doesn’t that make me a murderer and a thief? I really did believe I deserved to die over that, all because of my belief that life had to be a zero-sum game where one person gets to live and one gets to die and the one who had to die should be me, that nothing could possibly change to distribute things more equitably unless I took my own life. That way, there’d be one less useless white body in the world, right? It would make white people that much less of a majority, right? Yes, I actually did go there, and the fucked-up thing about it was that I knew how fucked up it was to have that reaction, and that just made me feel that much worse.

Mine was an extreme and wildly inappropriate response, I’ll admit, and I’m pretty sure it’s rare for anyone to actually think that way. (My psychiatrist, when I first presented to him, had no trouble confirming my therapist’s diagnosis of Asperger’s, on the grounds that “your depression pattern is extremely atypical.”) But if that episode taught me anything, it’s that ideas can go through people’s filters in a way you can’t necessarily control from the outside. I can see where the defensiveness about privilege comes from; it’s about the belief that there have to be winners and losers at everything, and if you’re not one of the winners who has an advantage over someone else (earned or not), you have to be the loser, and in America being tagged a loser can cost you everything, including your life. Is this a matter of too much entitlement, or not enough? I think it’s a little of each; maybe you feel entitled to your own comfort, but not entitled to a world where you don’t have to be scared to fucking death of losing it for no good reason.

I think I’ll let Octo have the last word here:

At any rate, it strikes me that the endless carping about privilege is mostly for the benefit of the privileged. It allows a shame solution to a problem that really isn’t about whether or not the relatively privileged shamed person takes pride in herself. And therefore lets her off the hook easily, for the price of a mea culpa. Well, fuck that. It’s not that easy.

Fuckin’ A. Okay, I lied, the last word is MINE MINE MINE! Because it’s my blog, and I’m entitled.

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First Draft of My Letter to Sen. Wyden

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Right now, this is about as brief as I can make it without leaving anything out. I haven’t sent it yet, so if you have any feedback for me, I’d love to see it. If you were going to cut, what would you cut?


Dear Sen. Wyden:

I am a constituent of yours from Portland, and I have been following the healthcare reform fight with great interest. I am in my 40s, am diagnosed with Asperger syndrome (a form of autism), and I also have polycystic ovarian syndrome (a metabolic disorder that affects an estimated 5% of American women) and take psychiatric medications for severe, life-threatening depression. The drug I am on is the only one that has ever worked to keep my depression in full remission, and in combination with my metabolic disorder, it has also ensured that despite a high-quality diet and moderate activity level, I am teetering on the borderline of “morbidly obese.” I am told by my doctors that this is more common than not for people taking this medication and, keeping my PCOS in mind also, they do not blame me for my weight. I am grateful for this.

However, what these conditions mean is that I am umbilically dependent on a job to give me health insurance, since there is no way on earth I could possibly qualify for individual coverage with my pre-existing conditions, even if I were to (improbably) become “normal” weight. The job I have is one that is being hunted to extinction — I telecommute for a national medical transcription company editing speech recognition files and doing transcription. My bosses and coworkers have, in fact, never seen me in person. These jobs, at least in the U.S., are becoming more and more obsolete as “front end” speech recognition (edited by doctors themselves) and offshoring the work to overseas transcriptionists who are grateful to do the work for pennies on the dollar compared to what they must pay U.S. workers, and even more so because American workers depend on their jobs for healthcare. I am not particularly confident that I will make it to “Medicare age” without having to find another way to secure myself insurance, and with my disability and age, the number of insurance-providing jobs I can qualify for is vanishingly small. Therefore, I hope with all my heart that we can figure out a universal healthcare solution that is affordable and accessible for all, and I admire the work you have been doing to try to make this a reality.

This is why I was particularly dismayed to see that you supported Sen. John Ensign’s amendment to the healthcare bill that would allow companies to charge an insurance rate differential of up to 50% (with HHS approval, which would be no obstacle that I could see) for people whose “numbers” — weight, cholesterol, blood pressure, etc. — fail to meet their standards. It’s pitched as a “discount” for people who “take care of themselves,” but in practice, with most companies having yearly open enrollments for insurance, it amounts to the “good” (i.e. genetically luckier) people being allowed to pay the old, lower rate, while the “bad” people (who drew the short stick for DNA) are charged the new, higher rate.

And yes, the way I see this, it does also add up to punishment for “bad” genes. Surely you understand that there is a huge difference between people who can, for example, lower their cholesterol 30 points just by switching to soy milk, and people who have to go completely vegan plus take three statins (which are risky drugs in themselves) to lower it by even 10, yet both are expected to meet the same numerical standard. And if even one number is “off,” one gets dinged the same as if all the numbers were “off,” leading to disincentive to make any positive changes at all if merely being “imperfect” is going to cost them just as much as being overtly self-destructive (the latter of which is, I think, relatively rare). It’s also worth noting that people who are lower income (and nonwhite) are more likely to have numbers that are “off,” and that “living a healthy lifestyle” as promoted by mass media is largely a prerogative of the financially comfortable.

This hardly seems just, and if the goal is truly to get people to take better care of themselves (as opposed to taking the opportunity to squeeze more money out of employees), it is likely to backfire. People who have less money in their paychecks have less money to invest in fresh fruit and vegetables and high-quality whole-grain products, and people who have less money also have increased stress, which in itself is known to be deleterious to health. And those who must take second jobs or work longer shifts to make up for the shortfall in their paychecks — which would be common for people who work low-paying jobs such as retail — would have much less time for physical activity and cooking.

I know Sen. Ensign’s amendment provides for a waiver in case of medically documented inability to “make goal,” which I would likely get with my history. I also understand that companies are currently allowed to charge up to a differential of 20% for “good” numbers, and that 30% (the allowed differential without the HHS approval) does not sound like much of a difference. But 50% certainly is, and would almost certainly tempt many more employers (like the one I work for now, which currently charges no differential) to start testing everyone’s blood and urine and saliva and weighing and measuring them in order to save money. Even if I qualify for a medical waiver, I can see no good coming of having to tell my boss I have Asperger’s and PCOS and depression bad enough I was once hospitalized for it in order to get that waiver. It seems like a great deal for them to hold over my head.

And while I have never smoked, and I understand the rationale for banning smoking at work since that affects the health of others, I fail to see how testing people’s saliva to make sure they have not had a cigar in the privacy of their own living rooms of late is going to accomplish anything except further eroding trust between employees and employers. It seems obvious to me that top-ranking executives will not be subject to these interventions, and thus my suspicion that this is merely a way to justify pay cuts among the rank and file — no more, no less — is especially keen. Given all this, I hope you will reconsider your support of this amendment.

Sen. Wyden, I am not in the habit of writing letters to politicians; you are my first. I know your reputation for considering all sides of an issue and being open to new ideas, and in considering the impact of the laws you work to pass on people who live lives very different from your own. This is a rare commodity in a Senator, and I treasure it. I also know that people are coming at you from all sides regarding the healthcare issue, and I realize that some people might regard the things I have written about here as mere trivia when considering the “big picture” of reform. However, I also would like any healthcare law that passes to actually be a help to people like myself, rather than a hindrance, which is why I am raising these issues with you here. Thank you very much for your time.

Sincerely yours,


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Lots of Stuff About Us, All of It Without Us: Writing a Letter to a Senator

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Recently, something happened in the neurodiversity/autistic self-advocacy movement that made me feel right proud, although I had nothing to do with it. Autism Speaks — an organization that allows almost no autistic people to be involved in its operations, and is devoted to the goal of eliminating the presence of autistic folks from the face of the earth — recently came out with a film called Autism Every Day I Am Autism, which they posted on their Web site. Apparently, they solicited footage of autistic kids and adults participating in everyday life, and then overdubbed said footage (without the knowledge of the participants) with a voiceover that was rife with we’re-autism-we’re-coming-to-eat-your-children’s-brains-mwahahahaha cant. (Transcript here.) And it took about two seconds before the participant bloggers in the Autism Hub (a group of linked neurodiversity blogs not dissimilar to the Fatosphere) raised enough of a stink that AS took the video off their Web site. (It can still be found on their YouTube channel, though.) The gist of the protests came down to this: They don’t even talk to us. They don’t even ask us what we think, because they think we’re delusional. All they care about is getting rid of us. Fuck them. They can’t do that to us.

Sound familiar, Fatospherians?

“Nothing about us without us” is a saying adopted by many stigmatized groups, and especially by the disability-rights movement, of which neurodiversity (ND) is a part. But every frigging day we see examples of people talking mounds of shit about fat people, and very few examples of those same people having talked to us in any great numbers. And it’s rarely questioned by anyone but us fringe wackadoodles, although I’m pleased as punch to see there’s a lot more pushback now than there was even a couple of years ago. But it’s hard to pick up a book or read a magazine article or a Web site or see a movie or TV show on any subject without running into an example of fat-bashing. So much about us. Damn near all of it without us. After all, we’re not just physically sick, we’re crazy too, right? Nothing’s getting between us and our baby donuts, and we don’t care about anything else. We’ll run over kittens in the street to get to our donuts, so how can we possibly be believed about anything?

You’ll notice, though, the difference between how the ND groups were received when they protested, and how fat-rights people are received when they protest. No, AS hasn’t changed their minds about us; they still think autism is a scourge, and furthermore, that anyone who has the presence of mind to complain about it can’t possibly be autistic. (A neat trick, no? Way to create a permanent underclass, by claiming everyone who actuallly belongs to said underclass is incapable of self-advocacy.) But they did something. They’re getting the idea that more people are on to them, and they were forced to tone down the rhetoric. And I truly think a big part of that is that 1) autistic people aren’t blamed for being autistic, and 2) NT people haven’t been terrified to death that they’re two slices of pizza away from become autistic themselves, because that’s completely impossible. “Nothing about us without us,” it seems, only really applies when you have no — and I mean NO — chance of ever leaving the stigmatized group in question. If you can just stick to your diet and get out of the group and stay out, what do you have to whine about? So you don’t get your donut, fatty, get over it.

But there’s overlap, oh yes there is. When we protest that we haven’t had any donuts and don’t even particularly want any, that there’s a lot more to body weight than just food, and furthermore it’s hypocritical to tell people to butt out of everyone’s sex life if you’re just going to turn around and butt into their eating life instead, how can we expect anyone, even other fatties, to believe us? Those other fatties raise their hands and say, “Well, I eat whole boxes of donuts and I’d be thin if I didn’t, therefore all fat people who say they don’t eat boxes of donuts are liars,” and we’re sunk. Most fat people think they’re to blame for their weight, so those few of us who don’t buy it aren’t real fatties for the purposes of the argument and therefore don’t count. If we’re lucky, we’re acknowledged as “freak exceptions” who can’t get thin no matter what; if not, we’re lazy liars who don’t want to work for our social rewards like everyone else has to. When they’re doing a story on fatfatfat, and they decide to put on their lipase-repellent outerwear and actually talk to one of us for the few seconds they can stand to, of course they’re going to look for the folks who live on donuts and Pepsi, not the people with metabolic disorders, not the people on heavy-duty psych meds (actual mental illness being another thing that eats into mass-media credibility, of course), not the vegans who have been fat since toddlerhood, not even people who merely eat the omnivorous diet in the same amounts and get as much exercise as their considerably-thinner friends. Confirmation bias.

Just like people want to believe all autistic kids will spend all their days biting passersby and smearing their shit around the walls of their institutions forever, and therefore autism must be wiped off the face of the earth, they want to believe that all fatties are stupid and sick mentally and physically and could stop being sick and stupid if we only tried, or alternatively, if only Big Food didn’t have us under perpetual helpless hypnosis (just a different way of calling us sick and stupid, really). People need their boogeymen. They feel so lost without them that they’ll actually make shit up about them to justify keeping them around. Therefore, eating boxes of donuts is seen as a punchline, something nearly all fatties secretly do, and even a fantasy of the perpetually dieting classes, rather than a relatively rare but vexing illness that’s damn difficult to treat and really is not fun at all for the people who suffer from it. We can’t even pick on the donut-snarfers anymore? PEOPLE HAVE NO SENSE OF HUMOR!

