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	<title>Comments on: From the Mailbag: Good News, Bad News</title>
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		<title>By: littlem</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-111682</link>
		<dc:creator><![CDATA[littlem]]></dc:creator>
		<pubDate>Mon, 28 Sep 2009 22:40:12 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-111682</guid>
		<description><![CDATA[@Epiphenomena:
&lt;i&gt;&quot;I’m currently skipping a lecture on how to take “non-judgmental nutrition histories” because, well, I just wasn’t up to arguing with a lecture hall full of 160 people today or patting anybody on the back for their extraordinary powers of medical empathy.&quot;&lt;/i&gt;

I think it&#039;s quite telling that they&#039;d have to offer a class in non-judgmental methodology, which assumes that the default is judgmental.
Also, you have my unconditional support and praise for just ... even ... dealing with med school and I hope someday to have you as a doctor.

@Carleigh:
No.  Because then no one could feel superior, and also, economic skies would fall.  Dogs and cats, living together, mass hysteria.  You know the drill.]]></description>
		<content:encoded><![CDATA[<p>@Epiphenomena:<br />
<i>&#8220;I’m currently skipping a lecture on how to take “non-judgmental nutrition histories” because, well, I just wasn’t up to arguing with a lecture hall full of 160 people today or patting anybody on the back for their extraordinary powers of medical empathy.&#8221;</i></p>
<p>I think it&#8217;s quite telling that they&#8217;d have to offer a class in non-judgmental methodology, which assumes that the default is judgmental.<br />
Also, you have my unconditional support and praise for just &#8230; even &#8230; dealing with med school and I hope someday to have you as a doctor.</p>
<p>@Carleigh:<br />
No.  Because then no one could feel superior, and also, economic skies would fall.  Dogs and cats, living together, mass hysteria.  You know the drill.</p>
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		<title>By: TwinkieD</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72484</link>
		<dc:creator><![CDATA[TwinkieD]]></dc:creator>
		<pubDate>Mon, 29 Sep 2008 22:08:58 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72484</guid>
		<description><![CDATA[wellroundedmama said: 

&lt;i&gt;I do know that some in the medical community have been advocating that the “normal” standards be ratcheted down to 22 or 23. I believe WHO has discussed doing this for Asians, and there was a study that found that risk for diabetes and related problems began at a BMI of 23 (iirc).&lt;/i&gt;

As if the BMI wasn&#039;t offensive enough, now it&#039;s going to be racist too? Yikes.

Since I&#039;m half White and half Asian, would I take an average of Asian &quot;normal&quot; and White &quot;normal&quot;? *eye roll*

Also, I can&#039;t get over the &quot;homo stupidus&quot; slide. Coming from people who are supposed to be some of the smart ones...]]></description>
		<content:encoded><![CDATA[<p>wellroundedmama said: </p>
<p><i>I do know that some in the medical community have been advocating that the “normal” standards be ratcheted down to 22 or 23. I believe WHO has discussed doing this for Asians, and there was a study that found that risk for diabetes and related problems began at a BMI of 23 (iirc).</i></p>
<p>As if the BMI wasn&#8217;t offensive enough, now it&#8217;s going to be racist too? Yikes.</p>
<p>Since I&#8217;m half White and half Asian, would I take an average of Asian &#8220;normal&#8221; and White &#8220;normal&#8221;? *eye roll*</p>
<p>Also, I can&#8217;t get over the &#8220;homo stupidus&#8221; slide. Coming from people who are supposed to be some of the smart ones&#8230;</p>
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		<title>By: Julia</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72412</link>
		<dc:creator><![CDATA[Julia]]></dc:creator>
		<pubDate>Sun, 28 Sep 2008 00:44:38 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72412</guid>
		<description><![CDATA[I see that it&#039;s been disproven, but I am &lt;i&gt;totally&lt;/i&gt; obese if this change ever happens. 27.1, baby! Ten years ago, that would have barely squeaked over the &quot;normal&quot; line. Oy.]]></description>
		<content:encoded><![CDATA[<p>I see that it&#8217;s been disproven, but I am <i>totally</i> obese if this change ever happens. 27.1, baby! Ten years ago, that would have barely squeaked over the &#8220;normal&#8221; line. Oy.</p>
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		<title>By: SugarLeigh</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72376</link>
		<dc:creator><![CDATA[SugarLeigh]]></dc:creator>
		<pubDate>Sat, 27 Sep 2008 17:03:47 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72376</guid>
		<description><![CDATA[Wow, guess I was super late to the party, there&#039;s been like three updates. ^_^

