访谈录 2010-07-16&07-20 姐就是长的胖，怎么了吧-

When I stopped dieting, my weight stabilized 1. You know I have permanently 2 screwed up my metabolism 3 because I dieted from the age 7 to the age 27. You know when you put pre-pubescent children on diet, we don’t really know what that does to them. I mean that’s, that’s an insane age to start a kid at.

Did your mum put your on a diet, did she?

Yes, she did. I think I am genetically 4 predisposed to be, you know, larger than a thin person. I will never know what that size would have been, because you can set your start point up. I’ve weighed almost exactly the same thing for five years, the only time my weight being increased was when I started taking birth control, and then it went back down to what I have weighed for five years. When I stopped dieting, my body settled and stopped changing and my health improved, and I was able to pursue physical activity because physical activity made me feel good. You know I was able to take on these healthful behaviors that have had no impact on my weight whatsoever 5, but have had excellent impact on my health, and I think that is where the framework of the question becomes so incredibly important like … So when you see your physician, what does he or she tell you?

She tells me this is your blood pressure, this is your cholesterol 6, this is this. I go once a year. You know, and it’s… And your numbers are good?

Yeah, it’s great. It’s so nice to go to the doctor and not be yelled at about my weight, because … Nobody needs that.

Yeah, nobody needs that and it’s like makes you, I think, dread 7 going to the doctor, avoid healthful behaviors. It’s incredibly mentally unhealthy. Because we talked about physical health, but I think we need to talk about mental health as part of the picture as well.

Doctor Bether?

Touch on a few of the points you made, I think that the experience with the doctor is so crucially important that it’s a support of a relationship that you are getting information that you can use to make a decision about your body. I mean that’s very important. You made a couple of comments about dieting in children. I wanted to touch on that. When I think of the word diet, we are all on a diet.

Yes.

A diet is what we take in, and you may take in more calories or less calories, or more balanced diet, but we are all on a diet. And the approach to children who are overweight or obese 8 you have to be really really careful about that, that you are talking to them about healthy choices and  a healthy diet, not about calorie restrictions 9 like here is a healthy diet for a child this age, here are some choices that you can make. So that is put it in that perspective, and not a punitive 10 kind of we are focusing on your weight. We are focusing on health, and promoting health and promoting healthy choices. And I think that’s appropriate at every age. I will see children in my clinic who are six months old, who are being incredibly over fed, and they need to be on a better diet than they currently are.

I think if on the wide scale, people were looking at children and then going, ok, as a child, there are the choices you can make, this is how food works, this is what’s going on if we want it, this is you know when you feel hungry, you know, versus 11 when you are bored, if we want to educate everybody about that sort of thing, I think that’s great, but that’s not the reality of how fat children are treated, you know when you go to a doctor, and the doctor… A friend of mine recently had the experience with her eleven-year-old, you know, he wants the eleven-year-old to lose like 15 pounds. And it’s not gonna happen, he is eleven, he is in martial 12 arts, and he plays outside and he is an incredibly active little boy, who happens to weigh more than the high-end weight chart says. And I think that’s sort of, it’s institutionalized, that’s the point. You know you go the doctor, the doctor says you are too fat, and doesn’t ask about your behavior, doesn’t ask about your eating, doesn’t ask about, you know, any of these other things that are having an impact on your life. They look at one thing, and they make a judgment 13, and I think that is an incredible, incredible problem.

One of the health issues that normally is in discuss with obesity 14 is PCOS (Polycystic Ovarian Syndrome), and I recently, in last few months, start reading things on the Fattest Fear Google Reader, why not, and once someone has PCOS, they can’t lose weight, and becomes a really scary vicious cycle. So it’s one of the things that it’s higher numbers in our population than we realize and it’s actually creating a really nasty cycle.

I have a family member who has that and I actually have to say that, yes she is correct, and this particular family member does struggle with her weight. Eats very healthy, actually walks four miles a day, home from school, so I think that, you know, it’s very interesting, because that person is still a size 18, and yes, has that thing.

And I think that’s really a good thing to bring up too, because then you do get into what the actual societal cost of the world on obesity is, because these people are shamed and told that they must be doing something wrong, and treated like they are lying about their diets, you know what they eat versus a restrictive diet. You know when we make these assumptions about fat people as a sort of monolithic 15 category, it hurts everybody involved, it hurts people with chronic 16 illness. And thin people have chronic invisible illness too. I mean it’s not like everybody who stand is magically healthy.

One of the problems we face is the complexity 17 of the messages. I see people looking at the nutritional 18 labels all the time and they are puzzled. They don’t know what 7 percent of blablabla means. So it doesn’t stop them from purchasing that particular whatever product. What could do it is feedback, like for examples, having scales in the subways or on the streets.

Scales on the subway, feedback, do we need that?

I think that education is always good. I think that might be the wrong sort of motivation for people because once again, pretends that you can get an accurate picture of someone’s health from looking at one factor. I think that if you want to, you know, have an open and communicative relationship with your doctor and get feedback about your health that way, I think that’s fantastic.