My doctoral thesis is on the question of what counts as 'normal' when we are discussing health and disease (psychiatric and somatic) -- i.e. the question of how we ought to analyse normative claims in biology and medicine.
My considered and educated opinion after reading a lot of material by psychiatrists on this question is that many psychiatrists are teh fucked up.
It wasn't that long ago -- the 1970s -- that some psychiatric textbooks recommended leucotomy/lobotomy operations for women who were i) being beaten/abused by their husbands and ii) unwilling to leave the marriage.
Linked in a spirit of full disclosure and masochism. I took the contrarian position to the best of my ability in comments, and if anyone feels I was not sufficiently bitch-slapped in the thread, feel free to exploit any material left undeveloped. I usually do one thread per issue in the sphere and get exhausted, but will display cuts and bruises as inflicted.
The doctor in my opinion is overly concerned with the beauty aspect. The weight gain should have been a concern from an overall health perspective. 3 stone is 42 pounds. 42 pounds in three weeks is a LOT of weight.
That a pretty stunning rate of weight gain. About 20 pounds more than Morgan Spurlock gained in Super Size Me, in ten fewer days. I agree that the tone of the article is disgusting, but that's a sign of seriously unhealthy metabolism.
6, 7: It's barely possible that the treatment she received was more responsible than it sounds, based on the medically alarming rate of weight gain. Still doesn't make the article any less horrifying.
The reason I'm focused on the article and not the doctors is that I didn't want to second-guess their decisions; they might have been rightly concerned about her health, and heck, maybe I don't even blame them for trying to find a drug that would treat her symptoms without the weight gain for aesthetic reasons--as long as, when it didn't work, they put her back on the old one right quick, and as long at the source of the concern was her adjustment and well-being. On the other hand, it's not clear to me that being overweight is worse for adjustment than striking conventional beauty. But if we took this out of the hotly sensitive realm of weight and made it, say, a serious skin problem, maybe more people would think an effort should be made to find a diferent drug (of course, everyone thinks skin diseases are ugly; there's a lot of varying opinion on fat). I'm not ready to jump all over the doctors; there may have been reason for concern.
This is more of the glamorization of mental illness. Oh, how sad we treated his depression. All the great artists were depressed. Oh, how sad we treated his schizophrenia. All the great mathematicians were schizophrenic. To claim that someone else needs to be ill for our own aesthetic enjoyment is bad enough; but Nia was just pretty. (That would have been gone by age 25 anyway, eh?)
It sounds that the treatment regimen itself wasn't that bad. 42 pounds is a lot of weight, especially for a thin person. Gaining a third of your body weight can't be healthy, and if another drug can cure the side effects without the weight gain, it's probably preferable.
But the article's focus is just disgusting. Better insane than fat! And if you aren't sad because first you were insane and pretty and now you're fat and sane, there's something wrong with you?
People should follow McManus's link to Majikthese.
30 years ago I was good friends with a woman who was in the dilemma McManus mentioned on the Majikthese thread. The anti-psychotics she took made her feel flat, stupid, and half dead. But without them she alternated between normality, extraordinary creativity, and life-threatening psychotic behavior.
She was, without question, the most talented, and able person I have ever met in my life. She was also hard-working and productive, but all she left behind was a book of poems and some letters, because in her last crisis she burned her writings and committed suicide.
The creative schizophrenic is not a myth. I've known two others less well.
Her own choice was to go off her meds. This wasn't imposed on her by people who wanted to read her writings. What I now think is that what should have happened, but didn't, is that a support group should have been organized to take care of her. The real hero in the Van Gogh story is Theo. A lot of classic artists and writers only survived with the help of a lot of very tolerant and uncritical patrons. My friend did get a lot of support, but not enough, and most of her support people were pretty close to the edge themselves.
My Psych 1 textbook once had an unintentionally striking demonstration of how schizophrenia can give the sufferer a certain kind of metaphorical power. It had two block quotes from a patient, one before meds, and one after. The book said something like, "notice how the first quote is unintelligible, but in the second he speals lucidly (about trying to find a way out of the space he was trapped in during his schizophrenic episodes)." But if you looked back at the first quote, it seemed clear (at least to me) that it was on the exact same subject, and actually was very interestingly and poetically expressed. I wish I had them still. Of course, that doesn't mean I weep tears of blood for what was lost when he got meds, either, I just found the book's failure to notice what it had juxtaposed kind of funny.
14: And there's a lot of people who are quite normal and depressed, or quite dull and schizophrenic, or pretty boring and Touretter's. I didn't say it was a myth, but I've heard it said, "Oh, those meds are bad. Van Gogh wouldn't have been as creative without them."
Fine. But is every depressed person a hidden Van Gogh? Doubtful. Meds might not always be the answer, and certainly they're no fun. But for a lot of people, feeling flat and stupid and sane might be preferable to feeling crazy, suicide, and fairly average.
12: I don't know if it *was* an aesthetic question. 42 pounds in three weeks sounds like a serious health question. (It depends on how big she was to begin with. I've been mentally assuming around 120.)
I just meant that I wouldn't rake doctors over the coals for considering a side effect that was cosmetic, as long as what they were considering was the patient's well-being, and not their own pleasure in beholding her.
Oh yeah, true. A friend of mine has had some health troubles, and the combination of meds has caused her to gain about 50 pounds. That's a health risk, but the cosmetic side-effect hasn't been lost on her. And if there was a med that would make her better that didn't cause the weight gain, she'd probably take not just for health reasons.
Slightly off-topic, but Aspergers Syndrome (high-functioning autism) is a disorder sometimes associated with genius. (Newton and many others have been proposed as Aspergers). Aspergers' people are often very, very bright and productive, but insensitive to other people's feelings and socially completely inept.
Edgar Schneider's "Discovering my Autism" is a first-person account. Schneider was misdiagnozed as schizophrenic and institutionalized for awhile. One interesting thing is that while Aspergers leads to a kind of flattened affect and indifference to many human concerns, at all points during his life Schneider loved music and was an active amateur musician.
The idea that mental illness is associated with creativity or 'genius' is a very very old one indeed.
Of course with Asperger's and a number of other conditions it's by no means trivially obvious that they a) form a unified disease 'kind' or b) are even disorders in the first place.
man, I was totally on that shit for like six months last year! while the weight gain was not that dramatic, it was real. only now am I really losing weight again (21 months after baby snots-a-lot) while with daughter x I was back to 130 lbs in nine months. I have to say I found the weight thing disturbing. on the other hand, my shrink kind of said she would have institutionalized me if not for the fact that I had a little baby, on account of she reckoned I had post-partum psychosis. she shouldn't have said that, since, as my brother agreed, that's just a reason to lie to your shrink, which is a waste of money. I was less crazy but suffered from "loss of affect". my family said I seemed...not myself, kind of out of it. now that I'm only taking two kinds of anti-depressants, I'm back to my sparkling self! sparkling crazy self! plus, I can fit into my size 10 pants and size 8 dresses now, which still rules about 90% of my fucking wardrobe out, but is nonetheless heartening...aren't you guys glad I'm here to give you the inside skinny on teh crazy! also, that was the most fucked-up article ever.
my fat friend is really sassy. she sometimes does that thing where you snap three times in the air at different heights. also, there's a special "black laugh track" that comes on when she says something funny, different from the normal laugh track in that a black woman can be clearly heard whooping above the background laughter. she's crazy like that.
Re. weight gain: Twisty blogged this article as well, and in comments someone said they had taken the drug named in the article and one of the not-infrequent side effects is that it makes you ravenously hungry, and you eat constantly. Hence the weight gain.
Schneider was instutionalized because he was not socially functional -- he had a breakdown of some sort after some kind of critical disastrous interaction. He definitely had a disorder. Knowing specifically what his problem was made it possible for him to deal with it, partly by reorganizing his life and partly by learning how to recognize problems more quickly when they arose.
One reason why the "genius / madness" cliche is so durable may because there's some truth in it.
One theory I've seen is that "normality" consists partly of several layers of inhibitions of inappropriate behaviors. But there's a cost to these inhibitions, and in fact one major form of therapy consists of helping people who feel that they've missed out on life because they've been too conventional and too cautious.
Someone without inhibitions might have problems for the same reason that they were more creative. Inventiveness requires willingness to accept lots of failures and fuckups.
Stretching still further, uninhibited guys get more support than uninhibited girls. This may be a damper on female creativity and venturesomeness.
On fat: come now, people. Fat is not inherently unhealthy. It is *associated* with health risks, but that could perfectly well be simply becuase it is, itself, a symptom of certain health problems, rather than a cause. And 50 lbs isn't necessarily that much, either; I was much fitter and more athletic when I weighed 40 lbs more than I do now, and I was still quite happily within an acceptable aesthetic norm, too.
On "what about Van Gogh"? Honestly, given the choice, I personally think I would prefer to be sane than to be a famous painter. *Our* sense of loss in the hypothetical where VG is "cured" of his genius is irrelevant.
I'm not even sure this is right. As regards B, she was 40 lbs heavier, but a lot of it was probably muscle. (As muscle weighs more than fat, even the aesthetic difference in sizes is smaller.) Certainly people are overly conscious of aesthetics and weight gain, but excess weight is nothing to be sneered at.
Seriously, SCMT, the science on fat and health is mixed. *Extreme* obesity is unhealthy, as it puts too much burden on organs and joints. But what we normally talk about as "fat" may actually be an advantage in terms of longevity. The problem with the fat argument is that it gets bound up in aesthetics (as in the linked article) and that "fat" gets taken as a synonym for "unfit"--which it isn't, necessarily, though it may be a frequent *symptom* of unfitness.
#30: You're joking? You mean I am insane?? B/c I sure ain't a great painter.
Well, no. Being obese has direct consequences to your health. High blood pressure, Type II diabetes, hypertension, higher incidence of osteoarthritis in the back and knees, etc.
40 pounds overweight is likely less of a health hazard for women, who tend to carry excess fat in the the lower portions of their bodies, but for men, who are more likely to have that weight gain up in the torso and carry that weight around their organs, it's more of a problem.
And being 40 pounds overweight is not the same as gaining over 40 pounds in 21 days. That rate implies she's on the fast track to morbid obesity.
Obese is not fat. And there is a different between *can* have direct consequences, and *has* direct consequences. Not all people classified as obese necessarily have those health problems, although I am not arguing that obesity--which again, is not fatness--is not a major risk factor for them.
I just saw a study saying that excess weight is unhealthy even if you're physically fit and exercise a lot. As I remember, the direction of research is toward saying that even very moderate overweight has some ill effects.
Disclosure: I'm 30-40 lb. overweight even granting that my natural weight is higher than the generic norm.
One reason why the "genius / madness" cliche is so durable may because there's some truth in it.
The author, Sylvia Nasar, discusses the link between schizophrenia and mathematical in a short aside in A Beautiful Mind, She notes that many people wonder if we harm great geniuses by medicating them, given the creativity linked to their madness. She agrees it's a common sentiment, but wrongg. Nash lost thirty years of his working life to the disease. No mathematics was going on at all in that time; it wasn't until the disease receded on its own that he was able to return to the university.
I would rather be crazy and Van Gogh than sane and talentless. But let's face it. Genius is oft allied with madness, but not everyone afflicted with mental illness is a great artist. And I think that for me personally, if the choice is between sanity and being a B student and insanity while going to Harvard, I think I'm going to be better off with the Bs.
What if an Al-Qaeda bomb was ticking in Times Square, and Kotsko were so fat that if you were to push him he would absorb the impact, and he just happens to be standing on a ledge on, um, some building in Times Square so that if you give him a nudge he'd fall onto it, saving everyone else? And then while you're going up to push him off, he slips and starts to totter, and you just stand by and let him fall off? Would it then be OK to torture suspected terrorists, given that torturing people is kind of fun?
Schizophrenics do tend to get diabetes and heart disease. I watched a UCLA grand rounds presentation about how psychiatrists aren't concerned enough about their patients physical health and ought to be coordinating with primary care providers.
If she's got any mania, she could try adding topiramate to her cocktail, since one of its side effects is weight loss.
Bitch, That's why they need to be tortured, to keep them from jealously guarding their artistic genius. Or perhaps it would directly produce artistic genius -- there's a reason we have a stereotype that artists tend to suffer, and that's because suffering is directly productive of artistic genius. I have a couple anecdotal points that seem to prove this pretty conclusively.