I love how the mice &quot;prove&quot; that &quot;it&#039;s all our fault.&quot; Obviously, mice share human Puritanical views and morals about how to &quot;take care of themselves&quot; and &quot;choose&quot; to overeat, which causes their problems. Because anthropomorphism is only a mortal sin when it means we might have to consider the ethical implications of torturing animals for money, er I mean science. Genes only predict, you know, everything else about you. Not your health. That&#039;s ALL you. You unhealthy slob. Because there are moral values implicit in your health. 

Wow. My brain hurts.]]></description>
		<content:encoded><![CDATA[<p>Wow, guess I was super late to the party, there&#8217;s been like three updates. ^_^</p>
<p>I love how the mice &#8220;prove&#8221; that &#8220;it&#8217;s all our fault.&#8221; Obviously, mice share human Puritanical views and morals about how to &#8220;take care of themselves&#8221; and &#8220;choose&#8221; to overeat, which causes their problems. Because anthropomorphism is only a mortal sin when it means we might have to consider the ethical implications of torturing animals for money, er I mean science. Genes only predict, you know, everything else about you. Not your health. That&#8217;s ALL you. You unhealthy slob. Because there are moral values implicit in your health. </p>
<p>Wow. My brain hurts.</p>
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		<title>By: marymette</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72362</link>
		<dc:creator><![CDATA[marymette]]></dc:creator>
		<pubDate>Sat, 27 Sep 2008 06:52:39 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72362</guid>
		<description><![CDATA[I&#039;m so glad to read all your comments right now, and it&#039;s sadly funny that this post came up today, because TODAY I went to a new primary care doctor - the first time I&#039;ve been to a GP in more than a year.  It was a hard day.

My size 20 butt just barely fit into the waiting room chairs.  That&#039;s a pretty small chair.  

There were a bunch of different brochures out, supposedly talking about treating disease but really advertising medicine, and there was one for that weight loss drug, Alli.  

I got weighed for the first time in years and tried to have a FA attitude about it, but I have to say I didn&#039;t completely succeed.  I&#039;d gained about 50 lbs since the last time.  Also, my BP was a little high, which is hereditary in my family, both from my thin father and fat mother.  I was trying to tell myself it was not from gaining the weight, and that I am beautiful at this weight, but that awful little I-hate-my-fat-self voice would not shut up.

When the doctor was ready to see me, it was NOT the one I had made an appointment with; instead, it was his partner.  I had spent hours this morning doing research and reading reviews about drs in my area and I had chosen the other guy, NOT the partner.  But whatever, I was there and I was sick so I saw the guy.

Since it was an initial visit, I had filled out a bunch of forms with medical/family history and I told the Dr. about my other health issues (as well as the ear infection I went in for).  I let him know that I had gained weight and wasn&#039;t thrilled about it - I guess it was a defensive measure to say it first before he mentioned it.  Anyway, I should have just shut up because once he started talking he was very negative about my weight, and I felt like my comment which was supposed to fend him off just gave him justification for harping on it.  

One of my health issues is that I get VERY crabby and unable to focus when I get hungry, and if I wait too long to eat I can start acting weird and cry and refuse to eat anything.  But if my husband gets me to eat something, I get better quickly.  I think it might be hypoglycemia, so I told the Dr I wanted my blood sugar tested.  His response was that it isn&#039;t good if I need to eat frequently, because of my weight.  WTF!!!!  I said very sharply, &quot;Just because I&#039;m fat doesn&#039;t mean I don&#039;t have to eat!&quot;  Admittedly, he ordered me a fasting blood test to test my sugar, but it seemed like he was more worried about me getting fatter than about my blood sugar!

