Dr. Patricia Farrell on Medika Life

Punish the Lazy Obese, Shower Shame on Them, and Refuse Disability Benefits to Them?

Obesity is an evolving medical disorder that still includes shame and the refusal of disability benefits without serious medical side effects.

Overweight persons, especially those in the obese range, are stigmatized, victimized, and shamed for their girth. But is any of this acceptable, or should we be more enlightened?

Should our BMI (body mass index) be the same for everyone, or does it need recalculation? It was constructed using white European data exclusively initially in 1896. Doesn’t that matter and scream internal bias? It seems some in the profession do see it has multiple flaws. It’s been in use for over 100 years.

Religions tell us that gluttony is one of the Seven Deadly Sins, and that may be where it started, but it’s contemptible. It could be a holdover from a time when heavier persons couldn’t contribute to life in ancient societal groups. Cultures may then have morphed into groups where food was plentiful, and weight meant positions of power (no need to work). But now, we see body image as a highly problematic issue in medicine and psychiatry.

In 2019, there were 10K mental health apps on the market, some to help with depression, anxiety, motivation, and diet. Were all of them useful, and how many had validated effectiveness by outside professionals? Let’s zero in on weight and its place in our culture for a moment.

Weight, whether it’s weight loss or weight control, is a significant market that has grown incredibly during the last few decades. It is now estimated that this market in 2021 was $254 billion and will reach $377 billion by 2026.

In other words, either people are very concerned about their body image, or they are being sold an image and trying to maintain it through various devices, food programs, or exercise regimes. Buy a $4K exercise device and you, too, can have that beach bod or look like that super-sleek athlete. Nonsense. The only thing in someone’s life is how much weight they’ve lost? I don’t think that’s how quality of life should be measured. Sorry, Marie, stop it now.

When we consider the issue of sales and how the products are presented to consumers, I can reach only one conclusion: body image is all, and shame comes to those who don’t fit in. What a terrible thing to do to anyone struggling with their weight and the health problems it brings.

Self-esteem is on the line and individuals who don’t meet the current standard undoubtedly, suffer anxiety, depression, lack of motivation, and a life with less joy than they could have had. The cascade of psychological issues can only increase disincentives, and we know carbohydrates are soothing, so they are the “medicine” of choice.

Chocolate has an impressive effect on mood-elevating neurotransmitters, which aids them in directly affecting our mood by their entry into our brains. I’m referring to tryptophan and its association with serotoninRead the following paragraph carefully.

Did you know that most serotonin receptors (for mood elevation) are located in the gut, not the brain? The relationship between the amino acid tryptophan and mood is well detailed. Tryptophan is converted into the neurotransmitter serotonin in the brain, and serotonin in turn, is active in areas associated with eating behaviors, passivity/violence, addiction, and depression.

No, the above information doesn’t bother those selling weight reduction products. The purveyors of all the weight-control plans, products, and devices rob individuals of their happiness. One quick solution, purchasing a meal plan, an exercise device, or a programmable wrist device, won’t do the trick. And spare me the spokespersons who keep gaining and losing weight themselves.

I know that’s a strong statement, but I feel compelled to make it in the interest of those being deceived into feeling less than acceptable in our culture. Weight isn’t a straightforward issue as any knowledgeable medical professional will tell you. There are psychological and physiological reasons people gain weight, and it’s not out of gluttony or laziness or wanting sympathy.

Why do people become obese or gain excessive weight just short of obesity? If you can provide a fully delineated response/formula to that question and it is proven valid and workable, you’ll get the Nobel Prize in Medicine.

The complexity isn’t any one thing but a coordinated interplay of physical, genetic, hormonal, neurotransmitter, sleep, and environmental factors and probably more than I’ve mentioned or that we know at present. Weight is a massive jigsaw puzzle that still makes some rich and others miserable.

Those who have been lured into the quick-fix diets, purges, and other weight control methods and then failed at each are prime because of their wish to be “normal.” Why do you suppose people put their lives on the line with surgery and exotic drinks or pills that promise quick weight loss?

We know about quick weight loss that can lead to a weight-loss addiction such as anorexia is that when the body loses too much weight, it cannibalizes itself and the heart is its target. What killed the singer Karen Carpenter? Look it up. She died of heart failure.

Another area that contributes to the shaming of overweight persons, especially women? The clothing industry with its unrealistic sizing, non-American figured women, and emphasis on being skinny is right up there on the list of non-helpers. No healthy American woman has a 24 in. waist, nor is 5′ 7″ tall or taller or wears a size 4 shoe.

Maintaining a healthy weight is a psychological issue and a medical one, and healthcare professionals, not TV personalities or apps, are going to fill the bill. Don’t place your life on the line for someone else’s gain.

What about disability benefits for those who are obese through no fault of their own and cannot maintain themselves on a job to support themselves?

Three Little Words

The Social Security Administration determines benefits based on three requirements that are needed to remain on a job; pace, persistence, and concentration. And this remains the gold standard for establishing the right to claim adult disability benefits under SSA (children are gauged by schoolwork and activities). All of the categories are either under a specific medical or mental health category.

Previously, the Adult Listings detailing codes for each disability listed did include one for obesity, but that was determined not to be sufficient for benefits. We have to ask how anyone with an unacceptable BMI (30 or over) who is over 400 to 600 lbs. would be capable of maintaining pace alone, much less the other two mandates.

In 1999, the code for obesity was dropped as an allowable disability. The thinking was that lazy, overweight people would sit back, eat, get fatter and collect checks. It was and is discriminatory because it is a means of shaming obese persons. Did anyone do any research to back up these assumptions? I suggest they didn’t.

Now, anyone who is obese must have an acceptable additional impairment that meets one of the listings in order to receive benefits. If they don’t meet a listing, they must have additional impairments that indicate an inability to meet the three mandated requirements.

You are eligible for disability benefits, but you and your physicians and, possibly, your psychologist, will need to support your application with documentation. If you can’t work because of weight and the medical disorders that it brings, you are entitled to benefits and, if needed, get your US Senator involved in your case. They do have individuals in their office who specialize in this.

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Pat Farrell PhDhttps://medium.com/@drpatfarrell
I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

DR PATRICIA FARRELL

Medika Editor: Mental Health

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

Patricia also acts in an editorial capacity for Medika's mental health articles, providing invaluable input on a wide range of mental health issues.

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