Another touching, sad, chilling account of obesity in America.
July 19, 2004 10:37 AM   Subscribe

Another touching, sad, chilling account of obesity in America. The story of Anamarie Regino, a 3-year-old who was abnormally large for her age. Anamarie was taken out of her parents' custody because, it was determined, her life was in jeopardy because of her size. This despite a 550 calorie/day diet and obvious signs that "too much food" wasn't an issue.
posted by hijinx (76 comments total)
 
This was something you couldn't have posted as a comment in the existing discussion because...?
posted by PrinceValium at 10:57 AM on July 19, 2004


She weighed a buck-eighty but her parents were feeding her increasingly shrinking diets and she lost no weight at 550 calories day? Naturally, they were being completely honest about what she was eating and the child was drawing mass from some Marvel Comics-style "extradimensional source."
posted by Mayor Curley at 10:59 AM on July 19, 2004


US Government officials have a long history of kidnapping Native American children, from their parents, "for their own good".

Although I'm sympathetic to concern over a possible new encroachment into personal civil liberties by the state, I'm also rather suspicious of the agenda behind many points advanced by "Spiked Online" :

"Spiked has a close association with the PR firm, Hill & Knowlton. Of the 34 seminars Spiked has organised in the last three year, over half have listed Hill and Knowlton [ which "designed the tobacco industry's strategy for counteracting scientific evidence which linked cigarette smoking to lung cancer" ] as Spiked’s “partner/sponsor” and been held in the PR company’s office. ....[ "Spiked" has taken up ] genetic engineering, climate change, the debate over vaccination and hosted the Danish environmental sceptic Bjorn Lomborg ......Spiked online is created and maintained by Rob Lyons, who also created the website for LM group-related lobbying organisation Sense about Science."

__________________

mayor curley - she might have just been a natural born Breatharian !
posted by troutfishing at 11:06 AM on July 19, 2004


She weighed a buck-eighty but her parents were feeding her increasingly shrinking diets and she lost no weight at 550 calories day? Naturally, they were being completely honest about what she was eating and the child was drawing mass from some Marvel Comics-style "extradimensional source."

Yep, and those researchers with the genetically modified mice that grow abnormally obese on a regular diet? Clearly frauds. There ought to be a full-scale investigation.
posted by transona5 at 11:08 AM on July 19, 2004


I think "Spiked" is advancing this story as a stalking horse to ward off pressure on the junk-food industry, which has some 'splainin to do :

"A recent study done by doctors from Harvard , and published in the American Journal of Clinical Nutrition...found a Type 2 diabetes/sugar link : that the increased consumption of refined carbohydrates (i.e., corn syrup) in the American diet, combined with decreased consumption of fiber, parallels the increase in Type II diabetes."
posted by troutfishing at 11:12 AM on July 19, 2004


I see your point Mayor... but, the issue here is how do we stop the gubment from removing fat kids from people's homes for nothing more than being super-fat? This is out of hand, running rampant, AN EPIDEMIC! My neighborhood has seen three little fat kids hauled outta here in the last month alone. This is scary.
posted by Witty at 11:13 AM on July 19, 2004


This was something you couldn't have posted as a comment in the existing discussion because...?

Irrelevant to the conversation over there. I was following the guidelines of MeFi, as I do believe this is an interesting piece that others should see.

Witty: that wasn't.
posted by hijinx at 11:14 AM on July 19, 2004


I was glad to read the three-year old's parents are suing the social workers who did this. I hope the people responsible for taking Ana away from her parents lose their jobs.
posted by orange swan at 11:16 AM on July 19, 2004


trout- that's awesome!

transona5- those mice could eat 1/4 of the normal required intake and live? Do you realize that the girl allegedly lost no weight on the same amount of food that prisoners at frigging Auschwitz got?

witty- you're right. This could be the next scary new trend. Remember how widespread satanic ritual abuse was in the 80's? This is the next threat to our children!
posted by Mayor Curley at 11:20 AM on July 19, 2004


I hope the people responsible for taking Ana away from her parents lose their jobs.

I hope the people responsible for taking Ana away from her deserved normal life lose their kid.
posted by Mayor Curley at 11:21 AM on July 19, 2004


the issue here is how do we stop the gubment from removing fat kids from people's homes for nothing more than being super-fat?

Feed them more, obviously. If they eat enough, they'll weigh too much to be dragged from their homes.
I'm sorry.
posted by octobersurprise at 11:32 AM on July 19, 2004


Mayor Curley, some children do have metabolic and/or hormonal diseases that lead to abnormal growth (including obesity).

Now, clearly, this child wasn't abnormally tall, abnormally hairy, or abnormally early in dental development because her parents were feeding her junk food. Why do you assume that her abnormal obesity wasn't produced by the same disorder that led to her abnormal height, hirsuitism, or dental development?