All this is a lengthy prelude to the fact that I’m working on composing my first letter ever to my senator. Or any senator. Or any elected official, ever. The subject: The amendment to the health-care bill that allows employers to give a deeper goody-two-shoes discount on insurance than they’re allowed to now. U.S. employers are currently allowed to have a 20% differential between people whose numbers are “perfect” and people who fall short of the mark; the amendment, proposed by John Ensign (R-NV) would increase that to 30% and could even go as high as 50% according to “HHS secretary discretion.” It was approved by the Senate Finance Committee by a 19-4 vote; all four “no” votes were by Democrats (Schumer, Menendez, Rockefeller, Nelson). Kerry, Stabenow, Wyden, those great advocates of the downtrodden, all voted yes.

Ron Wyden is my senator. As politicians go, he seems like a fairly reasonable person who might be willing to listen to a well-crafted argument about why this bill sucks (and doesn’t actually contain the word “sucks,” in all likelihood). Here’s the main reason: We don’t have total control over any of our “numbers,” let alone all of them. It might not sound too radical to allow employers to give a 30% discount instead of 20% for the halo-wearers, but what it really amounts to is a fine on those of us who don’t 100% comply — you “good” people get the old rate during annual open enrollment, and you “bad” people who put butter and salt on your broccoli pay the new, higher rate! Yes, they provide a waiver for people who have well-documented medical reasons for not being able to comply; being someone with a metabolic disorder on psych meds, I have a pretty good chance of getting that waiver. And it doesn’t seem likely that if the difference is 30% as opposed to 20%, that it’s going to make that many more employers start nosing around in our britches. But if it goes up to 50%? What employer could resist? And at the rate things are going, it’ll be at 50% before we know it.

I fail to see how charging people more for health care is going to make them healthier. Taking more out of their pockets for premiums means they have less money available for quality food, not to mention that it essentially functions as a poverty tax, since many workers live in areas where obtaining quality food is nearly impossible. It probably also means that there is a possibility that people will have to take second jobs to make up the shortfall in income, which would leave them more tired, more stressed out, and with less time for “joyful movement” and “slow cuisine.” And if they think forcing people’s numbers down by any means necessary is going to mean a reduction in health care costs, they’re not seeing the big picture. More pills, more therapy, more tests = more doctor visits. Not to mention that it encourages more and more buttinskyism on the part of employers; not wanting people to smoke on the job is one thing, since that affects the health of others, but how is it anyone’s business if someone has a cigar in their own living room? And do I really have to tell my boss I have PCOS and Asperger’s and depression bad enough that I was once hospitalized for it? What’s next, are they going to get to read all my shrink’s notes, too?

Part of the reason I’ve never written to an elected official is because I have to crunch down everything I’m thinking about into two or three paragraphs. As you know, that’s not necessarily a natural gift of mine. But this is a first step, in trying to get people making the laws think a little harder about the people who are going to be most affected by them, people who are different from themselves in ways they don’t yet understand. I’d love to know if any of you have written a letter to a politician other than a garden variety fan or hate letter, and what the result was.

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Ten, Two, Four

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Heidi’s post today that mentioned soda reminded me of something. Recently there was an episode of Mad Men (see photo above) that was set in 1963 and featured a vintage Dr. Pepper machine (vending 10-ounce glass bottles) in the waiting room of a hospital. Now, there are some people who doubt the historical veracity of that; evidently those machines were common down south and possibly out west then, but almost unheard-of in New York City, where Mad Men is set. But the machine is true to period, and so is its logo, which says “10 2 4.”

Know what those numbers mean? Those were the times of day — 10:00 AM, 2:00 PM, and 4:00 PM — that one was encouraged to down one of those tasty-ass beverages. Yes, all three! According to the Dublin Dr. Pepper site, this was based on research from the 1920s that demonstrated that people who had something to eat or drink at those times of day were more alert and productive on the job — regardless of whether it involved manual labor or not — and shortly after that research came out, Dr. Pepper came out with the “10, 2, 4” slogan, which was in use for a good 40 years. Evidently, nobody thought it was evil then to encourage people to drink 30 ounces of sugared soda a day. Gasp! The utter decadence of it!

What I want to know is, if we’re all such giant lardfactories because of soda, why were people thinner in the “10, 2, 4” era? Is it really the corn syrup? Then how do you explain us fatasses who hardly ever consume HFCS? (I avoid it mostly because of taste; to me, all soda sweetened with HFCS tastes the same. And I see no reason to dump it into things like soup and crackers just to get rid of it.) And if it’s not All About the Calories, if it’s actually the chemical content of corn syrup as opposed to cane sugar that’s so fattening, then isn’t the “100 extra calories a day is the difference between a thin person and a lardbutt” meme propagated by cities like New York to justify slapping calorie counts on everything in giant neon, just so much stinky hot gas?

Not that I want soda (of any kind) three times a day, mind you; that’s too much belching for me. But I can remember a Miller beer ad from my childhood encouraging people to drink “beer after beer” and a radio ad for Coke saying that since it was sweetened with pure cane sugar, “you can drink as much as you like.” Just imagine anyone coming out with an ad like that now.

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If You Get Too Fat, We’ll Tax Your Seat (Or Is That “Eats”?)

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I’m sure it must have everything to do with the fact that I get stupider and stupider with each pound I gain — IT’S SCIENCE! — but I am still not getting the point of taxing sweetened drinks and “junk food.”

Is the purpose to increase revenue? I don’t have a problem with any nonessential-for-survival item having a surtax on it if the tax is actually going to be used for something useful, although if the purpose is to create more billboards telling me my fat ass should have cut off my circulation forever by now and also my mother dresses me funny, then they can bite me with extra mustard. But if they’re going to use the money for something like universal health care, I don’t really have a cogent argument to make against taxing sugar-sweetened drinks specifically for that purpose, other than that implementation would be a pain in the keister if you’re going to make C-stores put the sugar-sweetened drinks in a separate fountain from the non-sugar-sweetened ones and charge extra for them, and make restaurants charge for refills on everything except Diet Coke. If you’ve got something else you think I’m missing, though, feel free to say so.

But if what they’re trying to do is decrease consumption, and even more so if they’re doing it especially to make fatties lose weight, I think they’re full of tush-mush, frankly. I already banged on that drum here, so I won’t unduly repeat myself, but here’s the thing about all this “fat tax” talk, whether it applies to beverages or anything else. If you (and you know what “yous” I’m talking about here, readers) don’t want me consuming that stuff because you think its availability makes me a giant inflatobutt, know this: I have never in all my almost 46 years consumed fewer sugar-sweetened drinks than I do today, I have never consumed less fast or processed food, I have never been a “healthier” eater than I am today — and I am fatter than ever. Yes, that’s right — when I ate and drank way more “junk,” I was a lot thinner than this. BECAUSE IT’S NOT ABOUT THE FUCKING FOOD, GODDAMNIT. IT’S NOT.

Screw taxing that stuff, screw it to the wall. You could BAN all those things and I’d still stun you with my ginormitude. I will repeat that for emphasis: You could burn down every fast food restaurant, clear every sweetened or alcoholic beverage off every shelf, sweep all the processed food on earth into a ten-mile bonfire, ban every form of candy, cookies, cake, donuts, muffins, ice cream, you name it, and I would still be a huge freaking child-frightening oxygen-sucking flapping-in-the-breeze Shamu McLardypants. My weight would not change at all, I wouldn’t even come close to losing the “magic” 10%, let alone approach “normal” weight. Those foods are not staples of my diet; they are occasional treats. Banning them would not do anything for me except make my life slightly more annoying. Fortunately, I do know how to cook and bake, and I have time to do it. (What are they going to do, ban cookie sheets? I know, don’t give them any bright ideas.)

But unlike gasbags like Mr. Pollan (oops, I named a name), I understand that not everybody is exactly like me, and not everyone has the time, money, or spoons to do what I do. (They say we aspies lack empathy, but lemme tell you, there’s nothing like being autistic to remind you on a daily basis just how unusual you really are.) Shannon wrote very cogently about this the other day, the idea that it’s all well and good to scream “BUY LOCAL! BOYCOTT BIG FOOD!” at people, but if you don’t understand that there are millions of people who would just love to do that but simply can’t, you’re basically gonna be stuck preaching to the yuppie choir and that’s it. (That’s one reason I prefer Lisa Jervis as a source for the fresh/local/sustainable stuff; she hasn’t forgotten what it’s like to have to punch a clock, or that the burden of “cook at home more!” disproportionately falls to women. Michael Pollan, on the other hand, probably thinks “being written up” means something like, “the Times just did another interview with me.”)

I’m surprised, frankly, that nobody has seized upon the fact that so many fat people don’t drink sugar-sweetened drinks at all, and millions of skinny teenaged boys drink gallons of it, and surmised that we’re so fat because we’re not drinking enough soda. I mean, look at me! I went from three cans of soda a day to two a month, and look at the dent I make in the cushions now! Seriously, though, does anyone really think that banning fast and processed food would mean everyone would eat healthier? No, it’s more like millions of people wouldn’t eat at all. Does anyone remember scurvy? Rickets? Beri-beri? Pellagra? Kwashiorkor? These are dangerous diseases of true nutritional deficiency that used to devastate poor people in this country; now, even the poorest Americans rarely get them, largely due to the readier availability of big bad Big Food.

“But we’ll drop off a big organic veggie box FREE to every household! Give them cooking lessons! We’ll even give them pots and pans and olive oil!” Great. Are you going to cut their working and commuting time to less than 40 hours a week and give them free protein too, enough to feed everyone in the house? And babysit the little ones, too, while you’re at it? Last month, The Well-Rounded Mama wondered aloud why so many people refused her offers of free veggies from her garden; like I told her, lots of people just don’t cook or prepare food much at all now. Some people don’t like to cook or don’t have an aptitude for it, and others aren’t physically or mentally able to do it, and still others are just slammed and don’t have the time, especially if nobody else in the house besides them will eat the veggies. (And anyone who thinks you can “make” kids eat what they dislike, check the dog’s poop for telltale leftovers and you may find out otherwise. Besides, I can’t tell you how many times I’ve heard, “My mother made me eat that shit when I was a kid, I’m not touching it now,” especially from men.)

I don’t think not cooking is a crime, personally, even though I like it and I’ve been doing it since I was 7. And I’m all for more quality and variety being available to more people, but I don’t see how punishing people for not being affluent — which is what a “junk food” tax really amounts to — is going to do it. Hungry people will eat what’s there and what they have the money for. Tired AND hungry working people will grab what’s easiest. If you’re going to replace the cookies and chips in the vending machine with fruit, you’d better make sure the bananas aren’t green and the apples aren’t mealy, and that you’re not going to charge more for them. If you’re going to insist everyone pick the salad over the fries at lunch, you’d better provide for an extra snack in the afternoon because they’ll be that much hungrier. And if you’re going to tax the shit out of soda, that thing young America frequently wakes up on because they can’t afford or don’t like coffee, you’d better make sure the drinking water (and by extension, everyone’s tea) doesn’t taste like a swimming pool. (When I lived in Phoenix, I used to joke that the tap water there was so hard you didn’t have to freeze it to make ice cubes.)

I’m not going to congratulate the shit out of myself or demand a Good Fatty Badge because I get Spud deliveries and don’t live on McDonald’s. I made certain choices, like not having kids and not driving much or having a commute, that not everyone’s in a position to make. And I’m not even part of the El33t Koastal Kreative Klasses, but I’m still more privileged than a lot of people, including the me I used to be — the one who had soda farts all day and weighed 30% less.

(And speaking of gasbags, yes, I read what that flamebaiting buttcyst said on Huffington Post about what a great idea it would be to tax people based on body weight. I’m not even going there.)

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Your Chocolate or Your Life? (Me, I’m Thinking It Over)

meowser-48.jpg posted by meowser

(With apologies to Jack Benny.)

