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From: [e-mail] (Sharon)
Newsgroups: soc.support.fat-acceptance,alt.support.big-folks,alt.answers,soc.answers,news.answers
Subject: Big Folks Health FAQ
Followup-To: soc.support.fat-acceptance
Date: 8 Jun 1998 11:33:51 GMT
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Summary: This posting contains a list of Frequently Asked
        Questions (and their answers) about health as it relates to
        large people.  Discussion on these topics goes on in
        soc.support.fat-acceptance and alt.support.big-folks.
Xref: senator-bedfellow.mit.edu soc.support.fat-acceptance:41258 alt.support.big-folks:40105 alt.answers:34597 soc.answers:9959 news.answers:131988

Archive-name: fat-acceptance-faq/health
Posting-Frequency: monthly to *.answers, bi-weekly to
        soc.support.fat-acceptance and alt.support.big-folks
Last-modified: January 2, 1997
Version: 5.1

        Frequently Asked Questions (FAQ) about Health and Fat People

This document contains information about health issues for fat people.
If you don't find what you're looking for
here, try one of the related FAQs (see question B1 for a complete
list).

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Recent Changes:

Added a topical (as of Jan 1998) interesting article from the
New England Journal of Medicine, see section A7.

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Contents

SECTION A:  FAQ about health for fat people

A1)     How healthy or unhealthy is fat *really*?

A2)     What advice do you have on dealing with doctors?
  A2-1)      What if the doctor says my problem is weight-related?
  A2-2)      What if the doctor wants to weigh me?
  A2-3)      Is there any special equipment for large people?

A3)     What is BMI?

A4)     What research exists on fat people and health?

A5)     What specific information is there about fat people and
  A5-1)      Anasthesia
  A5-2)      Arthritis
  A5-3)      Blood Pressure
  A5-4)      Cancer
  A5-5)      Diabetes
  A5-6)      Exercise
  A5-7)      Fertility
  A5-8)      Gallstones
  A5-9)      Gout
  A5-10)     Heart Disease
  A5-11)     Hiatal Hernia
  A5-12)     Menstruation
  A5-13)     Osteoporosis
  A5-14)     PCOS
  A5-15)     Plantar Fasciitis
  A5-16)     Pregnancy
  A5-17)     Sleep Apnea
  A5-18)     Thyroid Problems
  A5-19)     Varicose Veins
  A5-20)     Yo-Yo Dieting

A6)     Are there any health advantages to being fat?
  A6-1)      Diseases less prevalent amongst fat people
  A6-2)      Diseases where fat people have a better prognosis

A7)     Are there any informative web pages on health for fat people?


SECTION B: Information about this FAQ

B1)     Are there other related FAQs?
B2)     Posting information
B3)     Availability of the FAQ
B4)     Contributors

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SECTION A:  FAQ about health for fat people

A1)     How healthy or unhealthy is fat *really*?

In short, it's very difficult to tell. Filtering out what is real
risk or benefit from the over-exaggeration and prejudice is tough.

For example, there is the common view that going to the gym and lifting
weights is healthy, but when considering fat people who do this
permanently, the common attitude is that it is unhealthy. It's
difficult to see objectively the health benefits of being fat against
the health risks, and these may vary a lot with the individual.

Being fat does *not* automatically mean that one is unhealthy.

A clearer way to examine the risks is to look at the research. Even then,
care must be exercised. There are many studies that show correlations
(positive and negative) between many diseases and obesity. But correlation
is not the same as cause. Obesity may cause disease X or disease X may
cause obesity, or a third factor could be causing them both.
Obesity may exacerbate or hurry the onset of an illness that would have
happened anyway.

To examine how healthy it is for you to be at a certain weight, don't
just consider what health risks you may have at that weight, but also
consider the effort (and mental happiness) required to change weight,
and the effort required to maintain that new weight, the probability
that you will rebound to your original weight, the health risks included
in the weight change and possible rebound, and the health risks at
the new weight (if you manage to stay there - it's difficult to maintain
a weight larger or smaller than your body naturally wants to stay at).
You might well conclude that you'd be happier and healthier not concentrating
energies on weight change.

It is unproven that losing weight increase longevity.

One anecdote from a.s.b-f even mentions how being fat saved one guy's
life. He was on his bike, hit by a car, and thrown some distance into
the street. Passersby thought he was dead, but he had only bruises, and
it was his fat that saved his life.

