Topic 3 - Would You Rather?
 

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Okay, that one seriously caught my attention as well when I was reading the book. And I thought about it. And thought. And thought some more.

It's a tough one, really. In all honesty, though, I think I would still choose being obese. I just can't push my mind to put weight on the same level as a serious disability, an amputated limb, full-blown diabetes, deafness... at least, not in my case (I got overweight, then borderlined on obesity because of my own bad choices; 10% of it all may be due to genes in my case, the rest is my doin only). And blind? God, no.

Deep in my heart, I admit it, I'm an uncorrigible optimistic, and a person who believes that the power to change our lives comes from us first and foremost, not from external sources. So, no matter how hard it is to lose the weight, it still would be MY choice to do it. Whereas I wouldn't have any choice at all if I was disabled (an artificial limb is never the same, hearing aids are imperfect...). It would be my accomplishment. It would be something I have the power to do, to strive for, the drive to struggle for. It would suck, I'd be angry, despaired, crying, devastated... but less devastated than if I were to be blind.

We all are different in that regard, of course, and I'm aware I'm probably not among the people who have struggled the most with their weight, so I really hope nobody will be offended by this post of mine (probably that to a person who's been morbidly obese to the point of needing, say, respiratory aid, I just come off as the skinny-minny whining that she's 110 pounds instead of 108...).

As for why the researcher got that answer... I'm not sure. I can only hazard guesses. What degree of obesity are we talking about here? Were those people morbidly obese, having struggled with it for 20 years, being really desperate about it? Were they just 'fat' and maybe not exactly weighing (hah, pun not intended) the real implications of their answer? I don't know.

To be even more honest: that would be a very LOUSY choice to have to make, in any case!

My answer is again going to be coloured by my believe (still) that if I was obese again, I'd still have the tools to do something about that.

I'm going to harken to Heather/Wyllen again ... how was this question asked? what alternatives were the participants given? have they ever met someone with a disability for which there is no hope of improvement let alone life expectancy?

Yes, I've known several people who are/were permanently disabled. I'd be surprised if most people hadn't.

I'd choose fat as well. But like Kery, my experience of fat is overwhelmingly cosmetic. I was never big enough to worry about walking to the bus stop or employability or airline seats. My body got bigger than I'd have liked but it was never big enough to have functional issues in daily life. That probably makes a big difference.

I know without one little bit of doubt that I will struggle with my weight till I'm an old, old lady - G-d willling. I do think that at some point I will have to stop worrying about it - like when I'm in my 80's I suppose. :)

But difficult or not - it IS controllable. I would not prefer heart disease or diabetes and I've grown quite fond of my limbs, so yeah I'd like to keep those around. What I think perhaps I would rather have is an addiction to alcohol or drugs or cigarettes. I think that would have to be easier then dealing with food issues. You know the cold turkey route- and then be DONE with it, for the most part. Food is around us 24/7 and we can't possibly do without it. It's so abundant and it's used in celebrations and social situations. Yes, I would much rather have had those other nasty habits.

SusanB -- I've got you thinking like me!! Those are excellent questions!! WHO are the participants and HOW did they ask the questions!! I swear you can ask that about every research study and it helps put it in perspective.

Now, when the evidence mounts and you have similar results from a number of studies using different types of participants and multiple "measurements" you can start to think about whether this evidence is sufficient. One study is never enough!

As for MY answer to the question, I think I would pick obesity, and for many of the reasons above. Maybe "the devil you know" is more attractive, but honestly, amputating a limb sounds like it would significantly and permanently affect my life more than obesity.

But going back to Susan's initial point -- would your answer change if the choice were: a PERMANENT disability or PERMANENT obesity??? Take out the option to change your life, as it were.

Even if the question were a permanent disability or permanent obesity, I would choose obesity. But like Kery asked, it depends HOW obese. If I had to go back to 185 for the rest of my life, I would much rather do that than have a disability. Life wasn't that terrible even though I had crossed the borderline from "overweight" to "obese." But if I had to weigh 500lbs and was unable to get out of bed I would have to think harder about it.

Yeah, and at 500+ I'd likely have diabetes anways and the risk of having a leg amputated and/or blindness as well.

But, I would still rather be at 272 again than having any of those disabilities.

hmmmm...

Well, this is interesting. Given the questions we had, I decided to try to find the article in question by Colleen Rand. I started by looking in Rethinking Thin, but interestingly enough, Kolata does not list an academic reference, just another article she wrote herself, which, with a little digging, I found here.