I beliee that Carl Schmitt has shown that torturing Kotsko without any utilitarian goal would be more noble and more political than torturing him in order to find out where he hid the bubble gum and skittles.
No, they have to blow up fat Kotsko, the way they blew up that decomposing whale in Taiwan.
Actually that was a suicide-bomber whale that blew itself up. Oddly enough, the Taiwanese are not whalers; it's the Japanese. But whales aren't that spmart, no matter what Greenpeace tells you.
Yes, obese and fat aren't necessarily the same. But there is evidence that even being moderately overweight often has consequences. Yes, there's exceptions. But even mild weight gain can have a significant effect on arthritis. Overweight increases your chances of renal disease. It's a good indicator for risk of insulin resistance. A recent study on a Chinese population suggested a BMI cutoff as low as 23 might be appropriate to identify obesity-related metabolic disorders.
#59: There are also studies showing that being underweight is unhealthy, and yet these studies never come up in threads where we're talking about how hott Scarlett Johanssen is.
You know, gswift, I just clicked through to a bunch of your links, and none of them controlled for diet or exercise frequency. I find this kind of shocking.
The other thing about these fat / health studies, is that no one ever points out that, as with studies of cranial capacity in the nineteenth century, if you're specifically looking for associations between "fat" (defined how?) and ill health, you will find them.
That lovely fat ass of hers is the hottest thing in all of media. She looks like those dolls who always stand up straight when you tip them over, because their lovely big asses keep them equilibrious.
B, you say, "I was much fitter and more athletic when I weighed 40 lbs more than I do now, and I was still quite happily within an acceptable aesthetic norm, too."
Hey, you'd be within MY acceptable norm, but does a 40 lbs difference really put you within a generally acceptable one (unless you're 7 ft tall)?
I know people who freak out about 5 lbs.
BTW, I think it's rather sweet of the docs to be concerned about the destruction of a patient's beauty, despite the fact they're being maximum jerks.
The article is terrible. But it seems very, very unlikely that the doctors altered her meds for aesthetic reasons. It doesn't hold up to scrutiny -- if you've visited a mental health facility since the advent of the atypical antipsychotics, you know that a lot -- maybe most -- of the patients are overweight because of the drugs; this is not a novel dilemma. And the cardiovascular concerns are real (I believe that the drugs affect fat metabolism as well, making this kind of obesity even more unhealthy than it normally would be).
There are more medications out there than the author pretends. If she and her doctors were willing to keep trying new ones until they found a better one, then that's pretty clearly what they should have done. Even if she wasn't concerned about the weight gain, if she was willing to try new drugs her doctors should have encouraged her to.
Not that getting outraged isn't fun, but the idea that medical professionals would allow someone to suffer just so she'd remain hot sounds like a caricature to me.
B-Wo, touching my breasts in public wouldn't prove you weren't gay; it would make your gayness all the more apparent. If you want to prove you're not gay, stand on the other side of the split screen with a mike and hot blonde woman, and have the blonde woman inform America that you couldn't get away with that, because you're straight. Then no one will think you're gay.
Tia, my reasoning was that if no gay men are allowed to touch your breasts, then my touching your breasts would constitute proof that I'm not gay, because if I were, I wouldn't have been allowed to do so, see?
But it's worked out so swimmingly for Ryan Seacrest! Who never dreams of a leather clad Simon Cowell squeezing his balls while he (Ryan) sings "The First Cut is the Deepest" in a tremulous falsetto! Never!
A recent study on a Chinese population suggested a BMI cutoff as low as 23 might be appropriate to identify obesity-related metabolic disorders.
That's, um. Very low. Like 5'5'' and 135 pounds low. Perhaps it's contingent on being Chinese (and small-framed)? Cause that's what I weighed in college, and I was in ridiculously good shape. And ten pounds heavier. I'm a lower BMI now, but I was definitely healthier then.
There's no doubt that there's a link between not exercising and being unhealthy. There's no doubt that there's a link between eating poorly and being unhealthy. There is some evidence that being fat is a poor proxy for judging whether someone is eating poorly and not exercising. And there's even more evidence that being thin is a poor proxy for judging someone's eating habits and activity level. I know a fair amount of skinny undergrads who are skinny just because they're 22, not because they all eat like anorexic angels.
(Still, B, 40 pounds? Aren't you my size?)
But the prejudice doesn't take any of that into account. I'm thin, even though my diet these days is close to nutritionally bankrupt. I exercise. I drink alcohol. But if you saw me walking along eating an ice cream cone, you wouldn't assume I was out of shape and destroying my health. Why? Cause I'm thin. A heavier-set woman, who exercises and eats well? If she's eating an ice cream cone, people are going to assume 'No wonder she's fat.'
81: In all honesty, it just means that one can shift from the thin side of acceptable to the heavy side of acceptable, especially if one puts the weight on in a relatively balanced way. I know guys who were on the thin side at 145 and on the heavier side at 185, but in neither case stood out. Same thing can apply to women.
83: Wait! I thought of a rebuttal! Though the set of straight men and the set of gay men are equally disallowed to touch my breasts in public, only members of the set of gay men might mistakenly think they can get away with it. Ergo, touching my breasts in public would demonstrate that you were gay.
90 - However, it sounds like making an attempt to touch Tia's breasts in public would put you out of the running of ever touching them in private so the calculation of whether it is in one's interest to attempt a public-touching would involve not only gay/not-gay set theory but a statistical analysis of the probability of a future private touching.
From age 20 to 22 i put on about 50lbs without any increase in waist measurement at all. All the 'man-hormones' kicking in plus serious levels of exercise can do that pretty easily.
Right now I'm about 20-30lbs overweight [based on the weight that looks good/feels healthy for me] but my BMI even when I was very fit would have been over 30. They are just not good indicators for men.
I think tom's right. At a minimum, 40 lbs extra is going to put greater strain on your joints. Depending on a variety of other factors, including your build and your level of activity, it might not have a bad effect. But there are plenty of NBA players whose weight-associated injuries have limited their effectiveness. See, e.g., Shaq.
I think for me teh conventionally hot range is probably +/-15. It would all end up in my legs, which are short and stocky to begin with. (My feelings wuz hurted when you all made fun of the volleyball player with the stocky legs.)
I think the BMI sucks as an indicator. It really doesn't address lean muscle/fat proportion at all.
Well, I'm 5'7' ', I have a large frame and carry/would gain my weight in such a way that it's/would be easy to emphazise my narrow waist and curvy hips and butt and look teh conventionally hott. I think it depends on your body. My legs are long and stocky.
To me, a guy should politely grope a woman's breasts when he first meats her, but I think that it' s wrong to put him under a microscope and ask whether he's showing too much enthusiasm (or not enough). It's really just a formality and doesn't have any real meaning -- like saying "How are you?" when you don't really want an answer.
We've gone from making fun of a doctor for worrying about a patient's looks more than her mental health to arguing the differential weights at which people can still retain their looks. Progress!
105: Which is to say, you must toil for long hours in The Mineshaft before you are permitted to even express the desire that one day you might hope achieve the necessary enlightenment to begin the journey of ascension to the Banana Lofts, much less penetrate the inner sanctum and pull aside the gauzy curtain of my receiving chamber, where I will be seated on seven cusions of spun gold, my robe pulled aside, one breast delicately exposed, awaiting my disciple's touch.
Tia: I didn't say I would -- just die to. Being the polite type, I'd ask first. Very sweetly, haltingly, demurely. And only if I thought I stood half a chance.
"I was much fitter and more athletic when I weighed 40 lbs more than I do now, and I was still quite happily within an acceptable aesthetic norm, too."
Just as another data point, I'm right now 40 lbs over where I was freshman year of college (125 then, 165 now; 5'7" at all relevant times). I was skinny, but not scary-looking then; I'm solid, but not particularly overweight looking now. Depending on your frame size, 40 pounds doesn't necessarily make a hugely visible difference.
The only reason that straight guys don't randomly grope breasts is that they know it would get in the way of more over-riding goals, which gay men do not share. In principle, however, we straight men gladly join hands with our gay brethren in our shared belief that women's bodies are or at least should be at our full disposal at all times.
Re: encounter between Tia and Ben -- you can't grope the willing. (Perhaps this applies to what transpired with Bitch, too?)
Man, have I got to start looking at IDs with more attention. I thought Adam was Kotsko being uncharacteristically lewd, until I realized that Kotsko was commenting as well.
Definitely. It doesn't work for anyone who has a lot of lean muscle mass.
Generally, among people I know, that tends to be guys but it's just as useless for athletic women..
[In terms of myself the increase in weight and corresponding increase in BMI doesn't reflect the crappiness of the shape I am in since as well as gaining 20 lbs I'm sure I've lost a fair bit of lean body mass and that wouldn't be reflected in the BMI score]
#107: It'll be progress when we start discussing eating disorders in the "which hott model do you like best" threads.
I'll vouch for Adam. He's not a n00b to me. How he found me here, though, I don't know.
Matt McG, agreed: except that, like you, I'm not in shape either, so I don't even think it has so much to do with athleticism as it does with simple body type.
I don't have a link at my fingertips, but I'd be stunned if there were negative health effects from carrying too much muscle (that is, someone with a high BMI, but a normal or low body-fat percentage). I don't think I've ever read anything suggesting that that is the case.
115: Heavy round-the-clock flagellation with some spiky objet is my immediate destiny, I fear. But I shall prevail over all desire, basely justified as it may be. I'd also like to wallow in the ID of noob, if only I knew what the heck it meant -- blogging nomenclature moves too fast for those of us mired in our sodden, muddy, downtrodden, earthbound desire for the unattainable Banana Lofty. Yet, there is always the risk that even a dim, half-lit, gossamer glimpse of said Lofty, not to mention spun gold, would render all the flagellation useless in one ecstatic instant. What's a poor het to do?
LB, I've never seen it discussed. But if the problem is a small heart driving a big body, it wouldn't necessarily make a difference what kind of big it was.
Muscle seems nice and good, and fat seems bad and evil, but if bulk is the problem maybe they work the same.
I have no opinion on this, but the question seems worth raising, and I've never seen it discussed.
Noob, it's customary around here to grope all the women when you first show up. They pretend they don't like it, but really they do. (They're all like that, except for lesbians.)
But if the problem is a small heart driving a big body
Couple of things: (1) I'm pretty sure that that's not the problem, so much, the problem is that fat is associated with clogged arteries that kill heart tissue; and (2) athletes have bigger hearts. Just like any other muscle, when you work it, it grows. (There was actually a misconception in the early part of the century that athleticism was bad for the heart because dead athletes, when autopsied, had larger hearts, and there are some forms of heart disease that also cause the heart to grow larger. It took doctors a while to grasp that larger due to athleticism was harmless and healthy, while larger dues to heart disease was bad.)
blogging nomenclature moves too fast for those of us mired in our sodden, muddy, downtrodden, earthbound desire for the unattainable Banana Lofty. [sic]
I think we should help him attain his desire for the Banana Lofts, really I do.
This suggests that really big football players have seriously negative health outcomes. It includes the statement, "When you get that big - regardless of whether your body is muscle or fat - your heart is stressed."
Some athletes (weightlifter types) get the body mass without doing other kinds of exercise.
I don't think you can build all that much muscle mass without getting a cardio workout. I lift weights (moderately -- I'm nothing all that impressive) and in 40 minutes of lifting weights, my heart rate is pretty far up there for most of it.
Emerson, you've got me all wrong. I'm not the seedy hoodlum of whom you speak. I am a mere supplicant, humbly waiting for the Divine High Priestess T to strew my path with broken glass, so I can crawlingly earn in blood the right to gaze from afar upon the majesty of the Banana Lofty, before I go thrillingly fulfilled to my grave, the words "Tia, Tia" wafting from my dying lips.
I don't have a link at my fingertips, but I'd be stunned if there were negative health effects from carrying too much muscle (that is, someone with a high BMI, but a normal or low body-fat percentage). I don't think I've ever read anything suggesting that that is the case.
I believe Emerson's right. Fat brings additional problems, but mass in general is an issue. Check out some obits for weightlifters, bodybuilders or ex-linebackers (or the article Matt linked). They seem to rarely make it out of their sixties.
