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size, shape, and medication
I haven't got round to writing anything constructive about my doctor's appointment on Tuesday because I'm still processing. More about the actual health stuff later.

Got weighed again and discovered that since coming off mirtazapine I have lost 5 kg of mass without doing anything differently. Eating the same amounts of the same foods and doing about the same amount of exercise. This is a Good Thing. And of course, now I have to explain why it's a good thing so as to not offend anyone.

I don't think that all weight loss is automatically good. The non-consensual weight loss I had when I was very ill with my gall bladder was hardly a good thing. Sure, the number on the scale and the wretched BMI were only at the top end of "normal" rather than firmly in "overweight" or "obese", but I looked unhealthily skinny and not like myself.

I am ambivalent about whether people should deliberately try to change their masses. Sometimes there are good reasons to do so, such as because you need surgery and less anaesthetic is needed for people of lower body mass, hence it's safer. I tend to feel that dieting doesn't work, and it's only permanent lifestyle changes that will permanently affect body mass. In particular, I think that "going on a diet" is a VERY BAD IDEA, because you'll lose the mass while on the diet, then put some or all of it back on once you stop. I think slow lifestyle changes where you gradually train your taste buds to like less and less refined sugar and saturated/hydrogenated fats will be much better for long-term health than the kind of "diet" where you stop eating things you love cold turkey so suffer from constant cravings for them. Anyway.

In this case, I have two problems. Firstly, I have been putting on weight in an unusual place for me. Naturally, I pile on weight around my hips, bottom and thighs. I actively like the hips and bottom, although the thighs annoy me because I often can't get trousers to fit even in "plus size" shops. However, over the past year or so I've noticed fat being deposited on my stomach. The way I feel is that I don't care what size I am, as long as I'm the right shape That is, the shape that I am genetically programmed to be and which I have been since the age of 10 or so. And having fat around my middle is alarming and upsetting to my mental health. It gives me a certain amount of body dysmorphia - obviously, nowhere near as bad as some people, but enough to make me really miserable and self-hating.

The second issue is that extra weight on around my diaphragm makes it harder for me to breathe. I have asthma, respiratory allergies and a chronic fatigue condition linked to poor breathing (hyperventilation occulta). Chronic hyperventilation leads to joint pain and weakness to the point where I could hardly even walk. I was basically housebound during the time before I had a diagnosis and treatment plan. So it's clear that the last thing I need to do is to restrict my ability to breathe.

In this sense, then, it is good that I've managed to "prove" that it was the drug making me fat rather than my lifestyle. I hope it's being adequately noted on my medical records, so that if I have this problem again with any future medication, it'll be taken seriously. It's also good that I am slowly losing the extra fat around my stomach so that I can move and breathe more easily. However, I am not deliberately losing mass and have no particular target mass in mind. Nor do I think that there's anything wrong with being fat if that's the way you are. I just want to be shaped like myself again, at whatever size and mass it settles out.

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From: kshandra Date: 31st July 2008 23:37 (UTC) (Link)
although the thighs annoy me because I often can't get trousers to fit even in "plus size" shops.

Yeah, that. My hips are the next size up from my waist, which I can deal with; but my thighs are the next size up from my hips, which is just maddening.
From: redbird Date: 31st July 2008 23:43 (UTC) (Link)
Breathing is valuable. (Yes, that's reiterating the obvious.)
nessbutterfly From: nessbutterfly Date: 1st August 2008 07:21 (UTC) (Link)
I had tried to post earlier, but it seems to have gone missing...

I can understand the whole body image thing... only my natural body shape, thanks to the PCOS, is for all fat to go to my stomach. Stomach fat is dangerous fat, and I have an intense hatred of it. The prednisone also sends fat to my stomach...

Skinny arms and legs, and a fat belly that I hate. You can imagine what changing body shape due to pregnancy is doing to my head!

I hope a drug solution which allows sleep and doesn't promote excess fat was able to be found.
purplerabbits From: purplerabbits Date: 1st August 2008 07:25 (UTC) (Link)
Yes to all that.

My thighs are way to big for comfort or most trousers. My best ever trousers were a size 30, and only fit cos they had a drawstring waist (and they were designed to be 3/4 length on normal height people)

I am trying to change my habits, and am very ambivalent about the word 'diet' - though properly it should just refer to whatever you eat :-)

My breathing when lying on my back is affected by the fat on my neck and chest, which is one reason I can tell I'm getting to above a good weight for me right now...
firecat From: firecat Date: 1st August 2008 20:13 (UTC) (Link)
Sometimes there are good reasons to do so, such as because you need surgery and less anaesthetic is needed for people of lower body mass, hence it's safer.

Anesthetic drugs are much safer than they used to be. Weight loss can weaken your heart, take away reserves that might be helpful for healing, and weaken your immune system. I don't think that weight loss for the purpose of surgery is an overall safety win.
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