Tuesday, November 16, 2010

Dissecting my health risk assesment.

So my company just got some new insurance and we were required to take an online risk assessment or risk being charged money. And let me say that as I'm writing this I realize that there could be some triggering stuff re diet, exercise and disordered behavior be aware.

So let's talk about some issues I have with this shall we? And why this method of data gathering is just off.

The first is the presumption that everyone who takes this is a driver. There is no option to say that you do not drive.

Apparently people like me who don't drive ever at all and maybe ride in cars 1-2 times a year don't exist.

Next up nutrition.

There is no question about food allergies or sensitivities. The first thing it tells me that to DRINK MOAR MILK. DO IT DO IT DO IT! Um. If I drank the daily recommended allowance of milk or had dairy every day at all, I would shit my pants. Not in a metaphorical sense but in the, I can't leave the house because I'm afraid I'm going to drop a load in my pants way.

Next, it doesn't ask what kind of meat and protein I eat but after I entered my weight the presumption is I'm eating all fat all the time. Also the "solution" for my apparent too high fat intake is to eat fresh fish 3 times a week. I don't know where the survey creators live but I'm going to imagine hey probably make a shitload more money than I do and can therefor afford to eat fresh fish 3 times a week.

I can't afford to eat that way. I would like to eat fresh fish every day actually, but there is no universe in which I could afford that.

Moving along.

I have had doctors tell me to eat less grains because of teh fat, THE FAAAAAAAAAAAAAATASS, and this one suggests I eat more.

Now as far as my diet goes, there are no questions about caloric intake. If I were designing the questions I would if someone selected a very low amount of whatever food group, I would put in an option to find out about food allergies or sensitivities. it would be a far more accurate picture of my actual dietary intake day to day, to ask a few more specific questions. For instance where it says how many servings of Dairy do you have in a day, and I chose 0-1 there should be a drop down that says, are you lactose intolerant? Dislike dairy products? For even more accuracy, asking if someone is a vegetarian or vegan, etc.

Now of course the big issue is my weight. Despite the fact that my waist to hip ratio is pretty right in the area of awesome. 10" difference. And given my actual answers in the dietary portion of the survey, their advice to manage my risky weight is as follows. (Bear in mind that this is the first line of advice)

* Cutting down on portion sizes.
* Limiting foods high in fat.
* Eating more fruits, vegetables, and whole grains.

Quite frankly if I were to take the advice of the all knowing risk assessment I would not be eating pretty much at all. The fact is I don't really eat enough as it is. I have some issues with recognizing when I should eat and it's difficult for me to eat enough during the day. Most of the time I honestly forget to eat or don't recognize hunger as being hunger until (which I've mentioned before) my blood sugar is so low I'm sitting here seething and on the verge of tears.

Next. In the weight section they say this:
In the long run, your goal weight should be between 107.8 and 145.1.

I have been in that weight range almost precisely. Without information as to my build, how muscular I might be, nothing but my height this is their recommendation. Honestly, even at the upper end of that at 145 pounds, that is something that is really difficult for me to maintain.

I maintained a weight between 140-150 pounds for about four years. In order to maintain that weight I had to eat a strict diet of up to 900 calories with an exception for when I was on my period where I would bump it up to 1200 or so by eating more meat. I also had to exercise at a minimum of 3 hours daily. Normally I split my work outs between intense cardio and weights.

In addition to this I did thousands of crunches at home and then as now I walked everywhere. Because our culture discounts commutes and the idea that someone doesn't ever drive, I didn't count the fact that I walked up to a mile out of my way every day.

That was straight up disorders. If I thought I overate, I purged with extra exercise.

I was also a miserable bastard.

I'll confess that looking back, I'm pretty sure a lot of my behaviors were more than borderline eating disordered and I was being cheered on by my doctors. It was the most vicious thing. When my weight was closer to 150 I was chastised, asked if I had fallen off or otherwise done bad things.

