fattypatties

This month, I am participating in a ReVolution! -- Every Monday in January I plan to write a blog post here about my life and how Health at Every Size℠ has changed my life for better. This is the fourth installment of five.

HEALTH AT EVERY SIZE℠ AND THE LIFESTYLE POLICE --
(OR WHY HEATH AT EVERY SIZE℠ IS IMPORTANT TO PEOPLE OF ALL SIZES)

John Kennedy did implement the President's Council on Physical Fitness, which offered students rewards for various achievements in phys ed. I remember winning badges for things like long-jumping and running 100 yards (I had the second best time in my school for a girl in 11th grade). But there was not a lot of rhetoric connecting the physical fitness program with specific diseases and the question of public health. Since the 1970s, "fitness" has become more and more about policing behavior and personal responsibility, not about the joy of movement or the achievement of milestones.

What shifted in the 1970s with the physical fitness craze that led to the 1980s shift into funding lifestyle programs rather than prevention programs, was a fundamental understanding of health. The Baby Boomers seemed to have got it into their heads (as a group) that they could control their health. Jogging became a national past-time. Gym memberships rose. The belief that it was a good idea to do some exercise every day for general well-being became a quest to ward off all diseases. If we just ate the right foods, got the right amount of exercise, didn't smoke, didn't drink, and was conscious about nutrition, we SHOULD NOT GET SICK. EVER!!!

Of course, what that meant is that the poor souls who do get sick are suspected. Catch a cold, you didn't build up your immune system. Had an accident, you didn't stretch well or warm up in exercising. Contracted cancer, well it was obviously something you ate. Have a heart condition, your diet must be laden with, well depending upon who is speaking, too much fat, too little of the right kind of fat or if you eat correctly then it must be your Type A personality.

What started off as a system of promoting general well-being became a blame-the-victim game that has basically divided the population into haves and have-nots of health.

And of course, couple this with fat prejudice (as well as other kinds of prejudice) and a ready-made excuse for bigotry is woven into the culture. Believe that all fat people are lazy, ugly or dirty (the usual bigoted indictments of "other" groups), that's okay, you just care about their health.

This mechanism is, of course, not limited to fat people. Everyone with lung cancer is suspected of smoking. Everyone with AIDS is suspected of sexual "perversion." Liver disease means you must have drank too much. And so forth.

The new part of that rhetoric is "costs" -- almost daily someone somewhere publishes a report that shows how much the bad habits of others are costing everyone.

At the heart of this rhetoric lies two assumptions that need to be examined:

1. We have control of our health.
   
   
   


2. We are personally responsible for our own health and no one else's.

I believe that these two assumptions are patently false, though each with a grain of truth (as most lies need in order to be believable).

It is true that we have influence over our health and if we do things to excess (including exercising too much or restricting our food intake and obsessing over it too much), we will hurt our bodies in the long run and as we get older in the short run. But we do not control our health in full.

One of the original fitness gurus, Jack LaLanne died last week at the age of 96. He live a long and exceptional life, but the fact is he still died. He didn't die healthy. He died. Of course, a lot of people are pointing to LaLanne's life as an example, but I suspect that genetics played a bigger role in his longevity than his supporters would like to admit.

Jim Fixx was one of the thought leaders in the fitness craze of the 70s. He was a well-known runner. He died while running at the age of 52 from a heart attack. In truth, given that heart disease ran in his family and his father died in his early 40s, Fixx may have added some years and even quality to his life through his running. But he died young just the same.

The point is that there are a huge number of factors that determine health: some are under one's influence, most are not. To decide that Jack LaLanne had the superior fitness program over Jim Fixx is to pretend that we are masters of more than we have a right to claim.

Who cost the health care system more? Fixx died young, supposedly sparing us from his old age and the care he would need. LaLanne needed heart valve surgery at age 95. Was he a burden to the system because he prolonged his life until his valve needed care? These are absurd questions, but they are the kinds of questions to which the lifestyle think and victim blaming of current rhetoric lead us.

