I bet you’re just reading this comic for the compelling story.
These are their stories. DUN DUN.
For years the assumption has been that “obesity” leads to pain. Many patients have had the experience of looking for explanations of pain issues, only to have the problem never investigated and told to lose weight instead. Then years later, find out that their pain was actually the result of an underlying issue, made worse through a lack of early treatment. You might have seen a comic or visual joke involving a visibly injured patient and the doctor saying “have you tried losing weight?”
In my book, Young, Sick, and Invisible, I discuss how this same trope was directly responsible for my own autoimmune conditions being ignored long enough to cause long term and severe disability and damage.
In a recent post, I had responded to an intentionally insulting comment with a long explanation of how their assumptions about my use of a mobility aid and my weight was influenced by a series of misunderstanding about obesity, pain, and disability. Included among this explanation was the statement that “obesity” or rather weight gain, can often be a symptom of chronic pain rather than it’s cause.
In response to this statement I received a question, and while the phrasing made it clear the comment wasn’t actually a legitimate inquiry but another chance for the commentor to engage in fat shaming, the underlying question sparked my interest.
Heavily edited, the question was this:
“I understand how obesity can contribute to pain by putting stress on joints, but I don’t understand how the opposite can happen. Can you Please explain it to me and help me understand? How does Pain cause Weight Gain?”
To begin, the concept of “obesity” is widely misunderstood and is oppressive in and of itself. As a knowledgeable friend recently explained it – The word is based on the Body Mass Index scale (BMI) where the ratio of height and weight was determined and everyone who scored within certain parameters was considered as having a healthy BMI while anyone whose BMI was above this range was deemed obese. A person who had very little body fat, but was very muscled, especially in relation to their height, would be classified as obese. In fact, since muscle tends to weigh more than fat, a body builder is more likely to be classified as obese than what most people consider to be representative of an “obese” person.
The concept that obesity is synonymous with fatness is a misunderstanding that has become accepted as a standard, and is used by doctors to excuse their own medical negligence when it’s the result of internalized biases regarding fatness.
What’s more, more and more evidence suggests that body fat percentage is not actually a reliable indicator of an individuals health, nor is there actually a reliable standard as to what fat percentage can be considered healthy and which is unhealthy. That rather fat distribution and percentage is really just a variation in body type much the same way that shape, height, etc. are.
The attempt to pathologize fatness ultimately makes as much sense as claiming that a certain eye colour is an indicator of overall health. Contrary to popular belief, just being fat is not in itself unhealthy. A fat person can be just as healthy as someone who is considered slender. What is unhealthy is when there is a sudden significant increase or decrease of body fat percentage outside of regular growth and development. In the specific case of an increase in body fat levels, what is unhealthy is when it is spurred by malnutrition, stress, and immobility which in addition to spurring weight gain also have a measurable negative impact on blood pressure, blood sugar, and arterial plaque. Even in this case, it’s not the weight gain in particular that is of actual medical concern, but rather the specific effects on those measured stats.
The medically accepted myth that fatness all by itself is unhealthy is another example of the fallacy that correlation signifies causation. Additionally, this accepted fallacy has had significant impacts on our social understanding of body size and health.
A more accurate way to look at the connection between a high body percentage and pain would be that it can contribute to pain when an underlying problem exists, and when the specific individuals natural body fat percentage is significantly lower than what it is now. There are many people out there who are fat, who not only experience no pain whatsoever, but also have perfectly healthy stats.
In fact, the social convention of proper weight is so distorted, that the little abdominal bulge many women spend years trying to eliminate, is actually not the result of fat but is actually their internal organs pressing up against their abdominal wall.
Weight on it’s own, doesn’t cause pain. Rather, in an event that someone has an underlying condition that may cause pain, carrying more weight than their body naturally would under optimal conditions, can put additional stress on the injury site and make pain more intense. The impetus for the pain however, is still the initial underlying injury or condition.
What many ignore is that pain and its related symptoms can actually be the cause of accelerated weight gain and that the best way to address both is to treat the underlying cause of pain and to treat the pain itself.
How can this be?
Last year, I received one of the best gifts I’ve ever received. A kind family donated their departed matriarch’s wheelchair to me, after I had previously been told that my pain and inability to stand or walk far distances was not valid criteria to qualify for the accessibility device program.
Having access to the chair opened up worlds to me that I had long been unable to experience. I was able to go back into nature again, to explore my neighbourhood, my city, more thoroughly and comfortably. I was able to enjoy the outdoors more thoroughly than I had in years. I could even play Pokémon Go, without having to be the passenger in a slow-moving vehicle.
I met many of my neighbours and became an actual part of my community.
Although I was facing the fact that my marriage was falling apart, that I was facing even more financial vulnerability and hardship than I had already dealt with for the past seven years, I felt better about myself than I had in a long time.
I felt more a part of the world than I had before.
This year, I’ve been spending a lot of time building different things. I’ve had to start over in a lot of ways, and things are still shifting pretty dramatically for me. While things are unstable, it has given me an opportunity to learn how to do things I never really imagined possible.
Today I managed to see one project come to fruition. I built a Little Free Library (not yet registered in part because I can’t actually afford to) and it’s been installed at the Community Garden and Oven that I’m a member of.
The problem is that plastic straws are necessary for the survival of people with certain disabilities. Necessary for Survival. Without them People Will Die.
I wish I could say that that statement marked the end of the matter and the question of whether or not it is worth proceeding. Instead, what’s followed is endless weeks and arguments about whether we’re really sure that’s we will really actually die, and don’t we know that that doesn’t really happen.
While I’m not one of the people directly affected by this ban, I say we because while the specifics here don’t apply to me, I recognize all too well ALL of the arguments that showed up during the debates. They’re the same arguments I’ve faced whenever the subject of any disability accommodation comes up. These same themes form many of the backbones of systemic ableism. They are the arguments that are essentially used to excuse banning people from immigration on the basis of disability, the arguments against raising disability support payments, putting together socialized pharmacy care, building accessible housing, providing easy accessibility, and so on and so forth.
I’m back home and wanted to share some of the food I find only in Puerto Rico.
CN: talk of suicide, mourning a loved one
CN: mentions of suicidal ideation
For the last little while, I’ve been struggling quite a bit. I’ve been trying desperately to fix the situation I was left in last year. I’ve been just barely getting by with help from friends, by taking out more debt, and by surviving off of stores I’ve had sitting by just in case.
Rather than getting any easier however, things have just been getting worse. My roommate had to move to BC for work and while I was able to find someone to take over his room, the rental agency had issues with him replacing my former roommate on the lease. I couldn’t very well leave my old roommates name on it, and my own financial situation means they are not willing to have it be in my name alone.
As such, I had to give my notice for the end of summer.
I knew the rental situation in Ottawa had gotten worse in the years I’ve been living at this place, but even so I was unprepared for the reality I am facing. The rent costs have skyrocketed to such a point, where $300 over what disability considers a reasonable housing allotment gets me a room in a house with six other people, and I can forget about the house being accessible, meaning I have no idea what to do with my wheelchair, let alone how to be able to live in a place I can’t physically navigate.
Essentially, the way things stand right now, at the end of August I am homeless.
Cn: talk of consent, bodily autonomy, use of physical force to defend oneself