Fat Victims of Experimental Medicine

I have never agreed to be a subject in a medical experiment and yet for almost 10 years I was, completely unknowingly, a fat lab rat.  Doctors prescribed me experimental interventions over and over again.  Then to compound their error they told me that the interventions were proven to succeed and they blamed me when they failed. And there are millions more like me.

Today blog reader superbadgirl told me that her doctor’s office joined a multi-level marketing weight loss company and then tried to sell it to their patients as an office health initiative via a mass letter. In this program anyone can pay money to become a “certified health coach” overnight and start selling it, despite the fact that they don’t have a shred of evidence showing that most people will lose weight or become healthier in the long term.

A couple days ago a friend was lamenting how her life might be different if she hadn’t been put on her first diet at 7 years old and continued to cycle diet at her doctor’s recommendation for 20 years, knowing now that the research shows that the earlier and more often you diet the fatter you are likely to become.

The government is considering requiring fat people to undergo intense counseling as a health intervention despite the fact that they admit “the panel acknowledged that one problem with its recommendation was that no studies have shown such intensive programs provide long-term health benefits.” (That’s ONE problem?  Besides not working, what other problems are there?)

What these things have in common, along with every recommendation of weight loss to make someone healthier or thinner, is that they are experimental medicine.  Weight loss interventions do not meet the criteria for evidence-based medicine – they are experimental at best, and could be considered to be contraindicated since studies show that the most common outcome of a weight loss attempt is actually weight gain.

Setting aside the evidence that weight and health are two different things and that habits are a much better determinant of health than body size, in order to show success by their definition those promoting weight loss would have to have statistically  significant studies in which a majority of people moved from what they consider an “unhealthy” weight to what they consider a “healthy weight”, and improved their health outcomes over the long term.  They are not even close on any count – studies show that almost nobody loses weight long term, there are no good studies that show that those who manage to lose weight over the long term have better health outcomes than fat people who practice healthy habits, mostly because not enough people have maintained long term weight loss to get a study together. There is no evidence basis for weight loss as a body size intervention or as a health intervention.

This is made worse because it’s combined with a lack of informed consent.  You can practice experimental medicine but you aren’t supposed to do it while telling the patient that it’s a proven solution. If a cancer treatment has a 5% success rate and 95% of people have the cancer come back and 60% of those people’s cancer gets worse then it is unethical to tell a patient that everyone who tries hard enough cures their cancer via this treatment and to say nothing about the astronomical failure rate or dangers.

Of course this is made highly problematic in that doctors often consider fatness to be a disease state when it is actually just a body size that has been linked to diseases.  Baldness has been linked to heart disease but that doesn’t mean we declare baldness a disease insist that bald men try to grow hair to help prevent heart attacks.  That wouldn’t work since it turns out that neither causes the other – both things are  likely caused by a third factor (hormones, heredity etc.) so giving a bald man hair plugs will, unsurprisingly, not reduce his heart attack risk. Changing someone’s appearance to attempt to mitigate health problems is a generally bad idea.

Since there are not fat-person-only diseases, and since we have actual evidence-based treatment that we give to thin people for all the diseases that people try to link to obesity, there is no reason to experiment on fat people by rolling the dice that they can be in the 5% who lose weight long-term and then hoping against hope that being thin will make them healthy.  We don’t need healthcare Vegas style  – we can just give fat people the same interventions that we give thin people, and use the same health measurements that we use in thin people to see if it’s working.  Duh.

The interventions that are part of the war on childhood obesity are making an entire generation of kids into lab rats.  Fat kids are being lied to about the likelihood of behavior changes leading to weight loss so they are dieting like they’ve never dieted before which may be why hospitalizations for eating disorders in kids under 12 are up 119%.  Thin kids are being lied to – given the idea that their body size makes them automatically healthy, but seeing their fat friends become combatants in the First Lady’s war makes them terrified of being fat so they are dieting too so maybe that explains the rise in eating disorders and kids who say they’d rather lose an arm than get fat.  Almost all kids are having supposed health aka “anti-obesity” interventions foisted on them with no more proof of safety and efficacy than I have that giving every kid a pony will make them healthy.

I think it’s time to say “Enough.”  Fat people are not lab rats, our fatness does not make us diseased, and we deserve evidence-based medicine and informed consent, including the ability to refuse to participate in experimental medicine – and we don’t have to wait for the world to give it to us, we can demand it right now.

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Published in: on October 2, 2012 at 10:46 am  Comments (18)  

18 CommentsLeave a comment

  1. (TRIGGER WARNING for numbers!)
    I swear you can read my mind sometimes, Ragen! Just earlier today I was remembering the first time a doctor intervened with my weight. (Granted, I asked him to.) I was 19 years old, 5’5″, and 150 lbs. He prescribed me phentermine. I was just a freakin’ kid, only 20 lbs “overweight” at most according to the doctor’s charts and the guy wrote me a prescription for SPEED. Three years later I was being checked into the hospital for severe bulimia. I really wish health care providers would educate themselves about the facts when it comes to weight and health because they are doing serious and lasting harm.