That article, published in 1992 in the New York Times, is of no help either and does not cite the original source. All it says regarding that study is "In a recent study of formerly fat people who had lost weight after intestinal bypass surgery, researchers at the University of Florida reported that virtually all said they would rather be blind or deaf or have a leg amputated than be fat again." So, there is a little more info about the participants (they lost weight via gastric bypass), but not a lot.

I have access to academic databases, and have found a number of articles by Colleen Rand, but still have not uncovered this "classic". Rand is now retired from the University of Florida, so the University's website was of no help. I have found a number of references, but none of the abstracts include this info, and don't seem to have the right number of participants. I may keep looking, but Rand herself doesn't seem to cite this earlier article or make reference to these findings.

In other words, the only reference I have been able to find so far regarding this "classic" study, is a reference the author (Kolata) gives for another piece she wrote in which she cited it. In neither place does she provide a citation for the original source, so there is no way to verify the info and answer the kinds of questions Susan B asked!!

I'm a little disturbed by that.

Interesting. :chin: Google lists Colleen Rand's email. Perhaps you might consider contacting her, one academic to another? PM me if you need it.

Found it! Now, let’s see if I can access the actual article. Though, I don’t think it’s available at my college.

Successful weight loss following obesity surgery and the perceived liability of morbid obesity.
Int J Obes. 1991 Sep;15(9):577-9.
Rand CS, Macgregor AM.
Department of Psychiatry, University of Florida, Gainesville 32610-0256.


Patients (n = 47) who lost 45 kg (100 lb) or more and who successfully maintained weight loss for at least three years following gastric restrictive surgery for morbid obesity viewed their previous morbidly obese state as having been extremely distressful. In spite of the strong proclivity for people to evaluate their own worst handicap as less disabling than other handicaps, patients said they would prefer to be normal weight with a major handicap (deaf, dyslexic, diabetic, legally blind, very bad acne, heart disease, one leg amputated) than to be morbidly obese. All patients said they would rather be normal weight than a morbidly obese multi-millionaire.

Meg-- you rock!

If I can't find the article, I'll give her email a try. I can also request the article via interlibrary loan, though that can take up to 2 weeks.

Heather, I found this also on Medline. The journal is available in Anchorage, and I should be able to get it in a day or two. I'll let you know.

Oh, and I'd take the obesity, I think, but I'd sure like to know the parameters! If I just had to stay at my highest weight, fine. If it's 500 lbs, hmmm. :shrug:

The obesity vs disability question is very interesting to me because I'm on life time disability for an illness which medicine's caused my obesity.

When I was at my highest weight, I was ok with it because the medicine had stabilized my condition. I was happy that the medicine was working and I was willing to live with the side effect of the weight.

Now that I've had a switch in medicines and have subsequently lost all the weight I had gained on the previous one, of course I am much happier.

But I know that there may come a time when this medicine no longer controls my illness or that its other side effects become too threatening to continue taking.

At that time, I might have to take another medicine that will again affect my weight. If so, I would willingly be obese rather that live with my disability being uncontrolled.

I would choose my highest weight over some other disability. I was really surprised when I read about this study, too. Thanks for shedding a bit more light on the subject.

Great! I ordered it too.

Though, I don't know there will be much info there -- it's only 3 pages long!

OK - so what's different between us and the study participants? Everyone of us would prefer being obese to having a serious disability. For me, it's NO contest - be blind/deaf/an amputee! - or be fat? Just call me a little fat lady, thank you.

Lynn

I think maybe most of us are "only" :lol: obese, not morbidly obese.

Lynn -- That's a great question.

I wonder if people who decide to have surgery are different. Maybe when you get to that point, and go through with it, it's just more important than anything else.

Another explanation is that, having had the surgery, people feel it's important to justify that decision -- after all, it's a huge decision to make... I know from other research that people often feel the need to reduce any dissonance they might have following such decisions. So, maybe they felt that, if it weren't so important to lose weight, why else would they have gone through all that. (Please note, I'm not questioning the decision of anyone who chooses to have WLS... I'm just saying that when we make life-altering, irreversible decisions, we feel the need to justify them).

Finally, not only were these morbidly obese people who chose to have surgery, but according to the abstract, they lost weight (we don't know how much) AND kept it off... maybe there's something about all three of those factors together...

Of course, I am just speculating here... I see the need for more research already!!! :D

Of course I can't speak for anyone else, but I was morbidly obese and still don't want to lose a limb! :yikes:

Of course, I didn't make the decision to have surgery...

On sorta the same track ... if we need to self-positive talk oursevles into being constantly motivated to do what we must do to lose weight and (keep it off) ... it would be counterproductive to wistfully yearn for the good-old-heavy days????

Actually, I guess that's what Heather said.

