The War On Fat

[Crazed]

To make a long story short I am a student and I write quite a bit about the experience of becoming a nurse.

So with that being said I have decided due to some recent developments that I am going to write about the cultural war on fat focused on nursing.

I am acquainted with a woman who is a critical care nurse. I have to tolerate her toxic presence in my life due to her association with my dude's friend. Now, I would like to mention I am no small girl and have gained and lost, and gained again 100lbs. I have finally gotten to the point where I am not beating myself up about it and see efforts now as a matter of love for my body rather than hate. Recently she said this (to me of all people), "I hate fat people so much. They smell, they are hard to move around, and I think they should all die in a hole somewhere."

A member of my clinical group said, "You know these doctors will get upset at the COPD patient who is smoking like three cigarettes a day but say nothing to these fatties who don't follow their diets." I stood up, looked very serious for a moment and said, "HEY! I am one of those fatties that don't follow their diet." Then we went a few rounds with her saying she wasn't talking about me because I am "an attractive fatty."

What does my face have to do with my extra 100lbs? Seriously?

In any case I'd like an open dialog about the war on fat in nursing.

Do you see it in your practice? Are you militant anti-fat? If so why?

I've noticed that a good deal of the arguments that I've heard is fat is unhealthy, yet no one seems to see fat as being a symptom and not the disease.

[Crazed]

IT IS EXCPECTED you be able to lift a 6ft 500lb pt into bed magically should the need arise. ON your own.n If you can't do that you shouldn't even be a nurse ...

I did a 5'10, 350, R CVA weakness if that counts?

I'm thinking cybernetics.

In any case I thank you all for your lively and spirited discussion as it has given me some new perspectives to incorporate into my next article.

I wish you all the best.

[Stephalump]

Such a polarizing subject!

My 2 cents...I fully support a war on fat. I do not support a war on overweight people. I've never called anyone a "fattie," and I wouldn't tolerate anyone treating anyone else as anything less than a worthwhile human being.

But I entered the healthcare field because I feel passionately about it. For other people, obviously, but I owe myself the same kind of love and concern I give others, even though that comes much harder.

As authority figures and educators, there is a responsibility to walk the walk. That doesn't mean perfection, but I do think that means striving to be a better person every day. I think it means stopping perpetuating the same tired excuses health care workers everywhere are working so hard to eradicate in the general population.

Some people have a very hard time losing weight. Personally, not only have I bad hypothyroidism since I was a child, but I also have adrenal insufficiency, and those steroids I take every day, twice a day, pretty much guarantee that I'll never be a size 4 again. But I do believe someone who's struggling to maintain their health can actually be a more powerful force for change...look, I've screwed up, I've fallen on my face, I have health problems, but I think this is important for me AND you, so let's figure this out. Let's stop the cycle of obesity so our children aren't sitting in our place 20 years from now, struggling to break the habits we started for them. And the best place to start change is always with yourself.

-- A Lifelong Idealist

[Stephalump]

I enjoy home work-outs too. My wife bought the Tae Bo series and their elastic bands - I may have poked funny at her looking 'silly' once to which I was told to try it for myself.

Tae Bo is no joke :)

Foot in mouth, eh?

I bought a Tae Bo Cardio Explosion a month ago. I've made a point to forget about it ever since.

I've always been a snob about home workouts. I just didn't think you could get the results you could with access to gym equipment. But, I have to say, I'm more I shape from working out for 39 minutes a day, 6 days a week than I was working out at the gym for an hour, 3 days a week! If I even made it that often! I guess the most important thing is that you're doing SOMETHING.

[rubato, ASN, RN]

This thread still going?

cool.

Anyhoo, a thought occured.... some nurses said (to the effect that) they hate "fatties" due to the chance of injuring themselves moving them.

What about people like Greg Kovacs?

Dude is a 400 pounder.

Only thing is, he's 400 pounds of muscle (body builder... don't think he still does it as much, so no idea what his current weight is, but google him... dude's HUGE)

So.... do some of you folks also hate body builders, and instead of advocating excercise (which is what got them in this state in the first place) you advocate sitting on the couch watching TV?