It sucks that there isn't some reasonable ideal weight, but until you start running into malnutrition problems, skinnier is healthier. It sort of makes sense — your body is a particularly prolonged chemical reaction. Exercise can tune it sufficiently well that it makes up for whatever metabolic cost it adds, but in general it seems like the faster you run it, the faster it runs out (the extreme case being the effect wherein a super, super lo-cal diet (loaded up with nutrients to make up the loss of nutritional input) prolongs mammalian lifespan). Peak efficiency doesn't necessarily translate into longevity.
Didn't some huge study just come out showing lowest death rates in the moderately overweight category, with 'normal' having the same rates as mildly obese, and underweight being as bad for you as very obese? Or am I imagining this? It was sometime in '05, but I'm going out to dinner now and don't have time to find it.
Of course, the whole thing about whether "over" or "under" weight is healthier just goes to show that what we mean by "weight" is an aesthetic category, rather than a health one.
Of course, the whole thing about whether "over" or "under" weight is healthier just goes to show that what we mean by "weight" is an aesthetic category, rather than a health one.
Not necessarily. It could be standard model vs. newer model.
Alan Page, a Hall of Famer from the Vikings Super Bowl teams, ended his career after he saw the mortality rates for linemen. He didn't quit, he just started losing weight and they fired him. Football coaches encourage linemen to put on 50 lb. or so of fat too -- it makes people harder to move and adds heft if you're leaning on someone. Few linemen are lean, and steroids are also a factor.
Page is now on the MN State Supreme Court. He'd be a Senator except that the DFL was too chicken -- when Wellstone was killed they named Mondale to run in his place, but Page would have been the better candidate.
Matt's link is a hodge-podge of stuff. My favorite is "God put Scott on this earth and God took him off". Really, what do you need medicine for if religion explains everything.
Without knowing the studies I've got no idea how well they control for all the various external factors associated with being one weight or another. Presumably they didn't recruit their skinny participants from down by the methadone clinic, but there are tons and tons of subtle lifestyle differences associated with weight. In practice I've no doubt that people who are a normal weight live the longest, on average. But in the lab, slightly starved animals can be made to live much, much longer.
I think that we need to do an intervention with BPhD. She's not fat, but's she's awfully defensive about far issues. I think that she's planning to get fat.
We'll be sorry if we dither around until it's too late and we have to deal with a fat, jolly Bitch.
I've certainly seen articles in the popular science press reporting that to be the case -- that moderately overweight + fit is better than skinny + fit.
And fit trumps unfit whatever the weight.
Significant weight-loss is, apparently, correlated with long-term health problems too. Apparently if you're fat getting fit and staying fat is likely to be the best course.
Of course people (including me) want to lose weight for aesthetic reasons so the calculus may not be a solely health based on.
I think most of this starts with a bizarre post-modern fixation on body issues in general. I remember living outside the US, where people ate, drank, slept, fucked, lived and died, and nobody thought much about their bodies, except when their bodies told them to go the bathroom.
Story: The consultant favoured Olanzapine for Nia; he had found the drug to work well in her age group despite concerns about weight gain and diabetes.
SIDE EFFECTS: Side effects seen with olanzapine include akathisia (an inability to sit still), constipation, dizziness, drowsiness, insomnia, dry mouth, orthostatic hypotension (see DRUG INTERACTIONS), tremor, and weight gain.
[...]
There may be an increased risk of increased blood sugar levels and diabetes with olanzapine as well as the other antipsychotic medications in its class. Patients should be tested during treatment for elevated blood sugar. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Story: The nurses were so encouraged by her regular appearance in the dining room that they didn't question the heap of beans and potatoes. But soon it became apparent that insanity had been replaced by appetite. Within three weeks she put on three stone.
Or one stone per week. Going with alameida's six months that's 52/2 = 26 * 14 lbs. = 364 lbs.
Assuming she was 5'10" and 120, she'd then be 5'10" and 480 lbs. Which is about 150 pounds more than optimum for a 6'6" football linebacker.
Of course, maybe she won't pack it on so fast. Maybe after the first three weeks (+42 pounds) she only packs it on half as fast for six months. So 120 + 42 + ((26 - 3) * 7) = 323 pounds. (Keeping the other, distinct, possible side effects in mind: diabetes and cardiovascular problems.) That's not quite so bad, unless she's 5'0".
If it levels off after three weeks, ok. If it's compulsive, that is, this particular psychotropic compound had had an unexpected mental side effect, you've just traded one problem for another. Ergo, changing medications to try and find one that cures the problem without the side effects is the right thing to do. Because potentially inducing diabetes in combination with inducing compulsive, uncontrollable food consumption is a lethal combination. (Diabetics have blood sugar problems. Compulsive eaters consume everything, including sweets. Poor circulation, crapped out immune system and so on, right on up to diabetically-induced psychosis, coma, gangrene and amputation.)
Not to mention, she might hit 350 pounds, decide she doesn't like the weight, and stop taking her meds, and she's right back where she started +200 pounds. And then she jumps off a bridge. YAY!
If that isn't painfully clear, try a bit of creative rewriting:
What the staff didn't pick up immediately was Nia's need to remain clean. The nurses were so encouraged by her regular sojurns in the bathroom that they didn't question her constant showering. But soon it became apparent that insanity had been replaced by an obsession with cleanliness. Within three weeks the skin over her entire body was cracked, dry and bleeding and her hair was falling out [You try taking 10 half-hour showers a day for 3 straight weeks]. Now, for the first time, Nia's features were being corrupted.
But closing with the same line!:
Perhaps, in fact, this was a merciful side-effect of medication, or even of the disorder itself; one that liberated Nia from the need to live up to the standards of an image-obsessed world.
Tia: If there were ever a quease-inducing cocktail, it is this article: the soft-focus, gooey treatment of mental illness, the elevation of a woman's appearance to near-paramount importance--just barely behind her sanity; no drug, no matter how potent, can stop the gastrointestical process now.
The writer's chose to take a story of mental illness and the perils of psychotropics and give it a quasi-feminist (psuedo-?) recast as a story about silly (male) doctors and their obsession with body image. Given the closing line, I believe they did so deliberately, unless they were fucking unconscious when they wrote it.
Ash, sometimes you make your points in a style that I find hard to clearly follow, and I'm not quite sure to respond. So take this as an effort that may be responding to points you're not making. If it's not clear from my comments in the thread, I neither endorse nor criticize the actions of her actual treating psychiatrists; I wasn't there and besides, to get to any truth about Nia through that article is like trying to get out of the sticky syrup at the bottom of a roach motel after having been shrunk by Rick Moranis (I realize this is not the best metaphor, but I'm using it because if that article had a smell, it would smell like a roach motel). I acknowledge in 10, 12, and 18 that there might well have been legitimate health concerns, and I don't even object to trying to find a drug that didn't have cosmetic side effects, if that was what Nia wanted.
What's so gross is the article. To make it clearer, there was no goddamned story here. Psychotropic drug causes weight gain. Dog bites man. These writers tried to turn it into a maudlin tragedy of nymphette beauty lost to the world, and said that it would have been better if sane Nia understood how valuable her sex appeal had been, and regretted its loss, because they did. The writers did not talk about her weight in terms of her health, but in terms of her value as object. They weren't worried that sane Nia was insensible to the self-damaging aspect of her weight gain; they were worried that she wasn't concerned that she wasn't beautiful to them. I don't understand how you can see even quasi-feminism in the writers' stance, unless the whole thing is parody, but I don't even see a hint of a wink.
I'd pull the licenses of both the 'young psychiatrist' and the 'consultant', if the following are accurate:
"Get a dietician ...; change her to Quetiapine."
"Put up the dose," said the consultant
The consultant felt there was no option but to put her back on the Olanzapine.
The desire to experiment further with her medication left the consultant and the young psychiatrist.
For a while the young psychiatrist worried about the consequences of the choices they had made in treating her.
This makes it clear that the patient was not making her own treatment decisions, or even participating in those decisions. Psychiatrists should never, never, never make treatment decisions on behalf of patients. That's an impermissible deprivation of the patient's autonomy and an impermissible conflict of interest. If the patient is incompetent, there should be a treatment guardian.
With that sort of attitude about who makes the decision, it's no wonder the two docs are a pair of arrogant patriarchist sexist pigs.
Yes, BMI is not always a good indicator. I tend toward the "overweight" side, a 24 or 25 as I do a fair amount of weightlifting. That being said, take a look around with regard to general trends. Are most people on the high end of a BMI chart because of their muscle mass?
With regard to moderately overweight being healthier, if it's the same study I'm thinking of, it didn't examine health. That was around this time last year, and it examined life span of moderately overweight people in the U.S. based off surveys done in the 70's, 80's, and 90's. It found that people who were a bit overweight lived slightly longer than the obese and underweight. It didn't examine obesity related diseases at all. This trend could reflect all sorts of things like better health care, socioeconomic factors, etc. Proclaiming the healthiness of being overweight is a bit premature.
And yes, weight gain is an independant risk factor. The best data I've seen so far is this Harvard study on coronary heart disease. Approx. 90,000 women over 20 years. Here's the money shot.
To follow up on Michael Schneider's 157, what was really remarkable to me about the article was the way that Nia as an agent seemed to drop out mid-way through. Yeah, before that halfway point she was hopelessly fetishized, but once she was institutionalized, the article didn't even try to represent her point of view.
And that's why the last line, as melodramatic as it is (and I'm still trying to figure out exactly what heartstrings it's trying to pull on), might through the absolutely shitty journalism actually represent a real problem: the involuntarily institutionalized Nia has not seemed to notice gaining forty pounds in three weeks.
If Nia--not her parents or doctors--thought that feeling sane was a good trade-off for potentially health-endangering weight-gain, that would be fine. Great, even; it sounds like she was really suffering before. But if Nia was representing herself as indifferent to the (very sudden-seeming) change to the people whom the journalist clearly did interview, then maybe her treatment course is more ethically problematic.
Since the article is so poorly and condescendingly written, it's hard to say. Clearly Nia wasn't willing to talk to the reporter, while the family and doctors were; that's already a bad sign.
Every time I re-read that article something else jumps out at me and screams. How about this:
His adolescent urges and manic disinhibition were a fertile mix and the staff found him trying every trick in the book to get into her bedroom. It's remarkable what can be contrived, even in a locked ward. One night, they were found in bed together. Nia was put on one-to-one observation.
Uh, a delusional psychotic patient isn't protected from other patients? Was this rape? Did anyone, like, investigate? Should we be thinking PTSD?
Later:
Nia was herself, but not herself. She blended in, lumpenly.
Uh oh. Flat affect? Dissociation? The DSM-III lists those as indicators of PTSD. We're calling this 'sane'?
JM, I think you're being charitable in saying : "...maybe her treatment course is more ethically problematic." One of the historical problems with antipsychotics, especially in institutional settings, is that the real goal of the overwhelmed staff tends to be compliance. A compliant patient can be discharged, always a goal in the usual situation where the census it too high. There's not enough information to be sure, but I think there are very good grounds for suspecting very bad practice.
Yeah, MHS, I noticed that break-in, and I was also wondering about rape. I don't have any direct experience in clinical, much less institutional facilities, but the glazing over of why must have been a horrific loss of freedom for Nia seemed incredibly callous to me.
And it's the lack of Nia's affect that scares me most in the article; if nobody interviewed could even suggest what Nia was going through, either the journalist was unusually daft (and that seems fairly likely), or Nia was totally isolated (unfortunately that also seems likely).
It's really too bad that a journalist spent so much time with this story and didn't have the courage (or intellect?) to go further with it. Poor Nia; pretty or not, there must be many thousands like her. I've known a couple.
I don't normally comment. It turns out that I'm on Olanzipine, and though I've never been fat, I've gained around 20-30lbs since I've been on the drug. You are a very stupid person if you believe that that does not affect your life negatively. My sex life has ceased, and it once was something to write home about. The doctor was a realist, it actually does matter a great deal to those affected. It's unfair but real. And the trade-off is likewise real.
In her case, no doubt it was warranted. But there are many others on it who are not so bad. Like the manic-depressives. And you have to consider how much better you were doing before. It just ain't that simple, when you consider people's actual lives. All this is is another way that we're fucked.
I used to work [summer job when I was 17] in a hospital for people with mental disabilities and, specifically, in locked wards for those who are also dangerous to each other and to themselves.
Rape is pretty common -- in fact I had to be moved out of one ward and sent to work elsewhere as it was felt that one of the 'patients' was showing too much of an interest and that I was at risk of rape.
