Yesterday, I sought medical treatment after suffering some severe dizziness. After some tests, the doctor told me that the dizzy spells and difficulty walking were a result of a medication-related drop in blood pressure. The problem–the psychiatric medication responsible allows me to sleep without nightmares. It was my decision–psych symptoms or physical problem.
“The Fat and Happy Paradox?” I asked.
“Exactly,” he replied.
Fat and Happy, or Thin and Sick?
The Fat and Happy Paradox is familiar to many people on psychiatric medications, and especially disturbing to people with borderline personality disorder (BPD). Basically, it’s a decision about whether or not to take the medications prescribed: Would you rather be fat and happy, or thin and miserable/psychotic/suicidal?
It seems like it would be an easy decision. However, American culture is downright cruel to people with obesity. As Kelly Osbourne observed, “I took more [expletive] for being fat than I did for being an absolute raging drug addict. I will never understand that.”
This stigma makes the decision considerably more complicated to a person with BPD, who may already have a fragile sense of self-image.
For my Examiner.com work, I wrote about a study revealing that obese people who feel discriminated against suffer more health problems than those who don’t. I interviewed Peggy Howell of the National Association for the Advancement of Fat Acceptance (NAAFA) via e-mail, and she wrote about the link between psychiatric medications and the obesity epidemic.
“Another reason [for the rising obesity rate] is the growing number of people on medications that have weight gain as a side effect,” she wrote in an e-mail. “Mood altering drugs are in this category and now we have hundreds of thousands of children and adults on drugs to calm them down or change their moods.”
Where’s the Understanding?
Study co-leader Kenneth J. Ferraro said in a statement: “We’ve seen considerable progress to address racial and gender discrimination in the United States, but the iceberg of weight discrimination still receives relatively little attention…. This is an interesting paradox because as the rates of obesity rise in this country, one might expect that anti-fat prejudice would decline.”
According to the Obesity Action Coalition, this stigma can even exist in therapy. Studies report that psychologists view obese clients as more ill than thin patients, with more severe symptoms, more negative attributes and a worse prognosis in treatment. This attitude is often detected and becomes a self-fulfilling prophecy: if the therapist believes these negative things, the client may reason, it must be true.
A Rice University professor, Mikki Hebl, observed: “This stigma is so severe that it is no wonder that the prevalence of eating disorders continues to increase and the fear of fat is part of young women’s normative discontent.”
There is considerable co-occurance of BPD and eating disorders. It is easy to see how this could negatively impact treatment.
Balancing Psychiatric Medication Benefits vs. Side Effects: It’s Your Decision
I can count on one finger the number of people with BPD I’ve known who aren’t on some sort of psychiatric medication. If my experience is anything to go by, many of us are familiar with the Fat and Happy Paradox. Ultimately, it’s up to the patient to make the decision, and each person has their own individual factors in this decision.
I choose to take the medication. First, it’s easier for me to deal with life–including my weight–when I’m not hearing voices or depressed all the time. Second, the medication enables me to look at my weight rationally: while I’m not happy about my obesity, I understand that it’s a side effect of the psychiatric medication that enables me to live a somewhat normal life.
To me, it’s easier and more enjoyable to be fat and happy instead of thin and sick.
http://www.healthyplace.com/blogs/borderline/2011/05/the-fat-and-happy-paradox/