If you are autistic, or you’ve done any reading in depth about it, one thing you have probably heard of is the GFCF (gluten free, casein free) diet. That basically means no wheat or most other grains, and no dairy products. The theory is, firstly, that autistic people are congenitally unable to fully digest those foods, and that’s why we have so many Digestive Iss-Yews. Secondly, advocates of this diet say those foods function as “opiates” for us and thus make us more stuporous than we would otherwise be.

Me, I’m agnostic about it. If you feel better, or your autistic kid does better, eating that way — great. I’m not gonna shove pizza down anyone’s throat. However, it needs to be said that it’s likely most autistic people don’t actually follow this diet, at least not all the time; they (and/or their parents) don’t find it particularly useful or even especially sustainable to keep up. (I don’t think there’s ever been a study done of what the percentages are of autistic people following GFCF; my assumption is largely based on anecdata.) Joel Smith of the blog NTs are Weird believes that the “gut issues” associated with the autism spectrum are mostly about stress, rather than an inherent inability to digest certain foods, and given the ridiculous amount of stress most of us experience throughout our lives, it’s tough to argue with that.

However, Gut Issues are pretty much what I’m all about. I admit it — what I like to eat sometimes (okay, a lot of times) doesn’t like me back, and that fact doesn’t necessarily stop me from eating it again. And it doesn’t have to be “junk” food, either; sometimes a vegetarian meal of legumes and veggies and rice and flatbread that looks perfectly salubrious on paper goes through me like a tornado. This is where all the hatebags will probably descend on me screaming, “See? You fatties, you just eat whatever you want even if it fucks you up and you don’t care about MEEEEEEE and my bank account!” Here’s the problem, though. It’s a lot harder to pinpoint what does “fuck me up” when I eat it than to ascertain what doesn’t. If vegetables and salads do that to me, then it’s probably not just that I have a congenital inability to eat gluten and casein, yadig?

My shrink (who’s not autistic) told me that a couple of years ago, she was having Gut Issues herself. So she, following the advice of a nutritionist who believed in the “systemic candidiasis” gut theory, went on a dietary regime for two years that was not only gluten and casein free, but also low carb. (So much for being vegetarian on a diet like that, huh?) The idea was that those nasty yeasties would have nothing to yeasty-feast on and would eventually die off and go away. She was already quite thin and wasn’t interested in weight loss, and she did eat small amounts of potatoes, brown rice, and oatmeal, enough that she wouldn’t go into ketosis. And she ate as much protein, fat, and non-starchy vegetables as she wanted, lots and lots of each of those, so didn’t go hungry. And, she said, “My gut issues cleared right up.” She’s now back to eating much more omnivorously, with no problems.

Now, think about what a diet like that would consist of. Or, more to the point, think of everything you’d have to eliminate. Obvs, no baked goods, no fruit (!), no pasta, no white rice, probably no alcohol, no desserts — and most especially, no chocolate. For two years. Are your coffee beans broken? I can’t do that. Yeah, there’s an end in sight and I wouldn’t have to do it forever, but would it feel that way? Besides, how do you stick to something like that and never fall off? I don’t have a lot of confidence that there wouldn’t be recidivism, especially living with two skinny men (one an extremely active 18-year-old) who heart their carbs and would be very cranky not having them in the house unless it was a matter of life and death for me, or at least a matter of my being able to work versus not being able to.

I asked her, “Weren’t you depressed eating that way?” I remembered reading Geneen Roth’s Appetites, which was centered around Roth’s experiences with a “Candida diet,” and Roth basically said the diet didn’t do anything but piss her off and screw up everything she’d managed to learn about intuitive eating. Being someone with a history of major depression — not to mention someone who has binged pretty fiercely after restrictive diets — this was not an idle concern for me.

“At first I was,” she admitted. “But after a while I felt so much better.”
She did say that if I decided to do this, I shouldn’t do it on my own, but that I should work with a GI specialist and a dietitian (or naturopath) who knew what they were doing.

When there’s something you really, really want and don’t have, it’s easy to be vulnerable to the claims of people who say they have the Instant Cure. Part of me kept saying, “Oh hell no, I can NOT do that. There’s no way.” And another part of me says, “You’re not going to get to eat everything you want forever, everyone has dietary restrictions if they live long enough, so get over it.” And with me, of course, all of this feeds into normalcy pangs. Don’t you want a group of real friends, living right here in town, to hang out with every week? Don’t you want less gas and not having to spend so much time in the john? Don’t you want a real career? Is chocolate and all those other things worth sacrificing all that for? Think of all the friends you’ll have if you give up carbs! Women love talking about what they’re not supposed to eat! You will be One of Them at last!

Yeah. And I’ll also be living alone because I will have driven my partner irretrievably bonkers. Thanks for playing.

And this isn’t even a “diet” in the weight-loss sense. There’s no getting on a scale or whipping out the measuring tape to see if I’m doing it right. And once it’s done, it’s done; once the two years are up, I can start phasing all those foods I love back in gradually, and life will go on. There’s no going to bed hungry. There’s no getting clipped about the head by a “counselor” who’s pissed at me for cheating with cough drops. Only one thing is important: Do I feel and function better eating this way?

And yet, even this much seems overwhelming to me. Not to mention objectionable in other ways; I would probably have to eat a whole lot more meat than I’m eating now, and I don’t particularly want to do that. I feel guilty enough eating the amount of it that I do, and haven’t ruled out becoming a vegetarian again. And isn’t it true that once you haven’t eaten something for a while, you lose your ability to digest it? What if something looks or smells so good I can’t resist, and by then I don’t have the enzymes to digest it anymore? Won’t that make me seriously sick, much sicker than I am now?

On the other hand, I feel like I’m so weak for not feeling capable of doing this, for being such a slave to my appetites and cravings that I won’t give up anything I love, even if it would help me. I feel like maybe people are right to discriminate against my fat ass, that their perception of me as weak-willed and self-destructive simply by dint of my body shape is accurate. Sacrifice? Hard work? Stiff-upper-lip attitude? Strike one, strike two, strike three. Yeah, it’s true. “My chocolate or my life” doesn’t sound like much of a choice, and I’m not even eating a lot of chocolate or eating it every day. Even doing one of those things — no gluten, no casein, OR low carb — seems like a recipe for feeling mentally lousy, even if it’s time-limited. What if I do have medically related dietary restrictions one day? Am I going to be one of those people who’s chronically noncompliant?

I guess I have some thinking to do. Now, if you’ll excuse me, I have an overripe banana to eat.

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What Does Health Care Reform Really Mean to American Fatasses? Conclusion: How Expensive Am I Really?

meowser-48.jpg posted by meowser

The first four parts of the series are here, here, here, and here.

First, I want to thank everyone who’s participated in the discussions here. Even those of you I disagree with on this subject. I’m really impressed by the level of discourse here and by everyone’s willingness to share their experience and insight.

I said in my first post that I was going to talk about the “let them eat emergency rooms” meme, but as it turns out, Dr. Pattie Thomas of Fattypattie’s did it better than I could, here and here. (And in case I’ve never said it, Pattie Thomas just kind of rules in general.) YEAH about the complete waste of resources involved in making people go to emergency rooms for nonemergency care (including the spread of communicable illness, some of it extremely debilitating, from people waiting for hours in an ER lobby), just because ERs can’t ask patients for payment in advance. Contrary to popular belief, though, they certainly do get billed — and how. Like Pattie says, price gouging (e.g. charging $15 for two aspirins that probably cost hospitals less than a penny each) is the name of the game; they figure that if they keep presenting outrageous bills to people, someone will cough up and thus make up for all of those who stiff them. Thus, health care expenses get easily conflated with health care costs.

Which leads me into all the BS I’ve seen lately (I don’t even know how to begin where to link, there’s so much) about how Americans are so costly to treat because we’re such bad little girls and boys (and intersexed kids) who put all kinds of naughty things in our mouths even after our parents (i.e. the superslim health-food el33t) told us a million times not to or we’d be punished but good. Shit, even parents of 2-year-olds manage to put plugs in the light sockets to prevent their little darlings from electrocuting themselves; if they’re going to treat us like children, they might as well go all the way and ban all those things we’re not supposed to be having. Seriously, if two-thirds of us are being smothered to death by our fat, and the foods we eat are drugs of abuse for a substantial majority of the population, why aren’t they banned? Putting out cooked food in front of hungry, tired people and expecting them not to partake because they want to be Goody Goody Good just sounds kind of…I’d say interplanetary, but I suspect even creatures from other planets would think we had flipped.

Part of the reason why, of course, is because if people only ate and drank what they needed to for base survival, our economy would go into the shitter and never come out. They might not want us eating “excess food” but they sure as hell want us buying it. But the other reason is that nobody can especially agree on what everybody “should” be eating for their health. The Atkins-heads and the vegans can’t both be right that their diet is optimal for everyone. Nuts are great, unless you have diverticular disease. Leafy greens rule, unless you have to limit your vitamin K intake because you’re on blood thinners or phlebotomy treatments. Spinach rawks, only don’t touch the stuff (especially if it’s double-cooked) if you have a history of kidney stones. Tofu and soy protein? Fabulous, unless you have to avoid soy isoflavones because they mess up your hormones. And of course, we all know about all the mercury in the fish and the hormones in the chicken and the beef, unless we spend a squillion dollars a pound for the untainted stuff or grow it ourselves on our own private farms. Not to mention all the people who have illnesses and disabilities for whom cooking a “good wholesome meal,” especially day in and day out, would just use up all their spoons and make them feel worse. As Barry Glassner said, “A diet that is harmful to one person may be consumed with impunity by another.”

But let’s imagine, just for a few seconds, that we could come to a consensus about what constitutes healthy-diet-for-most and healthy-exercise-for-most. Let’s make it even more fun and make Michael Pollan and Alice Waters the supreme arbiters of what almost-everyone should eat and how almost-everyone should spend their leisure time. Since everyone in their world has plenty of leisure time, let’s imagine everyone else will be given the same gift, of not having to work more than 35 hours a week to cover basic expenses, and will at the same time have their food budgets increased to the point where they can afford the very best of everything. (Oh, what the heck, let’s throw in enough of a housing budget so everyone will live in California and have a year-round vegetable garden, too, since we’re playing with Monopoly scratch and it’s a really BIG state that should easily accommodate a population of 300 million and counting. No? Too much? Michael and Alice have that, and we’re playing that everyone has to live like they do, and they couldn’t do it in North Dakota in January. I dare them to try.) Oh, and while we’re at it, we will rezone everything so that everyone can walk or bike to work (assuming the universal physical ability to do so with a belly full of healthy grub, since they assume that).

Does anyone have any freaking idea how expensive that’s going to be?

Not, mind you, that I think it’s a bad idea for everyone to have that much leisure time and that much great food and that much sunshine and fabulous topsoil. If nothing else, the reduction in stress would be a boon to people’s mental health, and we know that mental health impacts physical health, and both mental and physical health count towards health-care expenses, not to mention overall quality of life. But you can build all the sidewalks you want, and it’s not going to matter unless people can work a lot less and a lot less hard to get by. You can build all the public parks you want to compete with McDonald’s Playlands, and it’s not going to matter if people don’t feel safe going there or letting their kids go there. (Not to mention the fact that if you’re a kid who’s been hassled even once for your weight on a public playground — and what fat kid hasn’t? — you’re not going to want to go back there unless you’re forced to. So without ratcheting down the fatphobia in society by a lot, there aren’t going to be a lot of fat kids playing outdoors.)

Furthermore, none of that stuff is going to make the vast majority of people go from “obese” to “not obese,” unless their “obesity” was very borderline to begin with. (It’s also not going to prevent “not obese” people from becoming “obese” unless you’re also going to outlaw being on a diet in fourth grade like half of all 9-year-old girls are, which I could actually go for, AND also outlaw all medications that have weight gain as a side effect, which I couldn’t, while simultaneously finding a safe and effective cure for congenital insulin resistance. And maybe we’d better throw in a little gene splicing, too, while we’re at it.) And as we know, those of us who believe in HAES are still considered kooks, so once five years have gone by and almost everyone who was fat before is still fat, one of two things happens: They give up, figuring they’ve wasted enough money already, or they do it harder (as in forcing people to exercise harder and harder and eat barrels full of veggies and less and less of everything else). I can only guess which direction they’ll go in.

