The Skinny on the AMA and Obesity

The American Medical Association has just announced that it has recognized obesity as a disease.

[Disclosure:  I am married to an obese physician, whose activities with the AMA have, over the years, declined from sparse to zero.].

There is no doubt that fat people are extremely predisposed to a wide range of illnesses and medical issues, that the ranks of the fatsos are growing (individually and collectively), and that it is a major public health issue.

Be that as it may, I'm not so sure that the AMA's latest action is such a great thing.  Changing labels does not, in and of itself, address the root causes of any problem, and what the AMA is doing is updating labels if not creating them.  And once the labels are in place and utilized by the population in general and the healthcare industry in particular, obese patients, having been labeled (synonym:  Stereotyped), will likely be subjected to treatment based upon the label and not based upon their individualized medical situation and lifestyle.

The insinuation of Obamacare into the healthcare equation (including the IRS) can only exacerbate the negative attributes of the foregoing dynamic.

What bothers me the most, however, is not whether obesity is or is not a disease, but rather, the political dynamic behind the whole thing.  Politics has usually done more harm than good to the delivery and efficacy of healthcare, whether in the prevention of administering the polio vaccine by the jihadis in Muslim countries, or the politicization of the AIDS/HIV epidemic.  And in that regard, the medical profession's politicoes have already shown that designation or nondesignation of a condition as a "disease" is based more upon political than health considerations when political correctness induced the declassification of homosexuality as a disease.

Whether a given person's weight, sexual preferences, or eating or drinking habits are or are not a disease is a red-herring issue.  The real issue here is the corruption of the healthcare delivery system, and the doctor-patient relationship, by political agendas, and the squelching of patient autonomy and informed consent.

Orts & Ephemeris

Lots of things are going on now, so I am not postured to do any deep intellectual blogging -- at least for the next 24 hours. The following items and events have occurred, are occurring or are slated to occur:


A. A new law review article of mine has been published. Another article in a different law review is in its final editing stage and is slated for publication shortly. And a third article, not nearly as research-heavy as the two just mentioned, has been accepted for publication in a legal periodical, and is slated to appear within the next 2 months.


B. I have a court date tomorrow, and need to prep for that.


C. I have just completed administering my Final Exams. Well, almost. A greater than usual number of students didn't show up for the exams. Most of them contacted me in advance with their situations, and for these I have made or will make accommodation. Those who did not contact me in advance (and indeed, have yet to contact me) will receive a big, fat "zero" for their final exam grade. And they will go to the Department Chair and whine. But my Department Chair has almost always backed me up on this type of thing, and I would expect him to do likewise. After all, the syllabus handouts, distributed to everyone on the first day of class, explicitly lay down the rules about the need to contact the professor in advance if any accommodations are to be made for missed exams.

[This is a cultural value I picked up from my days with the Internal Revenue Service. Untimely tax returns are penalized, and extensions (at least the first one) are granted for the asking if requested before the due date. A similar world order is imposed upon my students.].

I think that the flu epidemic is playing at least some sort of role behind the higher numbers of absentees. But the rules are uneffected: Apprise the professor in advance that you are missing the exam, and reasonable accommodation can usually be made. Don't come to me after the next semester begins, as a few have been known to do, and for the first time tell me how sick you were! How long do you think you would last if you pulled that shtick with your gainful employment?

In any event, I am now grading the exams. I am going blazooey, so posting this is my much-needed break.


D. Speaking of Final Exams, our son has completed his, and is now moving his chattel goods from the dorms and back home. There goes the privacy my wife and I had enjoyed. Awshucks!!


E. Notwithstanding item D above, our son will be away with friends this coming Shabbat. Not to feel lonely, though. We have four houseguests slated to come over and visit, including our fatso friend, referred to as "He" in prior postings (here and here and here and here). As for the dining dynamic described more fully here, we will sort of be evenly matched: 3 fatsos and 3 non-fatsos (though the excessive adipose tissue on one of the guests counted in the "fatso" column has only been acquired relatively recently). We're looking forward to it.

Burnout

I'm all burnt out, after a busy week. In no particular order:

My Final Exams are finished -- sort of. There are still 4 students who need to take their Final Exams, what with conflicts and medical issues and the like. I'm not much on making the special arrangements, but these four all had legitimate situations.

Actually, the exams were originally scheduled for first thing this coming Monday morning, but none of the students were too keen on the idea, and I was even less keen on the idea (and I had a conflict, to boot). So I was able to get a room (ironically, the same room in which the class had normally convened during the semester) in the late afternoon to the evening, so I held two exam sessions, and covered all but 4 students. That's not bad. And, what with the snowstorm(s), I guess that the students and their instructor really lucked out.

But now, I need to grade the Exams. That's my project this coming week -- along with grading the Term Papers.