That leads to why the second assumption is also bogus, but with a grain of truth. We live in our bodies and in those bodies only we know what it feels like. We know our pain and we know our joy in ways that no one else, even our most intimate of lovers can really know. We do owe ourselves care and loving ourselves is, in part, about taking care of ourselves.

But health is not singular. The air we breathe we share. The water we drink we share. Every plant and animal that becomes our food is affected by that air and water as well. We share the planet with bugs. Some of those bugs do us good and some of those bugs under specific circumstances do us ill. We like to think of our bodies are singular, but in fact we have colonies of other creatures who share our body and some of those creatures like the bacteria that lives in our intestinal tracks are necessary for us to function. Where do we end and the bugs begin? Where do we end and the air begins? Where do we end and the water begins?

Carl Sagan once wrote, "We are star stuff." We are the elements and we will return to the elements. All matter does.

This inter-connectivity means that some health problems are better solved at a level different than the individual. Politics, pollution, climate, economics, personal relationships, stranger relationships, historical and sociological contexts affect our health and well-being.

We cannot calculate the cost of the contraction of disease without making some really big and fallacious assumptions. We are assuming that whatever condition or disease that is being examined is preventable and that the incident of that disease could have been prevented. This is always an estimate and it is always speculation.

Calculating the cost divides us and presents some of us as a burden to others of us.

And calculating the cost assumes a set price for our health that is never negotiable or questionable. Health "costs" do not occur spontaneously out of the mouth of some god somewhere. "Costs" are "charged" by people for services supposedly delivered to other people. Want to reduce costs? Charge less or pay less for medical services.

So how does Health at Every Size ℠help us with this understanding of health and the current lifestyle police mentality that essentially want to fault and make victims pay for their "crimes" against the healthy.

The Association for Size Diversity and Health offer 5 Principles of HAES℠:

1. Accepting and respecting the diversity of body shapes and sizes.
   
   
   


2. Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects.
   
   
   


3. Promoting all aspects of health and well-being for people of all sizes.
   
   
   


4. Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure.
   
   
   


5. Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss.

Accepting that people are diverse is a good beginning. Jim Fixx was a different person from Jack LaLanne. Both of these men were a different person from my great-grandfather who lived to be 99 years old, weighed 300 pounds when he died and probably never ran a mile in his life (though I'm quite sure he did his share of physical labor on the farm).

Personally I'm glad the world is full of diversity. I'm easily bored and without the wonderful diversity among us, it would be a really boring place.

Health and well-being are multidimensional and we sometimes choose one thing over another. I like playing poker. But I hate second-hand smoke. Even so-called non-smoking poker rooms are full of smoke because they are rarely cut off from the rest of the casino. I could not play daily, but I enjoy it enough to take the smoke every once in awhile. The exposure is limited but I know it is damaging just the same. Life is full of dimensions and complexities and no one can really draw a straight line of cause and effect with most health-related experiences.

The principles laid out are simple. They suggest that promoting well-being should be about acceptance not creating restrictive and constrictive rules that probably will not have the intended impact.

At the heart of these principles is a belief that all people deserve to be given a chance to show what they are made of -- all people deserve dignity.

The lifestyle policing and cost analyses come from a position of power and control. They are not about good health but about passing the burden on to someone else. They are about blame.

So perhaps you think that because you are average size or smaller this is not an issue for you. Well, the lifestyle think is what drives health care costs. Pre-existing conditions are a brainchild of this way of thinking. Dropping your insurance when you get sick is "only right" in a world where people are to blame for their illnesses. More and more companies are demanding fitness tests of their employees. Better not get too many colds because your boss might decide you ate too much candy or didn't work out enough and compromised your immune system. He will be able to fire you because you are costing the company too much in labor costs and insurance costs for having that cold.

The really sad part of this myopic view of health is that the real problems of pollution, poverty and daily stress are not being addressed. By ignoring the real problems we are making them bigger. You may be worrying about losing weight today, but ignore pollution and global warming and your children may be worried about how to find food for you in your old age.

Adopting a Health at Every Size℠ view of the world can contribute to a broader understanding of health and the major factors that contribute to health as well as creating a more just and sound basis for addressing those factors. Allowing fat people (or any group) to be scapegoated in the name of cost-cutting and blaming will open the door to anyone being blamed for their illness or disability.