Either way, it’s going to be unbelievably very extremely scary expensive to do all that for absolutely every American. (Not to mention that preventative care, which we’d presumably be getting a lot more of if we get more people covered, makes people live longer. A longer life is almost always a more expensive life.) We might be able to evolve that way over a century, save for the moving-everyone-to-California part, but those of us who are middle-aged now won’t likely live to see it. They’re going to have to deal with our flawed bodies and our nasty habits the way they are, seeing as we’ll be entering our Medicare years dealing with the sequelae, such as they are, of both. (And if you’d told me in high school that drinking a milkshake would one day be considered the self-destructo-equivalent of freebasing, I’d have thought you were having a pretty good freebase hallucination yourself.)

And speaking of which, I love how we’re simultaneously told that we big fatty mcwhaleypantses won’t live to see our 70th birthdays and that we are also going to bankrupt Medicare in ways we would not if we switched bodies (and by implication, personal habits) with our slimmer (and allegedly much longer-lived) peers. So which is it? Am I going to live long enough to clean out the treasury, or aren’t I? To be honest with you, I don’t much care if I do or not. I don’t even know if I could deal with having chemo and radiation without having a total meltdown, let alone deal with people sticking instruments into me all day long while simultaneously not being able to have kitty cats around or wake up and see my sweetie’s sweet face, and all the healthy habits on earth aren’t going to guarantee that I won’t end up that way eventually. I once did data entry of patient-care info as a temp for a nursing home, and I swear some of the machinations they had to put people through to get a few grams of crap out of them were unbelievable. Give Dulcolax, and if Dulcolax doesn’t work, try more Dulcolax. If more Dulcolax doesn’t work, try a Fleet’s enema. If the Fleet’s enema doesn’t work, try a suppository with a lighted fuse on the end of it. And get catheterized urine samples too while you’re at it. ARRRGH. I bet I’d be a very bad autie under those circumstances.

What I do care about is, am I going to have the foundation ripped out from under me in the next 20 years, in a way that will shorten my life enough that I’ll never even see a Medicare card with my name on it? Because that’s a very real possibility. I know that my current state of mental health is an incredible gift; annoying medication side effects (and potential long-term sequelae thereof) notwithstanding, after a year of treatment I don’t even think of suicide at all anymore. The last time it happened, and it was so long ago I can’t even remember when, I was able to brush the thought away within minutes. I can actually work, albeit at a job where they tolerate my eccentric work habits and schedule. And it can all be taken away from me with a finger snap, if the drugs stop working and I can no longer work, or if someone decides that I’m getting too many perks and decides to slash my coverage. That kind of stress, of always being aware of the shark tank beneath my tightrope, can’t be good for my health, for any part of my body. Killing people — which a health care system that only covers the healthiest Americans inevitably will do more of — certainly makes them less “expensive.” But we want it both ways. We want everyone to live to be 95 years old and productive and happy and active right up to their last breath — and we also want to save money. And we think we can do all that by everyone being enough of a goody-goody that we’ll all just peacefully expire in our sleep, after having spent 30 years needing almost nothing in the way of drugs, hospitalizations, or surgeries. But bodies are expensive. Any bodies. The sooner America figures that out, the better.

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Reply from Sandy to My Last Post

meowser-48.jpg posted by meowser

Sandy from Junkfood Science just posted a long reply to my last post; since the thread had died by then, I thought I’d put it up top, because there are some issues she brings up that I wanted to tackle (and give other people a chance to also). This is the post in its entirety:

Arguments based on the past are irrelevant when we’re discussing healthcare REFORM. For everyone’s sake, the fat community desperately needs to understand the reality of what is being planned and put into place, the complete picture and consequences, and understand what words (like ‘quality’ of care) actually mean — not get caught up in what they’d like to see happen or what they think is right. Nor can anyone afford to believe media, anecdotes and social marketing. (RWJF interests, for example, have widely infiltrated online communities.)

The noncompliance examples given are spurious. What will label doctors noncompliant are pay-for-performance measures — those clinical guidelines and performance measures that make money for stakeholders (i.e. pharma). The medical literature has well documented that most all of these P4P measures are unsound and don’t actually improve patient outcomes or lower costs (and are all too often to the detriment of certain patients), yet the interests beind them have imbedded themselves in every level of the HHS and the CDC (see July 30th post). Under government managed care, the numbers of P4P measures have exploded and the consequences for doctors who fail to comply with them are steadily becoming more severe. Doctors who don’t do what the government says, already find their livelihood and licensure jeopardized (failure to comply is already on a schedule of increasing pay cuts, and negative ratings on their practices). Electronic medical records that are being required of every Medicaid/Medicare provider are being set up to monitor their compliance to P4P measures (tests ordered, prescriptions written, etc.) which will determine their pay, and automatically report their patients’s (our) medical information to the government to identify those for case management by government/insurance company. Medicare already pays doctors and hospitals 20-30% less than comparables, Medicaid pays 30-40% less, meaning fewer doctors and hospitals can afford to care for the poor. More importantly, out of necessity, care is restricted to what the government will cover.

Compounding the discrimination, they aim to pay doctors based on patient outcomes –- which means if you are fat or have a chronic disease and your health indices don’t meet guidelines, your doctor will receive less reimbursement –- doctors won’t be able to afford to take care of these patients and the patients will have increasing difficulty finding a doctor practice to accept them. Under their planned medical home model of government managed care, however, we won’t have the ability to just go to see any doctor to get the care we want. Instead, you’ll get the cheapest care because you’re costing the practice and hospital. Politicians are also looking at some troubling ways to ‘incentivize’ compliance among patients, calling it tough love. Look at what already happened to poor mothers on Medicaid in increasing places — noncompliance with healthy lifestyles contracts means no more government assistance or additional subsidized care needed for their special needs babies. There is nothing moral or compassionate about third-party health management.

You really don’t want your doctor having to answer to a third party payer (the government or government insurance plan), rather than provide the care he/she feels is best for you (especially if you are fat, aging, poor or have a disability). That also goes against every tenet of medical ethics. It’s why so many doctors and nurses have and will leave the profession rather than be forced to do that. Their conscience won’t let them be shills for pharmaceutical companies and political stakeholders or, worse, have to participate in things they know will hurt people.

Stakeholders are promoting bariatrics and weight loss interventions as saving the system money (while actually making THEM money) — they are not interested in the efficacy (soundness of the scientific evidence), long-range complications and deaths. Fat people are seen as undesirables in the prejudicial visions they have for a healthy perfect populace. But, the public largely believes obesity is a person’s fault and the obesity industry realized years ago that the public wouldn’t support paying for weight loss interventions for fat people – that’s why those same interests starting making it about their ‘health’ and turning to ‘obesity-related’ health indices, with a pill and lifestyle intervention for each. Another example of the need to understand what is going on: Did you know they are already eliminating funding for repeat hospitalizations for complications from the same diagnosis for all patients under government healthcare (Medicare/Medicaid)? This most affects elderly, about 20% of whom are rehospitalized after a medical incident due to complications. (And bariatric patients, of course.) Talking with ICU nurses last weekend, they were in tears because they saw that they were going to have to turn people away or give minimal care because the hospital was facing being unable to afford to provide it free and without compensation. And the hospital had already cut staffing, especially of the most experienced medical professionals, and they were being worked to death with mandatory overtime.

The most significant consequence of the clinical guidelines and pay for performance guidelines under managed care will be denying subsidized care to fat people who haven’t lost weight, to the disabled and to seniors; or providing suboptimum care. Such people are being said to be burdens on the system and not cost effective to expend much money on, under the comparative analysis method they are planning to use to prioritize healthcare spending. You need to understand how healthcare spending is planning to be allotted.

Most important: You are confusing health COVERAGE with heathCARE. As Big Liberty said, what will happen is that fat people and seniors who need care beyond the government’s free basic coverage, will have to find a way to pay for it themselves or suffer. Discrimination can be disguised as equitable.

The best hope for fat people and everyone getting older is a system that allows as many choices of plans and care providers as possible. Not one where the government eliminates their options.

First, Sandy, thanks for stopping by.

But I do think the past (especially the recent past) with regards to UHC is very relevant. You’re trying to tell us that we’re going to be the only country on the face of the earth where, if UHC is implemented, Big Brother is going to force us to live on plain broccoli and work out five hours a day and we’d better like it, when even current forms of U.S. government-sponsored health care, by all indications, are NOT like that. I have recent experience working at a VA Hospital; I did their medical records. Believe me, if they were only treating total goody-two-shoes whose abs you could bounce dimes off of, they wouldn’t treat anybody.

Also, all the problems you mentioned about third-party interference in care are going on right now. You’ve even written about it yourself! American doctors right now are experiencing more and more bean-counter interference from third parties (i.e. insurance companies). People kill themselves because they can’t get care approved by the bean counters.

This American for-profit health care wonderland where nobody interferes with individual doctor-patient decisions, and those decisions are always made in the patient’s best interests, doesn’t exist. (Just ask anyone who’s tried to get a birth control pill or Plan B scrip filled in the Bible Belt.) In fact, it’s likely it never really has; in the pre-HMO days, we (especially us hysterical wimmenz!) had to worry about sleazy doctors and hospitals goading us into accepting medically unnecessary surgeries and other treatments to line their pockets; now, in the name of preserving the ludicrously overprivileged lifestyle of insurance company executives, we are told that the care we’ve paid all our lives for might not be there at all when we need it, and that that’s just the way it is.

You (and also Big Liberty) seem to think all we need to do to get everyone completely covered without bean-counter interference is to allow everyone to purchase policies from out of state. Maybe I’m dense, in fact that’s probably a given, but maybe at least one of you could explain to me how that prevents the sort of rescission and cherry-picking or excluding coverage for preexisting conditions that we’re seeing now, and won’t lead to even more price-gouging and the sale of completely worthless junk policies from fly-by-night companies.

This rescission shit is serious. It’s not to be taken flippantly. Insurance companies actually have rescission quotas, a certain number of policies they have to find (or make up) a reason to kill each month in order to stay profitable. And if you’re on a group policy, they can slap surcharges on your company for your treatment so huge they have no choice but to either scrape together some reason to fire you, or sharply reduce coverage for everyone to make up for the surcharge. I worked for one company which, over a five-year-period, switched carriers four times, and finally wound up offering pretty much a total junk policy that would have cost so much out of pocket it wouldn’t have been worth signing up for. That’s what we poor old disabled fatties you claim to be beating the anti-UHC drum for are facing here, being totally fucked between now and Medicare.

Right now I have what I’d say is B-minus to C-plus coverage. I know it could be worse, and with trends in this country the way they are, and having experienced what I have, I can ill-afford to be smug about it. So what happens to me, someone who is increasingly difficult to employ because of size, age, and multiple disabilities, and isn’t eligible for state-run care or Medicaid, if my company lays me off, or drops or guts our coverage, and I can’t hook on anywhere that offers something better because this gutted care has become industry standard and everyone thinks I’m too high-maintenance? You think the free market will take care of me? How, when all carriers’ entire business, their whole reason for being, is set up to avoid people like me whenever possible?

OK, readers, I open the floor to you. (And once again, please stay on topic; I don’t want this thread to become open season on Sandy. As we used to say in “program,” principles before personalities.)

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What Does Health Care Reform Really Mean to American Fatasses? Part 3: Fat and Compliance

meowser-48.jpg posted by meowser

Part 1 is here.

Part 2 is here.

And thanks to Michelle for getting the ball rolling on the subject of “compliance” — that is, Following Doctors’ Orders (or else?).

