Thursday, November 6, 2008

Fat and PCOS

I ran across this Q&A on The-F-Word (emphasis mine, except for the question itself):

How does one go about practicing Health at Every Size with a chronic condition (e.g. PCOS, a thyroid problem, diabetes, fibromyalgia, etc.) or special-needs diet (gluten-free, low-sugar, etc..)?

Lifestyle changes such as diet adjustments and increased movement are often important to improve chronic conditions such as diabetes, cardiovascular conditions, PCOS and other conditions. But a focus on weight loss is not important and often damaging.

Research shows that changes in diet and physical activity result in health improvement (lower blood glucose, lower blood lipids, lower blood pressure) with no or little weight loss. Also, the NIH-AARP Diet and Health Study published in August 2006 showed that people in the overweight BMI category (BMI 25 – 29.9) had the least risk of premature death. And most epidemiological studies show that weight loss is associated with a greater risk of premature death by up to 260%. This may be due to chronic dieting and weight cycling which is associated with a much greater risk of cardiovascular disease.

Also, if diet changes are necessary for health conditions, it is important to avoid any unnecessary restriction leading to feeling deprived. For instance, instead of giving up high fat desserts, why not shop for yummy high fat desserts containing high quality fats. And contrary to common belief, high fat foods do not lead to weight gain above natural weight if eaten when hungry (and neither do high carbohydrate foods). Usually, people feel most satisfied when eating all three major nutrients (protein, fat, carbohydrate) at meals.

Reading this left me feeling...strange. Like a void has been partially filled. I know nearly nothing about PCOS and what its relationship with my weight is. All I know is that weight gain is a common symptom of PCOS (about half of women with PCOS are overweight - but who knows how "overweight" is defined), and that 77% of one's weight is determined by genetics. So how much of my weight is genetic, how much is PCOS, and how much is my life style and environment? I don't know.

When my OBGYN diagnosed me with PCOS, she told me that I should try to lose weight. As I thought more about how to go about doing this, I realized something. If weight gain is a symptom of PCOS, how on earth does losing weight address the root cause? In fact, I'm not the only one that's been told this. So has Branwyn, at A Day in the (Fat) Life:
One doctor, the one who finally diagnosed me with PCOS, still told me to lose weight, and it would cure the PCOS. Ummm, okay. Since obesity is one of the symptoms of PCOS, I want to know how that works.
I've been reading a lot of fat acceptance blogs lately, and so many of their stories are the same as my own, and I've read so many things that feel good to read, that make me feel like all of this PCOS stuff isn't so hopeless. Perhaps I am doomed to be fat the rest of my life. I'm starting to feel like maybe that's not bad. That's okay. I can be okay with that. I can get used to that. Maybe I can even learn to enjoy it. The alternative looks a lot worse to me. I don't want my weight to be a constant struggle for the rest of my life. Learning not to hate myself and my weight because of some things out of my control sounds pretty good, actually.

So here's where I can take control. I can be healthy. Being fat and being healthy are not mutually exclusive. I can do both. Eating healthy (not the same as dieting) and exercise do not have to have a goal of weight loss. They can just have a goal of overall good health. Won't that help my PCOS more than merely reducing an arbitrary number that doesn't accurately measure my overall health in the first place?

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