First They came... - Pastor Martin Niemoller

First they came for the communists,
and I didn't speak out because I wasn't a communist.

Then they came for the trade unionists ,
and I didn't speak out because I wasn't a trade unionist.

Then they came for the Jews,
and I didn't speak out because I wasn't a Jew.

Then they came for me
and there was no one left to speak out for me.

This month, I am participating in a ReVolution! -- Every Monday in January I plan to write a blog post here about my life and how Health at Every Size℠ has changed my life for better. This is the third installment of five.

HEALTH AT EVERY SIZE℠ AND GETTING OLDER


When I first decided in late 2000 to quit dieting once and for all, I was chronically ill with what I thought at the time was lupus (and have since learned was probably sub-clinical hypothyroidism). For the most part, these symptoms were chronic but not debilitating on a daily basis. I had flare-ups but had settled into routines that seemed to work. I had some sort of pain almost daily but usually dull pain and with regular exercise and eating good food and getting plenty of rest, I felt generally healthy.

I spent the first couple of years re-learning my hunger and satiation cues. I had dieted so much that I literally did not know when I was hungry or what my hunger felt like. In the past, I depended on outside cues to tell me when to eat and how much to eat. This was a process of mindful eating and, frankly, trial and error. I often waited too long at first, feeling ravenous when I finally sat down to eat and then finding I ate so fast that I was full long before I realized it. I slowed down my eating, learned to savor food and learned how to identify hunger before it was starvation.

In December 2002, I got pneumonia and became very weak. It was months before I could walk without gasping for air. I found a great program that started me working out in water with paddles and eventually I was doing 20 minutes on the treadmill and weight training in the gym. I became stronger and my metabolic health was excellent (blood pressure, blood sugar, cholesterol, pulse rate, etc.). AND I didn't lose weight or gain weight.

By the Spring of 2004, I felt the healthiest I had in years. I was still dealing with arthritic symptoms and flare-ups but not as often and not as severe. When we went on the road in The Ample Traveler, I felt good and maintained that feeling for some time. I turned 47 that summer.

It was easy to believe in Health at Every Size℠ under those conditions. When I wrote Taking Up Space with Carl, I was confident and had no doubt that this was a better way of living than the 30 years I spent fighting my body's natural tendency to be bigger.

I sprang my foot in 2004 and had nerve damage that left me walking with a cane, but even that didn't slow me down or shake my confidence. I had so much experience with chronic conditions at that point, that it became just one more thing to care for with my body--an annoyance, but my view of health had long since changed into an understanding of relative health rather than a set criteria. So I felt I was the healthiest I could be with chronic conditions.

Then I turned 50 and the "other biological clock" for women started. I became menopausal, I started having metabolic problems and I went through a rough period with Health at Every Size℠.

The same conditions that are supposedly connected to fatness are connected to aging, especially in women going through "the change." I began to doubt my choice to not diet and spent many days thinking through the whole process. I felt alone in some ways because I had fat-acceptance friends who were talking about how healthy they were and I knew I was not healthy. In fact, it felt like at the time that I was turning into the poster child for all the conditions that they were bragging they didn't have. For a while I kept quiet. I didn't write here and I didn't reach out. I didn't diet, but my reason for not trying to lose weight was that I was thoroughly convinced that it would not work, that I wouldn't lose any weight. I had been down that road and it made me sick and I didn't want to get any sicker. But I wasn't sure about the new road and whether I'd feel better.

I did reach out to some private groups eventually and I began to see that fat women who were going through menopause and who had type 2 diabetes and other metabolic problems were using HAES℠ to help them deal with their conditions. I started reading about these conditions and discovered that there were strong indications that the dieting I had done for 30 years as well as the aging process probably contributed to those conditions.

Let me be clear about another aspect of this. It didn't help that I had little access to health care due to no insurance and it didn't help that I am an underpaid teacher who has to work several jobs to supplement my income in order to be able to teach. Stress doesn't help. Stigma doesn't help. Fear doesn't help. Isolation doesn't help.