In America (and I’m guessing most other countries too?), nobody is required by any law to do exactly what doctors tell them to do. Hell, nobody even has to see a doctor in the first place if they don’t want to, even if it means they’re delaying getting a problem checked out that will be more expensive to treat if they wait. And without violating any HIPAA regulations, I can tell you flat out after many years of creating medical records that people refuse recommended treatments all the time. I do a lot of ER reports, and the following scenario is extremely common: Patient presents to the emergency department. Doctor thinks patient should stay and have some tests run, maybe have some IV antibiotics or other medications. Patient says sie wants to go home. Doctor tells patient sie really should stay, and that sie runs the risk of dying or becoming much sicker if sie leaves. But patient is still permitted to sign out AMA (against medical advice) and go home if sie wishes.

And what do you think doctors tell patients when they do sign out AMA? “Okay, but don’t come back again if you get really sick, because you didn’t listen to me”? No. They say, “Return to the emergency department if there are any problems.” Because it would be completely ludicrous for them to say, “Well, asshole, you had your chance at proper medical treatment and you blew it,” right?

And yet, that’s what frequently happens to fat people who seek medical attention. They’re “ordered” to lose weight, more often than not they either fail to do so or gain back whatever they do manage to lose, and they’re told, “I can’t do a thing for you unless you lose all the weight I told you to lose and keep it off.” You’d think by now that more of them would get a clue that almost no one loses 50 or 75 or 100 or more pounds permanently through diet and exercise alone — except possibly for a few people who start out being extreme binge eaters and/or binge drinkers and don’t have a long dieting history, or who have made getting and staying thin their full-time job and never EVER cave in and eat anything “bad” or miss their two-hour (or longer) daily workouts even with the most wracking knee injury or virulent case of bubonic-boogie flu. And that’s just not reality for most of us. But the idea that most people have limited control over their weight hasn’t gained a whole lot of traction yet despite the staggering pile of evidence in its favor.

So we fatasses who remain fat — i.e. almost all of us — constantly run the risk of being labeled “noncompliant” by our doctors just because we exist. And the vast buttinsky contingent that exists here (though not, of course, exclusively here) just loves to bleat about how expensive we are compared to them because of our stubborn “refusal” to slim down. (Although I note with more than slight puzzlement that these are usually the exact same people who think their perfect habits are going to carry them through to their 100th birthdays — exactly how is it “inexpensive” to your fellow Americans to live to be 100?) They love to say things like, “Well, if you’re not following doctors’ orders, you deserve to have to wait your turn behind those of us who are trying to be good.”

To which I always say something like this: “If you’re going to rank people as a lower priority for care because of not following doctors’ orders, what on earth makes you think you won’t be next?

I’m one of those radical fruitcakes who thinks “imperfect” people deserve health care just as much as the Goody-Twelve-Shoes Club does. Because let’s face it, even the Goody-Twelve-Shoes Club has people in it who have pasts. How can anyone know that those 10 years of chain-smoking, or hard drinking or drug abuse, won’t come back to haunt them later? I and my fat ass never did any of that, so nyaah, all you smug former party animals. The GTS Club thinks it’s reserving its bared fangs and spittly hissing for people who are still doing those things right now, but believe me, the people who used to do that stuff won’t be far behind if we start holding out on people for being “bad.”

Michelle’s post was about a doctor who was having a hissy-pissy because his dialysis patients were drinking water when they were thirsty against his orders. Yeah, that’s all it took to bend his antlers; he talks about them “chugging gallons of milk or juice” at home, but I’ll bet my next Hot Lips fruit soda that the offending amounts of liquid were much smaller than that. (The comments on that post are terrific too; highly recommended reading.) So he wants all patients to do exactly what their doctors tell them to do, and no backtalk? He really wants to go there? It got me thinking about a whole pile of potential behaviors, none of them especially outrageous, that could possibly get a patient labeled “noncompliant” under a system that makes “good behavior” a prerequisite for care:

– Smoking pot. (It always astounds me how many pot smokers who don’t smoke tobacco think the smoking-is-noncompliance stick will never be used on them. With THIS government? Hah.)

– Not wearing your compression stockings when it’s 100 degrees out and the air conditioner is busted.

– Eating something that’s not on your 1800-calorie diabetic, soft foods only, no seeds, 2 grams sodium, low cholesterol, low residue, low fat, low oxalate, low protein diet. (Yes, people are actually given diets that ridiculous to follow at home.)

– If female, not having children young so as to ward off postmenopausal breast cancer.

– Staying coupled to someone who keeps flaking on you when you need to be driven to and from appointments.

– Self-discontinuing a medication because you don’t like the side effects, or not filling a prescription because you don’t feel comfortable taking that drug, or forgetting to take the drug as scheduled.

– Not having mammograms or prostate exams or colonoscopies or DEXA scans (for bone mineral density) as often as your doctor recommends, for any reason.

– Playing with or helping out the kids or grandkids when the doctor has told you to rest.

I’m sure you can think of others.

Heck, I even think people who do stuff I personally find objectionable — like screwing around in the car instead of watching the road and getting into an accident, or yelling at their employees to the point of making them come down with stress-related illness — shouldn’t get down-triaged for care. Because people aren’t perfect, and no amount of withdrawing care is going to make them so.

But let’s get real. We’re never, ever going to have a health care system in America where everyone pays and only the GTS Club gets full care. Because in case nobody’s noticed, this country, more than any other, is crawling with celebrities and other wealthy people. Many of these people don’t have the world’s most perfect health habits, or aren’t what doctors would consider “ideal” weight. Can you imagine an NFL linebacker being refused care for being too hefty? I can’t. Sure, do that knee replacement on him! It’s not like he’ll beat up on it tackling people for a living or anything. And if they don’t consider him to be a waste of a perfectly good prosthesis, there’s no reason *I* should be if I ever wind up needing it, when all I’m going to do is walk on it.

Chain-smoking movie stars? Alcoholic rock stars? No problem, they can hop right on in. There’s no way on earth they won’t be able to, even under UHC. And there’s no way on earth they’ll be told, “Quit right now, or no health care for you.” If they ever were, they’d scream bloody murder. If Michael Jackson could find one doctor to remove his entire nose and another to give him fucking propofol to use at home (something no mere mortal would ever, ever be allowed to leave a hospital with), there’s probably no limit to what you could find a health care provider to do if you’ve got the scratch. Yeah, they’re really going to outlaw all that stuff here and enforce all those laws to the letter when they’re already not enforcing laws that already exist. And I’m Malibu freaking Barbie.

That’s why I’m not putting a lot of stock in the idea that under UHC, we fatasses are all going to be “ordered” to lose lots of weight for good, no matter what it takes, or not get care. As it stands right now, they’re saving buckets of dough by millions of us never going to doctors because we’re not allowed to or can’t take the abuse. Can you imagine the expense of having WLS performed on every single “obese” person? And all the followup care? It would make all our current “fat related health care expenses” look like Slurpee money. (Not to mention the fact that Shaq et al would just refuse.) There are about 300 million of us, and they can’t even prevent all the convenience store owners from selling cigarettes to 13-year-olds in a country this size, even with a federal law in place prohibiting it, because it would be too expensive to crack down on all of them round the clock. If the idea is to make everyone “compliant” to save money, they don’t even want to know how much that’s gonna cost them.

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What Does Health Care Reform Really Mean to American Fatasses? Part 2: Working Us To Death

meowser-48.jpg posted by meowser

Part 1 is here. (And everyone who commented on that post, thank you so much, it was great to read your stories. And if you haven’t left a comment yet and want to, feel free.)

Last year, Sara Robinson posted two articles, both of which I highly recommend, on “mythbusting Canadian health care” for the site Robinson, who has dual citizenship in Canada and the U.S. and currently lives in British Columbia, spoke of her experiences in both systems in part I; in part II, she shoots down what she considers to be the most pernicious “free marketeer” myths surrounding both Canadian and other forms of universal health care. There’s plenty of great stuff there, but there’s one passage in the first article that particularly struck me, when she was talking about Canada’s attitudes towards health versus America’s:

[T]here’s a somewhat larger awareness that stress leads to big-ticket illnesses — and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed.

It got me thinking. How many health problems (of both body and mind) in this country stem from the fact that we work people to fucking death here? Because really, we do. Other than a lucky few with relatively cushy jobs, we work people to fucking death. Pretty much literally. And proudly. And anyone who can’t, or won’t, be worked to death is more or less just stood out at the curb with the broken highchairs.

Not, of course, that you have to have a full-time job (or, yikes, more than one, as many Americans must to pay for just the basics) to be worked to death. Full-time parents get worked to death — no highballs and bonbons here, you’d better be stuffing your child’s brain with learning and nurturing every damn second, or risk being royally snubbed. Ditto caregivers who are expected to be there for free to care for seriously ailing partners or family members, in addition to everything else they have to do to survive. People with disabilities get worked to death too, what with second shift for the sick and all.

Oh, and if you have a partial disability, rather than one that prevents you from working at all, you get virtually nothing but sneers for being lazy and wanting people to take care of you. It can’t possibly have anything to do with using up your spoons (or, if your disability has to do with brain function, colored spoons). No no no. If you can do something sometimes, you must be able to do it all the time, or you are a big faker! You know no one will believe you, much less give you any aid. So you try, and you try, and you try try try and try, and you still can’t make it through even half of the sixteen-hour action-packed day after day after day that’s expected of you as an American. Faker.

It’s even more festive when your particular disability doesn’t allow you to get a job with benefits OR qualify for free or reduced-cost health care, and therefore you don’t even know exactly what your disability is, much less how to manage it — only that you can’t hack it like you see everyone else doing. The only way you “deserve” health care in America is to be ready, willing, and able to be worked to death. Right now. And forever, or at least until nobody wants to employ your aging worn-out ass any longer.

That’s what happened to both of my in-laws when I was married. My FIL had a job for decades as a postal carrier, schlepping bags of mail over hill and dale, until his knees gave out for good. Did he ever have the nads to complain? Are you kidding? He thought he had it made, right up until the day when getting up for a glass of water became excruciating. My MIL had a government job that called for oodles of overtime; in theory she could have refused — or even retired, once she hit 65 — but didn’t dare. She did the OT, then rushed home to care for her sick husband, who was in the hospital every blasted week, it seemed, as a result of a septic illness that cost him 100 pounds in six months. Then she keeled over of a heart attack.

Was she, an aging fat woman, a big old drain on the health care system? Well, let’s put it this way. When the coroner first came out, he couldn’t put a cause of death on her certificate because she hadn’t received enough medical attention for anyone to know what was wrong with her. I had seen her lipid panel recently, though, and it was hella nasty (her brother had had a quadruple bypass at about the same age she was then, and both her parents had died young of heart attacks).

And she was out of breath just walking 50 feet on flat ground to her car. I begged her to go to the damn doctor. She said no, the last time she went all they did was tell her to lose weight and it would go away. My protestations that most fat people, even her age, don’t get out of breath walking to their cars unless something is really wrong with their lungs — and that therefore, her doctor’s answer was unacceptable — went unheeded. I even offered to go with her and make sure she got the attention she needed. Still no. She couldn’t. Her office needed her. Her husband needed her. Soon, though, there would be no “her” for anyone to need, and she just did not see it coming.

At her funeral, right around what would have been her 67th birthday, I cannot tell you how many people came up to me and said, “I had no idea she was under that much stress. If I did, I’d have offered to help her, maybe I could have watched her husband for her while she went to a movie or did something for herself. But she never said anything. She just smiled and pretended everything was fine.”

And these were people who had health coverage. Pretty danged decent health coverage, near as I could tell. But they were victims of the workaholic culture. Just keep pushing, pushing, pushing, pushing, pushing. Don’t let anyone know you’re breaking down even if you are. Do not whine, and do not foist any “drama” on people. (Except, of course, for the people closest to you or those beneath you at work, who you can feel free to take out your frustrations on. At which point they, too, will have to find a human dumping ground for their frustrations, and on and on and on.)

Then, of course, there are migrant workers, who live an average of 49 years — sacrificing almost three decades compared to “normal” lifespan to bring us the endless bags of veggies and fruits we demand to keep our middle-class bodies all healthy and stuff. Parasite, meet host. I swear, the next snotty yuppie who has the guff to go on and on in my presence about how “those people” (i.e. people who have the gall to earn less than $50,000 a year) Eat Soooo Much Junk is gonna get a fair trade banana stuck in hir ear. Which sie will have to go to an emergency room to remove, and thanks to down-triaging will have to sit there in the waiting room with a banana in hir ear for five hours while everyone else points and laughs. Especially migrant workers’ kids.