"But I've heard that obesity gives you a 1200% greater risk of dying!"
No, everyone has a 100% chance of dying. The figure comes from a study
where 200 obese men were put on a diet for two years, and regained the
weight. The number of men in the 25-34 age group who died during the
follow-up period was 12 times the expected number for men of this age.
Draw your own conclusions as to what the risk was - the reference is
in the Research FAQ, [DBSJ].

See the new Research FAQ for relevance references about obesity and health.

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A2)     What advice do you have on dealing with doctors?

The first and most important thing to remember when dealing with
doctors is "You are the customer."  If they do not treat you with
respect or do not treat you as an adult or keep pushing you to lose
weight when you have explained that this is not an option, take your
business somewhere else.  If necessary, walk out of their offices.
And don't pay for services not rendered.  If they won't treat the
problem you are there for, don't pay them money.

With that said, there are good doctors who are not fat-phobic.  It's
probably worth the hassle of looking around for one.  Ask your friends
which doctors they like.  Interview doctors before making an
appointment with them.  Tell them that you are a large person and
that you are not interested in losing weight.  Ask them what they
think about large folks, dieting, and so forth.

If you've had a history of dieting, and a doctor is recommending
weight-loss, then you might wish to say something along the lines of
"Let me tell you what happened to me before....do you really want me
to go through that cycle again?".

A fantastic new resource for fat folks in the US is the
Fat Friendly Health Professionals List. This is maintained by
Stef Jones, and available at http://www.bayarea.net/~stef/Fat/ffp.html.

  A2-1)      What if the doctor says my problem is weight-related?

What can you do if your doctor tells you your problem is
weight-related and the only way to treat it is for you to lose weight?
If this is clearly not true, i.e., you are there for a sinus
infection, you probably want to find another doctor.  If it is
possibly true, ask them, "Do you mean to tell me that thin people
_never_ have this problem?"  You are not being obstinate by asking
this question.  Losing weight is an incredibly energy-intensive
process.  Losing weight and keeping it off is even more so.  If
there's any other way to treat whatever condition you have, you want
to find it.  Besides, being heavy may contribute to your condition.
But there are probably other factors that contribute as well.  After
all, it is not true that every single fat person in the world has
whatever problem you do.  So start with the other factors, and see if
they help.

An example.  Say your feet hurt all the time, and your doctor tells
you you need to lose weight to fix it.  Ask your doctor, "Do you mean
to tell me that thin people's feet _never_ hurt?"  Your doctor will
probably admit that some thin people's feet hurt.  "And what do
you do for thin people whose feet hurt?" you ask.  And your doctor
will tell you about analyzing how they people walk (to see if they're
doing something weird), and applying contrast baths, and getting
orthotics and whatnot.  And then you tell your doctor that you would
like those same things done for you.

  A2-2)      What if the doctor wants to weigh me?

What about getting weighed at the doctor's office?  There's usually no
need for you to be weighed at the doctor's office if you don't want
to.  Doctors want to weigh you every time you come into the office for
two reasons.

First, they want to keep track of whether you've had any sudden
changes in weight, as this is generally a bad sign.  Sudden changes in
weight up or down should be reported to your doctor.  (Even if you
don't weigh yourself regularly, you'll probably notice significant
weight changes because your clothing will fit differently.)
Unfortunately, some doctors assume that any loss of weight for a large
person is positive.  If this happens to you, explain to them that you
were not dieting and this is not usual for you, and make them look
into it.  Also, some doctors assume that weight gain by large folks is
simply evidence that they're eating too much.  Again, insist that this
is not the case, and insist they run tests for conditions that could
cause it.

Second, they want to know your body weight so they can prescribe the
correct amount of drugs.  However, almost no drug scales linearly with
weight, and the dosages for most drugs don't depend on weight at all.
If it turns out they need to prescribe you one of the few drugs that
they do prescribe differently for different weights, they can weigh
you then.  Or they can ask you how much you weigh, if you know.

So whether you get weighed in a doctor's office or not is totally up
to you.  Some people on a.s.b-f don't get weighed because they think
it is unnecessary, they want to head off possible lectures, or they
don't want to know what they weigh.  Other people on a.s.b-f think
that being weighed is no big deal, provides the doctor with useful
information, and they do it without a fuss.  How the people in the
doctor's office react if you refuse to be weighed may be a good
indicator of how a large patient will be treated in that office.  If
they are not open to being educated, you may want to find another
doctor.