    • Ugggh, that’s awful! I’m sorry that happened to you.

      • I am sorry about that too! How irresponsible of that doctor!

        A friend of mine was put on phentermine at age FOURTEEN! She was perfectly active and healthy (normal cholesterol, blood pressure, organ function), physically able to play basketball and everything else she wanted to do. But her doctor decided that some excess weight was unhealthy and put a fourteen year-old girl on speed.

  2. I know this one very well indeed. My mother transferred her own body issues to me as a young child. Because I looked like my father, she thought I would be big like him. When I was 8 years old my mother had my pediatrician prescribe amphetamines to make me loose weight. Every few weeks she was putting me on another diet that was popular at the time. Because of the judgement and criticism I faced I was forced hide what I ate, and turned to the very thing she hated (food) for both comfort and in rebellion. Even today, she still projects her issues on me. I have had to forbid her to use the word diet in my presence and even in the presence of my children and grandchildren. She has never learned that this does not work, It destroyed our relationship, and my metabolism.

    • That is the saddest part of this obession with thinness is that it has destroyed your relationship. Doesnt get any worse than that. Im so sorry. I have ‘fear’ when I talk to thin friends as I am close to the ‘no diet talk’ zone and it may cause problems. Whatever, right?

    • [Note for disordered eating.]

      My mother transferred her own body issues to me as a young child.

      Ah, I see that your mother has met my mother. (Or, really, I’m sure this is a very common issue for mothers and daughters.) My face looks like my mom’s side of the family, and my personality takes after that side as well — but my “oh, I will just heave that thing effortlessly over my shoulder” body frame takes after my dad’s side of the family.

      So I really think that what happened was this —

      My mom has a naturally smaller frame along with some mood/MI-related binge eating issues (for which health care providers recommended restriction). Though this is not true for everyone with the same issues, her body tended to gain weight when her binges were more frequent.

      Even growing up, I reminded my mom of herself. Except, even at its smallest, my body frame has always been wider than my mom’s.

      So she may well see my body as her body plus XX(X) pounds — and therefore assume that: 1) my body size should be her body size (or her desired body size); 2) that my body size does not fit her first criterion is evidence that I am eating too much and therefore should diet.

      Which, the first is not a valid assumption, and even if it were, the second is not an appropriate treatment. All that led to me having my own cycle with disordered eating patterns, and — like you — setting some subjects as off limits for discussion. (My sister also had a similar experience — while that’s not good in itself, it does mean that the two of us are on the same page with our mom, which makes the enforcing of said boundaries easier.)

  3. Wow these are some horror stories. Have doctors offices or these programs been confronted about this – how how it’s not proven to work or they are experimenting on patients without their consent? I wonder what they would have to say for themselves.

    • I’ve raised the issue. Mostly the response has been, “AHAHAHAHAHAHAHA**, get out of your denial and just lose the weight for your own good. You want it for your health, don’t you?”

      At which point — because I have multiple health issues and cannot afford to be without a primary care provider — I switch providers, remembering to follow up with a complaint to their practice if I can. No one has ever contacted me regarding said complaints.

      ** Okay, to be fair, providers have only actually LOLed at me maybe 5 times or so. Still and all, that is 5 times too many.

  4. What gets me is the same people who would advocate for programs like these (because, “fatties, gross!”) are the same folks who would deny the efficacy of HAES or other “alternative” i.e. natural medicines because… wait for it… they’re “experimental.” And also disagree with their world view which, apparently, values people based on the size of their body rather than their capacity for kindness.

  5. Dang it Ragen, You are such a good writer and can make your point so well. Have you sent your articles to magazines and such? Im sure it would be hard as their advertisers tend to be ‘diet’ based. I wish I had an answer for you on how to do that but if you havent done it yet, please do so. Even a local paper or a home owners assoc. newsletter and small newsletters are a good start. Your book and this blog nails it!!! Thank you so much. Marla

  6. “the panel acknowledged that one problem with its recommendation was that no studies have shown such intensive programs provide long-term health benefits.” (That’s ONE problem? Besides not working, what other problems are there?)

    “Other than that, Mrs. Lincoln, how did you enjoy the show?”

  7. Here’s a wonderful response to fat-bullying, from a news anchor – amazing.
    http://video.news8000.com/watch.php?id=36335

    • Awesome video! Thanks for posting the link.

    • I saw this today as well and am even more thrilled because she lives and works right here in my community. I see her as kind of my local TV role model.🙂

  8. You rock, Ragan.
    And all my Brothers and Sisters who’ve survived diet fiascos… I am sorry that we endured them at the hands of our health care providers, parents, teachers… Let’s hope that our voices can have some impact on helping the next generation.

  9. Hey Ragen, my blog changed servers, and the updated link to that post about the letter from my doctor is http://x.superbadgirl.com/blog/2012/10/01/gotta-letter-from-the-doctors-office-the-other-day/

    (I saw in my site stats a few people tried to access it.)

  10. Ive missed your blog. I have changed emails and have been trying to get back to you. will see what happens this time


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