Then there was the matter of my having to leave a job because my officemate insisted on coming to work with every bug known to upright simians, even when everyone begged her to stay home. She said she couldn’t afford to stay home sick, even though we worked for the same company and got the same benefits and I knew nobody was allowed to cash out sick leave. This job was in a hospital complex, mind you, where we shared elevators with the patients, many of whom were little kids, or adults who were severely immune compromised. Catching a virus that seemed like nothing to her could have killed one of them. She knew. She did not care. She was convinced no one could do without her for even a day or two, that taking off work would put her in the poorhouse, and no exposure to reality would convince her otherwise. Work work work work work.

We hear all the time about lazy, lazy people — especially fatties! — who won’t get off their butts and do anything for themselves. Sure, they exist, but I think they’re pretty rare compared to all the people who are just trashed from all their responsibilities. Even the people I know with good jobs and money, especially if they have kids, they’re just wiped out nowadays. They’re in all kinds of pain. They need a four-week nap just to reset themselves, and they won’t ever get it. And the people with bad jobs and even less money are even more wiped out, by orders of magnitude.

And as Sara Robinson notes, doctors in America get worked to death too:

My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid — quietly, quickly, and without hassle.

Do we have it in us to change? I mean, I’m sure there are plenty of workaholics and super-double-busies in other countries too, but how many countries are there where a 35-hour a week job, with retirement at age 65, won’t ipso facto be enough to cover basic expenses? How many countries are there where, as Sara Robinson mentions, people are “working 60-hour weeks trying to hold onto a job that gives them insurance,” and therefore don’t have enough time to give their elderly relatives the attention they need? How many countries are there where people are expected to spend so much time in their cars, fuming in endless traffic jams, to get themselves and their kids where they’re going? I’m sure a lot of those people would love to live in more “walkable” communities, closer to their jobs, but we’ve made them such a scarce commodity that only the affluent can afford them.

Furthermore, in a country where being chronically sleep deprived and stressed out to the breaking point is the norm, and where fat people have the extra added stress of knowing that their bodies don’t measure up, and trying and trying and trying and failing over decades to force their weights down, getting fatter and sicker with every failure, and knowing that they will pay and pay and pay in every single area of life for falling short, how can we isolate fat alone as an independent cause of illness? If we concerned ourselves a lot less with people’s weights and a lot more with their stress levels, we’d probably all be a lot healthier, both physically and mentally. And then maybe the people who did get sick wouldn’t get so much resentment heaped upon them for “doing it to themselves.”

I got your health care cost containment and “preventative care” right here, Mr. President. Dare we all dream?

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Does It Really Cost To Employ My Fat Ass? Or Does It Pay? (And Who Cares?)

meowser-48.jpg posted by meowser

I’m going to run with the ball I picked up at Lara Frater’s place about the CDC’s new clue-allergic LEAN Works program.

Lara says:

This new program is wrong on some many levels.
1. It’s discriminatory. Are jobs going to weigh people or demand intimate information from their personal life? Programs like this don’t encourage healthiness, they encourage companies to fire fat employees regardless of their health.
2. It’s filled with factual errors as well as lack of information. Many “Facts” have footnote numbers next to them, but I have yet to find those notes in the materials. The $117 billion “obesity” cost has always been a shaky number.
3. It encourages disordered eating. Healthy fat people may take it upon themselves to lose weight when they don’t really need too.

Those are good ones. I’d like to add a couple more to that list:

4. Inasfar as a fat person might have physical or mental health problems (remember, the latter go towards health care costs too!), it’s incredibly short-sighted to assume that said physical or mental health problems in a fat person are caused directly by their fat, or that weight loss — should that person go through the ordeal of trying to lose a great deal of weight and succeed — would result in a reduction in health care usage during time of employment by that person. (If, let’s say, I get to quit seeing an endocrinologist but wind up needing a psychiatrist instead, how is that a reduction in expense?) Which leads me right into number 5.

5. If you want everyone to have “perfect” numbers in everything, it’s going to cost you. “Perfect” numbers, inasfar as they’re even possible to create in someone who doesn’t replicate them naturally, usually mean pills. Pills require lab work. Multiple pills require even more lab work and multiple doctor visits — often from specialists, who are even more expensive than general practitioners — to monitor efficacy and safety. “Successful” dieting, when it does happen, often requires multiple medication adjustments and the addition of even more pills to suppress appetite. And the pills themselves are not without risk, either. Insulin sensitizers and statins and antihypertensives and appetite suppressing agents have side effects. Sometimes really freaking HUGE side effects. And if said weight loss plan involves taking people off their “fattening” antidepressants and neuroleptics, then what? Monkeying with everyone’s brain and body chemistry to get them slimmed down as much as possible, and with gorgeous blood pressure and blood sugar and lipid panel right up to the 65th-birthday sendoff? Is. Going. To. Be. Ex. Pen. Sive. Don’t kid yourselves, CDC, and don’t kid employers, either. If I’m going to monkey with my brain and body chemistry, I don’t want some bean-counting yutz at my company with no fucking medical degree overruling my doctors’ agreements with me about what I “should” be taking. They don’t know what they’re getting themselves into if they go that route. (Fortunately, my company hasn’t, and I doubt they will, for reasons I will elucidate below.)

6. And also inasfar as a fat person might have physical or mental health problems…hmm, let’s see, what’s that toothy monster hiding in the bushes? Oh, hello…it’s STRESS. Nice teeth ya got there. Now, what could possibly cause a fat person to be stressed out? Certainly not the relentless pressure from all corners since they were single-digit ages to slim down and being told they aren’t really hungry, that a few lettuce leaves and celery stalks would fill their stomachs just fine and if they craved anything more than that, they were just being greedy and selfish. Certainly not being overworked and underpaid for decades because they couldn’t fit into an Armani suit. Certainly not being refused friends and lovers and apartments and educations and pretty much anything else a person could be refused, just because they didn’t burn calories as fast as their peers did. Certainly not their own children being embarrassed to be seen with them and their spouses calling them ugly and either threatening to leave or just flat out dumping them for no other reason but weight. Certainly not their own families of origin constantly criticizing them for their greedy appetites. Noooo, that doesn’t take a toll on people’s physical or mental health at all. Nobody ever needs serious medical attention because of stuff like that. Yeah. Ha. Ha ha ha. (And speaking of “Ha ha ha,” how is it the Blanche DuBoises of the world are the ones who “need” psychiatrists, while the Stanley Kowalskis just go right on screwing around with people with no conscience?)

Oh, and 7. DIETS DON’T WORK. They didn’t work in 1909, and they don’t work now. A diet actually working, without any further toll in physical or mental health to the dieter, is a fluke. “Fluke” does not mean “never ever happens,” but it does mean “don’t hold your breath.” And guess what — the CDC’s own data indicate that only 2% of Americans in the “normal” BMI range were “obese” 10 years earlier, and that includes people who lost weight without trying. Do they not even hear themselves?

It’s always fascinating to see people who don’t actually have to work for a living (that is, have their schedules completely governed by an employer with very limited flexibility) snotting off on the alleged costliness of those of us who do. Let me tell you something. Our employers, for the most part, are getting us cheap. Really. Most of us have at-will employment — that is, they can let us go any time they feel like it and not have to tell us why. You can’t even prove weight-based discrimination (or for that matter, any other kind) if nobody actually says to you, “Go home and take your undesirable-for-this-reason ass with you.” And they get away with underpaying us, too, because they know that for many of us, our opportunities are limited, especially once we get up over 40. (Anyone care to compare the relative health-care expenses of affluent thin people and affluent fatasses, versus nonaffluent thin and fat? No? My ears, they hurt from the cricket noises.)

They want to replace us all with thin people to save money? Good luck with that. Thin people are going to demand higher salaries and turn over faster voluntarily, and training new people is costly. And thin, young, conventionally attractive, well educated, currently able people aren’t going to accept nearly as much shit from management as fatties (and older people, and PWD, and people with less education) do. Why should they? They can go somewhere else if they don’t get respect where they are. And “desirable” employees have babies and get sick and need to see psychiatrists, too — so, so much for the low-maintenance thing. Humans are expensive, even extremely compliant ones. I’m sure they’d all love to have an all-robotic work force if they could, only they’d still have to have people around to fix the robots. So inconvenient.

In my particular line of work, being hired remotely and working remotely, without your boss ever laying eyes on you, is industry standard. My company alone has thousands of remote employees, and there are multiple others like it. There’s a reason they don’t install “cams” on all our computers and survey all our activities night and day — it would cost too much. Can you imagine? Having to babysit thousands of working adults around the clock (it’s also a 24/7/365 line of work), every single day? It would be ridiculous. I’m sure they’d love to know what we’re all up to when we’re on the clock. I’m sure they’d love to know about the quick sex we’re having and the chin hairs we’re tweezing and what unsavory political activities we might be participating in, and why we think we can eat Frosted Mini-Wheats with a spoon and type at the same time…but it’s easier for them not to know. It’s not easy to find people who can do what we do with the required speed and accuracy. Two years of experience is usually necessary to land a job like this, and believe me, you want that experience, because you’re going to be paid by the line and that means being able to make out mumble-mouthed diction and fuzzy cell-phone-speaker transmission and sixties that sound like fifties even on a noise-cancelling headset without having to look up every other word, or you’re not going to be paid even minimum wage.

It’s probably not much of a stretch — even without having met a single one of my fellow remote employees ever — to assume that my line of work employs a lot of old people, a lot of fat people, and a lot of people with disabilities, in various combinations of the three. Because thin young hipsters, for the most part, don’t want these jobs. They don’t pay enough. They make you work weekends and holidays. There’s no prestige. And it’s not the most interesting work, frankly, it’s very repetitive. Yeah, but I can stick my finger into any orifice I want, any time I want, and nobody will know! I’m allowed naps! I say gooshy things to my pets, the same thing every single night, and they can sit in my lap while I work! Oh yeah…and my boss doesn’t have to know about every single little piddly-shit health issue I might have either, unless it keeps me from doing my job. Having a shit attack or a crying jag? No problem. Nobody has to know. It’s a beautiful thing.

If they don’t care if I fart, I can only imagine what a pain in the ass it would be for them to have to monitor all our farts, and whatever else is going on in our bodies and brains, to Save Health Care Money. If the CDC brainiacs want me to use up less health care, physical AND mental, what they need to do is build a time machine that will go back forty-cough years, and tell everyone I ever came in contact with that I’m fucking autistic and they should let up on me, and also that I have PCOS and that’s why I’m so hungry and hairy. Also, HIPAA violations anyone? It’s currently illegal in America for your company or anyone else to go nosing around in your medical records without your permission. My company is in the health care business. They know that. I’m pretty well convinced that that’s another reason they’re not going there. Know what else is expensive? Lawsuits.

I may complain about my job, but I think I’m healthier in this job than I would be if I had to work in an office. Getting to decide for myself when I need a break, instead of my employer unilaterally making that decision, makes me healthier. Not having to disclose my autism unless I choose to do so (I haven’t had much luck hiding the fact that I’m “different” otherwise) makes me healthier. Getting to have home-cooked food for virtually every meal, and so does eating it when I’m hungry, not when the clock says it’s time. All those things are tremendous stress reducers. For someone who’s not in a chattering-class occupation, I get treated pretty well. I’ve had other jobs and know it could be much, much worse. And yes, I’m a big fatty fatass who goes to therapy every other week and the psychiatrist every few months and just had a big problem with my back and leg requiring physical therapy. Think that’s expensive? Imagine what deliberately setting out to drive me bonkers might cost.

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No Food for Me, Please — I’ve Just Been in a Car Wreck

meowser-48.jpg posted by meowser

Today I did something I’ve never done before in my life. I crashed a Zipcar.

