Bariatric Rescues

Madwife2009

Just saw this on the BBC News website: http://www.bbc.co.uk/news/health-37384318

It's so sad, especially the last quote:

"Senior doctors I speak to say there are many people who don't leave their homes so they don't even put themselves in a position where they may need to be rescued.

"They are scared of being seen in public."

Tragic.

pdm3547

But how does a person get to that condition in the first place?

lemurcat12

What's the debate topic?

amusedmonkey

pdm3547 wrote: »

But how does a person get to that condition in the first place?

Reading the article, many of them had medical reasons.

"The vast majority of people I encountered were obese because of medical reasons - lymphedema in particular. Some were partially mobile, some were wheelchair-bound and some were completely bedridden."

Lymphedema and lipedema can get pretty severe.

I'm sure some of them were also fat on top of that, but that's easy to explain. How does a person get fat? By eating too much for their activity level and not having weight controls high enough on their list of priorities. Just like many of us got here.

pdm3547

amusedmonkey wrote: »

I'm sure some of them were also fat on top of that, but that's easy to explain. How does a person get fat? By eating too much for their activity level and not having weight controls high enough on their list of priorities. Just like many of us got here.

Well, OK. I'm sure that's scientifically true

I have asthma which is a lifetime chronic condition. Every 12 months, I have to go an see the practice nurse for a review of my medication before they resubscribe. In the past, I've had a finger wagging conversation about my weight, BP, etc.

Surely if people have other chronic conditions, their GP has an oversight of their overall medical condition. That's what I mean about "how do people get in this position?"

GottaBurnEmAll

amusedmonkey wrote: »

pdm3547 wrote: »

But how does a person get to that condition in the first place?

Reading the article, many of them had medical reasons.

"The vast majority of people I encountered were obese because of medical reasons - lymphedema in particular. Some were partially mobile, some were wheelchair-bound and some were completely bedridden."

Lymphedema and lipedema can get pretty severe.

I'm sure some of them were also fat on top of that, but that's easy to explain. How does a person get fat? By eating too much for their activity level and not having weight controls high enough on their list of priorities. Just like many of us got here.

Tangentially, I'm curious about these conditions because while I know they can be severe (I've googled anorexic lipedema), as far as I know, the severe case came after the person had lost weight everywhere else but could not lose it from the affected limbs.

Do you know more about the condition to enlighten me?

I'd like to know this in light of how they became disabled and hard to rescue... sort of a chicken/egg thing here. I know lipedema progresses in stages, but in most photos I've seen of stage 1 sufferers, they were of normal weight. Does the act of putting on weight make the disease progress?

If you don't know, I'd hope that someone else does. The disease fascinates me for some reason.

amusedmonkey

GottaBurnEmAll wrote: »

amusedmonkey wrote: »

pdm3547 wrote: »

But how does a person get to that condition in the first place?

Reading the article, many of them had medical reasons.

"The vast majority of people I encountered were obese because of medical reasons - lymphedema in particular. Some were partially mobile, some were wheelchair-bound and some were completely bedridden."

Lymphedema and lipedema can get pretty severe.

I'm sure some of them were also fat on top of that, but that's easy to explain. How does a person get fat? By eating too much for their activity level and not having weight controls high enough on their list of priorities. Just like many of us got here.

Tangentially, I'm curious about these conditions because while I know they can be severe (I've googled anorexic lipedema), as far as I know, the severe case came after the person had lost weight everywhere else but could not lose it from the affected limbs.

Do you know more about the condition to enlighten me?

I'd like to know this in light of how they became disabled and hard to rescue... sort of a chicken/egg thing here. I know lipedema progresses in stages, but in most photos I've seen of stage 1 sufferers, they were of normal weight. Does the act of putting on weight make the disease progress?

If you don't know, I'd hope that someone else does. The disease fascinates me for some reason.

I don't know much about lipedema, except that the whole thing is not yet well understood. Some theories that it has to do with hormones. Undiagnosed it's actually often mistaken for obesity in stages beyond 1. Some people are both obese and have it, which makes things worse. Sadly, it does not respond to caloric intake because it's caused by fat cells filling up with fluid and you can't diet that water away. The only thing that kinda works is liposuction to remove as many of these abnormal fat cells as possible.

I haven't read about it in depth, but I know a relative who has the condition. She is both fat and has lipedema, but fluid deposits make her weigh much more than she otherwise would have. Randomly guessing, judging by her upper body, she would have been about 200-230 pounds but she weighs 295 and her case is not one of the worst. What's even worse if you have both lipedema and lymphedema - that double whammy of edema can be devastating in later stages. Google stage 4 of either edema. Not many people get to weigh 600-700 pounds by being fat alone.

asnnbrg

GottaBurnEmAll wrote: »

amusedmonkey wrote: »

pdm3547 wrote: »

But how does a person get to that condition in the first place?

Reading the article, many of them had medical reasons.

"The vast majority of people I encountered were obese because of medical reasons - lymphedema in particular. Some were partially mobile, some were wheelchair-bound and some were completely bedridden."