After all... if moving 400 pounds is dangerous to you, then "what" the 400 lbs is shouldn't really matter.

Just a thought. (now go ahead and accuse me of trolling, but not actually address anything )

First off, no one ever used the word HATE! If you're going to throw it back at us, make sure you quote us properly. What we were saying is that it is unfortunate that due to the fact that so many people are obese and there aren't enough lifts, we are getting hurt.

Second, you keep using examples that aren't the norm. You mentioned a body builder, running, exercise, etc..... No, it wouldn't be any more fun to lift a 400 pound body builder, but, if he's as healthy as I would think he is, he shouldn't need to be lifted anyway. He'll probably stay out of the hospital.

You say that you're a healthy overweight person. That's fabulous. But, it's not the norm!!!!!!! This is what everyone is getting at. Being obese leads to health problems. It just does. You can argue it to death, but you're wrong. You are an exception if you are as healthy as you say you are. And, like someone else said earlier, you are probably young, so that helps.

I don't think you're trolling, I just think you are incorrect.

[BluegrassRN]

There is a website I stumbled across the other day, for those who might be interested:

First, Do No Harm

Mainly it's personal accounts from people who feel they have been mistreated in the health care system because of their obesity. While one should of course read every account with a grain of salt (it's of course only one perspective of what I'm sure is a complex issue), and everyone once in a while I read an account of someone who is obviously so far in denial it's sad; there are many stories of truly terrible care someone received.

I think it's good to read these, to help us caregivers remember to not blame every health issue on obesity, to see how obese people often view the health care industry as well as themselves, and to understand where they are often coming from in terms of previous interactions, miscommunications, and disappointments.

Personally, I feel that every fat person knows they need to lose weight. Beating them over the head with it isn't going to make it happen. Instead, I focus my education on adding activity and improving their nutritional intake. I always assess what they are currently doing, reinforce the good, and make suggestions on small improvements that could ultimately have major positive consequences. I think this is less overwhelming, is perceived as less judgmental, and is ultimately more effective.

[wooh, BSN, RN]

Personally, I feel that every fat person knows they need to lose weight. Beating them over the head with it isn't going to make it happen.

True. That would only cause a head injury, requiring you other nurses to have to pull my fat butt up in bed and injure yourselves. :)

[Stephalump]

Personally, I feel that every fat person knows they need to lose weight. Beating them over the head with it isn't going to make it happen. Instead, I focus my education on adding activity and improving their nutritional intake. I always assess what they are currently doing, reinforce the good, and make suggestions on small improvements that could ultimately have major positive consequences. I think this is less overwhelming, is perceived as less judgmental, and is ultimately more effective.

I think most people respond better to empathy and a positive attitude across the board. And people can tell if you're coming from a position of genuine concern or something more negative.

However, I will say that I know a few people personally who's turning point with their commitment to losing weight was being told, point blank, they were going to die. My mother in law was 5'3 and 375 pounds when she decided to start NS. She could barely walk to her mailbox without doubling over, and failed out before her first year was over because she just couldn't keep up. She ended up in the hospital (panic attack from NS stress$ where she was told she was fasttracking her way to the grave. The ten years I'd known her, she had every excuse in the book why she couldn't lose weight. Metabolism, hormones, genetics.

Guess who started weight watchers, lost 150 pounds, and just graduated from NS this month!

She knew she needed to lose weight, but I don't think she realized how badly and how much better her life would be until everything hit the fan. Too bad she hasn't adopted the same attitude with her children. She shoves soda and junk food down their throats and blames their weight on genetics.

Not that I'm planning on telling everyone they're going to die...just making conversation :-)

[BluegrassRN]

Our docs do a good job of the doom and gloom. They are very up front about the health implications of lifestyle.

If I honestly think someone does not understand the consequences of their choices, I have no problem stating that point-blank. "I don't understand why I can't shake this bronchitis!" "It's because you smoke, and your husband smokes. If you quit smoking, your lung health is going to improve significantly. As long as you and your husband keep smoking, you are going to be fighting off bronchitis all the time. Eventually those cigarettes are going to have you on oxygen and struggling for air day and night. It's going to kill you before your time." (True story).