For the same money that was spent to put this child in a foster home, Child Services could have admitted her to a hospital for a thorough endocrine evaluation, which might actually have helped her.
posted by Sidhedevil at 11:47 AM on July 19, 2004


I am sensitive on this topic, because my Mom died at 42 from a heart attack that could well have been caused by undiagnosed Cushing's Syndrome.

She went to a doctor three years before her death because she couldn't lose weight on an 800-calorie diet. The doctor told her that she "must be lying" about her food intake. She then went on a 500-calorie diet for a year, and lost only five pounds.

It was only after that year of starvation that her doctor realized that, no, she wasn't overweight because she was "eating too much"--she was overweight because her endocrine system was fucked up.
posted by Sidhedevil at 11:52 AM on July 19, 2004


some children do have metabolic and/or hormonal diseases that lead to abnormal growth (including obesity).

Yes, of course. But even a child with the worst hormone imbalance in the world couldn't maintain a large adult's weight on 550 calories a day. What's more, the kid was thoroughly tested.

So either the doctors were in on the Great Sick Child Abduction conspiracy, or the kid was being overfed by her parents despite thier claim to follow the suggested diet.
posted by Mayor Curley at 11:55 AM on July 19, 2004


FatFilter!
posted by dhoyt at 12:01 PM on July 19, 2004


But Mayor Curley, the kid was twice as tall as she should be for her age, more than twice as dentally developed, and as hairy as an adolescent (I have seen this child on TV).

So whether or not the parents were doing a good job of following a very low calorie diet for her seems irrelevant--she has a serious hormonal or endocrine imbalance of some sort. That is clear.

Starvation diets do not cure endocrine imbalances. Taking a child from her parents because they may not be doing a good job of managing a serious illness despite good-faith efforts doesn't seem like a helpful social policy.
posted by Sidhedevil at 12:04 PM on July 19, 2004


Mayor Curley, I'm writing you off as yet another waste-of-time troller, but I have to say in parting (and it has been so nice to spend time with you and your opinions!) that I really wish you'd consider reading sources for actual content instead of just something to snipe at.

kalessin, I read it. Please tell me how someone who weighs as much as a large man can maintain weight on 550 calories per day? Esepcially when they've seen tons of doctors who found her to be physically normal? Do you think that the simplest solution is A.) she's a unique human marvel never before seen in the history of humanity or B.) someone was feeding her more than they claimed?

Maybe if you'd been taken away by CPS, you would have been placed in a home where a nice family would have tought you better execution of sarcasm or at least had the heart to tell you that you suck at it.
posted by Mayor Curley at 12:05 PM on July 19, 2004



She weighed a buck-eighty but her parents were feeding her increasingly shrinking diets and she lost no weight at 550 calories day? Naturally, they were being completely honest about what she was eating and the child was drawing mass from some Marvel Comics-style "extradimensional source."


Ha, you remind me of when I was 9 years old, when I insisted a chocolate bar physically couldn't make you gain a pound of weight, because the bar itself didn't weigh a pound.

Didn't realize at the time -- water may have no calories, but that doesn't mean its weightless. If your body wishes to retain mass, believe me, it's got no shortage of crap (no pun intended) to hold onto.
posted by effugas at 12:05 PM on July 19, 2004


Sidhedevil-- I'll concede that given the presentation of the article, if I accepted it at face value, I'd have to agree with you. But the fact is, the article's clearly presenting in a "can you friggin' believe this" style and, more importantly, there were numerous doctors and social workers behind this and I can't believe that they'd be so cold about the whole thing if they didn't believe that the kid was in immediate danger.

And I have to say it again-- 180 pounds and no weight allegedly lost at 550 calories. That wouldn't be possible even if she were cold-blooded. We're not getting the whole story.
posted by Mayor Curley at 12:13 PM on July 19, 2004


"This is out of hand, running rampant, AN EPIDEMIC! My neighborhood has seen three little fat kids hauled outta here in the last month alone. This is scary." - witty, can you point me towards some news reports on this ? I can imagine how they'd get buried in this news-busy year.

"witty- you're right. This could be the next scary new trend. Remember how widespread satanic ritual abuse was in the 80's? This is the next threat to our children!" - it's so easy to blame the parents and to exculpate the fast industry which spends billions on advertising, a lot of which targets kids.

Kick the little folk ! So easy, so fun, so satisfying !

curley - you're missing one possibility : maybe this kid just moved very, very slowly, like a slug, and had an absurdly low metabolic rate ! Maybe too, she was sucking calories out of the air on the sly - for all we know, she could have been living next to a fried chicken joint, say, and been sucking up the fried grease fumes.
posted by troutfishing at 12:18 PM on July 19, 2004


effugas, you don't think that the doctors checked her retention levels?

And please don't suggest that I have a nine-year-old's view of nutrition. If you can be bloated to 180 on a starvation diet, why weren't there any fat people behind the fences when Auschwitz was liberated? Or did Stalin have them painted out of the footage and I'm too ignorant to realize it?
posted by Mayor Curley at 12:20 PM on July 19, 2004


Wait, didn't the article say something about doctors not being able to find any explanation for the weight gain?

