I can weigh over 400lbs. and be healthy. True or False?
The instant response from most people would be FALSE. It is impossible for anyone who weighs over 400lbs to be healthy. Even for those who accept that weight is not an indicator of health, being healthy at 400lbs is difficult to accept.
How do we define health?
However, the answer depends on several factors, the first of which is, how do we define health? Is health merely a physical state? A level of fitness? Or does health go beyond physical to include mental and emotional health. Are my needs being met?
Am I healthy? No. I live with a chronic illness, so, of course, I am not 100% healthy. I have Lipedema and Lymphedema (often referred to as Lipo lymphedema). Lipedema is a congenital adipose tissue disorder in which my body produces abnormal amount of adipose tissue, aka fat, and stores it in my hips, thighs, legs, and arms.
The excess abnormal tissue does not respond to calorie restrictive dieting or exercise. Lipedema is progressive and eventually the excessive tissue triggers the onset of Lymphedema which is the accumulation of excess lymph fluid. These conditions impact my weight and impact my physical health.
Am I healthy? Yes. I am managing the conditions the best I can. I have greatly reduced the size of my affected limbs and decreased the recurrence of cellulitis (skin infections). Physically, other than BMI, all my vital medical statistics and labs are within normal range. Emotionally, I have an awesome support system of family and friends, and have been in a long-term relationship for six years. I also have a wonderful primary care physician (PCP) who treats me as a patient and not as a number on the scale. Mentally, I have a level of confidence and self-esteem often envied by my friends of all sizes.
Weight stigma is more harmful to my health than my weight. The weight stigma I encounter makes an already difficult and frustrating condition even more difficult to manage. My weight is the first thing people see, despite my weight actually being the lipedema and lymphedema. No one stops to ask the cause of my excess weight before making an assumption about my health and my character.
Results may vary
Even after I explain my medical conditions, I am offered advice on how to lose weight.
Recently, I gave a TEDx Talk about Weight Bias in Healthcare. After my talk, an audience member came up to me and offered me the business card of his holistic doctor who he was sure could help me.
I have also been offered help with my weight by a woman smoking a cigarette, and a drunk guy. Well, he wasn’t so much offering advice, he had stumbled to my table in a restaurant and asked me to please stop eating because I was killing myself.
Bad medical advice
People not only assume I am unhealthy but that I have ignored my doctor’s advice. The actual problem was bad medical advice in the first place, doctors focusing on weight instead of my overall health. For years I went undiagnosed, being told the abnormal size of my legs was “just my weight,” while the lipedema and lymphedema progressed to an irreversible stage.
Managing a chronic illness
I have not ignored medical advice. To the contrary, I actually put more effort into managing my health than most people do. Managing a chronic illness, I have to maintain every possible aspect of health for which I can control. I get my annual physical exam, recommended lab work and screening tests, and a flu shot. Recently, I reminded my PCP that I was due for my tetanus booster!
Since health is more than just a physical state of being, managing a chronic illness involves more than keeping symptoms under control and preventing flare ups. Years ago, I found myself overwhelmed with my diagnosis and treatment. It was difficult to balance work with doctors’ appointments and treatments that required my legs to be compression wrapped 24 hours a day. I had fought so hard to reclaim my health, yet it is a never ending battle. To help me cope with what would be my new normal, I began seeing a psychologist. I saw her regularly for four years, and I follow up with her as needed.
Making myself a priority
Part of the coping skills was learning to make myself a priority and to stop trying to prove my abilities to other people. I struggle with the stigma that people perceive me as being lazy, and I often over compensate and try to be what I think society considers “normal.”
That struggle was magnified when I had to stop working and apply for disability benefits. Disability definitely does not mean inability. I still have a purpose in life, and have learned to live life to the fullness in the present, since I do not know what my future holds.
I refuse to let my weight or medical condition stop me from enjoying life. And I refuse to let others project their own perceptions about weight and health upon me.
This month marks eleven years since my last hospitalization for cellulitis, and five years since any hospitalization. That is quite an accomplishment, given the state of health I once had. It took a lot of work to achieve, and it takes a lot of work to maintain. From the outside, it might be hard to tell, but my body does not look the same as other bodies, and neither does my health.
More about Sarah
Sarah is member of the Obesity Action Coalition (OAC) Board of Directors and OAC Weight Bias Committee. She also serves as Board Secretary and Ohio Team Leader for the Lymphedema Advocacy Group. Living with Lipedema and Lymphedema she writes about her life experiences at born2lbfat.com and utilizes multiple social media platforms to spread awareness about her conditions and to advocate for improved diagnosis, treatment, and insurance coverage. Sarah also shares her story in various media outlets to advocate against weight bias and stigma, specifically in healthcare and the workplace. Her advocacy earned her the honor of being 2014 OAC Member of the Year. She has appeared on the syndicated daytime television show The Doctors, and in March 2015 she gave a talk at TEDxNSU titled Breaking Bias.