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?

Fatphobia

I, like the vast majority of my culture, have fallen for the rule that Fat Women Are Gross. And I, as part of a tiny minority of my culture, am learning that that just isn't true. I'm not sure what I weigh now. I know I'm over 200 pounds, but I'm not sure how much over. I'm 5'5". I describe myself as "chubby" when I'm feeling optimistic, and "fat" when I'm not. Before I move on, I'm willing to bet that you've already made the assumption that I eat a lot more than I should and that I'm sexually starved.

Headline: Woman Eats Brownies, Gets Laid.

Well, here's the thing. To be honest, I don't know if I eat more than I should. Not anymore. I used to think so. But now I'm not so sure how much of that is our society dictating belief without evidence. (However, I do know that I do not eat healthily, and that likely has a lot to do with my weight.)

If I do eat more than I should, it's not because I'm sexually starved; it's not a substitute. Nor does being fat make me grossly unattractive. I get laid a lot. Couple times a week. I love every minute of it, and I have a strong suspicion that my partner does too. (If you just grossed out, then stop and think about what you just did, what prejudices you are host to, and why you think that way.) I don't eat food because food is a substitute for something that's missing in my life - I just like food. I like food like I enjoy listening to music, or coding, or writing, or reading. I just like it.

The other thing that deserves mentioning is the fact that I have Polycystic Ovarian Syndrome (PCOS). One of the major symptoms of PCOS is weight gain. So it's not just me and my love for food, healthy or unhealthy (and I can tell you that it's never safe to assume that it's that simple with other overweight women too).

The truth is - there are some men and women who are genuinely sexually attracted to the kind of woman that you would not find in a Playboy magazine. Big women. Non-thin, non-slender, non-skinny, non-lithe women. I'm willing to bet that there are a lot more people that find large women attractive than society thinks. When I got to college and stopped wearing clothing that hid my body, I began to see a lot more interest from my fellow students than I'd ever dreamed of in high school. I need two hands to count the number of individuals that showed more-than-just-friends interest in me. I never thought I'd need more than a finger or two for that. In fact, before reaching college, I had become very comfortable with the idea of being single (with lots of cats) for the rest of my life. And all my boyfriend says is, "You're gorgeous. I'm obviously not the only one that thinks so." I still have a hard time with this concept; I'm still learning a lot about how my body isn't ugly like society seems to think it is.

But the amount of people out there that still think fat people are bad far outnumber the people that don't. And that's a huge problem, pun unintended. The truth is that fat isn't always bad. There is no "epidemic." Some people happen to be fat, just as some people happen to be thin, and while environment and the food you eat has a lot to do with it, genetics has about 77% to do with it. That's right: 77%. Not to mention that diets not only don't work, but could do more harm than good.