Well, I am already dyslexic...does that mean I get to be fit and lean by default? :lol:

I would not wish to have any other disability that I don't already deal with if I could choose to have them in place of being overweight.

When I see people who have lost limbs, who are in wheelchairs or suffer in ways I do not, I feel so grateful that my biggest challenge at this time is too much body fat. It's no walk in the park, but at least I CAN walk in the park, ya know? After all is said and done, I appreciate my body for what it is, stretch marks, saggy skin, lumpy fat deposits and all!

I also would take my weight, but have never been severely or morbidly obese. However, to me, morbid obesity IS a disability, so now we're just playing "go fish" with our disabilities and singing the song, "my disability is worse than yours is..........." I can't imagine anything being worse than blindness, but that's just me.

Wyllenn, your before/after and the way you're wearing a sweatshirt hoodie in the before, just looks so much like a "The Biggest Loser" promo shot to me. That's great work there my friend!!

My wake up call was when I reached that no mans land between misses and plus sizes-- I was never actually big enough to shop at LB or Avenue.

So my experience of fat is really not much like that of someone who was both big enough and desperate enough to need WLS. That's a huge difference.

Coming in a little late to the discussion. Sorry!

I have to feel like this is a bit of a trick-question. After all, if I chose obesity again over diabetes, heart disease, amputation, etc. It seems to me that obesity itself will increase the risk of all of these ailments/outcomes! And yes the question is in dire need of some more solid parameters. Is the hypothetical obesity permanent, or can I try and lose it again?!

I think another very important question to ask about studies these days is: Who paid for them? Seems like there's a lot of shady data floating around these days. Especially when it comes to pharmaceuticals.

*chuckles*
Thanks!

You know, in a way I hate that "before" shot -- not because I look so big in it, but because I look so.... sad. My husband took that picture one day, and it was completely "natural" -- I didn't know he was taking it. I know I smiled when I was that big sometimes! :)

In fact, I don't really like the after pic sometimes, for opposite reasons. I need to learn to take a picture with a less "fake" smile, now that I'm not hiding from the camera all the time.

Or, maybe I need to learn to like pics of myself! :D

Okay another formerly MORBIDLY obese person ummm ..... weighing in here so to speak. Yes, I still would choose being MORBIDLY obese over the diseases. And I was most certainly miserable from it, it was life altering, my quality of life was POOR because of it. I was horribly inactive due to it. I had horrible pain in my knees. It was a horror for me. But, it was still my doing, it was my choice. And there IS a way out. It might not have been easy and I know that it never will get easy. That it WILL be a struggle for me forever and ever, but nevertheless it IS controllable.

But I do wonder if I say that now having lost 146 lbs. But I don't think so. I always knew deep down that I did have the abililty to lose the weight.

It is a great observation though - why do all of us here choose obesity over those other things? Hmmmm...........

It's not obesity we choose, though. It's mac-and-cheese or big macs or "fries with that" or not having to sweat or not having sore muscles or not having to haul ourselves to the gym.

Well, the second part of that applies to me, to a certain degree, yes, but the first part, no.

I realize I am in the minority, but I got to be over fat because of injuries, medications and only eating healthy, natural, organic vegan foods (just too much and without exercising enough). Then there is the genetic factor (everyone in my family, even those I never knew growing up but then met later, were large).

Re: what's the difference between us and the people who answered that study:

Again, I'm taking a wild guess, but is it possible that strong mental perceptions are a key in all that? I mean, we're here now discussing this book, but we are part of a support community that helps a lot, lots of people here are maintainers so they ALREADY KNOW it is possible, and the others aren't at goal weight, but they were still confident enough to read the book, knowing the conclusions it entails and the studies contained in it. I would say we are people who don't get easily discouraged (or not anymore), and who are convinced/know that even when fighting bad genetics, it doesn't have to end with our losing the battle forever.

To quote a part from the linked article, too: "And, he added, unlike the blind or the deaf, fat people are told that they could be thin If they really wanted to. "It's kind of a double punishment," Dr. Brownell said."
But... isn't the truth that it is, well, sort of true--in that we DO have the ability to start working on our lifestyles, just walking more, that kind of things? (People on medication that made them gain weight are probably a whole other matter, though.) It hurts to say it, but in most cases, indeed, a blind person will remain blind, but the overweight one at least has the CHOICE to try and do something about it. Maybe it'll fail, maybe in the end s/he'll succeed. That's the important part for me--the ability to DO something, even if it's doomed to fail, vs. the helplessness of being disabled for life and knowing nothing will ever help.

(By the way, Clvquilts, thanks for adding your opinion. It is interesting to see the point of view of a person who has a disability. I've been thinking about this discussion on an off yersterday evening, and somehow I can't prevent myself from feeling at unease about the opinion that a disability can't be worse than obesity, because to me, it really is.)