2. Our fatso friend, referred to as "He" in prior postings here and here and here, was our houseguest this Shabbat. He initially had set out to go to the city to visit his son and daughter-in-law, but the snow was coming down and he saw the aftermath of a collision, so he called our rabbi, with whom he also has an open invitation. The rabbi's daughter had 3 friends staying over, and one of the rebbitzin's friends was also there, so the rabbi called me to ask us to put He up for Shabbat. It was no problem, especially because our son was still away at school (his last final exam is this coming Tuesday).

The best thing is that He didn't have a chance to stop at the bakery for his usual fattening cakes and pies, so my wife wasn't tempted to eat those things (believe me, she ate enough as it was, especially for Shabbat lunch, when the Ivy League lawyer mentioned here also joined us, thus replicating the same situation -- and results -- as the Shabbat on Sukkot when I was the only nonfatso at the lunch table. But we all had a good time, as usual.

3. A law review article of mine, written and published a couple of years ago, came to the attention of a lawyer with whom I am acquainted. Turns out that it is relevant to a case he has. The upshot is that I got paid to do an hour's research regarding related issues in his case. If he plays his cards correctly, his client stands to gain a nice piece of change from some of his former business associates.

4. Tonight is the first night of Chanukah. It was just me and my wife, being that our son is still away at school. But that's not so bad either!

Happy Chanukah (to all those who celebrate it)!

Fitness, Fatness, and Fitting into the Sukkah

We are now amidst the Festival of Sukkot (as briefly mentioned in the prior posting). It has been quite enjoyable to us, for all of the reasons it is enjoyable to everyone everywhere. My one observation thus far involves the social dynamic at the meal.

Specifically, at the first night's meal I was the only nonfatso in our Sukkah, outnumbered three to one. The three fatsos were (1) my wife, (2) our houseguest known in this blog as "He" (discussed here and here), and (3) a fellow attorney, graduate of an Ivy League law school, who has an uncanny knack for getting himself into some strange predicaments in his personal and professional life.

On the other hand, at last night's meal, the Shabbat meal during the Festival, there were six of us in the Sukkah all told, of whom, my wife was the only fatso. In fact, three of the guests (Mom, Dad and 20-something daughter) are tall, and thin as rails.

It was amazing to observe the differences in my wife's food intake when she was in the company of other fatsos, as compared with her food intake when she was outnumbered by nonfatsos. Seems that she ate less food, and healthier foods, when she was not with the other fatsos.

This observation by a non-scientist is obviously not of the quality for publication in some sort of medical journal, but maybe someone would like to do some sort of controlled scientific experiment on the effects of the presence of multiple fatsos on the dining behavior of one another.

Chag Sameach Sukkot

In a few hours the sun will set, and it will be the Festival of Sukkot. I finished building my sukkah within the past 24 hours, and now need to verify that the electrification in the sukkah is properly operational (i.e., the timer is properly working) so the lights go on and off at the proper times.

We have a house guest, namely, "He" as discussed in the post of 31 August. And, sure enough, He stopped by earlier with some pies and other fatso food, which surely will do little to help my wife get to healthy eating habits.

Fortunately, the projected weather seems to be reasonably fair, so my wife will at least get some exercise by walking the mile to shul and back.

In any event, I still have a lot to do, so everyone have a good holiday!

Chag Sameach Sukkot!!

Feeding the Fatsos

As expected, my calendar has been quite active since previous posting.

During this past week was my first day of classes for the Fall Semester. As usual, there were several fires for me to put out upon my return to campus after a few weeks hiatus. These included, in no particular order:

* Catching up on the pile of mail in my departmental mailbox (most of it was junk, of course).

* Renewing my campus parking sticker -- which meant that I had to go to the Bursar's Office to make the payment. And, while I was there, retrieve my paycheck from the Summer Session. This was a bit more expeditious than initially envisioned. One of the front-line supervisors behind the Bursar's window happens to have been one of my students a few years ago. She called me to one of the unused windows, processed my parking payment, and got my paycheck for me. Less than 5 minutes total! But hey, was I supposed to turn down the gratuitous offer?

* Searching for the Syllabus for one of my classes. All of my Course handouts had been sent to the copy shop a few weeks ago by my Department Secretary, after I e-mailed the documents to her. She is very meticulous and trustworthy, so I knew that she wasn't the problem. Turns out that one of the copy jobs had inadvertently been wrapped in a package sent to one of my colleagues. When she opened her class handouts package, she immediately realized that the Syllabus was not hers, so she gave it to me. But ….

* Turns out that the copy shop had collated the job incorrectly. Fortunately, they were in a slight slack period, so they redid the copy job. Which was just as well, because there were a few changes to be made to the Syllabus (typo errors, relocation of the Course to another classroom in another building, change in some resource URLs on account of a total recast of the Library's website, et cetera). So they redid the copy job with the correct info in the Syllabus.

* Reserve audiovisual equipment for demonstration lecture planned for next week.

Classes went off without any unusual hitches. I think that I'll enjoy this semester.

And at another institution of higher education, my son is now moving into the dorms this weekend. He's looking forward to it (as are my wife and I).