If you are being weighed, and you have an idea of what you weigh, you
may want to set the scale to the correct numbers yourself, rather than
weighting for the person weighing you to slowly increment the scale.
If you don't want to know what you weigh, there's no need to look at
the numbers on the scale.  Look in the scales section in the Big Folks
Resources FAQ for how to be weighed if you're heavier than the highest
number on the scale.  (People in doctor's offices should know how to
do this, but a surprising number don't.)


  A2-3)      Is there any special equipment for large people?

Large-size blood-pressure cuffs:
It is vitally important that they use large-size blood pressure cuffs,
since conventional-size cuffs give high blood pressure readings when
they are used on large arms.  It may also be possible to measure blood
pressure in the radial or ulnar artery -- use a regular-size blood
pressure cuff but put it on your forearm, rather than your upper arm.
It's apparently harder to hear, but it can be done.

Large-size gowns:
Several suggestions. If they don't have them, you could try two
gowns, one on the front, and one on the back. They might make you
a little hot, but will preserve modesty.
If you're nifty with a needle, you could make your own, or you
might be able to buy one.
An ad in the Spring '95 issues of Radiance declares:
Supersize Hospital Gowns - Don't get caught without your own.
Check/M.O. for $30 to NAAFA Feminist SIG, c/o Lynn Meletiche,
2065 First Ave., #19-D, Dept. RM, NY, NY 10029, USA [phone].
Allow 4-6 weeks for delivery.
Alternatively, try (again, in the US)
NAAFA, P.O. Box 188620, Sacramento, CA 95818, tel. [phone] (Mon-Thurs).

MRI (magnetic resonance imaging) machines:
There do exist open-sided machines, where only the head slides under the
mechanism. These are for people that are large or claustrophobic. You
might need to call around to see where this service is offered.
Alternatively, depending on what you need the machine for, it might be
possible to look at your body in other ways, for example a CAT scan.
The Philips Medical Systems' Gyroscan T5 is designed to
handle patients up to approximately 500 pounds and is in use in many
hospitals around the US. Give them a call and they can tell you the
location of the nearest hospital that has one.
Their number is [phone].

Also see the scales section in the resources FAQ for how to be weighed if
you are heavier than the highest number on the scale.

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A3)     What is BMI?

BMI stands for Body Mass Index and is a common rough measure of
how relatively large a person is (you may come across it in the
literature).

To calculate your own BMI, divide your weight in kilograms by the
square of your height in metres.

1 kilogram is 2.2 pounds
1 inch is 2.54 centimetres

Obesity is usually defined to be a BMI of 30 or more.


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A4)     What research exists on fat people and health?

See the Research FAQ for many studies on fat people and health that
seem relevant. References in this FAQ are to the Research FAQ.

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A5)     What specific information is there about fat people and

Specific information (collected so far):

  A5-1)      Anasthesia

For years, fat people used to be denied surgery until they lost weight.
When weight-loss surgery came along, anesthesiologists had to figure
out how to anesthetize fat people.
The problem was that common anesthetics are absorbed by fat tissue,
so a higher dose is needed to anesthetize a fat person (although
not to maintain anesthesia). Nowadays much more is known about
anesthesia for fat people and it is much safer.


  A5-2)      Arthritis

There are two main types of arthritis, rheumatoid arthritis and
osteoarthritis. Osteoarthritis is joint-specific, and involves damage
to the cartilage of the joint and inflammation at that site,
along with pain, stiffness, yucky grinding noises and sensations,
and the like.

There is a correlation between being fat and being arthritic. People
do have a tendency to gain weight after getting arthritis, and conversely,
there are several long-term studies which show that fat people are more
likely to go on to develop arthritis, after starting out healthy.
Arthritis of the knee is the only disease that can be conclusively linked
to increased weight per se.

Obesity is positively correlated with osteoarthritis, weight-bearing
and non-weight-bearing joints [VVVV]. It is not known whether obesity is
a risk factor, or whether there is an unestablished risk factor
affecting both [Fel+].

  A5-3)      Blood Pressure

Having high blood pressure is not a disease in itself, but a condition
that is a risk factor for such diseases as strokes and heart attacks.