Hi d, welcome. Thanks for commenting. I'd ask that you'd refrain from fantasizing about the deaths of all Republicans though; that's outside the bounds of Unfogged discourse. Besides, if we did, we'd have hung our most incisive commenter!
hi d! I hope I can say I understand (somewhat) where you're coming from. it's definitely true that gaining a lot of weight can have a serious impact on your life, sexual and otherwise. I think the objection we were all having to this is that the patient was represented throughout as utterly lacking agency, and this lack was seen most clearly in the lament that she didn't fully appreciate how hot she'd been before and how this had been lost. it seemed very much as if her external appearance to others [not her internalised vision of herself] was fetishized to a strange degree. if she were to say, "hey, I'm gaining mad weight, I don't like this. can we deal with this side effect?" that would be one thing. for the doctors and journalists to be saying, "she used to be so hot, and now she's fat! how sad that she doesn't even realize all the hottness has been lost!". that's a problem. I, for one, although I am a very vain and superficial person, was able to say that I was willing to trade weight gain and olazapine for being psychotic and institutionalized. if we had seen Nia making this trade-off it would be a different thing.
Just goes to show you: the pretty girls are all crazy.
Posted by bitchphd | Link to this comment | 02-10-06 11:42 PM
Un-fucking-believable.
Posted by teofilo | Link to this comment | 02-11-06 12:16 AM
[dons google-defeating cloak of reversing]
My doctoral thesis is on the question of what counts as 'normal' when we are discussing health and disease (psychiatric and somatic) -- i.e. the question of how we ought to analyse normative claims in biology and medicine.
My considered and educated opinion after reading a lot of material by psychiatrists on this question is that many psychiatrists are teh fucked up.
It wasn't that long ago -- the 1970s -- that some psychiatric textbooks recommended leucotomy/lobotomy operations for women who were i) being beaten/abused by their husbands and ii) unwilling to leave the marriage.
Posted by nattarGcM wehttaM | Link to this comment | 02-11-06 12:48 AM
Worst Shrink Ever ...Majikthise
Linked in a spirit of full disclosure and masochism. I took the contrarian position to the best of my ability in comments, and if anyone feels I was not sufficiently bitch-slapped in the thread, feel free to exploit any material left undeveloped. I usually do one thread per issue in the sphere and get exhausted, but will display cuts and bruises as inflicted.
Posted by bob mcmanus | Link to this comment | 02-11-06 1:10 AM
Let us read then, you and I,
When the evening is spread out against the sky
About a patient medicated for schizophrenia;
Let us read, through certain false-tragedic words
The maudlin style preferred
In feckless notes in one-note cheap juxtapositions
Of the dilemmas faced by a girl's physicians:
Words that wallow in a tedious article
Of insidious portent
To lead you to an underwhelming question ...
Oh, do not ask, "How is she?"
Let us go and see how looks she.
In the room the dieticians come and go
Talking of waist-to-height ratio.
Posted by eb | Link to this comment | 02-11-06 1:48 AM
The doctor in my opinion is overly concerned with the beauty aspect. The weight gain should have been a concern from an overall health perspective. 3 stone is 42 pounds. 42 pounds in three weeks is a LOT of weight.
Posted by gswift | Link to this comment | 02-11-06 5:53 AM
That a pretty stunning rate of weight gain. About 20 pounds more than Morgan Spurlock gained in Super Size Me, in ten fewer days. I agree that the tone of the article is disgusting, but that's a sign of seriously unhealthy metabolism.
Posted by apostropher | Link to this comment | 02-11-06 6:18 AM
That's
Posted by apostropher | Link to this comment | 02-11-06 6:23 AM
6, 7: It's barely possible that the treatment she received was more responsible than it sounds, based on the medically alarming rate of weight gain. Still doesn't make the article any less horrifying.
Posted by LizardBreath | Link to this comment | 02-11-06 6:42 AM
The reason I'm focused on the article and not the doctors is that I didn't want to second-guess their decisions; they might have been rightly concerned about her health, and heck, maybe I don't even blame them for trying to find a drug that would treat her symptoms without the weight gain for aesthetic reasons--as long as, when it didn't work, they put her back on the old one right quick, and as long at the source of the concern was her adjustment and well-being. On the other hand, it's not clear to me that being overweight is worse for adjustment than striking conventional beauty. But if we took this out of the hotly sensitive realm of weight and made it, say, a serious skin problem, maybe more people would think an effort should be made to find a diferent drug (of course, everyone thinks skin diseases are ugly; there's a lot of varying opinion on fat). I'm not ready to jump all over the doctors; there may have been reason for concern.
But this article was inexcusable.
Posted by Tia | Link to this comment | 02-11-06 6:50 AM
This is more of the glamorization of mental illness. Oh, how sad we treated his depression. All the great artists were depressed. Oh, how sad we treated his schizophrenia. All the great mathematicians were schizophrenic. To claim that someone else needs to be ill for our own aesthetic enjoyment is bad enough; but Nia was just pretty. (That would have been gone by age 25 anyway, eh?)
It sounds that the treatment regimen itself wasn't that bad. 42 pounds is a lot of weight, especially for a thin person. Gaining a third of your body weight can't be healthy, and if another drug can cure the side effects without the weight gain, it's probably preferable.
But the article's focus is just disgusting. Better insane than fat! And if you aren't sad because first you were insane and pretty and now you're fat and sane, there's something wrong with you?
Posted by Cala | Link to this comment | 02-11-06 6:53 AM
I mean, really, on the aesthetic question, what they should have done is asked her if she wanted to try a different drug.
Posted by Tia | Link to this comment | 02-11-06 6:56 AM
8 is exactly right, and probably Apo's best post ever.
Posted by John Emerson | Link to this comment | 02-11-06 7:05 AM
4, 11.
People should follow McManus's link to Majikthese.
30 years ago I was good friends with a woman who was in the dilemma McManus mentioned on the Majikthese thread. The anti-psychotics she took made her feel flat, stupid, and half dead. But without them she alternated between normality, extraordinary creativity, and life-threatening psychotic behavior.
She was, without question, the most talented, and able person I have ever met in my life. She was also hard-working and productive, but all she left behind was a book of poems and some letters, because in her last crisis she burned her writings and committed suicide.
The creative schizophrenic is not a myth. I've known two others less well.
Her own choice was to go off her meds. This wasn't imposed on her by people who wanted to read her writings. What I now think is that what should have happened, but didn't, is that a support group should have been organized to take care of her. The real hero in the Van Gogh story is Theo. A lot of classic artists and writers only survived with the help of a lot of very tolerant and uncritical patrons. My friend did get a lot of support, but not enough, and most of her support people were pretty close to the edge themselves.
Posted by John Emerson | Link to this comment | 02-11-06 7:19 AM
My Psych 1 textbook once had an unintentionally striking demonstration of how schizophrenia can give the sufferer a certain kind of metaphorical power. It had two block quotes from a patient, one before meds, and one after. The book said something like, "notice how the first quote is unintelligible, but in the second he speals lucidly (about trying to find a way out of the space he was trapped in during his schizophrenic episodes)." But if you looked back at the first quote, it seemed clear (at least to me) that it was on the exact same subject, and actually was very interestingly and poetically expressed. I wish I had them still. Of course, that doesn't mean I weep tears of blood for what was lost when he got meds, either, I just found the book's failure to notice what it had juxtaposed kind of funny.
Posted by Tia | Link to this comment | 02-11-06 7:31 AM
13: I was aiming for power through succinctness.
Posted by apostropher | Link to this comment | 02-11-06 7:39 AM
14: And there's a lot of people who are quite normal and depressed, or quite dull and schizophrenic, or pretty boring and Touretter's. I didn't say it was a myth, but I've heard it said, "Oh, those meds are bad. Van Gogh wouldn't have been as creative without them."
Fine. But is every depressed person a hidden Van Gogh? Doubtful. Meds might not always be the answer, and certainly they're no fun. But for a lot of people, feeling flat and stupid and sane might be preferable to feeling crazy, suicide, and fairly average.
12: I don't know if it *was* an aesthetic question. 42 pounds in three weeks sounds like a serious health question. (It depends on how big she was to begin with. I've been mentally assuming around 120.)
Posted by Cala | Link to this comment | 02-11-06 7:47 AM
I just meant that I wouldn't rake doctors over the coals for considering a side effect that was cosmetic, as long as what they were considering was the patient's well-being, and not their own pleasure in beholding her.
Posted by Tia | Link to this comment | 02-11-06 7:50 AM
Oh yeah, true. A friend of mine has had some health troubles, and the combination of meds has caused her to gain about 50 pounds. That's a health risk, but the cosmetic side-effect hasn't been lost on her. And if there was a med that would make her better that didn't cause the weight gain, she'd probably take not just for health reasons.
Posted by Cala | Link to this comment | 02-11-06 7:59 AM
Slightly off-topic, but Aspergers Syndrome (high-functioning autism) is a disorder sometimes associated with genius. (Newton and many others have been proposed as Aspergers). Aspergers' people are often very, very bright and productive, but insensitive to other people's feelings and socially completely inept.
Edgar Schneider's "Discovering my Autism" is a first-person account. Schneider was misdiagnozed as schizophrenic and institutionalized for awhile. One interesting thing is that while Aspergers leads to a kind of flattened affect and indifference to many human concerns, at all points during his life Schneider loved music and was an active amateur musician.
Posted by John Emerson | Link to this comment | 02-11-06 8:33 AM
The idea that mental illness is associated with creativity or 'genius' is a very very old one indeed.
Of course with Asperger's and a number of other conditions it's by no means trivially obvious that they a) form a unified disease 'kind' or b) are even disorders in the first place.
Posted by Matt McGrattan | Link to this comment | 02-11-06 8:51 AM
man, I was totally on that shit for like six months last year! while the weight gain was not that dramatic, it was real. only now am I really losing weight again (21 months after baby snots-a-lot) while with daughter x I was back to 130 lbs in nine months. I have to say I found the weight thing disturbing. on the other hand, my shrink kind of said she would have institutionalized me if not for the fact that I had a little baby, on account of she reckoned I had post-partum psychosis. she shouldn't have said that, since, as my brother agreed, that's just a reason to lie to your shrink, which is a waste of money. I was less crazy but suffered from "loss of affect". my family said I seemed...not myself, kind of out of it. now that I'm only taking two kinds of anti-depressants, I'm back to my sparkling self! sparkling crazy self! plus, I can fit into my size 10 pants and size 8 dresses now, which still rules about 90% of my fucking wardrobe out, but is nonetheless heartening...aren't you guys glad I'm here to give you the inside skinny on teh crazy! also, that was the most fucked-up article ever.
Posted by alameida | Link to this comment | 02-11-06 9:00 AM
tonight, on a very special episode of unfogged, the mysterious alameida triumphs over psychosis...with the help of a fat friend. and urkel.
Posted by alameida | Link to this comment | 02-11-06 9:02 AM
Does yer fat friend have a good word for anyone? This could be the best episode ever.
Posted by Matt Weiner | Link to this comment | 02-11-06 9:10 AM
my fat friend is really sassy. she sometimes does that thing where you snap three times in the air at different heights. also, there's a special "black laugh track" that comes on when she says something funny, different from the normal laugh track in that a black woman can be clearly heard whooping above the background laughter. she's crazy like that.
Posted by alameida | Link to this comment | 02-11-06 9:14 AM
I was thinking about a fat young man without a good word for anyone, IYKWIM.
Posted by Matt Weiner | Link to this comment | 02-11-06 9:34 AM
Re. weight gain: Twisty blogged this article as well, and in comments someone said they had taken the drug named in the article and one of the not-infrequent side effects is that it makes you ravenously hungry, and you eat constantly. Hence the weight gain.
Posted by bitchphd | Link to this comment | 02-11-06 9:37 AM
Schneider was instutionalized because he was not socially functional -- he had a breakdown of some sort after some kind of critical disastrous interaction. He definitely had a disorder. Knowing specifically what his problem was made it possible for him to deal with it, partly by reorganizing his life and partly by learning how to recognize problems more quickly when they arose.
One reason why the "genius / madness" cliche is so durable may because there's some truth in it.
One theory I've seen is that "normality" consists partly of several layers of inhibitions of inappropriate behaviors. But there's a cost to these inhibitions, and in fact one major form of therapy consists of helping people who feel that they've missed out on life because they've been too conventional and too cautious.
