There are a lot of people who think that the connection between excess weight and chronic illness is automatic and inseparable. But the truth is much more complicated – and much more serious.
Are you overweight? I am.
By the BMI standards, I am actually obese. Even my husband – who is very active and looks fantastic, if I do say so myself – is considered overweight by these standards.
A lot of modern healthcare providers are moving away from the BMI as a way to determine patient health. However, there are still plenty – the majority, in my experience – of health care providers who rely heavily on it to guide their diagnosis and treatment processes.
My insurance provider actually requires now that any patient who is overweight be informed of this at every visit by any healthcare provider they are seeing. It also requires that provider to advise weight loss, regardless of what they are seeing the patient for.
In my case, I am usually being seen for something regarding my various chronic health conditions. Most of these conditions, I have had since I was an incredibly active dancer and performer in my youth, and I still have them all these years – and pounds – later.
Let me pause to concede the obvious.
There is a direct correlation between weight gain and chronic illness. There is also a correlation between chronic illness and weight gain.
Those two statements are very similar, but they are not the same.
First, weight gain can often be a contributing factor – or even a direct cause of – chronic illness.
By this, I do not mean the occasional fluctuation of 5-10 pounds that most of us put up with. Rather, I am talking about a significant weight gain of over ten percent of a person’s body weight.
The problem is, not every person who becomes chronically ill is obese, or even overweight. So, to say that weight gain is always the cause or even a factor in every person’s chronic illness is factually inaccurate.
Inaccuracy aside, though, it is not the errant “science” that so many people still cling to that weight gain is the primary culprit of chronic illness that can be so harmful to the chronically ill and disabled. It is the fact that those of us who are either disabled or struggling with chronic illness are often labeled as responsible for our own health problems that endangers us.
Risking Patient Safety and Lives Over Weight-Related Bias
The most dangerous facet of this problem is that the symptoms and suffering of people with chronic illness, disabilities, chronic pain, and other conditions are often dismissed.
We are told that we wouldn’t be sick if we just lost weight.
It would be foolish to say that weight gain and being overweight do not contribute to illness. But to say that this is always the case – and that the pain and other symptoms that the chronically ill and disabled are reporting are all just the result of obesity – is absurd.
Personally, I remember this happening to me multiple times.
The most outrageous was when I was told by a nurse who was treating me for bladder issues that my weight was likely the cause. She told me that she would not advise the doctor to treat me until I lost at least 35 pounds, which would put me closer to my “ideal” body weight.
When I told her that I did not agree, she told me I also did not go to college for nursing.
I left that office and never went back.
Later, it was determined that I had a rare bladder condition, completely unrelated to my weight. Though my weight has fluctuated over the years, that condition is still present – and always will be.
I often wonder how many other overweight people – specifically overweight women – are being told that our suffering is all our fault and that we do not deserve care or pain relief for that reason.
Chronic Illness, Weight Gain, Repeat
As I previously mentioned, weight gain can lead to chronic illness. It is also true – and even more likely – that chronic illness will lead to weight gain.
It can quickly become a vicious cycle.
You are hurting or suffering, which leads to weight gain. That weight gain then results in worsened symptoms. Worsened symptoms can then result in even more weight gain.
This can continue for years or even the length of a person’s entire life.
Even when this does not happen, weight gain in chronic illness and disability patients is very common.
There are a wide array of reasons that this might happen. Some of these include:
- Medication that can cause fluid retention and weight gain.
- Inability to exercise.
- Chronic pain.
- Anxiety or depression.
- Comfort eating.
- Allergies, histamine issues, or food intolerances.
- Mast cell activation.
- A reduction in metabolism.
- Gut health issues.
- Digestive concerns, such as the inability to digest fats or carbohydrates.
- Adrenal issues.
- Thyroid and pituitary hormone imbalance.
- Use of corticosteroids.
- Estrogen imbalance.
- Impaired or altered thinking, brain fog, or inability to focus.
- Issues with sleep and resulting fatigue.
- Muscle pain, spasms, or atrophy.
- Financial worries that can lead to stress – and stress eating.
As you can see, there are a lot of reasons why people are unable to eat a healthy, balanced diet, exercise, and maintain a proper weight while chronically ill. Some spoonies actually do eat incredibly healthy diets, but still suffer from weight gain or an inability to lose excess weight.
It is important for people to realize this.
People who are struggling with excess weight while chronically ill are not necessarily “responsible” for their weight gain – and those that are often have extreme extenuating circumstances that are causing those gains.
Regardless of these facts, though, it is also critically important that our society stop directly equating a person’s weight and physical appearance with how much they deserve medical care and kind treatment from others.
Even people who are directly responsible for their weight gain deserve rights, accommodations, and appropriate medical care.
How Can You Help?
Wondering how you can help your fellow chronically ill and disabled peers who are struggling with being seen as deserving of care and compassion? It all begins with you.
Do not dismiss your friends and family who are overweight or obese. Listen to their concerns. Validate their feelings.
Treat them as human beings who deserve the same care and kindness that everyone deserves.
This sounds straightforward and painfully simple, but you have no idea how important this is. The first time I had a doctor who took my health concerns seriously despite my weight, I cried in her office.
It was a small gesture on her part, but it made a world of difference in my life.
If you want to help your friends and loved ones who are overweight and struggling with chronic illness, begin by showing your unwavering support. When others tell them to lose weight before being worthy of treatment, stand up to those voices.
Make your sound of support even louder.
Let me finish by saying I think it is a good idea for most people who are overweight to take action to minimize the risks that their weight might be posing to their health. I am personally on a weight loss journey, but that is because I am choosing to do so for my health and to hopefully extend my life.
I shouldn’t have to lose weight just to be believed when I say that I am hurting or sick.
No one should.
I would love to know if you have ever faced this kind of frustrating scenario in the course of your medical treatment. How have doctors, nurses, or others minimized your pain or illness due to your weight fluctuation? How have others treated you as a result of it?
Please know that this is a safe, supportive space, and if you have a personal story you want to share, I would love to hear it and offer you my unwavering support.
You are worthy of care and compassion. Always.