Obese people are more likely to get high blood pressure. However obesity
does not exacerbate high blood pressue (if you were going to have high
blood pressure anyway, being fat isn't making it worse). And in fact
a fat person with high blood pressure is less likely to get a stroke
or heart attack than a thin person with high blood pressure.

High blood pressure can be easily controlled by taking medication.

  A5-4)      Cancer

A quote from [GW]:
"Certain types of cancer appear to be more common with obesity (e.g.
obese women have higher rates of gallbladder, biliary duct, endometrial,
postmenopausal breast and cervical cancer; obese men have higher rates
of colon and prostate cancer). But obesity appears to protect against
overall cancer death and against death from specific cancer types that
are the leading causes of cancer death (e.g. in women, premenopausal
breast, lung, stomach, and colon, and in men, lung and stomach"

There have also been several anecdotes in a.s.b-f about how fat can
protect against cancer.

Relevant references include [EH], [NRC], [Wil+].


  A5-5)      Diabetes

In a person with diabetes, the pancreas' production of insulin is
affected, which in turn affects the regulation of the level of sugar
in the blood. There are different types of diabetes. The bodies of
people with Type I diabetes produce no insulin, whereas people with
Type II diabetes do some produce some insulin, but it is either not enough,
or defective.

Type I diabetes is less common in larger people; Type II diabetes is
more common in larger people. Most diabetics are Type II. The disease
is also genetically linked, and affects and is affected by weight.

The Pima Indians have the world's highest incidence of both fatness
and diabetes. However, the Pima women with the longest life spans
are 200% of "ideal" weight, and the men 145%.

Treatment concerns the regulation of insulin levels; this can sometimes
be done with injections and sometimes by a combination of exercise and
diet (whatever the diabetic's weight):
regular activity causes the muscles to use glucose, and counteracts the
problem to some extent irregardless of weight loss. Dividing total
caloric intake into a larger number of smaller meals also helps to
avoid overtaxing your regulatory system.

If you get diabetes, you owe it to yourself to find out as much as
you can about it, and your body's particular version of it. It is
a serious disease that needs careful control, as it is associated
with greatly increased risks of cardiovascular disease, strokes and
other diseases.

There is a mailing list for fat diabetics and hypoglycemics who are
looking for a place to discuss their condition and their lives in a
fat-accepting atmosphere. To get information about this list, send an
email to [e-mail] with the content: info fa-diab


  A5-6)      Exercise

Exercise is beneficial to the health of everyone, be they fat or thin.
See for example [Bla+].
It increases flexibility and mobility, provides more energy and muscle
tone, and can help to keep blood pressure at normal levels.
Also see the FAQs on Fitness Resources, and Sports and Activities, for
exercise tips for exercising as a large person.


There is a mailing list for those who wish to discuss fitness and
healthy eating in a size-accepting atmosphere. Discussion of weight loss
for the sake of health is allowed, but it is not assumed you want to lose
weight. To subscribe, send mail to [e-mail] with
the content SUBSCRIBE FATANDFIT (your name).


  A5-7)      Fertility

A common misconception is that fat women are often infertile and/or
don't get their periods. If you are having trouble getting pregnant, have
a doctor try to figure out what is going on.  Lots of other fat women have
become pregnant; almost certainly, a woman who is fatter than you has become
pregnant.  There are lots of reasons that one might not become pregnant
immediately.

A reference is [Zaa+], which
found that a larger waist-hip ratio had a negative impact on fertility
in women. Average-size and obese women had similar conception rates, but
underweight and very obese (BMI > 38) women were slower to conceive.


  A5-8)      Gallstones


Gallstones are formed from bile crystallizing in the gall bladder.
These are very common; many people have them without realising it,
and without them causing any problems.

Problems can be caused when stones get stuck in the bile duct,
possibly blocking the liver, and this causes pain, in the form
of gall bladder attacks.

Risk factors that can make one more suspectible to gall bladder
attacks are: femininity, obesity, stress and crash dieting.
The function of the gall bladder is to digest fats, and on a diet
very low in calories there is not much fat to digest, and so the
gall bladder is not used much, and so the bile can more easily
crystallize, forming gallstones. A quote from [CS]:
"During rapid loss of weight in obese persons, biliary cholesterol
saturation increases consistently and in about 50% of patients leads
to formation of cholesterol crystals or gallstones..."

