11 July 2014

On hearing the news this morning about NICE and WLS

I woke to the news that the National Institute for Health and Care Excellence, part of the British government's Department of Health, wants thousands of people to have gastric bands in order to prevent the National Health Service paying for diabetes treatment.

Dear NICE,

It is 6.30 in the morning and I am burning when I should be dozing.

You are slime.

I just want to call you names because I am so angry.

Let's talk about treating fat people with diabetes but let's not pretend that you have found a risk-free, health-enhancing way of enabling people to lose weight, or that weight loss is The Answer to Everything.

Instead let's talk about your treatment of fat people as guinea pigs and scapegoats.

Or the conflation of fat and diabetic.

Or pre-diabetes.

Or the obesity epidemic.

Or how fat people "cause climate chaos".

Or food addiction.

Or how fat people are responsible for The Deficit.

Or the need to tax sugary things.

Or The Children.

Or obesogenic environments.

Or the thousand other bullshit ways that hatred is leveraged to reconstitute and dehumanise fat people in the public eye through fatphobia, and how this affects a population's health.

You have no idea how difficult it is to access adequate healthcare if you are fat. That fat people's lives – probably including mine – are shortened by fatphobic 'care,' aka iatrogenesis, is the real scandal here. It is really hard to be healthy in a culture whose major institutions and centres of medical excellence want to obliterate you.

Now you have made it a lot worse.

A gastric band is a surveillance device. You throw up what the band decides is superfluous. Your body then eats itself because you are really really hungry. This is how you lose weight.

This government loves surveillance.

But like all surveillance, people inevitably find a way around it. It is a faulty surveillance device. It doesn't make diseased fat people into healthy thin people, it makes people have really fucked-up relationships with food and it causes the kinds of problems you would imagine would be caused if a major organ was messed with. Surgery is a relatively recent intervention and it is hard to know long-term outcomes. It's a gamble. It doesn't keep people thin. People still regain weight after a band has been installed. Diabetic people too. What then?

Gastric bands further medicalise people, including those with diabetes, for the rest of their lives. How does this save the NHS money?

I cannot believe that you would mandate more weight loss surgery. You want to invest in something that is entirely duff and requires expensive and risky procedures to install.

You want to invest in this rubbish instead of no-risk, cheap, community-based health promotion rooted in Heath At Every Size. Models that have success records, that fat people are happy to engage with because they/we are seen as agentic authors of our own lives with lived expertise to offer.

It makes no sense at all. Whose sponsorship is behind this decision? Who is making money out of this? What further crap will this recommendation inspire?

With horror,

Disgusted of E15

PS. Insert Headless Fatty here.

6 comments:

Patrice Aggs said...

Equally horrified to hear this on the Today programme. The interviews did not even begin to question the validity of surgical intervention. NICE obviously have an agenda, but I thought the BBC was meant to present arguments from both sides. Grrrrrrr

Dr Charlotte Cooper said...

There's only one side when it comes to talking about fat. Especially on the Today programme.

manchester fat acceptance said...

this makes me incredibly irate. by chance, i was looking up gastric bypass information for a future blog post, and i saw that it can cause neurological problems due to long-term vitamin deficiencies. although it is not an exceedingly common side effect, the fact that such a procedure is advocated without consideration for such severe side effects is absolutely reprehensible.

about NICE, i wrote about them a short while back when perusing a document on weight stigma. i cannot believe they are allowed to have any influence whatsoever because they are clearly clueless.

http://fatinthefatcapital.blogspot.co.uk/2014/01/shame-on-you-nhs.html

Dr Charlotte Cooper said...

Thanks for that.

C Franks said...

Thank you for raising this issue. I felt very offended by this news today. It is pitting slim people against larger people, making us the enemy. I felt so self conscious walking around today, feeling that passers by would be thinking I would be costing them money. I always feel extra sensitive on these kind of news days, but i felt particularly vulnerable about it today. Especially as it seemed to follow, some journalist who had proclaimed herself a proud fatist writing the day before in one of the papers. I find this idea that people of size should just be put under the knife quite evil. Oh why can't they see that this is so backward? It beggars belief. I know a handful of people who have undergone the gastric bypass and without exception they are all gaining or have gained their weight back. i am worried now if i go to the doctor i will be forced to be operated on. It feels so wrong, it's such violation of people dignity and physical boundaries.

Dr Charlotte Cooper said...

Thanks for your comment.