How about this from the article (bold is my emphasis):

her mother was taken aside by a group of doctors and social workers. In Martinez-Regino's words, she was told 'Ana's in grave danger. We know it's hard not to give in to everything she wants. We just think you can't handle your daughter. And we don't want her to die down the line'.

So the doctors thought she was lying. So did the social workers. So do I. That's all I know, and all that I've claimed to know.

We did read the same article, but you filtered it through your "fat-positive/fat people are discriminated against" agenda and decided that the side with the fat person was automatically in the right. The professionals in the srticle have a well-formed opinion and the only thing in the article to dissuade me is the family's claim that their daughter is a unique medical anomaly. Which is a lot less probable than "they lied."

I thought that you were done with me and had already dismissed me as a troll because I didn't side with the fat person's family.
posted by Mayor Curley at 12:35 PM on July 19, 2004


Also, as trout astutely pointed out long ago, this article was written by an umbrella group for the tinfoil hat industry.
posted by Mayor Curley at 12:37 PM on July 19, 2004


Also, as trout astutely pointed out long ago, this article was written by an umbrella group for the tinfoil hat industry.

"I don't agree with it, so if I can find an easy way to dismiss it without having to think critically, hooray!" Don't worry though, Mayor Curley; I considered you a troll a long time ago.

The authorities saw Anamarie getting bigger and bigger. The parents followed the doctors' orders to (over)control her diet and fitness regimen. The result? A three-year-old was taken from her parents' custody.

Those are the facts, bub. You can pretend that it's dismissable because of the particular site this link is on if you like. (In addition, I was finding it kind of amusing and sad how the comments above quickly turned into an echo chamber between Mayor Curley and troutfishing.)
posted by hijinx at 12:46 PM on July 19, 2004


I don't see how the parents could be lying - overfeeding and weight gain in children doesn't result in children developing teeth insanely early - that's the biggest indicator that there's something going on there besides parental overfeeding.
posted by agregoli at 12:48 PM on July 19, 2004


The authorities saw Anamarie getting bigger and bigger. The parents followed the doctors' orders to (over)control her diet and fitness regimen. The result? A three-year-old was taken from her parents' custody.

That's just it-- the writer tells us that they followed the orders, the doctors say otherwise. So everyone defending the parents has elected to take the words of some guy on the internet over professionals who say that this is medically impossible.

I certainly have attacked the situation by means other than dismissing the source-- I reiterate: everyone except the parents and the author say that the family is lying! How much clearer can I make that? You are siding with the family because you want to, not because they have any evidence except "well, she's big for her age and she magically can't lose weight on a diet that would kill a normal person after a few months."

Of course, you'll ignore this observation as well and just continue to attack, because all you have is the sworn word of an author from a pro-vice lobbying group. If the doctors are saying "she was continually overfed even when we pled with her parents and that is the only medically viable explanation," why won't you just frigging accept that?
posted by Mayor Curley at 12:59 PM on July 19, 2004


Just so no one focuses on some dross or phrasing in my previous comment, focus on this:

The doctors in the article are saying that the scenario as presented by the parents is medically impossible. If you believe the parents, then you also have to believe Mary Toth because her claims were only slightly less believable.
posted by Mayor Curley at 1:04 PM on July 19, 2004


Esepcially when they've seen tons of doctors who found her to be physically normal?

Are you sure you read the same article as I did? The one I read said the doctors couldn't find any harmful effects but also couldn't explain the weight gain. It also seemed to mention that Annamarie had other signs of growth not consistent with normal weight gain, as in teeth growing early and being taller than usual for her age. Hm. That doesn't sound like normal weight gain to me either, but maybe you have some inside line on this whole thing.


The article's second sentence, Samantha's parents claim that their daughter's weight problem is due to steroids that she took to combat asthma
posted by thomcatspike at 1:07 PM on July 19, 2004


"....overfeeding and weight gain in children doesn't result in children developing teeth insanely early." - no, but mass produced dairy products contain bovine growth hormones which have chemical similarity to human growth hormones. A diet heavy in dairy could contribute to this sort of freakish early development. Further - fat-soluble persistent organic pollutants which have an estrogenic effect ( Dioxin, PCB's, PAH's...) which also might promote abnormally early growth patterns (at least in human females) are now pervasive in the environment and also in - you got it ! - dairy products.
posted by troutfishing at 1:09 PM on July 19, 2004


"...Samantha's parents claim that their daughter's weight problem is due to steroids that she took to combat asthma." - and, Asthma is associated with childhod obesity. I'd bet the steroids helped to compound an already existing problem.
posted by troutfishing at 1:11 PM on July 19, 2004


you remind me of when I was 9 years old, when I insisted a chocolate bar physically couldn't make you gain a pound of weight, because the bar itself didn't weigh a pound

Ok, this is simply absurd. There's this thing called the conservation of mass. It's a law. Not like "the speed-limit is 55 but I'm going to go 80" kind of law. The sort of law that cannot be broken. Eating a 6 oz. candy bar cannot make you gain a pound of weight.