The standard procedure when someone is experiencing repeated
gall bladder attacks is the removal of the gall bladder. This can
either be done by full abdominal surgery, or by laser surgery
(the technical term is laparoscopic cholecystectomy).
The laser surgery standardly involves a general anasthetic, and
a small number of incisions. The incisions are small so there are
no stitches or staples, just butterfly sutures.

Some doctors are reluctant to recommend laser surgery for large folks,
although some big folks have had the surgery without problems.

From anecdotes on the newsgroup, most big folks were enthusiastic about
the laser surgery and much better after it, some recovering very quickly,
others taking a little longer. Some had standard abdominal surgery and
were happy with that option. One was unhappy with the laser surgery,
and one was still having problems after the surgery.

  A5-9)      Gout

Gout is caused be an excess of uric acid in the blood, and it crystallizes
at the joints of the legs and ankles, thus causing inflammation.
The cause of the excess is not known, but there is a hereditary
component. Precipiating factors include rich foods, alcoholic drinks,
a high fat diet, and inadequate exercise, but they are no more than
precipitating factors. The disease can occur in vegetarians and
teetotallers. Fatness as an independent factor is not known to have
any effect.

  A5-10)     Heart Disease

Some studies show that heart problems are more prevalent in fat people.
This is connected to the fact that high blood pressure is more prevalent.
There are studies (trying to find references for these) that look at the
risk factors for heart problems that find no relation to weight,
after controlling for the effect of smoking, cholesterol levels and
blood pressure.

References mentioned in the reference section have mixed results.

   [Wil+] finds no link between BMI and heart disease.
   [Man+] reports that obesity and weight gain is associated
   with an increased incidence in coronary heart disease.

There also are studies indicating that cardiovascular risk factors decline
with weight loss (eg [Blo+]) and increase with weight gain (eg [AK]),
but there are few studies that indicate mortality risk is reduced with
weight loss, and there are some indeed that suggest that weight loss leads
to an increased mortality risk. e.g. see [HG]

Of interest might also be [DBSJ], which is primarily concerned with
very low calorie dieting, but some of the deaths of the men concerned
were from heart disease.


  A5-11)     Hiatal Hernia

A hiatal hernia can be 2 types, sliding or paraesophageal.
Sliding is more common.  In obese persons, especially older persons,
the hiatal area is more relaxed and stretched.  A piece of the
esophageal junction (part of the esophagus) slides up
over the diaphragm with a portion of the stomach.  The sphinter that
closes off your esophagus functions poorly, and gastric juices
reflux (back up) and causes heartburn. This gastric juice reflux
leads to esophagitis (swelling and inflammation) and can cause a
stricture or narrowing as scarring takes place.

Early treatment includes a bland diet, antacids, weight reduction,
and sleeping in a semi-sitting position to control reflux.  More
drastic treatment for severe cases include surgery to repair the
esophageal junction and replace it below the diaphragm.

  A5-12)     Menstruation

Body fat can have an effect on menstruation, in particular because
estrogen is produced by fat cells (as well as from the ovaries). Very
thin women (e.g. anorexics or very fit athletes) tend to stop ovulating
because their production of estrogen is low due to the lack of body fat.

In contrast, fat women have plenty of estrogen. In very obese women,
this can play havoc with the menstrual cycle, either lack of
menstruation, or irregular menstruation. For regularizing menstruation,
where pregnancy is not required, oral contraceptives may prove useful.
If pregnancy is required, there are drugs or hormones that can be
taken to help normal egg production.

  A5-13)     Osteoporosis

Osteoporosis is a disease weakening the structure of the bones, and is
usually throughout the skeleton (though some bones may weaken faster
than others). Bone minerals are gradually lost and the bones turn
brittle.

Dieting and improper nutrition during fitness training are positively
correlated to osteoporosis (that is, people who diet are more likely
to get it). Obesity is negatively correlated to osteoporosis;
it is thought to be attributed to both mechanical factors (the
weight-bearing helps strengthen the bones) and the estrogen from fat.
See [RTP].

  A5-14)     PCOS

PCOS stands for Polycystic Ovarian Syndrome. It is called a syndrome
as it characterized by a collection of symptoms, and it is not well
understood what causes it.

Symptoms include:
thinning hair, obesity, adult acne, excess facial hair, irregular cycles,
brownish skin on the back of the neck, tiny "skin tags", infertility,
diabetes, hypertension.