Yep. Six years — first with Flexcar, then with Zipcar after Zipcar ate Flexcar — and not so much as a scrape until now. (My last accident of any kind was in 2002, and both cars were barely nicked. I wouldn’t even have bothered to report my own damage if the other person hadn’t reported hers.) Pretty miraculous, especially considering that most people who have been in the car with me think I’m kinda the Terror of Colorado Boulevard. (Although that’s more out of ineptitude than recklessness — I won’t even fiddle with the radio with the car in motion, let alone do that plus pluck my eyebrow hairs, eat chicken parmesan with a knife and fork, and text five people simultaneously like so many people seem to be able to do every day of their lives without ever getting into a wreck.) I guess my luck was going to run out sometime.

Nobody was injured, nobody was totaled, nobody was drinking, neither of us even had a passenger. It was such a boring accident even the cops didn’t bother to come out, even though Zipcar duly made me call them to file a report. Basically, depending on how you looked at it, either someone clipped me on the driver’s side fender or I T-boned her while I was coming out of a parking space on a major street and she was about to make a right. I guess it’s up to the insurance compan(y)(ies) to decide which. *I* don’t even know, frankly, it all happened so fast, but I’m not going to be shocked out of my gourd if I’m found at fault, since I’m the one who did the T-boning. She got a dent, metal only, on the passenger side of her pickup, while I mauled my — or, I should say, Zipcar’s — fender of my/their Subaru Impreza wagon. (Nice little car, really. If I was ever going to buy one, I might consider that one. But first I’d have to decide if I’m ever going to drive again, which…well, ask me again in a week, okay?)

When I finally got home, with frozen cat food and Indian takeout and brain drugs in hand, I had a decision to make: Alcohol or Klonopin? I don’t use a whole lot of either one (as drinkie-poos and dextroamphetamine don’t exactly mix, I save the former for my weekly stimulant holidays), but I soon decided that while alcohol might be more fun, Klonopin was in my med stash exactly for situations like this. And when I say Klonopin, I mean like one-sixteenth of a Klonopin. One-eighth will put me to sleep. I am not kidding. I filled this scrip in August and have maybe used half the bottle, and might get around to using the rest before it expires. Benzos, like pretty much every depressant (alcohol included), render me almost entirely useless.

One thing I didn’t want to do a whole lot of? Was eat. Even with some very tasty chicken tikka masala in the house at dinnertime. Yeah, some fatty *I* am. Aren’t we all supposed to be Eating Our Feelings night and day? Not that I think it would be terrible if I did respond to stress that way; I can think of worse things to do after a car wreck than sticking your head into a vat of hot fudge. (Well, okay, room temperature fudge. Literally hot fudge might sting the scalp a little.) Some people go home after car wrecks and kick their pets around. Or scream at everybody in the house. Or deliberately break expensive appliances. Or even worse.

Not me. And I didn’t even want the fudge, or anything I else could swallow, for that matter. You know what I wanted? I wanted my yarn.

Yeah, I’ve got this crochet project that’s more ambitious than any I’ve ever done before, and it’s taking me twice as long as any other creature with opposable thumbs would take to complete it, because I keep messing up and having to frog my entire last row. Because I often crochet as a stress reducer, and as such I sometimes have attention farts. Which isn’t so bad if I’m making my usual endless series of granny squares, but this is a little more intricate than that. And I just got in a car wreck and I want to get back to where I was before I noticed my last goober and had to pull out a week’s worth of stitches, give me my damn yarnies! Let me make endless double-crochet stitches until I’m not agitated any more, and then maybe I can get some work done.

It’s interesting to think about this instinctive response to stress, because just last night I was thinking about the circles I used to run around with, the hyper-new-age 12-steppers who equate white sugar with crack cocaine. (In fairness, though, I’ve also known plenty of perfectly down-to-earth 12-steppers who have absolutely no truck with that sort of goofgassery.) I remember one woman we went out in a group with once being completely lethal to my boyfriend, which I didn’t find out about until he told me later, and I still don’t know — and won’t ever get to ask her — if it was because of my boyfriend, or because I, a fatass who dared to eat bread, made with white flour and everything, had the temerity to actually have a boyfriend, being a drug addict and all. I wondered what would happen if I ever met up with any of them again, if they’d note that I was fatter than ever and thus continuing to flick my chin at God by consuming carbs. How do I know I wouldn’t get and stay thin by cutting out all white flour and white sugar and white rice? Have I ever tried it? Well, no, because I’ve kind of gotten attached to the idea of not having to extract my poop out of my ass with a long tweezer. And also, because I like many foods made with those ingredients, and I don’t want to give them up unless medically required to do so. I personally think God (gods) can handle that about me.

But that belief can get a little lonely. I’m not sure most of them would buy the white sugar=crack equation if there weren’t safety in numbers. That’s where the fat=food addict=eating to quash feelings auto-assumption comes from too, you know. Numbers. Unless you were born a recalcitrant weirdo, like me, nobody really wants to be all that special, it’s too much work. You can and should stand out, but you’d better not stick out, and you’d also better know exactly where that line is. I think when I was younger, I did think of myself as a comfort eater. Why not? It’s easier that way. Everybody knows that people are more likely to break down and confess to anything if nobody believes them that they didn’t do it, right? Also, when you’ve declared yourself to have a strict calorie limit and YOU MUST NOT EXCEED THAT EVER PIGGY, caving in and eating anything that isn’t a celery-stick hologram is liable to make you label yourself “compulsive.” Well, of course I was. I kept doing it, restricting, expecting my appetite to somehow magically require only X many calories or X many points just because some piece of paper said so. It was like keeping myself up for 48 hours and locking myself in a room with a king-sized bed and then expecting not to go sleepy-bye just because I “shouldn’t.” So given all that, did I ever eat when I was upset or agitated? Maybe a few times. But not nearly as often as I was chastising myself for doing, and what “nervous nibbling” I did do, when I thought about it, really wasn’t a whole lot of food.

The point is, when I quit dieting, that went away. Which is something I could have just said up top and saved you 1300-plus words to comb through. But writing’s another thing I do to relieve stress. And it must have worked, because now I’m hungry. But I just found myself saying, “Are you sure? Do you really need to eat?” Yeah…I kind of do.

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A$$es and $eat$

meowser-48.jpg posted by meowser

What can I tell you? Recently my mom, who hasn’t gotten to visit with me in multiple Tisha B’avs, made me an offer I couldn’t refuse. She would fly me to New York, where she’s now living, and put me up and feed me and all the rest for five entire days. So I went last week. Alas, I missed Kate and Marianne’s Re/Dress shindig by a few days; I couldn’t logistically make everything fit so that I’d be there in time for that event, because I also had to schedule my trip so I could squeeze in a visit with my dad, who’s now moving down to Florida and would only be in New York very briefly before going back down south again. Bummer. So I’ve mostly been off the grid all week and for most of the week before that, in case anyone was wondering.

It was a nice trip, and I’ll probably go into more detail about it later. For now, what I’m going to talk about is the logistics of accommodating my mountainous tush on both the airplane and in other places where my butt took up occupancy on this trip. Like I said, what with the airlines and their you-must-pay-extra-for-not-controlling-your-greedy-appetite-fatass policies making the news of late, I have been more than a little reluctant to fly. We’re talking about a cross-country flight, which isn’t cheap, and even if my mom would agree to pay extra for tush shipment, which I’m sure she would if she had to, I would hate to put her out like that. And me, too. But I remembered that not only did Jet Blue have direct flights between PDX and JFK, but their seats were an entire 17.8″ inches across, which is a little bigger than most of the other airlines are offering these days. So I asked her to book me with them if she possibly could, and she did.

My flight out was a red-eye, which was okay with me since I normally keep vampire’s hours and I knew I’d have to do something pretty radical right off the bat to reset my body clock to Eastern Daylight Time. To my utter amazement, about a third of the plane was unoccupied; yeah, I know it was a red-eye, but I’ve taken this very same flight a couple of times before in the last couple of years, and it was ass to ass. Not now; in fact, the seat between my aisle seat and the window was unoccupied. Would there have been a problem if it wasn’t? Well, let’s put it this way; at about a size 20, I got on my seatbelt with no extender, no prob, but putting down that armrest? Owie. I could physically do it, but not by much. I actually had mine resting lightly on my left leg for takeoff with my elbow on top of it, and nobody said anything. If they had I’d have crunched it down, but I was very happy not to have to, believe me. And with the armrest all the way down, there would definitely have been thigh squooshage into the adjoining seat. So, bullet dodged, at least for the outbound flight.

The return flight was not a red-eye; in fact, it was scheduled for departure at 7:40 PM local time on Saturday, and sat there on the tarmac for two stinkin’ hours because the bumblefucks who did the scheduling didn’t realize that every international flight in the galaxy would be taking off at around the same time, duhhhh. I expected more tushes on this flight; not only was I wrong about that, but the plane was even emptier than the inbound one. In fact, it was so empty that before they bolted us into our seats for the tarmac wait, they encouraged people to move to a completely unoccupied row if we saw one that looked good to us. Unoccupied rows? What is going on here? Are people just not flying anymore unless they absolutely must? No wonder they all want to charge fatasses double; if they could get away with it, they’d charge everyone double. Triple, even. Wearing heavy wool socks? That’ll be $15 extra! I will note that on neither flight did I see anyone fatter than myself, and I don’t, in fact, remember seeing anyone else who was Officially Fat on the plane at all. What that actually means, I can only guess.

Now, since I am a Metsochist, while I was in New York, I just had to go to a game at the Mets’ new digs, Citi Field. I’d been hearing all kinds of great things about the park — better food, improved sightlines, nifty historical stuff, and one of the things that had been ballyhooed in the media was “bigger seats!” Only, I didn’t realize that they only meant “bigger seats” in the expensive parts of the ballpark, not the upper deck where I bought my ticket (on StubHub). It only took one extremely painful attempt to wedge my hips all the way back into my chair to realize that a 19″ seat in a stadium was a much different deal from a 17.8″ seat on an airplane; that 19″ is the entirety of your real estate, there is no squooshing out under the armrests. The lower deck seats, I found out later, top out at 24″ (although I don’t know for sure if they’re all that width, it’s not at all clear from the seating chart or any other information I was able to find online).

So if you ever go to a game or a concert at this facility and you are a wide load, be forewarned. Fortunately, as is the case with pretty much all the newer ballparks (built from 1992 onwards), you are not stuck in your seat if you want to see the game; with the open structure of the grandstands, you can take a walk around the concourse, even on the lower levels if you like, and not miss anything. You can even watch from different angles in different parts of the park, although I’m not sure if the same rules would apply during a concert.

Still, it kind of burnt my toast that none of the stories or publicly available info about this ballpark ever mentioned this little, um, quirk with the seats for those of us wearing bigger than size 12 bloomers. For whatever it’s worth, I saw plenty of fat guys with big bellies at this game, and they, natcherly, had no trouble fitting in the seats. I don’t remember seeing a single fat chick. Of course not! Fat chicks prefer to watch the game at home! Riiiiight…and my great-grandparents settled on the Lower East Side when they came to America because they thought Central Park West wasn’t good enough for them. Uh-HUH.

The food is really good, though. Gotta give them that.

I also rode Metro-North and the subway while I was there. God, all those stairs on the subway, just stairs and stairs and stairs and stairs. I can walk on flat land for days, no problem, but those stairs in Birkenstocks were killing my knees, going up or down. Also, what’s up with those seat dividers when there are all those seats in a row bench-style? What’s the point? Is it to keep the phantom schlong dudes from spreading their legs out to MX-missile width? Because if it is, then it’s not working, any better than it’s working to keep my ass from measuring more than 16″ across. You might as well just have a bench, just a flat old bench, and let people arrange themselves however.

At least they’re not talking about making fatties pay double on the subway or commuter train just yet. I guess it would cost them more to enforce that rule than they’d actually make from the deal.