So about 2 years ago, upon realizing that many of my health problems, including the chronic conditions that started in 1997, were probably from hypothyroidism,I had another epiphany like the one I had in 2000. I had been misdiagnosed because of the societal and cultural attitudes about fat. In 1997, when I first got sick, I had chronic fatigue. I couldn't sleep well. I caught one infection after another. I was oversensitive to light and had rashes from exposure. I had an abnormal ANA count. I felt like I had the flu all the time with my joints and muscles aching. It wasn't hard to understand why the doctor thought it was arthritic and sent me to a rheumatologist, who, like most specialists, diagnosed me within her paradigm. Thus, lupus.

Except there was one symptom that I ignored and my doctors ignored: I gained 90 pounds in about 6 months. At the time, my paradigm and my doctors' paradigm was calories in/calories burned. I was eating less because I was too sick to eat much, but I went from someone who rode a bicycle everywhere she went (lived 3 miles from school, so at least 6 miles on school days, probably about 30 miles a week total) to someone who was bed-ridden. It seemed obvious that was the reason for the weight gain.

However, rapid weight gain is a symptom of hypothyroidism and no one even explored the possibility at the time. Hypothyroidism mimics lots of other conditions, especially so-called "check-box" conditions like lupus (positive diagnosis for lupus comes from presence of 4 out of 11 symptoms plus elimination of other possibilities).

So as I face an aging body, I've come to realize that my aging process is affected by several factors: hysterectomy (not ovaries) at age 38, untreated hypothyroidism, and years of yo-yo weight gain and pushing my metabolism and immune system to its limits.

In the past year, armed with this new understanding of HAES℠, one that doesn't depend upon me being perfectly healthy to demonstrate its effectiveness, I have become more pro-active in my health care.

First, I bought a wrist cuff to monitor my blood pressure. This has resulted in a significant reduction of my blood pressure meds and a personal realization that my blood pressure and pulse are heightened when I go to the doctor. I take my basal temperature in the morning to monitor the hypothyroidism. I check my blood sugar often. I am faithful in taking my medications and supplements, including menopausal support. I use assistive devices without hesitation because they improve my stamina and overall health.

And most importantly, I continue to practice intuitive eating and try to move my body as best I can. I do not diet. I do not weigh. I do not worry about my body size. The truth is that under thyroid treatment I think I may have lost a little weight (judging from how my clothes fit), but that is an effect of taking care of my thyroid and not intentional.

I am not the spring chicken I once was and I am angry that much of my health was taken from me by cultural standards and socialization that has made my aging more difficult. But the answer cannot lie in now buying into that thinking. I believe with all my heart that if I tried to lose weight now, I would make matters worse. I believe with all my heart that dieting is not good for the health. I believe with all my heart that I dieted my way into disability and early aging.

I believe with all my heart that if I had known and practiced Health at Every Size℠ when I was younger I would be a much healthier 50+ woman.

I tell my story often because I hope it serves as a lesson for others. I told Sarah on the podcast this week that I was excited to see so many young people involved with fat acceptance because they might be spared the years of dieting and the effects of that dieting.

I think that history will look back on this period as barbaric when it comes to dieting and weight loss. We have abundance and resources and instead of celebrating and sharing that abundance, we have created generations of people afraid of food, afraid of our own bodies.

I have come to realize how strong my body is. I have abused this body and fought this body for years and it perseveres and even improves with love and care. As I have researched what dieting does to a body, I have come to realize that I could be dead now from many of the things I did in the name of "getting more healthy."

So let me affirm, right here and right now, that I may not be the usual poster-girl for HAES℠, I should be, because HAES℠ has saved my life and has made me stronger. Health is relative and has a multitude of factors contributing to one's daily constitutions. But given what I've had to fight and what barriers I've faced and what damage I've staved off, I am healthy at my size.

This month, I am participating in a ReVolution! -- Every Monday in January I plan to write a blog post here about my life and how Health at Every Size℠ has changed my life for better. This is the second installment of five.