It affects only women (obviously), about 6% of all women. You don't have
to be obese to have PCOS. PCOS promotes weight gain and is a symptom
rather than a cause. The irregular periods are caused by (and contribute
to) an excess of androgen hormones in the body.

PCOS is diagnosed in several ways, including a blood test, or through
sonogram or a laporascopy. By looking at pictures of ovaries, the doctor
can tell if there are cysts on the ovaries.

With PCOS, ovulation is not occuring regularly, but egg development is.
Thus as eggs develop but are not released, the problem snowballs as
each unreleased egg forms a cyst, and as these build up, these can
prevent further eggs from escaping.

The American Journal Of Medicine published a symposium on PCOS:
"Androgens and Women's Health", Volume 98(1A) Jan 16, 1995

Further information can be found from the PCO page at
http://www.prairienet.org/~eah/pcopage.html

There is also a recently formed newsgroup alt.support.pco, and a
mailing list at [e-mail] (open to both men and women,
anyone with an interest in the condition).

  A5-15)     Plantar Fasciitis

The plantar fascia is a muscle along the underside of the foot, and
if it gets inflamed it can cause heel pain. This usually manifests
itself as pain at the front of the heel, when getting out of bed in
the mornings and also after sitting down for a while.

Being large is a risk factor for plantar fasciitis, with a greater
proportion of fat folk having it than in the population in general.
However this is not a fat person's disease; the primary risk factor
is from being athletic and there are plenty of thin active folks with
this disease. Also having flat feet is a contributing factor.

There are various treatments. The most simple (and usually very effective)
include special stretching exercises, rest, heel lifts, shoe inserts,
ice, massage. If those don't work, other options such as night splints,
orthotics, injections, weightloss and surgery could be tried. Medication
and surgery are definitely the last resort.

Take care not to go barefoot, or just in stockings/socks. Also, do not
bound out of bed in the morning. Give the blood a chance to go to
your feet first. If you exercise a lot, you might want to consider
changing to non-weight-bearing exercise, like cycling or swimming.

Go to a podiatrist, and sort it out early before it gets worse
as time goes on.

Scott Roberts' excellent web page on plantar fasciitis
at http://www.mindspring.com/~scottr/foot.htm is a very good source of
further information.

  A5-16)     Pregnancy
   or...       What should I know if I'm fat and pregnant?

Some doctors advise their patients to lose weight before attempting to
get pregnant.  Other doctors simply recommend that patients maintain a
stable weight for the last year or so before attempting to get
pregnant.  Given how difficult it is to lose weight and maintain it
(especially when you are trying to eat well and you have morning
sickness), the second option is probably more sensible.  Many large
women (including some who post to a.s.b-f) have had babies without any
problems.

You may not gain as much weight over the course of your pregnancy as a
thin person might.  However, it is a very bad idea to deliberately try
to lose weight, or deliberately try not to gain weight, while you are
pregnant.  The baby can't get all the nutrition it needs from your fat
stores, and it needs the same amount of food as the baby of a thin
person. Large women are more at risk for inadequate weight gain during
pregnancy [GSK].

Your doctor should run frequent checks for gestational diabetes, but
they should be doing this for all their patients.

In general, most of the suggestions about dealing with doctors
(above), apply to dealing with your ob-gyn when you're pregnant (or
trying).  Insist on being treated as a full person.

Some common misconceptions:

* It's hard to do an ultrasound on a fat woman, so you have to press
  really, really hard.
        An ultrasound technician may have to press firmly to get a
        good picture.  But ultrasound should not hurt.  If the
        technician hurts you, tell them to stop, and tell them to find
        another technician (or your doctor) to do the ultrasound
        correctly.

* You can't hear the heartbeat of a fat woman's baby (or see its
  picture on ultrasound or whatever) at the same time as you can do
  these things for thin women's babies.
        Have them try.  They may be surprised.

Another generally friendly and knowledgeable resource is
misc.kids.pregnancy.  You may want to check them out.

See the conception and pregnancy section in the Research FAQ for
further information. Also the Large-size Maternity Resources FAQ run
by [e-mail]  has a lot of information. You can find this
and more information at the Plus-size Pregnancy Web Site, which is
at http://www.vireday.com/~rvireday/plus/.