Another issue is that I started having knee and foot problems about 5 years ago, back when I was a very trim size 12 and dieting (and unhappy) and going running.  These problems have made it harder to find exercise I can do but still like.  But I stay pretty active - I walk my dogs as much as I can with my bad feet, and do exercises and stuff.  Anyway, I&#039;ve started getting plantar fasciitis in combination with my other crap and guess what?  The Dr thinks it is my weight that&#039;s causing it.  And I believed him.  

Thank God for this website, because now I&#039;m revisiting it and realizing that maybe it&#039;s because I&#039;m on my feet all day at work, and that most of my problems STARTED when I was at my thinnest.  I know professional athletes have a lot of plantar fasciitis.  Except maybe for some linebackers, I don&#039;t know of a lot of them who would have a dr attribute their injury to their WEIGHT.

Anyway, a lot of other things made me uncomfortable in there (like the fact that when I mentioned my hubby and I are thinking of having a baby, he said that at 33 years old I didn&#039;t have a lot of time to decide).  But I&#039;ll leave it at this.  

Thanks for the opportunity to vent and for some catharsis!  And thanks to those few but wonderful doctors and scientists who don&#039;t believe the fat = homo stupidus and death CRAP.]]></description>
		<content:encoded><![CDATA[<p>I&#8217;m so glad to read all your comments right now, and it&#8217;s sadly funny that this post came up today, because TODAY I went to a new primary care doctor &#8211; the first time I&#8217;ve been to a GP in more than a year.  It was a hard day.</p>
<p>My size 20 butt just barely fit into the waiting room chairs.  That&#8217;s a pretty small chair.  </p>
<p>There were a bunch of different brochures out, supposedly talking about treating disease but really advertising medicine, and there was one for that weight loss drug, Alli.  </p>
<p>I got weighed for the first time in years and tried to have a FA attitude about it, but I have to say I didn&#8217;t completely succeed.  I&#8217;d gained about 50 lbs since the last time.  Also, my BP was a little high, which is hereditary in my family, both from my thin father and fat mother.  I was trying to tell myself it was not from gaining the weight, and that I am beautiful at this weight, but that awful little I-hate-my-fat-self voice would not shut up.</p>
<p>When the doctor was ready to see me, it was NOT the one I had made an appointment with; instead, it was his partner.  I had spent hours this morning doing research and reading reviews about drs in my area and I had chosen the other guy, NOT the partner.  But whatever, I was there and I was sick so I saw the guy.</p>
<p>Since it was an initial visit, I had filled out a bunch of forms with medical/family history and I told the Dr. about my other health issues (as well as the ear infection I went in for).  I let him know that I had gained weight and wasn&#8217;t thrilled about it &#8211; I guess it was a defensive measure to say it first before he mentioned it.  Anyway, I should have just shut up because once he started talking he was very negative about my weight, and I felt like my comment which was supposed to fend him off just gave him justification for harping on it.  </p>