Now, eating some foods will certainly affect how your body processes future foods, just as exercise alone can affect your metabolism. So you may be more likely to gain weight than had you not eaten the candy bar, but the candy bar itself is not "creating" pounds. Frankly, it's fucking stupid to think otherwise. Read this and get back to me.

I believe what Mayor Curley is alluding to is that, all things being "normal" (as the article alludes to nothing abnormal besides, well, incredible growth) the human body expends a certain amount of energy doing "stuff" all day -- breathing, walking, talking, even eating burns *some* calories. Point being, 550 calories is a very small amount to sustain a 180 lb. human being for very long. You can do it, but eventually the body has to tap into its reserves -- fat, muscle, mass of some kind -- which would mean the child's weight is no longer a constant.
posted by Civil_Disobedient at 1:12 PM on July 19, 2004


Samantha's parents claim that their daughter's weight problem is due to steroids that she took to combat asthma

Thomcatspike, obviously these doctors were so incredibly ignorant that they couldn't account for that. You're forgetting that this article is backed by the observations of some guy! Obviously, he knows better than the doctors.

and Civil_Disobedient, that doesn't work because everyone knows that the laws of physics were created to discriminate against parents and obese children.
posted by Mayor Curley at 1:14 PM on July 19, 2004


Eating a 6 oz. candy bar cannot make you gain a pound of weight.

Can it combine with 10 oz of water you drink to make a pound of fat tissue though?

We are, after all, mostly sacks of water.
posted by beth at 1:18 PM on July 19, 2004


Ok, I thought it was a hoax. Here's another article, with a picture of the girl. She is now a happy seven year old who stands taller than me, living with her parents. Apparently, it only took the state a few months to realize that there weren't having any success putting her on low-cal diets either.

Now then, everybody thought they were doing the right thing, and I hereby declare the whole thing "old news."
posted by ilsa at 1:22 PM on July 19, 2004


as of this writing, anamarie weighs 105 pounds - approximately 25 pounds less than she did at her heaviest. in addition to her strictly monitored diet, she spends three days per week at a local gym for children, called kid power. here she swims, jumps, and exercises muscles that have to be much stronger than an average child's to simply allow her to walk.

So, on a strictly enforced diet, one that is subject to official surveillance and monitoriing, one that is completely devoid of any substance that could be considered fatty, one that I would have rebelled against if it was foisted on me at three years old, and one that is suplemented with plenty of exercise, this child has lost a total of 25 lbs. She's still way overweight for her age, she's still extra tall, she's still FAT. So assuming this story is at all accurate in its recounting of details (and despite the attacks on the source, I've yet to hear anything to the contrary), this child has some medical problems that have yet to be diagnosed.

If the doctors are saying "she was continually overfed even when we pled with her parents and that is the only medically viable explanation," why won't you just frigging accept that?

You must know nothing but omnicient doctors. Funny, I've heard plenty of stories from people who have had rare disorders or diseases and spent literally years getting them properly diagnosed. Just because a doctor says something doesn't mean I'm going to frigging accept it. Sorry.

I reiterate: everyone except the parents and the author say that the family is lying!

And the parents say they aren't. Do you know them well enough to judge their veracity? Are you positive your interpretation is correct?

everyone knows that the laws of physics were created to discriminate against parents and obese children.

Jesus, this is getting stupid.
posted by deadcowdan at 1:24 PM on July 19, 2004


Good find, ilsa.
posted by Coffeemate at 1:27 PM on July 19, 2004


I bet cash money she has a giant box of candy bars hidden somewhere in her bedroom.
posted by uftheory at 1:42 PM on July 19, 2004


Eating a 6 oz. candy bar cannot make you gain a pound of weight.

Can it combine with 10 oz of water you drink to make a pound of fat tissue though?


Really, fat is potential energy for your body. It takes 3000 surplus calories to make a pound of fat.

So you eat the candy bar and your body converts it into glycogen, and different parts of the candy bar break down more or less efficiency based on whether it's a fat, carbohydrate or protein.

So all digestible food you eat is converted into glycogen, which is then converted into energy to replace the energy that you expend. However, if you take in more food than meets your energy requirements, your body converts the glycogen into fat.

So if a 6 oz candy bar has 400 calories, lets say, and you need 2000 calories per day to maintain your energy output, you would gain no weight if you ate 5 candy bars a day and nothing else with caloric value. Obviously, this isn't a healthy diet, but you wouldn't gain weight on it. Also, this is an oversimplification, largely because the different components of the candy bar (fats, sugars, proteins) will produce more or less glycogen, so it's not quite (but very nearly) as simple as "400 calories in, 400 calories in output."