  A5-17)     Sleep Apnea

"Apnea" means "lack of breath".  It occurs during sleep, when the
throat closes off and shuts the airway, and the lack of breathing
can go on for quite a long time. Since the person is getting little REM
sleep, he or she is often very tired during the day, to the point of
nodding off. Lack of energy and concentration, morning headaches,
and vivid dreams are other symptoms.

The condition occurs mostly in heavy middle-aged men; however,
after menopause, almost as many women have it in the same age
group.

Average weight people can get sleep apnea too, however weight can
contribute to the condition, as excess tissue in the airway causes
obstruction, and excess weight can lead to that. It is true that
sometimes losing as little as 20 pounds can alleviate the condition,
but there are other ways of treating sleep apnea, such as a CPAP
machine.

There are a number of sites on the internet for this condition. Check out
alt.support.sleep-disorder, and the Sleep Medicine home page on
Obstructive Sleep Apnea (URL http://www.cloud9.net/~thorpy/ )

  A5-17)     Thyroid Problems

The thyroid gland is located in the neck, just below the Adam's apple.
This produces thyroid hormone. Too much thyroid being produced
is hyperthyroidism; too little is hypothyroidism.

Symptoms of hyperthyroidism (not all are necessarily experienced)
include weight loss, a fast pounding heartbeat, frequent bowel movements,
inability to sleep, nervousness, muscle weakness and fine tremors
of the fingers and tongue.

Symptoms of hypothyroidism (not all are necessarily experienced)
include weight gain, tiredness, depression, feeling run-down,
skin/hair/nails may grow more slowly and be more brittle, constipation,
anemia, fatigue, loss of appetite, irregular or absent menstrual periods,
swollen ankles, puffiness about the face, elevated cholesterol and, possibly,
hypertension. To put it succinctly, the metabolism is just not working
fast enough.

Thyroid problems are fairly common, but not everyone with them has
been diagnosed. It is estimated that at least 6 or 7 million Americans are
hypothyroid. Hypothyroidism is 4 times more common in women than in men.
Although a small proportion of large people do have thyroid problems,
not every large and/or tired person has a thyroid problem.

Diagnosis of hypothyroidism is by a simple blood test, and treatment
is with tablets of levothyroxine, a synthetic thyroid hormone.

More information can be found on-line, for example at the on-line service
provided by the Santa Monica Thyroid Diagnostic Center
(URL is http://www.thyroid.com/ ).

  A5-19)     Varicose Veins

Varicose veins are those that bulge out. They are hereditary, but can
be exacerbated by excess pressure, eg high weight, constant standing
(nurses and waitresses are notorious for them) and pregnancy.
They do not go away if you lose weight, although if you do lose weight,
it might (or might not) stop more from forming.

There are surgical and non-surgical ways of getting rid of them.
The most common nonsurgical way involves injecting a saline solution
into the vein.  It then closes up (the blood flow goes through other veins).
You then have to wear a bandage around it for six weeks or so, so that it
doesn't pop out again.
Support stockings may help comfort-wise, although they might not
prevent more from forming.


  A5-20)     Yo-Yo Dieting

Some relevant references include [EH], [DBSJ], [NE], [Hay], [Ha+].
Particularly the second, as it's often cited (wrongly) as a study showing
the dangers of obesity.


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A6)     Are there any health advantages to being fat?

These lists are taken from [EH]:

  A6-1)      Diseases less prevalent amongst fat people

Anaemia
Atherosclerotic renal artery stenosis
Bronchitis (chronic)
Cancer:
     overall incidence,
     overall mortality,
     colon cancer,
     lung cancer,
     pre-menopausal,
        breast cancer,
     stomach cancer,
Diabetes type I
Eclampsia
Hip fracture
Hot flashes
Infectious diseases (overall fatalities)
Intermittant claucidation
Meningioma
Mitral valve prolapse
Obstructive pulmonary disease (chronic)
Osteoporosis
Peptic Ulcer
Premature birth
Premature menopause
Reno-vascular hypertension due to fibromuscular hyperplasia
Scoliosis
Suicide
Tuberculosis
Urinary tract infection
Vaginal laceration
Vertebral fracture

  A5-2)      Diseases where fat people have a better prognosis

Diabetes type II
Hypertension
Hyperlidemia
Rheumatoid arthritis

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A7)     Are there any informative web pages on health for fat people?

Yes, several. Some are fatphobic, others not.