CORRELATIONS, CAUSES AND EFFECTS

So a lesson in the modern scientific method before I get personal:

The news media loves to report about scientific studies in absolute terms. Such and such "causes" cancer or diabetes or "fill-in-the-blank-scary-disease-or-condition." Most scientific studies do not purport to establish such a strong or absolute relationship. In fact, NO SINGLE STUDY CAN EVER ESTABLISH CAUSE AND EFFECT. Here is why:

Only in rare cases is the establishment of cause and effect so solid that it can be stated in an absolute. However, science can help make a case for or against cause and effect by applying the scientific method. If enough studies are done using solid scientific methodology, then a very strong case can be made that one thing causes another thing. But three conditions have to be satisfied in order to make that case:

The "cause" has to occur in time before the "effect."

This may seem obvious, but establishing a time line is more difficult than it may appear. Just because something was observed in time before something else doesn't mean it occurred before. It just means a human paid attention to it. In medicine and health this can be particularly difficult because when a condition gets to the point of diagnosis it probably has been around for a while.

But this still remains one of the three criteria for making the case for cause and effect, so many things in health are never going to be established as anything more than related to each other.


A change in the "cause" must be met with a consistent and significant change in the "effect."

This is called correlation. It is probably the simplest and easiest criteria to establish in cause and effect because of the advances made in statistics in the 20th century. Basically, this relationship has to be tested with a sufficient enough data sample to produce results that cannot be explained by mere coincidence or random chance. So it has to be repeatedly demonstrated (which is why no one study would ever be able to solidly establish cause and effect) and that demonstration must be shown to actually be testing what it claims to test.

Small sample sizes, poor measurements or bad data collection means that correlations are not established. Data quality is very important. This includes how questions are posed. When money is involved (and it is always involved), one should take extra care to review how data collection occurred because this is where bias can be seen most often. Throwing out data that doesn't match, skewing questions and measuring techniques towards a particular conclusion and other types of biases can undermine the case made for correlation.


Once the first two criteria are established there must be NO OTHER EXPLANATION for what is being observed

That means that all other explanations should be considered and certainly that is the best reason why no one study or even a group of studies can "prove" cause and effect. All other explanations must be explored. This includes explanations about which the originators of the study can't or didn't think when they did the study.

Alternative explanations are the meat of science. It is where the debate occurs and out of it is how useful things get discovered and created. But it takes time and money to do this right, so this is where most things get subverted.

Each one of these conditions is necessary to establish a case for cause and effect. NONE of these things are singularly sufficient to establish a case for cause and effect. Yet day in and day out the news media uses the word "cause" when reporting scientific studies.

Why would news media so consistently get it wrong? Well, because, for the most part, instead of hiring a science journalist with a strong background in whatever field of science the news story comes, who can critically read the study and write intelligently about it, they just copy and paste press releases from research institutions. Often it is verbatim. So why would research institutions use the word "cause" so easily? Because, again, the person working in the public relations office is not concerned with science as much as they are with further funding and the word "cause" is often more exciting than the phrase "correlated with."

Cause is sexy. Cause sounds like a big discovery. Cause means something important has occurred with this study.

And, of course, there is also the problem in health of when do we move forward even if we can't establish cause. Epidemiology is the use of demographic information (prevalence and incidence of disease) to see patterns in diseases that allow health care workers to act effectively even if a cause and effect hasn't been firmly established. This works especially well with communicable diseases that are airborne or water-born because cutting off and quarantining the patient or the water source may in fact stop the spread of disease even if no one knows exactly which virus or bacteria is causing what. But there are definite limits to epidemiological methodologies. It does not work as well with diseases and conditions that have multiple factors.

What all this means is that you and I as both health care and media consumers have to be especially vigilant in receiving this information.

So what does this have to do with my life with HAES℠?

Before I understood these things, like many others in our society, I accepted what doctors and news media told me about my health and well-being. I figured that the system was basically honestly trying to help.

I have since learned that to be healthy I need to practice a healthy bit of skepticism. So short of becoming a biologist or spending all my waking free time researching this information, what can I do to ensure my own health?

This is my answer: Trust My Body!