Lymphedema and lipedema can get pretty severe.

I'm sure some of them were also fat on top of that, but that's easy to explain. How does a person get fat? By eating too much for their activity level and not having weight controls high enough on their list of priorities. Just like many of us got here.

Tangentially, I'm curious about these conditions because while I know they can be severe (I've googled anorexic lipedema), as far as I know, the severe case came after the person had lost weight everywhere else but could not lose it from the affected limbs.

Do you know more about the condition to enlighten me?

I'd like to know this in light of how they became disabled and hard to rescue... sort of a chicken/egg thing here. I know lipedema progresses in stages, but in most photos I've seen of stage 1 sufferers, they were of normal weight. Does the act of putting on weight make the disease progress?

If you don't know, I'd hope that someone else does. The disease fascinates me for some reason.

I'm not really sure what you're asking. I have lipedema, though, and would be happy to answer your questions as much as I can.

Lipedema is a disease that occurs regardless of diet or exercise. It's believed to be hereditary, hormonal and possibly autoimmune in nature. It's not caused by "not having weight controls high enough on their list of priorities." Not even remotely. It's a disease.

"Does the act of putting on weight make the disease progress?" No. The disease progression causes you to put on weight. Sometimes you can gain 10 or more pounds a month when nothing about your diet or exercise regimen has changed. Think about that for a minute. Think about how it would feel to have your body that much out of your control. And then to face the cruel judgment of a society that assumes you have no self-control because your body is doing something that, by all accounts, it should NOT. What's happening is that protein-rich lymphatic fluid is nourishing these abnormal fat cells, which are just soaking it all up and getting larger and larger. (And here's why early diagnosis could make such a huge difference: Proper compression, lymph massage, and other conservative treatments can stop this ugly cycle early on and could help prevent the progression. But sadly, most of us don't get diagnosed until much, much later in the game).

Just like tumors don't grow because someone is eating too much, lipedema lipomas grow regardless of what you are (or aren't) eating. They tend to grow around times of hormonal change, like puberty or pregnancy, but can also be triggered by profoundly stressful events, like a death in the family. My most severe flare was triggered by a death. People in the earlier stages tend to be of normal weight in their upper bodies but have disproportionately larger lower bodies that could be multiple sizes larger. They develop secondary obesity only after their disease progresses, often because they become less able to move properly and become more inactive -- in some cases, they also become depressed, and anti-depressants are obesogenics, and this kicks off a nasty cycle that can be really hard to overcome.

That said, lipedema (like any other disease) affects people of all shapes and sizes, which means that people who are overweight and obese can also be affected just like underweight people. So the disproportionate look might not be as noticeable in those who are overweight or obese.

To distinguish between lipedema and normal obesity, there ARE some differences, and they're pretty profound. First, there is the characteristic shape. The average person with obesity has normal legs or a normal leg shape. Lipedema legs tend to have a tree trunk or elephant leg appearance. The skin on lipedema-affected parts tends to be cool or cold to the touch and is usually hairless (some people in early stages might have patchy or sparse hair). Obese people have normal body hair and normal body temperatures. People with lipedema have waist-hip-proportions of 0.70 or lower (if their waists are higher than that -- 0.85 or so, they are likely either not suffering from lipedema or they may have secondary obesity as well). They bruise easily and often without cause due to increased vascularity. Feet and hands will typically be slender and bony, not fat. (In people with obesity, their hands and feet tend to be larger). In later stages, there will be severe tissue deformities -- visible lipomas, overhanging masses, joint deformities, etc. Arms are frequently involved -- in about 30 percent of cases by some estimates. The torso can be affected in the later stages. Some women have lipedema all over their bodies. This is more common in women who have stage four lipedema (or lipo-lymphedema). Fat in those with lipedema also has a characteristic texture. Normal fat is smooth when palpated.

In its late stages, the disease pushes the joints into bizarre and imbalanced positions. This causes permanent damage, pain and disability. The legs become so heavy that it is difficult to move them (it feels like you're walking in concrete). The fibrotic tissue -- basically, scar tissue -- adheres to your muscles, causing them to weaken and aggravating your symptoms. I went from living an active, vibrant life when I was in stages one and two of this disease (thinking that I was just a chick with fat thighs) to being virtually housebound in the space of a couple years when my disease progressed rapidly and severely. I'm now fighting back with everything in my power -- but I'm lucky. Most women are just told they're fat, and it's darned hard getting an accurate diagnosis, particularly for women who are also overweight or obese in any way. The physical pain is bad -- but the emotional pain and social stigma are almost just as disabling in a body-obsessed society such as ours.

I'm in late stage three. I have a size 12 waist (which, given my age and disease status, isn't half bad) with size 24 thighs. It's a brutal disease, extraordinarily painful and requires surgery to fully correct at this point. I'm lucky, though. I've not suffered permanent joint damage, I do have an accurate diagnosis, I have an excellent doctor and I haven't suffered a large amount of secondary obesity.

[Edited by MFP Moderators]

jerb00

Very thoughtful explanation. Thank you for sharing your very personal story.