<p>One of my health issues is that I get VERY crabby and unable to focus when I get hungry, and if I wait too long to eat I can start acting weird and cry and refuse to eat anything.  But if my husband gets me to eat something, I get better quickly.  I think it might be hypoglycemia, so I told the Dr I wanted my blood sugar tested.  His response was that it isn&#8217;t good if I need to eat frequently, because of my weight.  WTF!!!!  I said very sharply, &#8220;Just because I&#8217;m fat doesn&#8217;t mean I don&#8217;t have to eat!&#8221;  Admittedly, he ordered me a fasting blood test to test my sugar, but it seemed like he was more worried about me getting fatter than about my blood sugar!</p>
<p>Another issue is that I started having knee and foot problems about 5 years ago, back when I was a very trim size 12 and dieting (and unhappy) and going running.  These problems have made it harder to find exercise I can do but still like.  But I stay pretty active &#8211; I walk my dogs as much as I can with my bad feet, and do exercises and stuff.  Anyway, I&#8217;ve started getting plantar fasciitis in combination with my other crap and guess what?  The Dr thinks it is my weight that&#8217;s causing it.  And I believed him.  </p>
<p>Thank God for this website, because now I&#8217;m revisiting it and realizing that maybe it&#8217;s because I&#8217;m on my feet all day at work, and that most of my problems STARTED when I was at my thinnest.  I know professional athletes have a lot of plantar fasciitis.  Except maybe for some linebackers, I don&#8217;t know of a lot of them who would have a dr attribute their injury to their WEIGHT.</p>
<p>Anyway, a lot of other things made me uncomfortable in there (like the fact that when I mentioned my hubby and I are thinking of having a baby, he said that at 33 years old I didn&#8217;t have a lot of time to decide).  But I&#8217;ll leave it at this.  </p>
<p>Thanks for the opportunity to vent and for some catharsis!  And thanks to those few but wonderful doctors and scientists who don&#8217;t believe the fat = homo stupidus and death CRAP.</p>
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		<title>By: lauredhel</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72356</link>
		<dc:creator><![CDATA[lauredhel]]></dc:creator>
		<pubDate>Sat, 27 Sep 2008 04:42:59 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72356</guid>
		<description><![CDATA[BMI of 22? That&#039;s 56 kg; my fighting weight was more like 80. At 56 with my musculature and frame I&#039;d be amenorrheic, and getting osteoporotic fast.]]></description>
		<content:encoded><![CDATA[<p>BMI of 22? That&#8217;s 56 kg; my fighting weight was more like 80. At 56 with my musculature and frame I&#8217;d be amenorrheic, and getting osteoporotic fast.</p>
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		<title>By: janedoefour</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72345</link>
		<dc:creator><![CDATA[janedoefour]]></dc:creator>
		<pubDate>Sat, 27 Sep 2008 02:45:45 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72345</guid>
		<description><![CDATA[The American Heart Association isn&#039;t one of the organizations that makes the widely quoted and followed BMI standards anyway. That would be the National Heart, Lung, and Blood Institute and the CDC (who at some points have shifted their standards to comport with the World Health Organization). Which is not to say that the AHA and research they conducted/funded didn&#039;t play a role in the setting and re-setting of the BMI cutoffs, but whether anything they say unilaterally will have a major effect on people who practice medicine and public health is uncertain. I wouldn&#039;t worry about it.