Someone without inhibitions might have problems for the same reason that they were more creative. Inventiveness requires willingness to accept lots of failures and fuckups.
Stretching still further, uninhibited guys get more support than uninhibited girls. This may be a damper on female creativity and venturesomeness.
Posted by John Emerson | Link to this comment | 02-11-06 9:43 AM
On fat: come now, people. Fat is not inherently unhealthy. It is *associated* with health risks, but that could perfectly well be simply becuase it is, itself, a symptom of certain health problems, rather than a cause. And 50 lbs isn't necessarily that much, either; I was much fitter and more athletic when I weighed 40 lbs more than I do now, and I was still quite happily within an acceptable aesthetic norm, too.
On "what about Van Gogh"? Honestly, given the choice, I personally think I would prefer to be sane than to be a famous painter. *Our* sense of loss in the hypothetical where VG is "cured" of his genius is irrelevant.
Posted by bitchphd | Link to this comment | 02-11-06 9:57 AM
Alas, B., you are neither. (Joke).
I'd rather be Van Gogh. Seriously. My friend voluntarily took her chances too.
Posted by John Emerson | Link to this comment | 02-11-06 10:02 AM
Fat is not inherently unhealthy, but sharp swings in weight are.
Posted by apostropher | Link to this comment | 02-11-06 10:05 AM
Yes, sharp weight swings are a problem. But not quite as much of a problem as being insane to the point of institutionalization, I'd have thought.
Posted by bitchphd | Link to this comment | 02-11-06 10:08 AM
Fat is not inherently unhealthy,
I'm not even sure this is right. As regards B, she was 40 lbs heavier, but a lot of it was probably muscle. (As muscle weighs more than fat, even the aesthetic difference in sizes is smaller.) Certainly people are overly conscious of aesthetics and weight gain, but excess weight is nothing to be sneered at.
Posted by SomeCallMeTim | Link to this comment | 02-11-06 10:09 AM
Seriously, SCMT, the science on fat and health is mixed. *Extreme* obesity is unhealthy, as it puts too much burden on organs and joints. But what we normally talk about as "fat" may actually be an advantage in terms of longevity. The problem with the fat argument is that it gets bound up in aesthetics (as in the linked article) and that "fat" gets taken as a synonym for "unfit"--which it isn't, necessarily, though it may be a frequent *symptom* of unfitness.
#30: You're joking? You mean I am insane?? B/c I sure ain't a great painter.
Posted by bitchphd | Link to this comment | 02-11-06 10:13 AM
29
Well, no. Being obese has direct consequences to your health. High blood pressure, Type II diabetes, hypertension, higher incidence of osteoarthritis in the back and knees, etc.
40 pounds overweight is likely less of a health hazard for women, who tend to carry excess fat in the the lower portions of their bodies, but for men, who are more likely to have that weight gain up in the torso and carry that weight around their organs, it's more of a problem.
And being 40 pounds overweight is not the same as gaining over 40 pounds in 21 days. That rate implies she's on the fast track to morbid obesity.
Posted by gswift | Link to this comment | 02-11-06 10:13 AM
Obese is not fat. And there is a different between *can* have direct consequences, and *has* direct consequences. Not all people classified as obese necessarily have those health problems, although I am not arguing that obesity--which again, is not fatness--is not a major risk factor for them.
Posted by bitchphd | Link to this comment | 02-11-06 10:17 AM
Okay, this discussion--as discussions of the "unhealthiness of fat" will tend to do--is starting to frustrate and anger me.
Therefore I am going to step outside and have a cigarette. 'Cause smoking keeps you thin!
Posted by bitchphd | Link to this comment | 02-11-06 10:19 AM
I just saw a study saying that excess weight is unhealthy even if you're physically fit and exercise a lot. As I remember, the direction of research is toward saying that even very moderate overweight has some ill effects.
Disclosure: I'm 30-40 lb. overweight even granting that my natural weight is higher than the generic norm.
Posted by John Emerson | Link to this comment | 02-11-06 10:25 AM
One reason why the "genius / madness" cliche is so durable may because there's some truth in it.
The author, Sylvia Nasar, discusses the link between schizophrenia and mathematical in a short aside in A Beautiful Mind, She notes that many people wonder if we harm great geniuses by medicating them, given the creativity linked to their madness. She agrees it's a common sentiment, but wrongg. Nash lost thirty years of his working life to the disease. No mathematics was going on at all in that time; it wasn't until the disease receded on its own that he was able to return to the university.
I would rather be crazy and Van Gogh than sane and talentless. But let's face it. Genius is oft allied with madness, but not everyone afflicted with mental illness is a great artist. And I think that for me personally, if the choice is between sanity and being a B student and insanity while going to Harvard, I think I'm going to be better off with the Bs.
Posted by Cala | Link to this comment | 02-11-06 10:28 AM
My greatest fear is that I will become fat when I hit middle age -- greater even than my fear of al Qaeda, if you can believe that.
If the "president's" surveillance program can help me keep my weight off after age 35 or so, then I support it wholeheartedly.
Posted by Adam Kotsko | Link to this comment | 02-11-06 10:38 AM
Bin Laden is skinny and middle-aged. Why must you insist on being the message boy for the Islamofascists, Adam?
Posted by apostropher | Link to this comment | 02-11-06 10:42 AM
If al Qaeda were to attack an already-fat Kotsko, wouldn't that be ironic?
Posted by John Emerson | Link to this comment | 02-11-06 10:42 AM
It would be like ten thousand shoe bombs when what I need is a suitcase nuke.
Posted by apostropher | Link to this comment | 02-11-06 10:43 AM
*applauds Alameida*
Posted by Standpipe Bridgeplate | Link to this comment | 02-11-06 10:47 AM
But what if being fat was the condition for me to be a super-genius? And then al-Qaeda killed me right when I got fat!
Posted by Adam Kotsko | Link to this comment | 02-11-06 10:53 AM
That would be sweet.
Posted by ben wolfson | Link to this comment | 02-11-06 10:59 AM
What if an Al-Qaeda bomb was ticking in Times Square, and Kotsko were so fat that if you were to push him he would absorb the impact, and he just happens to be standing on a ledge on, um, some building in Times Square so that if you give him a nudge he'd fall onto it, saving everyone else? And then while you're going up to push him off, he slips and starts to totter, and you just stand by and let him fall off? Would it then be OK to torture suspected terrorists, given that torturing people is kind of fun?
Posted by Matt Weiner | Link to this comment | 02-11-06 11:04 AM
Dick Cheney's Philosophical Thought-Experiment Legislation.
Posted by Matt Weiner | Link to this comment | 02-11-06 11:06 AM
Perhaps if we tortured fat Kotsko himself, the terrorists would see the error of their ways and quit.
I imagine Fat Kotsko being somewhat like the Staypuff Marshmallow Man in Ghostbusters.
Posted by John Emerson | Link to this comment | 02-11-06 11:07 AM
But seriously: fat people are all unhealthy and on the verge of death anyway. Torture could only help in that situation.
Posted by Adam Kotsko | Link to this comment | 02-11-06 11:09 AM
ledge on, um, some building in Times Square
The Cup Noodles billboard, obviously.
Posted by Becks | Link to this comment | 02-11-06 11:11 AM
I really want to meet Alameida some day!
Schizophrenics do tend to get diabetes and heart disease. I watched a UCLA grand rounds presentation about how psychiatrists aren't concerned enough about their patients physical health and ought to be coordinating with primary care providers.
If she's got any mania, she could try adding topiramate to her cocktail, since one of its side effects is weight loss.
Posted by Bostoniangirl | Link to this comment | 02-11-06 11:34 AM
What if, under their fatness, fat people are all potential Van Goghs?
Posted by bitchphd | Link to this comment | 02-11-06 11:36 AM
Bitch, That's why they need to be tortured, to keep them from jealously guarding their artistic genius. Or perhaps it would directly produce artistic genius -- there's a reason we have a stereotype that artists tend to suffer, and that's because suffering is directly productive of artistic genius. I have a couple anecdotal points that seem to prove this pretty conclusively.
Posted by Adam Kotsko | Link to this comment | 02-11-06 11:39 AM
B, Kotsko isn't any goddamn Van Gogh. He's just fat.
Posted by John Emerson | Link to this comment | 02-11-06 11:39 AM
I beliee that Carl Schmitt has shown that torturing Kotsko without any utilitarian goal would be more noble and more political than torturing him in order to find out where he hid the bubble gum and skittles.
Posted by John Emerson | Link to this comment | 02-11-06 11:41 AM
Kotsko isn't any goddamn Van Gogh. He's just fat.
If Kotsko is already fat, does that mean the terrorists have already won?
Posted by Tia | Link to this comment | 02-11-06 11:42 AM
No, they have to blow up fat Kotsko, the way they blew up that decomposing whale in Taiwan.
Actually that was a suicide-bomber whale that blew itself up. Oddly enough, the Taiwanese are not whalers; it's the Japanese. But whales aren't that spmart, no matter what Greenpeace tells you.
Posted by John Emerson | Link to this comment | 02-11-06 11:51 AM
#36
Yes, obese and fat aren't necessarily the same. But there is evidence that even being moderately overweight often has consequences. Yes, there's exceptions. But even mild weight gain can have a significant effect on arthritis. Overweight increases your chances of renal disease. It's a good indicator for risk of insulin resistance. A recent study on a Chinese population suggested a BMI cutoff as low as 23 might be appropriate to identify obesity-related metabolic disorders.
Posted by gswift | Link to this comment | 02-11-06 11:57 AM
Plus, it can often be more difficult to find a date, leading to such diseases as spinsterhood or old crusty bachelorhood.
Posted by Adam Kotsko | Link to this comment | 02-11-06 12:02 PM
#59: There are also studies showing that being underweight is unhealthy, and yet these studies never come up in threads where we're talking about how hott Scarlett Johanssen is.
Posted by bitchphd | Link to this comment | 02-11-06 12:05 PM
How hot is she really? I mean, don't you want something to grab onto?
Posted by Adam Kotsko | Link to this comment | 02-11-06 12:24 PM
Isaac Mizrahi knows that Johansson's got plenty to grab onto.
Posted by ben wolfson | Link to this comment | 02-11-06 12:27 PM
Her hair?
Posted by Adam Kotsko | Link to this comment | 02-11-06 12:31 PM
You know, gswift, I just clicked through to a bunch of your links, and none of them controlled for diet or exercise frequency. I find this kind of shocking.
Posted by Tia | Link to this comment | 02-11-06 12:31 PM
S-Jo, in fairness, has got at least two things to grab on to.
Posted by Tia | Link to this comment | 02-11-06 12:32 PM
The other thing about these fat / health studies, is that no one ever points out that, as with studies of cranial capacity in the nineteenth century, if you're specifically looking for associations between "fat" (defined how?) and ill health, you will find them.
Posted by bitchphd | Link to this comment | 02-11-06 12:34 PM
Not quite, Kotsko.
Posted by ben wolfson | Link to this comment | 02-11-06 12:35 PM
As the commenters in the clip said: if you're gay, you're allowed to do that.
Posted by Becks | Link to this comment | 02-11-06 12:44 PM
I see, so it's just generic male entitlement and assholery, rather than any interest in what her tits actually feel like.
Posted by bitchphd | Link to this comment | 02-11-06 12:47 PM
Please don't get me started on Scarlet Johansen.
That lovely fat ass of hers is the hottest thing in all of media. She looks like those dolls who always stand up straight when you tip them over, because their lovely big asses keep them equilibrious.
B, you say, "I was much fitter and more athletic when I weighed 40 lbs more than I do now, and I was still quite happily within an acceptable aesthetic norm, too."
Hey, you'd be within MY acceptable norm, but does a 40 lbs difference really put you within a generally acceptable one (unless you're 7 ft tall)?
I know people who freak out about 5 lbs.
BTW, I think it's rather sweet of the docs to be concerned about the destruction of a patient's beauty, despite the fact they're being maximum jerks.
Posted by Adam | Link to this comment | 02-11-06 12:48 PM
The article is terrible. But it seems very, very unlikely that the doctors altered her meds for aesthetic reasons. It doesn't hold up to scrutiny -- if you've visited a mental health facility since the advent of the atypical antipsychotics, you know that a lot -- maybe most -- of the patients are overweight because of the drugs; this is not a novel dilemma. And the cardiovascular concerns are real (I believe that the drugs affect fat metabolism as well, making this kind of obesity even more unhealthy than it normally would be).