But if you ate your requisite needed calories and then ate the candy bar, you would gain almost a pound over a week by consuming 2800 extra calories, whch is just under the requisite amount to make a pound of fat. But if you kept on this diet, you would gain less weight as your heavier self then requires more energy to just sustain itself. Eventually, you would gain no weight because you needed 400 more calories to sustain that your mass than you did at the starting point.

This is probably more info than you're looking for, Beth, but I'm bored.
posted by Mayor Curley at 1:44 PM on July 19, 2004


Good call, ilsa. Nothing better than proving an arrogant guy wrong mid-sneer.

What ticks me off about your responses, MayorCurley, is how you refuse to take the parents' numerous visits to baffled doctors as an article of good faith. Did you think they were taking the child to doctor after doctor, then blithely ignoring their dietary advice and lying about it? No, something else was going on, and it wasn't Munchausen's by proxy.

I don't see this as a particularly terrible scandal -- ninety-nine times out of a hundred, a morbidly obese toddler should be taken from whatever slothful parents would let her reach that point -- but I think it's ridiculous that you won't consider contradictory evidence. (And what were you weighing against it? That article didn't cite the precise diagnoses of any specific doctors, and as the child was eventually returned to her parents, they must have been vindicated by her failure to lose weight under the direct care of doctors or the state.)

On preview: What a convenient time to get bored -- just as you've been proven wrong!
posted by Epenthesis at 1:48 PM on July 19, 2004


Mayor Curley, just curious here, but are you an M.D. with specialization in either nutrition or endocriniology? (disclosure: IANAD)

There are rare mutations and even normal variants of the human body which produce extreme conditions of size, shape, coloring, etc. It is in fact possible that this girl is perfectly healthy, if rather unusual. Her body may just be a bit different from most people's. Of course it's difficult to say on the information given, it's not clear how deeply they went into her endocrine levels, but she may just be a biological fluke or a "mutant" with a couple of genes wired differently.
posted by zoogleplex at 1:59 PM on July 19, 2004


Funny, I thought that the initial article said that social workers watched their every move and decided to give the kid back since they could find nothing wrong AND a judge dismissed the whole thing. So, Mayor Curley, NOT EVERYONE thought they were lying. And, apparently, on a 1200 calorie diet, she's STILL gaining weight. And I DOUBT that her parents would still be slipping her food after all this time and attention. Someone would find out.

This is just so stupid. If the doctors were so concerned, I think they could have gone about it another way. They could have temporarily put her in a "fat camp" for a few months where someone watches her every move, while still giving parents custody, to see if they were lying. As the article said, if they were rich and white, you BETCHA the state wouldn't have tried to take her away.

Again, overfeeding does NOT make a person taller, more hairy, and to get a full set of teeth years early, and probably reach puberty at 9. All the milk and calories in the world wouldn't do this. Have a little compassion.
posted by aacheson at 2:04 PM on July 19, 2004


What a convenient time to get bored -- just as you've been proven wrong!

Oh, was I? It turns out that she has ONLY lost weight when in protective custody, or when she was under 24-hour observation bt CPS. Twice her parents were caught deviating fron the prescribed diet before she was removed. In fact, when she was in protective custody, she LOST so much weight that they upped her caloric intake because the weight was coming off too fast. And she was only returned to her parents because of a legal loss by CPS, not because they couldn't make her reduce.

They also didn't consistently use her sleep apnea device. So, yeah, they're great parents who were wronged by the system. I should have googled 90 minutes ago instead of just basing my arguments on the provided sources.
posted by Mayor Curley at 2:07 PM on July 19, 2004


crickets...
posted by Mayor Curley at 2:42 PM on July 19, 2004


Curley, here's the thing:

A) The girl clearly isn't obese just because her parents are overfeeding her, according to her current doctor in the article you linked. She has some very serious hormone or endocrine imbalance which has yet to be successfully diagnosed, as her numerous other physical differences show quite clearly.

"Anamarie is not obese just because her parents feed her too much, [her current doctor] says. It could be that she has a glitch in her metabolism, but if so it is not a condition known to science, because every test Ana has been subjected to has come back negative. She may have a syndrome that has yet to be identified, one that might explain not only why she is so heavy but also why she is so tall, and also why her teeth erupted early but her speech and other developmental milestones were delayed."

B) On the other hand, her parents did seem to be having trouble sticking to the very-low-calorie diet prescribed for addressing one aspect of her current condition until a doctor came into the picture who was able to work with the parents, instead of treating the parents as antagonists.

So it's hard to see how the state's strategy of blaming the parents and insisting they were lying was an effective one. Is it, and should it be, a usual practice to take children with complex disorders away from parents because someone who knows very little about the disorder thinks that the parents aren't providing proper treatment?
posted by Sidhedevil at 3:06 PM on July 19, 2004


So it's hard to see how the state's strategy of blaming the parents and insisting they were lying was an effective one.