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NY Daily News “Fat-letes” Slide Show: Sports Entertainers of Size as Food/Eating Porn

meowser-48.jpg posted by meowser

I should have known. I never learn. So I’m poking around the NY Daily News sports pages for news about the Mets (speaking of never learning), and something on the sidebar catches my eye: a slide show called “Fat-letes: The Um, BIGGEST Sports Stars of All Time.” And I’m thinking, “Gee, that’s nice, they’re finally acknowledging that fat sports entertainers exist and have accomplished things! Let’s have a look!”

Oh yes. Let’s. (As per my flamebait rules, no direct link: here is the link to the photo gallery page, from which you can find it if you just can’t resist peeking.) There are 35 photos of fat current and former pro athletes, all men, from nearly every professional sport, plus one of A-Rod, who’s not at all fat but got a “dishonorable mention” regarding the “Bitch Tits” nickname allegedly given to him by his Yankee teammates for his roided-out pecs. If the latter gives you a big fat hint that this slide show is not meant to be the slightest bit complimentary or respectful, righty-o you are, Felix. Almost every picture in the series either shows the jock in question with food (e.g. ex-Met Mo Vaughn pictured with the mile-high sandwich the Carnegie Deli named after him), or references to him as something like “donut loving” (ex-MLB slugger Cecil Fielder), or having “eaten his awards instead of hanging them on the wall” (Hall of Fame outfielder Tony Gwynn) or, in the case of Cecil Fielder’s son Prince, who currently plays first base for the Milwaukee Brewers, marveling that a man of his dimensions could actually be a vegetarian. (Gasp.)

Yeah, most of those guys probably do eat a lot — or did when they were playing. Of course they did; in order to maintain the muscle mass necessary to perform at that level, you can’t exactly pick at dry salads, and I guarantee you their thin and buff counterparts put it away too, even if they’re health nuts. (Ever hear about Julio Franco and the 20 egg whites he used to have for breakfast — just breakfast — every day, as part of the 5000-calorie-a-day playing regime he employed to keep playing major-league ball until he was pushing 50? Now you have. You’re welcome.) But for some reason, thin and buff players (and, of course, thin and buff everybody else) who are big eaters never seem to have what’s on their plates lit up in neon like the fat folks do. People just really want to believe that we fatasses put it away like nobody else does, regardless of whether they actually have proof of such consumption or not.

I remember years ago going to a fat-positive spoken-word reading in San Francisco that Marilyn Wann put on, and one of the alt-weeklies advertising the event made the nudge-wink observation that there would probably be lots of great food there, you know, because fat acceptance means aaaalways eeeeeating. Even at a reading. A reading that TOOK PLACE WELL AFTER THE FUCKING DINNER HOUR. (There was no food there at all, in case you care.) I used to think this kind of thing kept happening because “non-obese” people were desperate to believe that our pariah status was completely voluntary, that if you took that away from them they’d whine about oh nooooes, yet another stigmatized group we have to try to be nice to and actually pretend to learn something about and come up with code words to mask our prejudices against — isn’t there anyone left we can pick on out loud anymore?

And maybe there’s something to that, but now I’m starting to believe that in many cases, the reason fat haters insist so loudly that every one of us fatasses must be constantly chewing and swallowing ALL THOZE CALORIEZ YAAARGH, even over our staunch denials, is because their insistence amounts to a form of food and eating porn. They need, right down to the fluid in their cells, to believe that somebody, somebody weaker of spirit and flesh than they, is consuming all that “sinful” food; since it can’t be them (because, of course, they could gain a hundred pounds if they do!), they can at least get to watch us, if only in their minds’ eyes, eat the mile-high sandwich and the (baby) donuts and the awards plaques and maybe even a few Daily News reporters for dessert. If we can demonstrate that our eating habits are nothing out of the ordinary, there goes that wank-target out the window.

Oh, I’m sure Matt Marrone, Andy Clayton and Matt Simonides, who put together this particular disrespect-fest, would deny my interpretation of it out their smug fratboy asses. OK, so here’s the thing. I don’t think fat jokes should necessarily be off limits per se, but for the luvva pastrami, why do they always have to be so witless? About 10 years ago, C.C. Sabathia, (yes, he’s in this slideshow too), then pitching for the Cleveland Indians, showed up in spring training weighing about 300 pounds, which led some media wiseass (whose name now escapes me) to dub him “CCC Sabathia.” See, now that’s funny. I laughed at that. I still giggle about it now. But what does it tell you that of all the fat jokes and japes I’ve heard, seen, and read since then — and good gravy Marie have there been dozens — not ONE has even so much as made me smile? If you people who are being paid six and seven figures to make funnies whiff every goddamn time you make jokes about subject X, if your “humor” about subject X never rises above the third-grade har-har-you-stuff-your-face level, shouldn’t it tell you that maybe you should lay off subject X already until you grow some wit? If you’re going to mock us, at least bring your A game to the field. The “fat-letes” you so disparage did exactly that, after all.

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There Are Diets, And Then There Are DIETS

meowser-48.jpg posted by meowser

Fillyjonk’s tremendous post yesterday on intuitive eating and how it doesn’t always mean eating everything you’re “allowed” to eat — and the ensuing discussion that climaxed in the question, “What if you can’t stop eating things you know are bad for you?” — got me thinking. (Ooh, dangerous.)

There’s no universally “bad for you” food unless it’s food that has been tainted in some way that will make everyone who eats it deathly ill. We’ve established that. But teetering on the precipice of codgerhood, and having created more medical records than I can count where people are put on restrictive diets for one medical condition or another, serves to remind me once again that there’s also no universally “good for you” food either, and that some food encounters that are benign for some people are less so for others. C. has had kidney stones and isn’t supposed to have spinach (or at least not very much of it). My XH has hereditary hemochromatosis and is told to avoid leafy greens. Similarly, people on blood thinners like Coumadin (a very common medication for people over 70) are told that if they do eat greens, they must eat the same amount every day or not eat them at all, so that their medication can be adjusted accordingly. But the rest of us are told that there’s no such thing as too many greens, we can knock ourselves out, and can actually be given a hard time for not eating enough of them, especially if we’re fatasses.

Some people with diabetes can eat sugar and other carbs and as long as they don’t go bonkers, it’s not a problem for them, they just adjust their insulin dosages or tweak their diets in some other way and they don’t have blood sugar spikes. Some others with diabetes find that even eating one or two bites of candy made with sugar will make their fasting glucoses soar into the 300s and beyond, or even put them in a coma. Some people with diabetes need to have sugar at a particular moment in time if they are experiencing hypoglycemia; others never get hypoglycemia at all.

People with kidney failure are told to avoid all but minimal protein. People with dysphagia (trouble swallowing) have to have pureed diets. People who are treated for heart disease in the hospital are given “heart healthy” diets which are low in saturated fat. People with dental problems need soft foods only and probably have to pass up that pizza unless someone puts it in the blender first. (Pizza shake, yummm.)

And of course, some people have food allergies or intolerances ranging from severe anaphylactic reactions to vomiting and diarrhea if they have wheat, dairy, mushrooms, shellfish, peanuts, soy, or any number of other things they don’t feel well after (or can actually die from) eating.

Me, I have PCOS. If my eating is too heavily carb-weighted, I will get foggy and sleepy. I don’t avoid any particular food entirely unless I just don’t care for it, but I do consider how certain foods will make me feel and function after I eat them. The combination of pizza and beer, for example, is restricted by me to times when I don’t have to do anything at all after I eat, because it will make me stuporous. Sometimes stuporous is nice, but not when you still have four more hours of work ahead of you. And if I haven’t been having a lot of fiber, my digestive tract pays the price and my energy can go out of whack. So I sometimes do push myself to eat more of it even if it’s not what I’m craving. It isn’t so much, “Get the brown rice, white rice is bad for you,” it’s more like, “I’d rather have white rice, but brown will be more filling, and I’ll be able to sit in my chair afterwards without bouncing up and down in it.” And sometimes I’ll get the white rice anyway and take my chances, and sometimes that will be the right decision, too, especially if I’m going to be active immediately afterwards.

The older you get, the more the odds go up that there’s going to be something you used to love to eat which you can’t chew, swallow, digest, or process the way you used to. And even a lot of younger people have health conditions for which their eating is limited by something other than personal predilection. So if that’s true for you, does that mean you have to throw IE out the window? Of course not. Whatever particular food restrictions or requirements you have, you just incorporate into your fund of knowledge about how to feed yourself.

If you have a food restriction that will cause an acute reaction if you violate it, of course, it’s a lot easier to follow that; if you know you get hives the size of NBA basketballs after eating strawberries, you’re probably not going to want to touch them no matter how tasty they look. But it gets trickier when there are no immediate sequelae to eating something your body has trouble processing, at least in the amounts you’re giving it, but the sequelae show up later in the form of impaired insulin response or sluggishness or constipation or some other decidedly non-salubrious effect. What then? Does that mean you can’t be trusted to feed yourself and need a “don’t eat” sheet?

Not hardly, say I. I don’t think there’s anything wrong with allowing the part of your brain that knows your particular body well to have final say over what goes in your mouth. For most people, that takes the form of, “You don’t want to be fat, do you? You’d better not, piggy.” But over here, where we practice earth logic rather than superstition, nobody voluntarily goes hungry to fit a certain pants size, not least because that will completely mess up your hunger responses and make you crave things (and amounts of things) you might not otherwise want. I’ve seen women on diets completely helpless in the face of a tray of day-old Costco muffins: “Get those carbs away from me!” And me, I look at the day-old Costco muffins and see…day-old Costco muffins, gag, no thanks.

The thing is, those it’s-bad/I-shouldn’t/I-want-it-even-more effects can persist for years — decades — after you cease trying to lose weight. (Remember the Ancel Keys semistarvation study? It doesn’t take much calorie restriction, or too long a period of time doing it, to potentially screw your head up but good.) That’s why not everyone can practice IE out of a book, or a blog post, without outside support (and why people with full-blown eating disorders can especially find it problematic). And that’s also why your particular brand of IE can involve your left brain as much as your right. Only it’s a matter of training your left brain not to make this about your looks or about your food choices as caste markers, so much as saying, “Is there something my body could use more of? What do I have access to right now that could satisfy that?”

It gets dicey, of course, when your access to foods your body wants is limited by finances. Sometimes I really, really want those white anchovies, but my bank account says, “Forget it.” That’s when my left brain steps in and says, “Here’s some canned sardines, you like those, too, and they’re a lot cheaper.” Maybe I won’t like them quite as much as the white anchovies, but it’s at least in the ballpark. Similarly, your life circumstances may not allow you (or whoever you live with) to do much cooking or food preparation or shopping, and sit-down restaurant meals may be a rare treat. It’s admittedly much more difficult to get a lot of dietary variety under those circumstances. In which case, I say screw it, you can only do what you can do, and you don’t owe anybody the last of your health and energy to find and chop cauliflower.

The last thing I would ever want to see is for intuitive eating principles to be something people think they’re “failing.” The whole point of doing this is to quit punishing yourself already! You don’t have to eat the exact thing that pops into your head, and that thing that pops into your head doesn’t have to be something “healthy,” or you flunk. Nobody flunks, okay? It’s perfectly understandable that some people will have to go about things a little differently for one reason or another; when you’ve had shit pounded into your head about right and wrong food from the time you were a little kid, those idees fixe can be pretty damn difficult to dispense with, especially if they’re mixed with genuinely appropriate reasons for you to avoid or restrict certain foods that your particular body has trouble with.

But maybe you can gently nudge yourself to start thinking in terms of addition rather than subtraction. C. isn’t supposed to have peanut butter either, which he loves, at least not as often as he used to have it. But he doesn’t clobber himself when he gives in and buys it and eats it more often than his doctors would approve of. Instead, he says, “What can we get next time that I can spread on bread, so I won’t automatically go to the peanut butter?” That’s the kind of thing I’m talking about here. Not forcing yourself to eat stuff you really don’t like, because as we know, you don’t get as much nutrition out of food you don’t care for. But I think you’re allowed to feel “meh” about what you’re eating and have it anyway, because that’s what’s there or because you genuinely need it for the sake of balance. If this is about loving every single bite you eat, and always picking the “perfect” thing and the “perfect” amount of it, I flunk too, believe me.

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