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Thursday 17 August 2017

The scales are really tipping when no one mentions 'fat' around you

You don't always have to wear xxl-size clothes to be categorised as obese by medics – but then neither does curvy always mean you're unhealthy, says Tanya Sweeney

Everyone has an idea of what 'fat' looks like.

It's the person on a news report, face pixelated, who lumbers with difficulty down the street. It's the woman who can't fit into the seat of an airplane. It's the man who needs help putting his shoes on.

We all have an immediate concept of what an inescapably obese person is ... but what of those of us for whom the concept comes in various shades of grey?

I, for instance, can still fit into clothing from Miss Selfridge. I can cycle up Dublin's hilly streets with relative ease. I have dresses designed to nip in the waist. I take wheatgrass supplements and eat soy products.

And yet the horrible and inescapable truth is there for all to see. My BMI – Body Mass Index, calculated using my height and weight – is currently at 33.9. The normal range is 18.5 to 24.9. Anything over 30 is officially classed as obese.

The whole concept of 'fat' has been shrouded in so much mystery, politics and confusion of late. We're looking at it through a kaleidoscope of mixed messages.

Celebrity

Pick up a celebrity magazine and a celebrity is classed as overweight if she is edging closer to nine or 10 stone. A picture follows, invariably, of her back at her 'normal' weight of seven or eight stone.

And, the way the narrative media plays it out, the star in question is back on track in her life once she is at her 'ideal' weight.

The way the media tells it, a couple of extra stone is never just simply weight; it's emotional holding. It's a nervous breakdown. It's a sign that someone is unhinged. In many instances, overeating is indeed a sign that something's off-kilter in life. But the message is now clear in wider society: if you are overweight, you are not 'on top' of things.

A size 26 or 28 person is considered obese beyond all doubt, yet for someone of my size, there can be good days and bad. Some days, a dress hits all the right spots, or everything untoward has been camouflaged. You appear to have cheekbones. A friend said recently, "You've definitely lost weight". In fact, I'd piled on a stone, but had managed to somehow master a clever optical illusion.

Friends, incidentally, are the worst at killing you with kindness (or, at least, killing your plans to change). I reveal my weight; their jaws drop. The duty of any good friend.

"The great thing about you is that you put the weight on evenly and you carry it well," offered one friend. This sounds like a compliment, but in truth it merely lulls you into a false sense of security. Others reveal their true colours by accident. Another friend and I were discussing the weight loss of a musician friend of ours. "I think he looks a bit older now," I offered. "Yeah, but before he was just fat," said my friend. The word sat in the air.

Realising his error – the use of a politically incorrect term that could directly be addressed to me – he tried to take it back. Flustered, he tried to soften the blow: "Well, not fat, really."

But the damage had been done. This is one way to know that you really are starting to tip the scales in a bad way; nobody is mentioning 'fat' around you.

Most people in Weight Watchers, Unislim or a similar programme often have one experience in common.

Often, their 'rock bottom' moment comes when they unexpectedly see an unflattering picture of themselves.

At the moment the picture was taken, they appeared happy and carefree, but it's only afterwards that they notice the rolls on the stomach, or the double chin. The shock of this jolt back to earth is often the impetus they need to change their lifestyle.

I've yet to experience this moment of shock, mainly because I spend a lot of time convincing myself that I'm OK; that I might pass muster as a normal-ish woman. It can't be a coincidence that vanity sizing – the idea that clothes' measurements have been altered by manufacturers to allow a size-16 person fit into a morale-boosting size 12 – has besieged the high street for this reason.

Skinny

A few years ago, we rounded ladies really had a moment, and it turned out to be a great and a not-so-great thing.

Thanks to Christina Hendricks and Kelly Brook, being able to 'pour your curves' into a dress wasn't something to be ashamed of; it was a badge of honour. Compared to the roll call of anodyne skinny minnies, we were juicy and exotic.

We were a throwback to the Technicolor era, when girls proudly squeezed their soft, untoned selves into tight sweaters, curve-hugging wiggle dresses and too-tight twinsets.

No ab-crunching or gym-bunny gimmicks for this lot; their ever-so-slightly squishy bodies were all-natural and all-woman, and very powerful.

But then everyone who wasn't Victoria Beckham was credited by the media as celebrating their abundance of 'curves' – from Cheryl Cole to Lara Stone – and that was pretty much the end of that.

While I spend a lot of time trying to convince myself that I look normal, statistics are certainly on my side.

In the UK, the average dress size is a 16, with Irish counterparts not too far behind. (The average Irish model is a size 10. You do the math.)

Here's the thing, if you don't think of yourself as particularly heavy, because everyone is roughly the same as you, you run the risk of missing some serious health problems on the horizon. Just because something is normal, doesn't make it healthy.

According to recent research about obesity, the weight epidemic is a tsunami waiting to happen.

Three-quarters of all health expenditure in Ireland relates to chronic diseases, almost all of which are hugely influenced by obesity.

Warning

In 2005, the direct fiscal cost of obesity in Ireland was estimated at €4bn a year – official figures have yet to be unveiled for this year, but the figure is expected to be way beyond that.

And being overweight is thought to dramatically increase our likelihood of developing cancers, heart disease and Type 2 diabetes.

In effect, I may feel OK, but what might a battery of tests indicate?

At the Grafton Medical Centre, my lovely doctor Emer O'Reilly notes that while health screening is a good indicator of what is happening physically, it is by no means a cast-iron report on the full story. Still, I'm booked in for a full NCT to see if there are any glaring shortcomings. According to research at least, I should be beset by physical ailments. Or, at the very least, the warning signs should be visible on the horizon.

In the end, my physical health is surprisingly good. If this were a test, I would have passed with flying colours. My hip-to-waist ratio indicates that I am indeed a 'pear' shape, which I'm told is good news. Apple shapes – people who carry their excess weight on their middle – are said to be at risk of kidney disease and putting strain on other organs.

My cardiac and respiratory exams come back with a resounding 'satisfactory' typed next to them, while a blood count, kidney, bone and liver profiles show no problems.

My cholesterol is 5.3 – a slight touch above normal, which is 5.1 – while my blood glucose is normal at 4.5 (fasting blood sugar should be less than 7). My blood pressure, at 115/80, couldn't be better.

However, it's not all claps on the back. I've been told that my weekly alcohol consumption – on average, a bottle of wine two or three nights a week – means that I am drinking on average three times the recommended unit intake of 11 units a week for women.

"When it comes to cirrhosis and liver disease, Irish women are winning the race against most other people in Europe," explains Emer. My liver function may be fine now, but even I know that obesity and alcohol consumption are rarely a good combination when it comes to keeping the liver free of fatty tissue.

Emer also tells me that, at the weight I am now, my risk of having a heart attack or stroke within the next 10 years is 0.5pc (typical of my age group and sex).

Meanwhile, my risk of getting diabetes in the next 10 years is 3.6pc (compared to 1pc in my age group).

For now, and coming into my late 30s, I'm blessedly free of health complications. Yet I'm keenly aware that youth is on my side for now, and I need to change my lifestyle sooner rather than later.

My body may technically be running as it should be for now, but in this culture, where weight issues are so loaded, my mind could probably use a reboot.

For information on medical screening, go to www.graftonmedical.ie or call 01 671 2122

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