But, as I said and everyone called me an asshole for insisting, they were lying. I owe a big debt of gratitude to the dude who had to go through that kid's stool and find the ham.
posted by Mayor Curley at 3:15 PM on July 19, 2004


"Lying" and "didn't remember every tiny thing" or "weren't willing to admit to every tiny flaw to hostile authorities" are not the same thing.

The SCARY EVIL FOOD found in the child's stool couldn't have amounted to more than 500 calories. OH MY GOD! What UNBELIEVABLY BAD PARENTS, because they didn't instantly turn in their 8-year-old niece for giving their child a slice of ham!
posted by Sidhedevil at 3:26 PM on July 19, 2004


See, Curley, you were suggesting that this child's childhood was being fucked up by her parents. It isn't. It's being fucked up by some kind of weird, undiagnosed endocrinological problem.

Her parents are not providing perfect medical care for that endocrinological problem, I'll admit. But, Geez, they've done their best to take their kid to as many doctors as their low income and poor education permit. Shouldn't social services be working with parents with sick kids instead of against them?
posted by Sidhedevil at 3:29 PM on July 19, 2004


(Note: for "are not providing perfect medical care" above, I meant "were apparently not providing perfect medical care".)
posted by Sidhedevil at 3:30 PM on July 19, 2004


Because I don't know what they're doing now.

You know, there are anti-circumcision activists who suggest that parents who circumcise their infant sons should be prosecuted on child abuse grounds.

I just don't think that parents who--on the basis of the most biased-against-them articles--seem to have done nothing worse than giving their child a 400-calorie solid meal instead of a 300-calorie liquid meal, or not reporting that the child's cousin had given her a small quantity of food are "bad parents".

They're not providing "gold standard" care, but how many doctors would be held accountable in any way for care that came that close to the "gold standard"?
posted by Sidhedevil at 3:33 PM on July 19, 2004


She didn't lose weight when put on the restrictive diets in her parents custody, but she lost it so fast when she was removed that they upped her caloric intake? Face it, they didn't get unlucky and get discovered the only two times they went against the diet. They fed her, and they fed her a lot despite their claims to the contrary.
posted by Mayor Curley at 3:43 PM on July 19, 2004


She actually did lose weight on the restrictive diets while in her parents' custody, according to most of the articles.

And I'm not saying her parents were providing perfect care for her illness/disorder--what I'm saying is that they didn't cause her illness/disorder.
posted by Sidhedevil at 4:04 PM on July 19, 2004


And, look, here's what her doctor said earlier this month:

"I don't think that, overall, she's being overfed," said Dr. Javier Aceves. "I think that Ana has a very unique metabolism that makes her accumulate fat, and she doesn't burn it very easily."
posted by Sidhedevil at 4:09 PM on July 19, 2004


I think that Ana has a very unique metabolism that makes her accumulate fat, and she doesn't burn it very easily.

I have a friend who is like this, so please don't take this comment the wrong way, but, What exactly is she burning for energy, then?

I just don't understand. Is her body more efficient than mine? Is that it? In the way that a long-distance runner only needs one heart beat to exchange oxygen to every two of my beats. Or the way a deep-sea diver can survive 5 minutes underwater without breathing, while I'd die at 2 minutes?

Thing is, in order to move, you need to use energy. This energy comes in a lot of different forms (turkey club, chicken parm, pasta, chocolate, etc.), and is stored in a few common ones (long-term is fat), but you can't get away from the fact that, if you exercise your ass off, you should, well, exercise your ass off. Your body has to come up with the energy from somewhere, right?
posted by Civil_Disobedient at 5:12 PM on July 19, 2004


Civil_Disobedient, that's the thing about metabolic disorders -- you're moving as much as you ever did, or more, and your body is coming up with the energy for it somewhere, but you're not losing weight. You're also excruciatingly, heartbreakingly tired all the time. (And depressed, and unable to concentrate, and sleeping irregularly and your reflexes and motor skills suffer.) The ABC article says that when this child walks a block, she has to stop and rest. That's the tradeoff.

A normal metabolism would permit everyday activities with a ton of energy to spare, and the energy is available in a regulated, constant stream. IME, a defective metabolism gives off bursts of energy, and when its taxed too far, it makes you feel like you're Atlas. Or Sisyphus. And you've walked a block when your hormones are not cooperating and you'd be happy to have a nice warm bed to crawl into right there on the sidewalk. It's a sucky, dreadful way to live.

The ABC article also says that the girl swims for four hours in summer. I'd be willing to bet that during the summer, when she's not at the pool, she does absolutely positively as little as possible, because she doesn't have the physical ability to do much more. It'd be interesting to know how many hours are spent reading on the bed or watching television after those marathon swim sessions, because that'd complete the picture of what it's like to live with your endocrine system rebelling against you.
posted by Dreama at 5:37 PM on July 19, 2004


Civil Disobedient, Mayor Curley, and so on: you're badly under-complicating how the human body works. Fat is not a perfect energy battery. There are multiple processes at work in your body that add and subtract to your fat (as well as your muscles, your bones, etc etc). If you reduce your caloric intake, only some of the difference will be made up by your fat. This is why hyper-obese people who go on starvation diets can starve to death while weighing 600lb.