There are more medications out there than the author pretends. If she and her doctors were willing to keep trying new ones until they found a better one, then that's pretty clearly what they should have done. Even if she wasn't concerned about the weight gain, if she was willing to try new drugs her doctors should have encouraged her to.
Not that getting outraged isn't fun, but the idea that medical professionals would allow someone to suffer just so she'd remain hot sounds like a caricature to me.
Posted by tom | Link to this comment | 02-11-06 12:51 PM
No gay men are allowed to touch my breasts in public! That goes for especially for you, Wolfson.
Posted by Tia | Link to this comment | 02-11-06 12:51 PM
Yes, Adam, at both my current weight and my previous one, I was generally accepted conventional beauty standards. 40 lbs really is not that much.
People freak out about 5 lbs because they're concerned about their HEALTH, don'tcha know.
Posted by bitchphd | Link to this comment | 02-11-06 12:52 PM
If I have to touch your breasts in public to prove that I'm not gay, Tia, then by god I will.
Posted by ben wolfson | Link to this comment | 02-11-06 12:53 PM
OK, maybe it's just me. I'm always getting my ass grabbed or felt up by my gay friends (in a joking, non-sexual way, much like the Johannsen clip).
Posted by Becks | Link to this comment | 02-11-06 12:54 PM
"was within generally."
Ben didn't grope my breasts when he met me.
Posted by bitchphd | Link to this comment | 02-11-06 12:55 PM
So perhaps Ben's *not* groping is proof that he's not gay?
I'm confused.
Posted by bitchphd | Link to this comment | 02-11-06 12:56 PM
Unless you've actually seen them have sex with another man, I'm suspicious of these "gay" friends of yours, Becks.
Posted by SomeCallMeTim | Link to this comment | 02-11-06 12:56 PM
B-Wo, touching my breasts in public wouldn't prove you weren't gay; it would make your gayness all the more apparent. If you want to prove you're not gay, stand on the other side of the split screen with a mike and hot blonde woman, and have the blonde woman inform America that you couldn't get away with that, because you're straight. Then no one will think you're gay.
Posted by Tia | Link to this comment | 02-11-06 12:57 PM
Must be because you're beautiful anyway, B.
Putting on 40 lbs would put my beauty at risk, I do believe.
Posted by Adam | Link to this comment | 02-11-06 12:58 PM
I dunno, that approach (or a reasonable approximation thereof) doesn't seem to have worked all that well for Tom Cruise.
Posted by bitchphd | Link to this comment | 02-11-06 12:58 PM
Tia, my reasoning was that if no gay men are allowed to touch your breasts, then my touching your breasts would constitute proof that I'm not gay, because if I were, I wouldn't have been allowed to do so, see?
Posted by ben wolfson | Link to this comment | 02-11-06 1:00 PM
But it's worked out so swimmingly for Ryan Seacrest! Who never dreams of a leather clad Simon Cowell squeezing his balls while he (Ryan) sings "The First Cut is the Deepest" in a tremulous falsetto! Never!
Posted by Tia | Link to this comment | 02-11-06 1:01 PM
A recent study on a Chinese population suggested a BMI cutoff as low as 23 might be appropriate to identify obesity-related metabolic disorders.
That's, um. Very low. Like 5'5'' and 135 pounds low. Perhaps it's contingent on being Chinese (and small-framed)? Cause that's what I weighed in college, and I was in ridiculously good shape. And ten pounds heavier. I'm a lower BMI now, but I was definitely healthier then.
There's no doubt that there's a link between not exercising and being unhealthy. There's no doubt that there's a link between eating poorly and being unhealthy. There is some evidence that being fat is a poor proxy for judging whether someone is eating poorly and not exercising. And there's even more evidence that being thin is a poor proxy for judging someone's eating habits and activity level. I know a fair amount of skinny undergrads who are skinny just because they're 22, not because they all eat like anorexic angels.
(Still, B, 40 pounds? Aren't you my size?)
But the prejudice doesn't take any of that into account. I'm thin, even though my diet these days is close to nutritionally bankrupt. I exercise. I drink alcohol. But if you saw me walking along eating an ice cream cone, you wouldn't assume I was out of shape and destroying my health. Why? Cause I'm thin. A heavier-set woman, who exercises and eats well? If she's eating an ice cream cone, people are going to assume 'No wonder she's fat.'
Posted by Cala | Link to this comment | 02-11-06 1:01 PM
81: In all honesty, it just means that one can shift from the thin side of acceptable to the heavy side of acceptable, especially if one puts the weight on in a relatively balanced way. I know guys who were on the thin side at 145 and on the heavier side at 185, but in neither case stood out. Same thing can apply to women.
Posted by bitchphd | Link to this comment | 02-11-06 1:01 PM
83: Oh, this is like math. It's all so confusing.
Posted by Tia | Link to this comment | 02-11-06 1:02 PM
Even having sex in public with a girl doesn't prove a guy ain't gay.
Posted by Adam | Link to this comment | 02-11-06 1:03 PM
83: Wait! I thought of a rebuttal! Though the set of straight men and the set of gay men are equally disallowed to touch my breasts in public, only members of the set of gay men might mistakenly think they can get away with it. Ergo, touching my breasts in public would demonstrate that you were gay.
Posted by Tia | Link to this comment | 02-11-06 1:08 PM
Worth a shot, though.
Posted by ben wolfson | Link to this comment | 02-11-06 1:08 PM
Cala, I don't know--what size are you? I"m 5'5" and about 120; fifteen years ago I weighed 160. Back then I was Marilyn Monroe-ish, now I'm not.
Posted by bitchphd | Link to this comment | 02-11-06 1:08 PM
(continued from 84)...but I guess you all know what my fantasies consist of now.
[slinks off]
Posted by Tia | Link to this comment | 02-11-06 1:09 PM
Heh. I'm about a 6, normally. Must be different frames; if I were 40 pounds heavier I can't imagine carrying it well at all.
Posted by Cala | Link to this comment | 02-11-06 1:10 PM
86:
Yep, got ya.
But it can also depend on how much of the weight ends up on the face.
Posted by Adam | Link to this comment | 02-11-06 1:11 PM
Or, for instance, take a guy who is six feet tall. 165 lbs = on the thin side, but not skinny; 205 = certainly not fat.
Posted by bitchphd | Link to this comment | 02-11-06 1:11 PM
I think I could lose 30 lbs or gain ten and still be teh hott.
Posted by Tia | Link to this comment | 02-11-06 1:11 PM
90 - However, it sounds like making an attempt to touch Tia's breasts in public would put you out of the running of ever touching them in private so the calculation of whether it is in one's interest to attempt a public-touching would involve not only gay/not-gay set theory but a statistical analysis of the probability of a future private touching.
Posted by Becks | Link to this comment | 02-11-06 1:12 PM
40lbs really isn't that much.
From age 20 to 22 i put on about 50lbs without any increase in waist measurement at all. All the 'man-hormones' kicking in plus serious levels of exercise can do that pretty easily.
Right now I'm about 20-30lbs overweight [based on the weight that looks good/feels healthy for me] but my BMI even when I was very fit would have been over 30. They are just not good indicators for men.
Posted by Matt McGrattan | Link to this comment | 02-11-06 1:13 PM
teh conventionally hott that is.
Posted by Tia | Link to this comment | 02-11-06 1:13 PM
#98: Nor for women either, is my point.
And since this is #100, obviously I am right.
Posted by bitchphd | Link to this comment | 02-11-06 1:14 PM
I think tom's right. At a minimum, 40 lbs extra is going to put greater strain on your joints. Depending on a variety of other factors, including your build and your level of activity, it might not have a bad effect. But there are plenty of NBA players whose weight-associated injuries have limited their effectiveness. See, e.g., Shaq.
Posted by SomeCallMeTim | Link to this comment | 02-11-06 1:15 PM
I think for me teh conventionally hot range is probably +/-15. It would all end up in my legs, which are short and stocky to begin with. (My feelings wuz hurted when you all made fun of the volleyball player with the stocky legs.)
I think the BMI sucks as an indicator. It really doesn't address lean muscle/fat proportion at all.
Posted by Cala | Link to this comment | 02-11-06 1:17 PM
If I weren't so distracted by Scarlett Johansen's ass, I'd be dying to touch Tia's breasts.
Posted by Adam | Link to this comment | 02-11-06 1:18 PM
Well, I'm 5'7' ', I have a large frame and carry/would gain my weight in such a way that it's/would be easy to emphazise my narrow waist and curvy hips and butt and look teh conventionally hott. I think it depends on your body. My legs are long and stocky.
Posted by Tia | Link to this comment | 02-11-06 1:21 PM
Adam, you are one fresh noob.
Posted by Tia | Link to this comment | 02-11-06 1:22 PM
To me, a guy should politely grope a woman's breasts when he first meats her, but I think that it' s wrong to put him under a microscope and ask whether he's showing too much enthusiasm (or not enough). It's really just a formality and doesn't have any real meaning -- like saying "How are you?" when you don't really want an answer.
Posted by John Emerson | Link to this comment | 02-11-06 1:23 PM
We've gone from making fun of a doctor for worrying about a patient's looks more than her mental health to arguing the differential weights at which people can still retain their looks. Progress!
Posted by SomeCallMeTim | Link to this comment | 02-11-06 1:23 PM
105: I was thinking the same thing, and he wasn't even talking about me.
Posted by washerdreyer | Link to this comment | 02-11-06 1:26 PM
Meets.
Posted by John Emerson | Link to this comment | 02-11-06 1:27 PM
105: Which is to say, you must toil for long hours in The Mineshaft before you are permitted to even express the desire that one day you might hope achieve the necessary enlightenment to begin the journey of ascension to the Banana Lofts, much less penetrate the inner sanctum and pull aside the gauzy curtain of my receiving chamber, where I will be seated on seven cusions of spun gold, my robe pulled aside, one breast delicately exposed, awaiting my disciple's touch.
Posted by Tia | Link to this comment | 02-11-06 1:32 PM
Tia: I didn't say I would -- just die to. Being the polite type, I'd ask first. Very sweetly, haltingly, demurely. And only if I thought I stood half a chance.
Posted by Adam | Link to this comment | 02-11-06 1:41 PM
"I was much fitter and more athletic when I weighed 40 lbs more than I do now, and I was still quite happily within an acceptable aesthetic norm, too."
Just as another data point, I'm right now 40 lbs over where I was freshman year of college (125 then, 165 now; 5'7" at all relevant times). I was skinny, but not scary-looking then; I'm solid, but not particularly overweight looking now. Depending on your frame size, 40 pounds doesn't necessarily make a hugely visible difference.
Posted by LizardBreath | Link to this comment | 02-11-06 1:41 PM
The only reason that straight guys don't randomly grope breasts is that they know it would get in the way of more over-riding goals, which gay men do not share. In principle, however, we straight men gladly join hands with our gay brethren in our shared belief that women's bodies are or at least should be at our full disposal at all times.
Re: encounter between Tia and Ben -- you can't grope the willing. (Perhaps this applies to what transpired with Bitch, too?)
Posted by Adam Kotsko | Link to this comment | 02-11-06 1:43 PM
Man, have I got to start looking at IDs with more attention. I thought Adam was Kotsko being uncharacteristically lewd, until I realized that Kotsko was commenting as well.
Posted by LizardBreath | Link to this comment | 02-11-06 1:48 PM
110: And only ten minutes ago, I didn't know I had anything to live for. If I knew where to sign up, I'd start cleaning out the stables ASAP.
Posted by Adam | Link to this comment | 02-11-06 1:49 PM
People seem to know me more by my last name, so I don't feel threatened by another Adam. Another Kotsko, however, would have to be killed.
Posted by Adam Kotsko | Link to this comment | 02-11-06 1:51 PM
re: 100
Definitely. It doesn't work for anyone who has a lot of lean muscle mass.
Generally, among people I know, that tends to be guys but it's just as useless for athletic women..
[In terms of myself the increase in weight and corresponding increase in BMI doesn't reflect the crappiness of the shape I am in since as well as gaining 20 lbs I'm sure I've lost a fair bit of lean body mass and that wouldn't be reflected in the BMI score]
Posted by Matt McGrattan | Link to this comment | 02-11-06 1:54 PM
#107: It'll be progress when we start discussing eating disorders in the "which hott model do you like best" threads.