Here's a topical (as of Jan 1998) article from the NEJM:

 -> http://www.nejm.org/public/1998/0338/0001/0052/1.htm

Sharon Curtis (the maintainer of this FAQ) also maintains some pages entitled
Health Information about Fatness, which can be found at

http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/BF/Inf/main.html

These pages offer information straight from research articles about how
fatness relates to health.

The Medical Sciences Bulletin has a page which focuses on obesity:

http://pharminfo.com/pubs/msb/obesity.html

Although it refers to obesity as a chronic disease, it does contain a lot of
useful information and common sense. It tackles several common misconceptions
about obesity and considers the social implications too.


There is also a page for AHELP (Association for the Health Enrichment
of Larger People), at

http://www.nrv.net/~ahelp/


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SECTION B: Information about this FAQ

B1)     Are there other related FAQs?

Yes. The list of them below can be found from the following page:

http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/BF/SSFA/faqs.html


  fat-acceptance-faq/clothing/canada
        information about clothing for large people in Canada
  fat-acceptance-faq/clothing/europe
        information about clothing for large people in Europe
        (excluding the United Kingdom)
  fat-acceptance-faq/clothing/uk
        information about clothing for large people in the UK
  fat-acceptance-faq/clothing/us
        information about clothing for large people in the US
  fat-acceptance-faq/health
        information about health issues affecting large people
  fat-acceptance-faq/research
        information about research concerning large people
  fat-acceptance-faq/maternity
        information about large-size maternity resources
  fat-acceptance-faq/sports
        information about resources for sports and activities
        for large people
  fat-acceptance-faq/fitness
        information about resources for fitness for large people
  fat-acceptance-faq/organizations
        information about organizations for large people
  fat-acceptance-faq/resources
        information about resources for large people (that aren't
        covered in the other resources FAQs)
  fat-acceptance-faq/physical
        information about resources for dealing with the physical
        aspects of being large
  fat-acceptance-faq/publications
        information about publications for large people
  fat-acceptance-faq/size-acceptance
        information about size-acceptance
  big-folks-faq
        general information file for alt.support.big-folks

There is some overlap in the topics covered by the FAQs. If you don't
find what you're looking for here, try the other FAQs.

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B2)     Posting information

This document is posted monthly to news.answers and alt.answers and
posted bi-weekly to soc.support.fat-acceptance and alt.support.big-folks.
Sharon Curtis ([e-mail]) maintains this FAQ.

--------------------------------------------------------------------

B3)     Availability of the FAQ

All FAQs posted to news.answers are archived at rtfm.mit.edu and its
mirror sites.  You can get any of these FAQs from rtfm.mit.edu via
anonymous FTP or via the mail archive server.  (To get information
about the mail server, send email to [e-mail] with the
body of the message containing the word "help", without the quotes.)
FAQs posted to news.answers are also available on the Web from:

http://www.cis.ohio-state.edu/hypertext/faq/usenet/top.html
http://www.cs.ruu.nl/cgi-bin/faqwais

You can find this FAQ at the following URLs:

ftp://rtfm.mit.edu/pub/usenet/news.answers/fat-acceptance-faq/health
http://www.cis.ohio-state.edu/hypertext/faq/usenet/fat-acceptance-faq/health/faq.html
http://www.cs.ruu.nl/wais/html/na-dir/fat-acceptance-faq/health.html

although the latest version specifically adapted for HTML and maintained
by the maintainer can be found at

http://www.comlab.ox.ac.uk/oucl/users/sharon.curtis/BF/health_FAQ.html

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B4)     Contributors

These are the people who contribute significant chunks to the FAQ.

Sharon Curtis           ([e-mail])
Sasha Wood              ([e-mail])
Largesse                ([e-mail])
Elly Jeurissen          ([e-mail])

Also, lots and lots of other people (too many to credit) contributed
information that appears herein, some via email and some on s.s.f-a or
a.s.b-f.  Thanks to them all.

Suggestions for additions/improvements are always welcome.

Copyright 1995 by Sharon Curtis ([e-mail]).
Permission is granted to copy and redistribute this article in its
entirety for non-commercial use provided that this copyright notice is
not removed or altered.  No portion of this work may be sold, either
by itself or as part of a larger work, without the express written
permission of the author; this restriction covers all publication
media, including (but not limited to) CD-ROM.


--
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