I had (have somewhat) an issue with people who have (or I perceive have) power over me. Back then, my doctor was at the top of the list and every time she mentioned my weight or that I had regained 4-6 pounds I felt like the worst piece of shit on earth. I remember riding the bus home after seeing the doctor and I had to get off of the bus and sit behind a bus stop crying my eyes out because I had failed so badly and my weight was back up to about 155 pounds.

How is that ever good?

Aside from the fact that, a "healthy" weight for me means I have to engage in unhealthy and risky behaviors, aside from the fact that at my "fittest" I was possibly the most unhealthy physically and emotionally I have ever been in my life- it's just bad fucking form to suggest that without any kind of warning or acknowledgment that the assessment might not be 100% correct.

There are no warnings that this advice might not be for you and I believe that is dangerous because a lot of us put full stock in what "professionals" say.

My point here is not that I have an issue with having helpful resources available. I do think that the way this information is presented is dangerous and in some of us could trigger disordered eating or relapses. The wording of these types of things tends to rely heavily on shock and shame.

Shame is why there are so many people who won't go to the doctor until they shave, or until they lose fifteen pounds, etc etc. Those are the people who wind up dying suddenly and shockingly of diseases that could have been easily treated or prevented.

This is why I so often say that no I don't believe you when it comes to what doctors, the diet industry etc have to say.

Now I do believe that things like this health assessment could be awesome tools to empower people to take charge of their health if they want to. If they really care I think that assembling or simply doing a user survey would be great. Get some feedback from people about how the survey makes them feel.

I would also like to see HAES presented as an alternative to the LOSE WEIGHT NOW NOW NOW ethos. Or if not HAES by name, something that says "hey, try this it could make you feel good."

I would like to see the shaming and judgmental language stripped away. Give me facts and skip the commentary.

I would like to see the health care industry turn away from being so far up the diet industry's ass and instead of pushing weightloss as the be all end all, support people in being as healthy as they choose to be.

That may mean not suggesting to Fatty Fat Pants that they lose eleventy billion pounds and all their health woes will go away.

That may mean that they suggest to the cartilage ruining runner, that they bring it down a notch and try rowing or something.

I'm talking about the stripping away of biases. I'm talking about holding medical professionals accountable for their bad behavior, shitty care and making sure that it is in their best interest to do their jobs and take care of their patients.

Or at least have the balls to say look, I can't care for you and let that person find a doctor who can so they don't have to suffer.

Okay that's enough.

You get my point you're smart people.

Bottom line is, I am really hoping I am able to find a good doctor or I will- I don't even know what.

Homo Out.


Meems said...

I think we're about the same height based on the weight range you were given, and yeah, I had to maintain a similar-ish routine to get down to just around 140 lbs. Except I never lifted weights because I was so scared of weight gain from muscle. I've since had multiple doctors and nutritionists tell me that they'd rather me weight more than maintain those disordered habits - and I wasn't able to maintain it for anywhere near four years. It's ridiculous what we're expected to do in order to be "healthier."

Now that I haven't dieted in about two years, my blood pressure is back down to very low, too.

It's ridiculous.

H. said...

Sharon, I know I'm a very new reader, but I just had to say that I really wish I had the $ to donate to your blog. I'm enjoying reading it so much... You're very talented, sensitive and amazingly funny. I've been browsing your older archives and can't stop reading basically.

Bless you! And thanks for putting all this out there...

Fat Bastard said...


Rachel said...

This is so, SO true: in my attempts to reach a so-called "healthy weight", I had to engage in a whole shitload of unhealthy, risky behaviors and pretty much making myself and everyone around me fucking miserable. I am so goddamn tired of these so-called "do-gooders" that obsess over the scale and every single thing they eat: it is a totally miserable way to live. These morons don't give a shit about our health; it's all about this hellbent quest to make us all have more "acceptable" bodies...it just makes me want to climb the tallest mountain and yell "FUCK THAT SHIT!"

But it's also why I only see a doctor if I totally think I'm going to die because my weight gets scapegoated for every goddamn thing, and I'm too hesitant to waste time and money going through more of these overcompensated assholes that won't do anything except go on about my weight.

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