However, ONLY doom and gloom bluntness does not work for most people. The follow up conversation with the smoker goes something like: assessing desire to quit; previous methods of quitting attempted; resources available; helping pt come up with a plan they think might work; encouraging them to take it a day at a time; showing support and empathy; reinforcing any positive improvements. I've quit smoking, I know it's not easy.

I have more time with my pts than my docs do. Often times, I'll discuss something at the beginning of the shift and provide written info, and then towards the end of the shift, when the pt has had time to mull it over, we discuss more details specific to that particular pt's needs and goals. It has to be their decision, their plan, their goals.

I'm happy if I can get my obese, sedentary pts to walk 10 minutes a day and adding one piece of fresh fruit to their daily intake. They'll be back. The next time they're admitted, I can praise their accomplishments. Later that shift, we can talk about increasing their walking by a minute a day, and adding a serving of fresh veggies every day.

Baby steps are more sustainable for many people. If they come back, they've lost 50 pounds and ran a 5K, of course I'm going to be happy for them. If they come back, they've cut their smoking in half and walk around the block every day, frankly, I'm going to be just as proud. Change is hard, and I'm happy for them if they make ANY positive lifestyle changes.

[Andy Droid]

I know a few people personally who's turning point with their commitment to losing weight was being told, point blank, they were going to die.

heh.... YEARS ago, I was just hanging out with friends when some dude walked up to us and said that if we didn't lose weight we would die. (3 or 4 of the half dozen of us were big folks)

I gave him my very best "astonished wide-eyed child at christmas" look and said "oh my god... you're IMMORTAL???"

We followed this clown around for a good 10 minutes asking how old he was, if he had ever met (random historical figures), if his immortality was from being skinny or if he wasn't human, but an ancient god in human form, and that kinda crap.

[Stephalump]

BlueGrassRN. I have to say, I really respect your attitude toward the topic at hand. It's easy to become a little jaded by the negative attitudes I've encountered (and I'm sure I'll always encounter) on the path to becoming a nurse. So I appreciate the good :).

Crazed, I meant to add that I've been in situations similar to you. Not about weight, but I'm a mix-y...half black/half white. There have been a few times friends and family have made racist comments in front of me, and when it was brought to their attention, I was informed that they weren't talking about ME! They don't think of me as a REAL black person, I'm different, or the good kind, or whatever. I'm not a super sensitive person, but it still irks me. I don't WANT to be an exception...I want you to grow up and realize you're harboring some serious prejudices against people! Ugh. Sorry for the slightly unrelated vent.

[Stephalump]

heh.... YEARS ago, I was just hanging out with friends when some dude walked up to us and said that if we didn't lose weight we would die. (3 or 4 of the half dozen of us were big folks)

I gave him my very best "astonished wide-eyed child at christmas" look and said "oh my god... you're IMMORTAL???"

We followed this clown around for a good 10 minutes asking how old he was, if he had ever met (random historical figures), if his immortality was from being skinny or if he wasn't human, but an ancient god in human form, and that kinda crap.

Bahaha! And that right there is exactly why I said I'm not planning on telling everyone they're going to die. I knew someone would conjure up some image of me chasing down overweight people in my car and running them off the road to tell them they need to lose weight

I must say, though, if I ever find myself in that same situation, I'll be stealing your approach. Touché.

[BluegrassRN]

BlueGrassRN. I have to say, I really respect your attitude toward the topic at hand. It's easy to become a little jaded by the negative attitudes I've encountered (and I'm sure I'll always encounter) on the path to becoming a nurse. So I appreciate the good :).

Why, thank you.

I should add, these conversations shouldn't just occur with obese people. Seriously, I think we tend to focus on them because there is visible evidence of a lifestyle that could use some improvement. MOST of my pts, thin or thick, can stand to improve their diets and lifestyles. ALL pts should have their health knowledge and lifestyle practices assessed, and if improvements can be made, we should be encouraging them. Who wouldn't benefit from an extra little bit of exercise and more fresh fruits and veggies?