Yep. And that was a big request from someone who spent a good 30 years trying to live up to an ideal that didn't fit my body. That was a big request from someone who's body is now broken from those years of trying. But I stand by it.

Science is useful but it is NOT THE ULTIMATE TRUTH. Science is a tool and like all tools, it can be used for good or for evil. Like all tools, it is only as good as the person's hands in which it resides. Like all tools, it is not perfect and can and will be improved through human effort.

Each of us has been issued a physical presence. This is a remarkable thing we have. It takes us places. It interacts with it's environment with or without our awareness. It is sensitive to and gives warning of danger. It feels pleasure as well as pain. It generally knows what it needs when it needs it and that need may or may not make sense rationally.

Health at Every Size℠ is an approach that has much scientific support, most notably, Linda Bacon's study that compared dieting versus non-dieting approaches. But like all science, Health at Every Size℠ should be studied with the skepticism and scrutiny that makes good science. In my own research, I have found that the relationship between health and size doesn't hold up to that skepticism and scrutiny well.

However, I am an advocate for Health at Every Size℠ for more than scientific reasons. My body clicks with this approach. When I was constantly dieting, I become sicker and, frankly, crazier with each dieting experience. There was no peace between me and my body. In the 10 years since I have been practicing HAES℠, I have discovered a trust in my body that has served me well. I don't fight it and even on days when I am ill and don't have the physical strength to be my most productive, I know that my body knows best.

So I invite you to learn to trust your body as well. It is a lifelong journey that begins with a simple premise: Only I know what I feel. But I assure you it is a better way to live.

Previous installments:
1. DIETING MY WAY INTO DISABILITY

This month, I am participating in a ReVolution! -- Every Monday in January I plan to write a blog post here about my life and how Health at Every Size℠ has changed my life for better. This is the first installment of five.

DIETING MY WAY INTO DISABILITY


For the majority of my life, Mondays were the start day. Every diet, exercise or personal improvement kick I tried started on a Monday. Monday was a day of atonement for the weekend.

Don't get me wrong. I was not someone who blew the diet on most weekends. No, when I put my mind to it, I stuck to the project. If I had never regained the weight I've lost on diets, I would have disappeared several times over by now. My problem was never "will-power." Almost every weight loss effort I did ended with illness. I would be working hard and losing weight and then I would come down with a kidney infection or low potassium or pneumonia. OR I would get very close to the goal weight and no matter how hard I tried, I couldn't lose the last little bit.

So with each successive attempt, I got more dysfunctional. I tried laxatives, diuretics and diet pills to help with the last little bit. My body would rebel and start gaining. I've gained weight eating nothing but celery and grapefruit.

I get a kick out of stupid projects like Super Size Me where the person tries to prove that eating nothing but fill-in-the-blank will lead to all sorts of symptoms. I ate so many lemons in a 4 week period one time that my face turned bright red and I had to take cortisone shots to get the inflammation down. I ate so many carrots one time that my finger and toe nails turned orange.

Then I turned 40 and nothing I did made me lose weight. My last few diet attempts were extremely discouraging because I was starving myself and over-exercising and not losing weight. I had yo-yo'd so many times that my survivor abilities were honed to perfection. I could subsist on virtually no food at all.

I suspect my story is not that unusual. I suspect that this is the plight of someone like me whose genetic make-up is determined to survive. My non-smoking older relatives have all been fat and have all lived well into their 80s and beyond. My great-grandfather weighed 300 pounds when he died. He was 99-years-old.

I'm what my husband calls "farm-fat," hard working-salt-of-the-earth fat people who need the extra muscle/fat mass because they work hard at daily chores. I suspect that if I had lived in a fat neutral world I would have accepted this early on and I would be a lot healthier today. Probably not as fat, but still fatter than the average.

But I didn't grow up in that world. I grew up in a world that demanded I lose weight from the time I was eleven years old. With puberty, I put on 20 pounds and that is when the panic began. I attended Weight Watchers at age 12. My yo-yo dieting started early and went on for nearly 30 years.

My message, which I tried to convey in our book, is that I dieted my way into disability.