And now, for the main purpose of this post:

Recall that this past Rosh Hashanah, we had a fatso couple as houseguests, who, per the posting of 16 September 2007, were referred to as "He" and "She." Unfortunately (but hardly unexpectedly), She dropped dead a few months ago, no doubt on account of her morbid obesity. Our houseguests this past Shabbat included He, who, ever the polite visitor, brought some dessert for after dinner. What did He bring? A Lemon Meringue Cake and a Napoleon Cake (from a reliable kosher bakery, of course).

And, of course, my wife, who has her own obesity issues, indulged in those delights which He brought. We usually do not have dessert for Shabbat dinner, but when we do it usually is fruits and/or sorbet. We do not go hot and heavy into the superfattening stuff like pies and cakes. Because if that stuff is ever brought to the table, then my wife will usually overindulge in it. Which is exactly what happened this past Shabbat (though only to a relatively minor degree -- it could have been much worse).

From viewing the old photographs of He and She, it is my hypothesis that once He married She, his diet made a significant change to all of those sugar-rich and fat-rich and fiber-poor victuals, many of which have metabolized into fat tissue. She never cooked anything non-fattening (my wife and I were hosted for dinner by He and She on numerous occasions). And, now that She is gone, He has yet to transition back to healthy eating.

Fatsos have enough of a problem as it is. And much of their problem is that they have been conditioned to stuff food into their mouths. Why do we have to feed them such things as would add to their weight? If your host or hostess is overweight, then don't bring them all of those fattening pastries and candies! Bring fruit or something like that! And don't encourage the feeding reflex!


Please Don't Feed the Fatsos!!

Transfatsos

We had some fatso houseguests for Rosh Hashanah (this is in addition to the one to whom I have been married for 20+ years). The couple (hereinafter referred to as "He" and "She") are long time friends of ours whose own house is currently undergoing reconstruction, so He and She stayed with us for the holiday. And they really are fine and wonderful people.

He was an athlete in his youth, and is still in reasonably good physical condition. She, on the other hand, makes my wife seem anorectic by comparison.

The sad truth is that She is too fat to walk more than about 25 feet without having to take a break. She is too fat to get up to light the candles for Rosh Hashanah or Shabbat. She is too fat to even get up to extend her reach a few inches so she can get the newspaper at the other end of the table. And She is obviously too fat to climb the short flight of stairs to the living room level of our house, let alone to the guest bedroom upstairs.

Which wouldn't be so bad, except that She is -- and there is no nice way of expressing this -- too fat to adequately tend to her personal hygiene. I'm not sure which is worse, the odor of her body fluids or the strong perfume She uses in a futile attempt to cover up the body fluid odors. I can ill tolerate being in the same room with her. After 3 days, it was really getting to be a bit much.

She spent the entire three days in one of three positions: (A) sitting on the chair in the ground-level den; (B) sitting on a chair in the dining room; and (C) using the ground-level bathroom of our house. While in Position B, the dining room, she ate quite a bit of fattening foods, while leaving the salads untouched. The most strenuous exercise that She ever gets is driving her car around the block. And so, She just keeps getting fatter and fatter.

[My wife may be significantly overweight, but at least she does get some amount of physical exercise in. My wife is able to walk a mile to Shul, and then another mile + to visit friends, and then return. Along with everything else she eats, my wife eats salads and other healthy foods (though her intake of other fattening foods is not really under adequate control). But for all her excessive weight, my wife can walk up and down stairs, can tend quite well to her personal hygiene, and sometimes even swims a few laps in our swimming pool.].

Fatso is not just a physical condition; Fatso is a state of mind. There are few fat people who do not engage in off-the-record munching which they fail to take into account when assessing their calorie intake (but which nevertheless is input to the metabolism processes). I know which dresser drawer my wife uses for her secret stash of chocolate. I have chosen to ignore it; my other alternative would be to call foul on it, after which she would only find some alternative location for her chocolate stash.

In any event, I note that Judge Holwell has just decided the case of New York State Restaurant Assn. v. New York City Board of Health, 2007 U.S. Dist. LEXIS 66935 (S.D.N.Y., 07 Civ. 5710, September 11, 2007) which essentially invalidated the New York City rule that required fast food restaurants to post calorie counts on their menus. Without going into the merits or specifics of the case, I will observe that the fatsos -- the very persons the various state menu calorie count rules were intended benefit -- pay no heed to calorie counts or other nutritional info anyway. Fatsos see food and eat it. Period! These calorie count rules and nutrition labeling rules cannot be expected to induce fatsos to lose weight.

Nutritional labeling only distracts from the real issues. The fatties don't pay the nutritional labeling any mind, and those of us who eat responsibly don't really need the nutritional labeling. The fatso lobby wants us all to accept the fatties and not discriminate against them and all that. But it's time for the fatsos to take responsibility for their bodies!


Love the fatso, but hate the fatness!