I'll vouch for Adam. He's not a n00b to me. How he found me here, though, I don't know.
Matt McG, agreed: except that, like you, I'm not in shape either, so I don't even think it has so much to do with athleticism as it does with simple body type.
Posted by bitchphd | Link to this comment | 02-11-06 2:06 PM
Bitch, you're a peach.
Posted by Adam | Link to this comment | 02-11-06 2:10 PM
Oh, I don't think there's a thing wrong with being a noob, even a bold one -- I just hadn't differentiated him yet.
Posted by LizardBreath | Link to this comment | 02-11-06 2:11 PM
I've never seen a study of whether heavy, fit, non-fat people (i.e. very muscular people) are at risk. For heart disease it's possible that they are.
Posted by John Emerson | Link to this comment | 02-11-06 2:11 PM
And, hi -- make yourself at home.
Posted by LizardBreath | Link to this comment | 02-11-06 2:11 PM
115: First, you must relinquish all desire. Report back when you've accomplished that.
Posted by Tia | Link to this comment | 02-11-06 2:13 PM
121-
I don't have a link at my fingertips, but I'd be stunned if there were negative health effects from carrying too much muscle (that is, someone with a high BMI, but a normal or low body-fat percentage). I don't think I've ever read anything suggesting that that is the case.
Posted by LizardBreath | Link to this comment | 02-11-06 2:18 PM
115: Heavy round-the-clock flagellation with some spiky objet is my immediate destiny, I fear. But I shall prevail over all desire, basely justified as it may be. I'd also like to wallow in the ID of noob, if only I knew what the heck it meant -- blogging nomenclature moves too fast for those of us mired in our sodden, muddy, downtrodden, earthbound desire for the unattainable Banana Lofty. Yet, there is always the risk that even a dim, half-lit, gossamer glimpse of said Lofty, not to mention spun gold, would render all the flagellation useless in one ecstatic instant. What's a poor het to do?
Posted by Adam | Link to this comment | 02-11-06 2:33 PM
LB, I've never seen it discussed. But if the problem is a small heart driving a big body, it wouldn't necessarily make a difference what kind of big it was.
Muscle seems nice and good, and fat seems bad and evil, but if bulk is the problem maybe they work the same.
I have no opinion on this, but the question seems worth raising, and I've never seen it discussed.
Posted by John Emerson | Link to this comment | 02-11-06 2:36 PM
Noob, it's customary around here to grope all the women when you first show up. They pretend they don't like it, but really they do. (They're all like that, except for lesbians.)
Posted by John Emerson | Link to this comment | 02-11-06 2:39 PM
But if the problem is a small heart driving a big body
Couple of things: (1) I'm pretty sure that that's not the problem, so much, the problem is that fat is associated with clogged arteries that kill heart tissue; and (2) athletes have bigger hearts. Just like any other muscle, when you work it, it grows. (There was actually a misconception in the early part of the century that athleticism was bad for the heart because dead athletes, when autopsied, had larger hearts, and there are some forms of heart disease that also cause the heart to grow larger. It took doctors a while to grasp that larger due to athleticism was harmless and healthy, while larger dues to heart disease was bad.)
Posted by LizardBreath | Link to this comment | 02-11-06 2:41 PM
First, you must relinquish all desire. Report back when you've accomplished that.
Dammit, Tia, he was going to clean our stables! Keep stringing him along!
Posted by Matt Weiner | Link to this comment | 02-11-06 2:45 PM
"Cleaning our stables" sounds kinky. No wonder Weiner's disappointed.
Posted by Becks | Link to this comment | 02-11-06 2:49 PM
blogging nomenclature moves too fast for those of us mired in our sodden, muddy, downtrodden, earthbound desire for the unattainable Banana Lofty. [sic]
I think we should help him attain his desire for the Banana Lofts, really I do.
Posted by Matt Weiner | Link to this comment | 02-11-06 2:54 PM
I'd just like to see the question discussed. Some athletes (weightlifter types) get the body mass without doing other kinds of exercise.
Posted by John Emerson | Link to this comment | 02-11-06 2:56 PM
"N00b" = newbie.
No worries, Matt: Adam will definitely up the Mineshaftishness once he gets the feel of the place.
Posted by bitchphd | Link to this comment | 02-11-06 3:02 PM
Up the Mineshaft!
This suggests that really big football players have seriously negative health outcomes. It includes the statement, "When you get that big - regardless of whether your body is muscle or fat - your heart is stressed."
Posted by Matt Weiner | Link to this comment | 02-11-06 3:08 PM
Some athletes (weightlifter types) get the body mass without doing other kinds of exercise.
I don't think you can build all that much muscle mass without getting a cardio workout. I lift weights (moderately -- I'm nothing all that impressive) and in 40 minutes of lifting weights, my heart rate is pretty far up there for most of it.
Posted by LizardBreath | Link to this comment | 02-11-06 3:08 PM
127:
Emerson, you've got me all wrong. I'm not the seedy hoodlum of whom you speak. I am a mere supplicant, humbly waiting for the Divine High Priestess T to strew my path with broken glass, so I can crawlingly earn in blood the right to gaze from afar upon the majesty of the Banana Lofty, before I go thrillingly fulfilled to my grave, the words "Tia, Tia" wafting from my dying lips.
Posted by Adam | Link to this comment | 02-11-06 3:12 PM
Well, we were looking for a seedy hoodlum.
Posted by John Emerson | Link to this comment | 02-11-06 3:14 PM
I don't have a link at my fingertips, but I'd be stunned if there were negative health effects from carrying too much muscle (that is, someone with a high BMI, but a normal or low body-fat percentage). I don't think I've ever read anything suggesting that that is the case.
I believe Emerson's right. Fat brings additional problems, but mass in general is an issue. Check out some obits for weightlifters, bodybuilders or ex-linebackers (or the article Matt linked). They seem to rarely make it out of their sixties.
It sucks that there isn't some reasonable ideal weight, but until you start running into malnutrition problems, skinnier is healthier. It sort of makes sense — your body is a particularly prolonged chemical reaction. Exercise can tune it sufficiently well that it makes up for whatever metabolic cost it adds, but in general it seems like the faster you run it, the faster it runs out (the extreme case being the effect wherein a super, super lo-cal diet (loaded up with nutrients to make up the loss of nutritional input) prolongs mammalian lifespan). Peak efficiency doesn't necessarily translate into longevity.
Posted by tom | Link to this comment | 02-11-06 3:14 PM
133: I thought we established that straight guys weren't allowed to get a feel of the place.
Adam, you just have to be more aggressive than Ewan MacGregor. Matlock gets her in the mood.
Posted by apostropher | Link to this comment | 02-11-06 3:17 PM
skinnier is healthier.
Didn't some huge study just come out showing lowest death rates in the moderately overweight category, with 'normal' having the same rates as mildly obese, and underweight being as bad for you as very obese? Or am I imagining this? It was sometime in '05, but I'm going out to dinner now and don't have time to find it.
Posted by LizardBreath | Link to this comment | 02-11-06 3:19 PM
And remember, sometimes a lofty banana is just a lofty banana.
Posted by Matt Weiner | Link to this comment | 02-11-06 3:19 PM
There are, in fact, studies that show that being moderately overweight is healthier than the converse.
Posted by bitchphd | Link to this comment | 02-11-06 3:20 PM
Of course, the whole thing about whether "over" or "under" weight is healthier just goes to show that what we mean by "weight" is an aesthetic category, rather than a health one.
Posted by bitchphd | Link to this comment | 02-11-06 3:22 PM
Of course, the whole thing about whether "over" or "under" weight is healthier just goes to show that what we mean by "weight" is an aesthetic category, rather than a health one.
Not necessarily. It could be standard model vs. newer model.
Posted by SomeCallMeTim | Link to this comment | 02-11-06 3:23 PM
It's pretty clearly both, I'd say. Just that the categories are poorly defined and vary across indiviuals.
Posted by apostropher | Link to this comment | 02-11-06 3:25 PM
Alan Page, a Hall of Famer from the Vikings Super Bowl teams, ended his career after he saw the mortality rates for linemen. He didn't quit, he just started losing weight and they fired him. Football coaches encourage linemen to put on 50 lb. or so of fat too -- it makes people harder to move and adds heft if you're leaning on someone. Few linemen are lean, and steroids are also a factor.
Page is now on the MN State Supreme Court. He'd be a Senator except that the DFL was too chicken -- when Wellstone was killed they named Mondale to run in his place, but Page would have been the better candidate.
Matt's link is a hodge-podge of stuff. My favorite is "God put Scott on this earth and God took him off". Really, what do you need medicine for if religion explains everything.
Posted by John Emerson | Link to this comment | 02-11-06 3:27 PM
Without knowing the studies I've got no idea how well they control for all the various external factors associated with being one weight or another. Presumably they didn't recruit their skinny participants from down by the methadone clinic, but there are tons and tons of subtle lifestyle differences associated with weight. In practice I've no doubt that people who are a normal weight live the longest, on average. But in the lab, slightly starved animals can be made to live much, much longer.
Posted by tom | Link to this comment | 02-11-06 3:28 PM
I think that we need to do an intervention with BPhD. She's not fat, but's she's awfully defensive about far issues. I think that she's planning to get fat.
We'll be sorry if we dither around until it's too late and we have to deal with a fat, jolly Bitch.
Posted by John Emerson | Link to this comment | 02-11-06 3:31 PM
"fat issues"
Posted by John Emerson | Link to this comment | 02-11-06 3:31 PM
137 & 139:
Listen, if T wants me to play Big Sweet Butch to her beauty, I can switch personas faster than Bloomberg can switch parties.
But she calls the shots, not you.
Posted by Adam | Link to this comment | 02-11-06 3:32 PM
#148: Yes, it's all about my internal ugly chick, like most other feminist arguments.
Posted by bitchphd | Link to this comment | 02-11-06 3:41 PM
re: 142 and 143
I've certainly seen articles in the popular science press reporting that to be the case -- that moderately overweight + fit is better than skinny + fit.
And fit trumps unfit whatever the weight.
Significant weight-loss is, apparently, correlated with long-term health problems too. Apparently if you're fat getting fit and staying fat is likely to be the best course.
Of course people (including me) want to lose weight for aesthetic reasons so the calculus may not be a solely health based on.
Posted by Matt McGrattan | Link to this comment | 02-11-06 3:41 PM
I think most of this starts with a bizarre post-modern fixation on body issues in general. I remember living outside the US, where people ate, drank, slept, fucked, lived and died, and nobody thought much about their bodies, except when their bodies told them to go the bathroom.
Posted by Adam | Link to this comment | 02-11-06 4:08 PM
[I should have posted last night.]
Story: The consultant favoured Olanzapine for Nia; he had found the drug to work well in her age group despite concerns about weight gain and diabetes.
Link.
SIDE EFFECTS: Side effects seen with olanzapine include akathisia (an inability to sit still), constipation, dizziness, drowsiness, insomnia, dry mouth, orthostatic hypotension (see DRUG INTERACTIONS), tremor, and weight gain.
[...]
There may be an increased risk of increased blood sugar levels and diabetes with olanzapine as well as the other antipsychotic medications in its class. Patients should be tested during treatment for elevated blood sugar. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Story: The nurses were so encouraged by her regular appearance in the dining room that they didn't question the heap of beans and potatoes. But soon it became apparent that insanity had been replaced by appetite. Within three weeks she put on three stone.
Or one stone per week. Going with alameida's six months that's 52/2 = 26 * 14 lbs. = 364 lbs.
Assuming she was 5'10" and 120, she'd then be 5'10" and 480 lbs. Which is about 150 pounds more than optimum for a 6'6" football linebacker.
Of course, maybe she won't pack it on so fast. Maybe after the first three weeks (+42 pounds) she only packs it on half as fast for six months. So 120 + 42 + ((26 - 3) * 7) = 323 pounds. (Keeping the other, distinct, possible side effects in mind: diabetes and cardiovascular problems.) That's not quite so bad, unless she's 5'0".
If it levels off after three weeks, ok. If it's compulsive, that is, this particular psychotropic compound had had an unexpected mental side effect, you've just traded one problem for another. Ergo, changing medications to try and find one that cures the problem without the side effects is the right thing to do. Because potentially inducing diabetes in combination with inducing compulsive, uncontrollable food consumption is a lethal combination. (Diabetics have blood sugar problems. Compulsive eaters consume everything, including sweets. Poor circulation, crapped out immune system and so on, right on up to diabetically-induced psychosis, coma, gangrene and amputation.)
