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Diseases caused by fat, part two. March 4, 2008

Posted by phledge in fat, medical school, yellow bile.
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Thrombotic disorders.

I get the feeling this is going to be a very long series of posts.

Also, thanks to Big Liberty for pointing out that child abuse and infertility should be on this list.  When I asked, during our OB/GYN series, why being fat causes amenorrhea but, then again, so does anorexia nervosa, there was some serious sputtering.  I swear, I could have learned this shit on my own and saved the $35K I’m paying these monkeys.

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1. AnnieMcPhee - March 4, 2008

So…why DOES being fat cause amenorrhea as well as anorexia?

2. Somebody - March 4, 2008

To AMP:

Being fat means more adipose tissue. Adipose tissue releases estradiol…too much whacks up your menstrual cycle so that it cannot do the process correctly. There’s more to fat than being fat.

Not enough fat means that your body can’t make what it needs to to continue the menstrual cycle.

3. jaed - March 4, 2008

PCOS causes both weight gain and amenorrhea. Effective treatment for the condition usually causes some weight loss along with restoration of a normal cycle; so my guess is that this is some sort of garbled version of “if a woman isn’t having periods and is overweight, treatment of her condition usually results in both weight loss and periods restarting, therefore the weight loss must have caused the periods to restart. Because fat causes everything!”

It’s sort of the Unified Field Theory of Medicine. 😉

4. phledge - March 4, 2008

I finally did get to the bottom of this, and I’m not entirely convinced that this is contradictory. With a significant decrease in fat depots, the anorexic patient’s hypothalamic-pituitary-ovarian (HPO) axis is incapable of producing sufficient amounts of follicle stimulating hormone (FSH) and luteinizing hormone (LH), the hormones responsible for creating the menstrual cycle. It’s not clear why this happens in anorexia or BMI < 18.

On the other hand, fat cells actually produce estrogen analogues and can thus suppress the cycle as well. It’s theorized that with the (sure, yeah, whatever) obesity outbreak in young girls has led to earlier menarche, but I suspect there’ll be more than just that. I mean, nobody really knows the impact of millions of women pissing their spent birth control pills into the groundwater; nobody know the impact things like rBGH in milk may have on the endocrine system. This, in addition to a true lack of an epidemic of obesity in young girls, leads me to think that it’s way more complex than “it’s teh FAT, y’know.”

5. kellycoxsemple - March 4, 2008

Hey Phledge,

I’ve seen your comments on BFB for a while, and somehow just now managed to find your blog. I hope you don’t mind if I occasionally wander by. I’ll comment so as to keep your study time to a minimum (although I like the idea of a future doctor having gotten lots of study time in!).

Kelly 🙂

P.S. We just recently moved and went through the process of finding new medical providers. We found a D.O. who has been nothing but wonderful, and not the least fat-phobic. I don’t know if this is universally indicative of this particular branch of medicine (your “diseases caused by fat” category might disprove the theory), but if so, I wish I’d known about it long hence!

P.P.S. I have a printed version of kitty-with-a-lime-football-helmet on my fridge. Riotous!

6. phledge - March 4, 2008

Somebody, I don’t mind your (correct) input but the statement “there’s more to fat than being fat” is dangerously close to a judgment. I don’t know if I have been explicit enough in saying so, but Four Humours is definitely a Safe Place for all bodies, fat and thin alike. Please bear this in mind when you comment, if you comment. Thanks!

7. AnnieMcPhee - March 4, 2008

Phledge, I also have long suspected – after seeing all the formula-fed babies (and so many of them on soy formula) growing enormous breasts, while seeing most of the breastfed babies developing in a variable range (though generally much smaller) that something about the soy is effed up as well. Now I read (but can not verify) that soy contains enough estrogen (or something similar) that feeding a baby soy formula is almost analagous to feeding her a birth control pill every day. However, with all that is being learned about the dangers of formula and the untold benefits of human milk for human babies, I wouldn’t doubt for a moment that these early menarches and possibly even the alleged surfeit of fat girls, that baby formula had quite a bit to do with it.

8. phledge - March 4, 2008

It’s so multifactorial, I don’t think anyone will ever be able to point their fingers at one specific event or influence that will cause all the female reproductive changes that we’re seeing in these last few generations. That’s why I’m suspicious of people who say, “Welp, it’s teh fatz. It’s as simple as that.”

9. BigLiberty - March 5, 2008

Somebody, does that mean all people with a certain percentage of adipose tissue will no longer have menarches?

10. kellycoxsemple - March 5, 2008

Somebody, how do you explain a person with a BMI of gazillion who has a perfectly normal menstrual cycle? You paint with too broad a brush.

11. Karen - March 5, 2008

Huh, when I was in school, 10 long years ago, we were told that girls were having their periods earlier because, as a culture, we’re healthier than ever before. One thing you can say about the obesity epidemic: If the poor are more likely to be obese, they certainly aren’t starving. We don’t recognize the symptoms of vitamin deficiencies, because, largely, we don’t have them anymore. Yes, they are still there, but quite rare.

Certainly, there is more to it than this, but it seems a decent rationale.

12. Karen - March 5, 2008

kellycoxsimple:

Perhaps it is the artificial change in weight that alters the menstral cycle? Not getting enough, over feeding yourself (because there are some who do), diseases, all of these and more can contribute to weight.

Someone else on another site, and I don’t remember who or where pointed out that both weight loss and weight gain are symptoms, not diseases in and of themselves.

13. Lindsay - March 5, 2008

I’ve also been told that my fat was the cause of my dysmenorrhea. The problems started with my first period at age 13 (i wasn’t skinny, but wasn’t fat either), and continue to this day. Interestingly enough, it was at its worst when i was at my adult-thinnest (size 16).

For years i heard, “just lose some weight and you’ll be fine”. Well, i managed to drop down to a size 16, only to find that my problem was far worse by them. When they finally opened me up, they found over a dozen dime-sized nodules of endometriosis. Since then, i’ve been able to keep things relatively in check. It’s gotten a lot better since i’ve gained more weight (up to a size 22, now).

Honestly, i think our squishybits are far too complex and far too individually genetically-tailored to make broad generalizations about such things.

14. BigLiberty - March 5, 2008

Lindsay, not only are the broad generalization that are stamped with the I’m-An-Epidemiology-Researcher-Hence-I’m-Right-You’re-Wrong seal too simplistic, but they’re *dangerous* to the health of people whose dysmenorrhea is a sign of a real problem (besides the problem of being some big fat fatty, of course).

Besides, it’s important to remember that some epidemiology researchers are being paid big bucks to prove that obesity is a disease (that’s what a good deal of ‘obesity research’ is about), and they’ll lose their big grants from Big Pharma if they show the opposite.

Conflict of interest, anyone?

15. phledge - March 5, 2008

Conflict of interest, anyone?

Can I get an “amen?” That’s why I’m part of the AMSA PharmFree Campaign. Check out the linkies to see what we’re doing. 🙂

16. ashleigh - March 29, 2008

you shouldnt swear

17. phledge - March 29, 2008

Hee. You shouldn’t tell people what to do on their own fucking blog.


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