Let me say that again: I am DISABLED TODAY BECAUSE of MY DIETING HISTORY.

I think this is important to say because the prevailing message is that dieting will spare you from disability and chronic illness. But my metabolic problems occurred first and then the weight came on. (see next week's entry for a discussion of cause and effect).

Health at Every Size℠ is an approach that emphasizes health not weight. Weight or BMI is a poor indicator of health with little medical or scientific support. At the beginning of this century, I consciously gave up dieting and weighing myself. I threw out the scale and have only allowed myself to be weight 3 times in the past 10 years and only paid attention to what I weighed once. I started on a journey to eat when I was hungry and stop eating when I was full (some times called "intuitive eating"). I started moving for the fun of it rather than to lose weight. Judging from my clothes, I have not gained or lost significant weight during that time.

The biggest benefit has been the time I have for other things. During the past 10 years, I have finished my Ph.D., wrote a memoir, made several films, co-produced a radio show, ran 3 different companies and taught at a Community College. Mondays are a renewal day for me still, but it is a day when I look back on things I accomplished the week before and things I want to do this week. NOT a day of regrets or self-loathing.

Am I healthier? Yes and no. It turns out I've done a lot of damage. I got sick in 1997 with what I thought was lupus and what I now believe was hypothyroidism. Before HAES℠ I had good days and bad days. After HAES℠ I also have good days and bad days. Turning 50 was not a good time for me. I got all the fun menopausal, hormonal, post-50 metabolic pain-in-the-butt challenges outlined in the textbook and, of course, had to re-work through all the issues of weight and comfort-in-my-own-skin.

But this I believe with all my heart: If I had not found HAES℠, I would be dead by now.

Because of HAES℠,I have approached my health problems as health problems, not "lifestyle, self-blame" problems and they are slowly getting solved. And I remind myself that many thinner counterparts who are over 50 experience the same challenges I do. It is called aging.

So, I may not be the poster girl for HAES℠, but I am a believer. And I hope that anyone reading this will consider this way of life instead of the yo-yo life I've lived. I suspect I won't live to be 99 years old like my great-grandfather because of the ways in which I fell prey to societal beliefs about weight and health. I grieve this often and have a lot of anger about it. But I do know this. I will live longer for having given up those beliefs.

I wish you long-life and health. Stay tuned next week for more on my Life with HAES℠.

A couple of quick updates. First, because my mom has never had to take higher than 150mcg for her hypothyroidism, I kind of assumed that I was somewhere near a maximum dose. I have since discovered that I am not. So the most likely fix is that I need meds adjusted.

The other bit of good news is the doctor's office called and I can see the doctor tomorrow (Nov 5) instead of having to wait another week. It takes a bit for meds to kick in so the sooner I can up the dosage the sooner I'll know if it is going to be sufficient.

I'm very disappointed/frustrated that I haven't found the maximum replacement level for me yet. But again, I have a lot of hope that this may be a core problem and it is fixable.

Thanks to all both here and on FaceBook who have offered support. It really has helped. To all of you who are struggling/have struggled with this I feel the connection.

I have the distinct impression that in a fat neutral world, this would be something that gets more attention and treatment. But since everyone JUST KNOWS that all weight gain is due to the eating and exercise habits of the person, conditions like hypothyroidism that affect weight are ignored.

BTW, this works on the other end as well. I've known cancer survivors who are complimented to no end about their weight loss even though it is one of the earliest symptoms of some cancers. Sort of reminds me of the "beautiful illness" of consumption (tuberculosis) where 19th century people admired the glow this horrible disease gave to the skin.

In any case, I go to the doctor tomorrow and hopefully will find some balance. I'm so far behind in my work and I find the fatigue is frustrating, especially have sleeping 11 hours and taking a day off (which I essentially did yesterday). One day at a time seems to be the only way to handle it all for now.

I've been in denial for a while now and for my own sanity I need to say something out loud.

Since March of 1997, I've been sick to some degree or another. I don't think there has been a day that has gone by where I have not experienced pain to some degree though some days are better than others and some years have been better than others.