Not to mention, she might hit 350 pounds, decide she doesn't like the weight, and stop taking her meds, and she's right back where she started +200 pounds. And then she jumps off a bridge. YAY!
If that isn't painfully clear, try a bit of creative rewriting:
What the staff didn't pick up immediately was Nia's need to remain clean. The nurses were so encouraged by her regular sojurns in the bathroom that they didn't question her constant showering. But soon it became apparent that insanity had been replaced by an obsession with cleanliness. Within three weeks the skin over her entire body was cracked, dry and bleeding and her hair was falling out [You try taking 10 half-hour showers a day for 3 straight weeks]. Now, for the first time, Nia's features were being corrupted.
But closing with the same line!:
Perhaps, in fact, this was a merciful side-effect of medication, or even of the disorder itself; one that liberated Nia from the need to live up to the standards of an image-obsessed world.
Tia: If there were ever a quease-inducing cocktail, it is this article: the soft-focus, gooey treatment of mental illness, the elevation of a woman's appearance to near-paramount importance--just barely behind her sanity; no drug, no matter how potent, can stop the gastrointestical process now.
The writer's chose to take a story of mental illness and the perils of psychotropics and give it a quasi-feminist (psuedo-?) recast as a story about silly (male) doctors and their obsession with body image. Given the closing line, I believe they did so deliberately, unless they were fucking unconscious when they wrote it.
YHBT. HTH. HAND.
ash
['Spit out the hook.']
Posted by ash | Link to this comment | 02-11-06 4:09 PM
Ash, sometimes you make your points in a style that I find hard to clearly follow, and I'm not quite sure to respond. So take this as an effort that may be responding to points you're not making. If it's not clear from my comments in the thread, I neither endorse nor criticize the actions of her actual treating psychiatrists; I wasn't there and besides, to get to any truth about Nia through that article is like trying to get out of the sticky syrup at the bottom of a roach motel after having been shrunk by Rick Moranis (I realize this is not the best metaphor, but I'm using it because if that article had a smell, it would smell like a roach motel). I acknowledge in 10, 12, and 18 that there might well have been legitimate health concerns, and I don't even object to trying to find a drug that didn't have cosmetic side effects, if that was what Nia wanted.
What's so gross is the article. To make it clearer, there was no goddamned story here. Psychotropic drug causes weight gain. Dog bites man. These writers tried to turn it into a maudlin tragedy of nymphette beauty lost to the world, and said that it would have been better if sane Nia understood how valuable her sex appeal had been, and regretted its loss, because they did. The writers did not talk about her weight in terms of her health, but in terms of her value as object. They weren't worried that sane Nia was insensible to the self-damaging aspect of her weight gain; they were worried that she wasn't concerned that she wasn't beautiful to them. I don't understand how you can see even quasi-feminism in the writers' stance, unless the whole thing is parody, but I don't even see a hint of a wink.
Posted by Tia | Link to this comment | 02-11-06 4:29 PM
But she calls the shots, not you.
How things have changed.
Posted by Tia | Link to this comment | 02-11-06 4:42 PM
I'd pull the licenses of both the 'young psychiatrist' and the 'consultant', if the following are accurate:
"Get a dietician ...; change her to Quetiapine."
"Put up the dose," said the consultant
The consultant felt there was no option but to put her back on the Olanzapine.
The desire to experiment further with her medication left the consultant and the young psychiatrist.
For a while the young psychiatrist worried about the consequences of the choices they had made in treating her.
This makes it clear that the patient was not making her own treatment decisions, or even participating in those decisions. Psychiatrists should never, never, never make treatment decisions on behalf of patients. That's an impermissible deprivation of the patient's autonomy and an impermissible conflict of interest. If the patient is incompetent, there should be a treatment guardian.
With that sort of attitude about who makes the decision, it's no wonder the two docs are a pair of arrogant patriarchist sexist pigs.
Posted by Michael H Schneider | Link to this comment | 02-11-06 5:19 PM
Yes, BMI is not always a good indicator. I tend toward the "overweight" side, a 24 or 25 as I do a fair amount of weightlifting. That being said, take a look around with regard to general trends. Are most people on the high end of a BMI chart because of their muscle mass?
With regard to moderately overweight being healthier, if it's the same study I'm thinking of, it didn't examine health. That was around this time last year, and it examined life span of moderately overweight people in the U.S. based off surveys done in the 70's, 80's, and 90's. It found that people who were a bit overweight lived slightly longer than the obese and underweight. It didn't examine obesity related diseases at all. This trend could reflect all sorts of things like better health care, socioeconomic factors, etc. Proclaiming the healthiness of being overweight is a bit premature.
And yes, weight gain is an independant risk factor. The best data I've seen so far is this Harvard study on coronary heart disease. Approx. 90,000 women over 20 years. Here's the money shot.
Even a modest weight gain (4 to 10 kg) during adulthood was associated with 27% (95% CI, 12% to 45%) increased risk of CHD compared with women with a stable weight after adjusting for physical activity and other cardiovascular risk factors. CONCLUSIONS: Obesity and physical inactivity independently contribute to the development of CHD in women. These data underscore the importance of both maintaining a healthy weight and regular physical activity in preventing CHD.
Posted by gswift | Link to this comment | 02-11-06 10:12 PM
To follow up on Michael Schneider's 157, what was really remarkable to me about the article was the way that Nia as an agent seemed to drop out mid-way through. Yeah, before that halfway point she was hopelessly fetishized, but once she was institutionalized, the article didn't even try to represent her point of view.
And that's why the last line, as melodramatic as it is (and I'm still trying to figure out exactly what heartstrings it's trying to pull on), might through the absolutely shitty journalism actually represent a real problem: the involuntarily institutionalized Nia has not seemed to notice gaining forty pounds in three weeks.
If Nia--not her parents or doctors--thought that feeling sane was a good trade-off for potentially health-endangering weight-gain, that would be fine. Great, even; it sounds like she was really suffering before. But if Nia was representing herself as indifferent to the (very sudden-seeming) change to the people whom the journalist clearly did interview, then maybe her treatment course is more ethically problematic.
Since the article is so poorly and condescendingly written, it's hard to say. Clearly Nia wasn't willing to talk to the reporter, while the family and doctors were; that's already a bad sign.
Posted by Jackmormon | Link to this comment | 02-11-06 11:18 PM
Every time I re-read that article something else jumps out at me and screams. How about this:
His adolescent urges and manic disinhibition were a fertile mix and the staff found him trying every trick in the book to get into her bedroom. It's remarkable what can be contrived, even in a locked ward. One night, they were found in bed together. Nia was put on one-to-one observation.
Uh, a delusional psychotic patient isn't protected from other patients? Was this rape? Did anyone, like, investigate? Should we be thinking PTSD?
Later:
Nia was herself, but not herself. She blended in, lumpenly.
Uh oh. Flat affect? Dissociation? The DSM-III lists those as indicators of PTSD. We're calling this 'sane'?
JM, I think you're being charitable in saying : "...maybe her treatment course is more ethically problematic." One of the historical problems with antipsychotics, especially in institutional settings, is that the real goal of the overwhelmed staff tends to be compliance. A compliant patient can be discharged, always a goal in the usual situation where the census it too high. There's not enough information to be sure, but I think there are very good grounds for suspecting very bad practice.
Posted by Michael H Schneider | Link to this comment | 02-11-06 11:53 PM
Yeah, MHS, I noticed that break-in, and I was also wondering about rape. I don't have any direct experience in clinical, much less institutional facilities, but the glazing over of why must have been a horrific loss of freedom for Nia seemed incredibly callous to me.
And it's the lack of Nia's affect that scares me most in the article; if nobody interviewed could even suggest what Nia was going through, either the journalist was unusually daft (and that seems fairly likely), or Nia was totally isolated (unfortunately that also seems likely).
It's really too bad that a journalist spent so much time with this story and didn't have the courage (or intellect?) to go further with it. Poor Nia; pretty or not, there must be many thousands like her. I've known a couple.
Posted by Jackmormon | Link to this comment | 02-12-06 12:11 AM
I don't normally comment. It turns out that I'm on Olanzipine, and though I've never been fat, I've gained around 20-30lbs since I've been on the drug. You are a very stupid person if you believe that that does not affect your life negatively. My sex life has ceased, and it once was something to write home about. The doctor was a realist, it actually does matter a great deal to those affected. It's unfair but real. And the trade-off is likewise real.
In her case, no doubt it was warranted. But there are many others on it who are not so bad. Like the manic-depressives. And you have to consider how much better you were doing before. It just ain't that simple, when you consider people's actual lives. All this is is another way that we're fucked.
-d
Posted by d | Link to this comment | 02-12-06 1:58 AM
I should add, I want to see all Republicans hung. I'm only biding time. That little snap at the end is all the reward for which I ask.
-d
Posted by d | Link to this comment | 02-12-06 3:12 AM
I used to work [summer job when I was 17] in a hospital for people with mental disabilities and, specifically, in locked wards for those who are also dangerous to each other and to themselves.
Rape is pretty common -- in fact I had to be moved out of one ward and sent to work elsewhere as it was felt that one of the 'patients' was showing too much of an interest and that I was at risk of rape.
Posted by Matt McGrattan | Link to this comment | 02-12-06 3:58 AM
Hi d, welcome. Thanks for commenting. I'd ask that you'd refrain from fantasizing about the deaths of all Republicans though; that's outside the bounds of Unfogged discourse. Besides, if we did, we'd have hung our most incisive commenter!
Posted by Tia | Link to this comment | 02-12-06 5:55 AM
hi d! I hope I can say I understand (somewhat) where you're coming from. it's definitely true that gaining a lot of weight can have a serious impact on your life, sexual and otherwise. I think the objection we were all having to this is that the patient was represented throughout as utterly lacking agency, and this lack was seen most clearly in the lament that she didn't fully appreciate how hot she'd been before and how this had been lost. it seemed very much as if her external appearance to others [not her internalised vision of herself] was fetishized to a strange degree. if she were to say, "hey, I'm gaining mad weight, I don't like this. can we deal with this side effect?" that would be one thing. for the doctors and journalists to be saying, "she used to be so hot, and now she's fat! how sad that she doesn't even realize all the hottness has been lost!". that's a problem. I, for one, although I am a very vain and superficial person, was able to say that I was willing to trade weight gain and olazapine for being psychotic and institutionalized. if we had seen Nia making this trade-off it would be a different thing.
Posted by alameida | Link to this comment | 02-12-06 6:15 AM
She blended in, lumpenly.
What does this mean? Is it a mistype? Did the author mean "lumpishly"?
Pednatry alert: "lumpen" means "ragged", not "lumpish". The lumpenproletariat are the poorest, least skilled, least employed workers.
Marx did compare the German proletariat to a sack of potatos, and potatos are lumpy, but that's not what "lumpen" means.
Posted by John Emerson | Link to this comment | 02-12-06 7:20 AM
i know i'm late to the party but i can't even bring myself to REAL the article--the synopsis has me upset enough.
Jesus Christ. On a bicycle.
Posted by Karyn | Link to this comment | 02-13-06 8:10 AM
that should be READ the full article. Preview is my friend from now on
Posted by Karyn | Link to this comment | 02-13-06 8:12 AM
Hey don't sell your typos short -- this could be a great neologism if we can figure out the usage rules.
Posted by Jeremy Osner | Link to this comment | 02-13-06 8:16 AM
And speaking of typo-based neologisms, I think there are possibilities in "pednatry".
Posted by Jeremy Osner | Link to this comment | 02-13-06 8:22 AM
The lumpenproletariat are the poorest, least skilled, least employed workers.
Not at the Mineshaft, John.
Posted by apostropher | Link to this comment | 02-13-06 8:29 AM
I see the verb "to real" being in the same ballpark as "to school." He was living a fantasy, but I realed him.
Posted by ac | Link to this comment | 02-13-06 8:32 AM
Apparently no, you're not allowed to grab someone's tits, gay or not.
Posted by http://theenvelope.latimes.com/news/env-et-scarlett3webonlymar03,0,6811375.story?coll=env-home-headl | Link to this comment | 03- 3-06 1:26 PM