Suppose you had reasonably efficient processes for adding fat, and drastically inefficient, or non-functional, processes for removing it. Suppose you could deposit excess energy in the form of fat, which is any energy that you don't need right now, because you're sitting quietly while you're digesting, but you couldn't withdraw it. Under such conditions, if your caloric intake is over the absolute minimum required to sustain life, you will store fat.

Normal person: Stomach --> bloodstream --> fat --> bloodstream. Hyperobese person: Stomach --> bloodstream --> fat. Maybe a little fat --> bloodstream, but not much compared to normal folks.

Belaboring the analogies in the interests of education: consider eating to be like getting paid, your bloodstream as like your wallet, and your fat as like a bank account. Any money you don't spend for your immediate needs, an dyou can only keep it in your wallet for a couple of hours, you must put into your bank account. Now, if something were wrong with your bank such that you couldn't withdraw money, you would slowly accumulate it. No matter how little you get paid each time: even if you get one cent more than you need to spend, into your bank account it goes.

This is my guess at what is wrong with some hyper-obese people. Therapeutically, my guess is that drugs which have an effect--or side-effect--of overdriving the fat --> bloodstream process will have the most benefit. If indeed such a drug exists.
posted by aeschenkarnos at 5:59 PM on July 19, 2004


Dreams' point is spot on. If your body prioritizes energy distribution into storing fat over moving around, you will be unable to move around as much.

Conversely, if your body prioritizes moving around over storing fat, you will become skinny and fidget a lot. Which is what my own metabolism does.

Ironically, if deprived of all food, both a skinny and a hyper-obese person will starve to death before a person with a normal metabolism. Over-fatness and over-skinniness are not a spectrum of metabolic efficiency, they're caused by a variety of different kinds of inefficiencies.
posted by aeschenkarnos at 6:06 PM on July 19, 2004


Thank you aeschenkarnos, I had composed something similar but not nearly as good.
posted by i_am_joe's_spleen at 6:26 PM on July 19, 2004


aeschenkarnos, I'm afraid your analogy is a bit, well, wrong. But I understand what you're trying to say. I believe Dreama makes the point perfectly, and one that explains the exchange of energy.

The "burst of energy" / "little to no energy" description fits well within my conservation of mass point, and it's something I can wrap my mind around. What I'd like to know is, when obese people with endocrine malfunctions (or whatever) are so tired that they cannot move -- if they were somehow forced to move, they would burn off those calories, right?

I'm not suggesting the term "forced" to mean "against their will". Instead, I mean that, regardless if they are asleep or tired, their bodies are kept in a constant state of motion that would burn off the calories they took in, whether it was under their own power or not. Or, for instance, if electrodes were connected to their major muscle groups, you could stimulate movement without the intervention of the patient.
posted by Civil_Disobedient at 6:35 PM on July 19, 2004


their bodies are kept in a constant state of motion that would burn off the calories they took in, whether it was under their own power or not

How would motion not under your power burn fat? That's like trying to slim down by rolling down a hill or riding in a fast car.

Or, for instance, if electrodes were connected to their major muscle groups, you could stimulate movement without the intervention of the patient

But then you could only do as much as the body's metabolism / energy supplies would let you, neh? After however long, all you'd get is feeble twitching and horrible cramps. Presumably in someone like Ana it wouldn't take nearly as long to reach that point as it would for you or me or He-Man.
posted by ROU_Xenophobe at 6:51 PM on July 19, 2004


aeschenkarnos, how can we make people like you understand that, disorder or not, if she was really on a 550 calorie-per-day diet, she would have lost weight?
posted by Mayor Curley at 7:04 PM on July 19, 2004


aeschenkarnos, I'm afraid your analogy is a bit, well, wrong.
How so, and why?

What I'd like to know is, when obese people with endocrine malfunctions (or whatever) are so tired that they cannot move -- if they were somehow forced to move, they would burn off those calories, right?
Only if their metabolic process for extracting energy from fat actually worked. Otherwise, they'd do what any living creature does if worked beyond its point of endurance: pass out from lack of energy and accumulation of fatigue poisons. Their point of endurance is really, really low.

You are still under the assumption that metabolic processes work as well for our hyper-obese person as it does for yourself. A body is an immensely complicated thing, sustained by millions of interacting chemical processes. If some of those go wrong--for example, if you contract a flu virus--then other processes are sped up and slowed down. If some go badly wrong--for example, if you develop leukaemia--then you're very likely to spiral down to death unless drastic changes, like drugs and surgery, are made to your body. If a process never worked properly in the first place--for example, if you were born with haemophilia--then your body does the best it can under the conditions, until those conditions kill you. Hyperobesity is such a condition.