Of course, if we take the hypothesis that the obesity would be for good, that again puts things back into another persepctive. Although I'd still choose obesity vs. blindness!

But, again, I'm a helplessly positive and optimistic person (in spite of my spells of bad mood and ranting just to let the stress out), and I've always refused to envision life in terms of "doomed to failure", "can't do anything about it", "that's my fate" and the likes. So maybe I am just too optimistic regarding that?

(I've liked the retort at the end of the quoted article, by the way. "You could just use some manners". We do not HAVE to let ourselves become victims. Even if the whole world is against us. No kidding, hey, WE are the survivors! ;))

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Do you think that surgery versus non-surgery explains the difference we're seeing between our responses and the study's?

Yes, sort of. I think that the perception of obesity as a disease may evoke the notion that it is best treated medically or surgically. Since we are in a treatment programme that is working ...

Meg -- You said it very well! That is certainly a possibility. I like Kery's point too.

Who these participants are is such an important issue. We can speculate until the cows come home about why the results turned out that way (and personally, I find that to be FUN!), but we can't know the degree to which the results would generalize to other groups unless that research gets done!

And the cool part, is that this is exactly how science progresses. People read a study and have exactly the same questions we do -- and then they go on and replicate (repeat) the study, except this time they use, for instance, the same group from the original study and then add OTHER groups, to see what differences emerge -- and also to see if those original results emerge a second time.

Can you all tell I get really excited about this stuff??!! :D

Maria, I am just like you. What's up with that no mans land anyway? I was never able to find clothes big enough in "regular" sizes and the plus-sizes were always cut awkwardly and huge on me.

In any case, I do think that the result of the study probably had a lot to do with the people involved having had WLS. WLS is a very serious and risky medical procedure and I think you probably have to be in a pretty bad place with your weight in order to consider it, much less undergo it. I know 3FC has some people who have had WLS, maybe if any are reading this they could put in their two cents?

This is really interesting. I posted back on one of the other threads about obesity as a "disease." But OTOH I can think of several diseases for which non-medical treatments are an option (usually for milder cases). For example, depression may be treated with psychotherapy instead of anti-depressants. ADD may be treated with very strictly controlled schedules or I even saw on TV someone who had a lot of success with her ADD child by sending him to martial arts classes. So maybe it is the case that for people for whom the "non-medical" treatments don't work, surgery is the only option left? Kind of like how I have tendinitis in my wrists. I tried ice, compression, rest, elevation, massage. None worked. I tried medication and it didn't work. I tried injections and they didn't work. Finally I had surgery. (That didn't work either but that's not my point! :lol: )

I feel like the odd man out, but I'd take the disability.

Maybe it's how I read the question - I read it to mean that I would be obese permanently or have a permanent disability.

My top weight was 340, if my choice is to 340 for the rest of my life or to be deaf for the rest of my life, I'll take deafness. Diabetes, well, they didn't say uncontrolled diabetes, I'm assuming I can still live a full life with my insulin shots, so I'll take diabetes. Heart disease? I'll take it and get lots of exercise & watch my cholesterol. An amputated leg? Protheses are great these days, I can still do my 5 & 10k races with a prosthetic leg. Bad acne? Please, I'll wear more makeup. Blindness is a little tougher, I might have to take my former weight over blindness, the lack of independence from being blind, just not being able to drive where I want to go, might be enough for me to prefer weighing 340 lbs everyday.

If the question wasn't permanent obesity, just a question of waking up tomorrow at 340lbs (which I could try to re-lose) or one of the disabilities, my answers might change, but frankly, I don't think that's how the question was intended. I think it was intended as a permanent obesity vs a permanent disability. And since the question was asked of people large enough to need gastric bypass surgery, I think that presupposes obesity of at least 100 lbs over your current or planned maintenance weight, as that's the approximate minimum of obesity needed before surgery is considered.

I'd be curious if anyone here would change their answer if the question was re-worded to be a permanent obesity of 100 lbs overweight versus those disabilities.

I already deal with other disabilities, but my answer would be that I would choose to be 100 pounds "overweight" and live a healthy, active life, eating well and being as healthy as possible rather than missing a limb or being blind or deaf.

That being the case, and other then being blind - I think I WOULD change my answer. Just the thought of me being permanently 287 lbs again, is enough to almost give me a panic attack right now. I couldn't do it. I just couldn't live that way ever again knowing that there was ZERO chance of me ever changing it. No thank you.

Well, in this hypothetical case, you would be 235 if 135 is your ideal ;)