I'm tough. I don't like being sick. I don't like admitting I'm sick. I don't like thinking about being sick. A part of me thinks, even after 13 years, that I can beat this.

Being fat complicates this. Getting old complicates this.

This culture is full of misinformation and blame-the-victim mentality and even though I've spent a great deal of time learning how to deconstruct that misinformation, I, like the rest of us, have some of it living in my brain anyway.

Now I've found out that I may have been misdiagnosed and that I may still be under-treated.

In 1997, I got sick at a party that several other people got sick at as well. We don't know if we all caught a virus or if the food was bad. The other guests had gastric symptoms for about 24 hours. Three days later I was cramping severely and dehydrated from several days of vomiting and other gastric symptoms and had to go to the emergency room and put on an IV. I didn't get well. I've not been well since.

The rest of the year was a series of doctors visits, lab tests and various treatments that eventually got me back to functionality. I managed to make-up the incomplete work and go back to school and actually finished my MA and PhD faster than many of my cohort. But I remained sick.

My husband is probably the only person in the world who knows how sick I've been. He has been my fearless care-taker and protector. For this he is and will remain my hero.

But I am acutely aware that there is so much more that I could have done with that 13 years than I've managed to accomplish. There is so much more I want to do.

I thought I had lupus. I met the criteria. And the preliminary tests sent me to a rheumatologist. Like mechanics and engineers, doctors have a tendency to diagnose within their specialties. I now know that I probably should have went to and endocrinologist. I have come to believe that I've been suffering from hypothyroidism during these 13 years. The lab tests didn't start being positive until 3 years ago, but I've had symptoms for years. Symptoms that have been misinterpreted.

I've slowly been dosed upwards on thyroid medication since being put on it three years ago. I'm back to showing all the symptoms. I feel like I'm walking through jello mentally. I'm cold even when it's over 100 outside. My hair is falling out (this is my most vain loss -- I once had very thick hair and now I'm balding). I'm exhausted when I get up from 9 or 10 hours sleep, when I can sleep. I have what I call energy dumps, where it feels like all my energy leaves my body instantly. I sometimes have pulled over to the side of the road to "nap" because of these dumps. My skin is dry in weird places (like my eyebrows or my finger knuckles). I'm irritable and feel raw with emotions. I'm fighting off weird infections almost weekly. In October alone, I had cold sores in my mouth, a UTI, a boil, and a head cold. My teeth and gums are getting worse. In short, I feel like all systems in my body are falling apart.

Please don't respond to this by giving me dieting advice or the latest alternative treatment. I've researched and I am capable of figuring the terrain out for myself. I just need to say out loud the I'm suffering. There are things I know I could pursue but there is no money to do them. I'm stuck with low-cost health care and therefore specialists and alternative medicines are beyond my reach at the moment.

This is a vicious circle -- I am finding it hard to work and yet I need to work to make enough money to pay for the treatments I need to be able to work.

I'm tired of being sick and sick of being tired.

I will probably write more about this because in the past writing has been my lifeline. Maybe I shouldn't be so public with this but somehow it is more real to put it out here on the net than to keep in my personal journals. So here it is. This is where I am today.

I do want to keep the silver lining in mind, however. If indeed this is thyroid deficiency (or related endocrine issues like hypothalamus and/or adrenals), it is treatable. Lupus is not treatable in the sense of actually changing the disease state. It is going to take some time and testing and money, but there are plenty of people running around quite happily and quite healthfully with hypothyroidism. I resent that this went on for so long without realization of the problem, especially since I gained 100 pounds in 1997 and everyone, including me, but also including doctors who should have suspected something, just assumed it was because I went from riding a bike 20 miles a week to being bedridden. Subclinical hypothyroidism should have been obvious in retrospect. But now that it is obvious, there are treatments.

I go to the clinic on November 10 to get latest blood tests. Hopefully we can figure this out and I can get my life back. Now that would be wonderful.

I rarely cross-post from my other blogs, but I wanted to tell as many people as possible about a great show I did this morning with Verria Kelly, the Good Health Coach.

Check out the details on Ample Ramblings.