Frankly, looking at the papers and reports of the agencies that have made the current BMI standards and trying to follow the references back to find out where they come from, I don&#039;t understand why they didn&#039;t put the &quot;ideal&quot; cutoff at 22 in the first place. The claim in these reports is that the cutoffs are based on the association between increasing BMI and increasing mortality risk (which, of course, more current research has brought into question, but this apparently is what they were looking at 10+ years ago). But if you look at their references, they show a fairly flat line of BMI vs. mortality risk for BMIs up to 22 and a continuous upward slope from 22 on up. So what&#039;s magical about the 25 point on that upward slope? No idea. 

I don&#039;t think it&#039;s in any way *reasonable* to expect or encourage everyone to have a BMI under 22, nor is it reasonable to expect or encourage everyone to have a BMI under 25. But I can see why one might want to be able to say &quot;people who happen to have this characteristic have a significantly lower probability of XYZ than people who happen to have this other characteristic&quot; (e.g. people who happen to be men have a significantly lower probability of developing breast cancer than people who happen to be women. Doesn&#039;t mean we should try to make everyone men, but might influence our behavior in other ways). But I don&#039;t  understand how the current cutoffs meaningfully accomplish even that much.]]></description>
		<content:encoded><![CDATA[<p>The American Heart Association isn&#8217;t one of the organizations that makes the widely quoted and followed BMI standards anyway. That would be the National Heart, Lung, and Blood Institute and the CDC (who at some points have shifted their standards to comport with the World Health Organization). Which is not to say that the AHA and research they conducted/funded didn&#8217;t play a role in the setting and re-setting of the BMI cutoffs, but whether anything they say unilaterally will have a major effect on people who practice medicine and public health is uncertain. I wouldn&#8217;t worry about it.</p>
<p>Frankly, looking at the papers and reports of the agencies that have made the current BMI standards and trying to follow the references back to find out where they come from, I don&#8217;t understand why they didn&#8217;t put the &#8220;ideal&#8221; cutoff at 22 in the first place. The claim in these reports is that the cutoffs are based on the association between increasing BMI and increasing mortality risk (which, of course, more current research has brought into question, but this apparently is what they were looking at 10+ years ago). But if you look at their references, they show a fairly flat line of BMI vs. mortality risk for BMIs up to 22 and a continuous upward slope from 22 on up. So what&#8217;s magical about the 25 point on that upward slope? No idea. </p>
<p>I don&#8217;t think it&#8217;s in any way *reasonable* to expect or encourage everyone to have a BMI under 22, nor is it reasonable to expect or encourage everyone to have a BMI under 25. But I can see why one might want to be able to say &#8220;people who happen to have this characteristic have a significantly lower probability of XYZ than people who happen to have this other characteristic&#8221; (e.g. people who happen to be men have a significantly lower probability of developing breast cancer than people who happen to be women. Doesn&#8217;t mean we should try to make everyone men, but might influence our behavior in other ways). But I don&#8217;t  understand how the current cutoffs meaningfully accomplish even that much.</p>
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		<title>By: A Sarah</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72323</link>
		<dc:creator><![CDATA[A Sarah]]></dc:creator>
		<pubDate>Fri, 26 Sep 2008 23:45:42 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72323</guid>
		<description><![CDATA[((((((Alibhe))))))

I have a 4 y.o. and I can imagine that conversation.  Recently my son said, &quot;But thin bodies are okay too, right?&quot;  I think I had been pushing the point a little too hard.  It&#039;s amazing what they pick up from us, and what they make of it in their active little minds.  Amazing, and daunting.  I wish we could get our kiddos together; they sound similarly precocious.]]></description>
		<content:encoded><![CDATA[<p>((((((Alibhe))))))</p>
<p>I have a 4 y.o. and I can imagine that conversation.  Recently my son said, &#8220;But thin bodies are okay too, right?&#8221;  I think I had been pushing the point a little too hard.  It&#8217;s amazing what they pick up from us, and what they make of it in their active little minds.  Amazing, and daunting.  I wish we could get our kiddos together; they sound similarly precocious.</p>
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		<title>By: Ailbhe</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72305</link>
		<dc:creator><![CDATA[Ailbhe]]></dc:creator>
		<pubDate>Fri, 26 Sep 2008 21:59:40 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72305</guid>
		<description><![CDATA[This may be deleted, I realise, but there isn&#039;t anywhere appropriate for it. Had thin person moment of fat-hate backlash recently. Cried after explaining that thinness isn&#039;t be all and end all of universe. 4yo daughter asked if I keep getting thinner will I be as small as a baby and how will I lift her? Also, she&#039;s now worried she will stop growing and get smaller and vanish.]]></description>
		<content:encoded><![CDATA[<p>This may be deleted, I realise, but there isn&#8217;t anywhere appropriate for it. Had thin person moment of fat-hate backlash recently. Cried after explaining that thinness isn&#8217;t be all and end all of universe. 4yo daughter asked if I keep getting thinner will I be as small as a baby and how will I lift her? Also, she&#8217;s now worried she will stop growing and get smaller and vanish.</p>
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		<title>By: killedbyllamas</title>
		<link>http://kateharding.net/2008/09/26/from-the-mailbag-good-news-bad-news/#comment-72303</link>
		<dc:creator><![CDATA[killedbyllamas]]></dc:creator>
		<pubDate>Fri, 26 Sep 2008 21:52:03 +0000</pubDate>
		<guid isPermaLink="false">http://kateharding.wordpress.com/?p=1931#comment-72303</guid>
		<description><![CDATA[Hmm, it seems that I am now potentially obese. They really should make some sort of announcement soon, so I&#039;ll know whether to drop dead in a pool of baby donuts or not. 

Deathly obese...*snort*]]></description>
		<content:encoded><![CDATA[<p>Hmm, it seems that I am now potentially obese. They really should make some sort of announcement soon, so I&#8217;ll know whether to drop dead in a pool of baby donuts or not. </p>
<p>Deathly obese&#8230;*snort*</p>
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