We're not talking about Joe Average putting his feet up in front of the TV and chowing down on twelve McBurgers a day for six months: if he does that he'll get fat, but the fatter he gets, the harder it will be for him to become even fatter. His body will attempt to adapt to its diet, and if that adaptation fails, as it probably will, he'll suffer effects like hardening of the arteries and so on. But he could, by exercising and reducing his food intake, save himself, because his metabolic processes that convert fat back into energy (in response to a need for energy that cannot be satisfied by the bloodstream) actually work. In the hyper-obese, it doesn't work anywhere near as well.

Externally driven motion of the body might stimulate the fat --> bloodstream process, or it might not.
posted by aeschenkarnos at 7:04 PM on July 19, 2004


I don't think so Civil_Disobedient, because ultimately burning calories means an ATP reaction.

Moving limbs through outside mechanical effort, or by applying an outside electric current, isn't going to do a damned thing to consume "energy" (ie glucose, fat, whatever) stored in the body.
posted by i_am_joe's_spleen at 7:05 PM on July 19, 2004


aeschenkarnos, how can we make people like you understand that, disorder or not, if she was really on a 550 calorie-per-day diet, she would have lost weight?

Do people like you think that, no matter what kind of disorder a car engine has, if you put petrol into it, it will run? Why should an immensely more complicated set of mechanisms, the human body, be more predictable?

The operative word here is "disorder". The disorder being, energy goes into fat, but does not come back out. Mayor Curley, how can a person with such a disorder lose fat? (Because simply losing weight might mean losing muscle mass, or worse, bone mass.)
posted by aeschenkarnos at 7:10 PM on July 19, 2004


What the fuck are you talking about? Are you insane or are you high? Seriously, that's so off-topic (muscle mass?) and crazy that I'm worried that you might live near me. Being ignorant of physics is the least of your problems, because you're huffing paint or something.
posted by Mayor Curley at 7:17 PM on July 19, 2004


aeschenkarnos, what surly Mr Curley is not pointing out is that in the article, it seems that she may not truly have been restricted to 550 calories by her parents, and that when in the custody of the state, she did lose weight.

MC, aeschenkarnos is making a really valid point, even if he/she did skim the article.
posted by i_am_joe's_spleen at 7:54 PM on July 19, 2004


I don't know if the 550 calorie figure is correct or not (perhaps not), but I'd side with aeschenkarnos' point about hyperobesity : the reason the Atkins Diet works for a lot of people - especially the hyper-obese for whom no diet or even severe caloric restriction has worked - is this : human endocrine systems tend to be malfunctioning among the very obese.

Think of it this way - one's body metabolism can run at different speeds, and when humans consume a lot of dietary sugar (and refined carbs which turn quickly into sugar) this triggers the endocrine to ramp down body metabolism and release hormones triggering the storage of fat.

If the assaults on the Pancreas and the Endocrine system - that high sugar intake amounts to - continue, Diabetes can occur.

Further, this pathology can make it almost impossible for those who suffer from it to lose weight even with quite severe caloric restriction. The most effective method for such patients, Atkins found, was to cut out all carbohydrates completely. I'm not sure how essential the consumption of protein and fat is to the process, but the net result is the triggering of Ketosis (the burning of fat) - a state I'm actually in right now due to the fact that I'm doing a three day fast.

But - as Atkins stressed - his diet was extreme shock therapy to be used mainly in cases where patient's inability to lose weight was truly life threatening.
posted by troutfishing at 8:43 PM on July 19, 2004


Let us revisit MC's original statement:
he weighed a buck-eighty but her parents were feeding her increasingly shrinking diets and she lost no weight at 550 calories day? Naturally, they were being completely honest about what she was eating and the child was drawing mass from some Marvel Comics-style "extradimensional source."
If we were to start this thread all over again, how many of you would be still be chewing his ass out for making what appears to have turned out to be a valid guess as to what was going on?

That said, the folks saying that there are people with fat<>energy freeways that are six-laned to fat but only single-laned coming back out have made an excellent point.

And trout, weren't you saying your fast was so short that it wasn't causing your body to eat itself?
posted by five fresh fish at 9:13 PM on July 19, 2004


because ultimately burning calories means an ATP reaction

That's neither here nor there. What I'm referring to is autonomous functions, in the case of moving muscles, the reaction of muscle fiber when connecting nerves are stimulated by electricity. Whether your awake, asleep, tired or unconscious, your muscles will still "twitch" when given an electrical impulse.

Understand, I'm not suggesting that we need to electrocute people to get them to lose weight, I'm just looking at alternatives.

And aeschenkarnos, the part of the analogy I thought was incorrect was the "deposit/bank" part. You said: "Now, if something were wrong with your bank such that you couldn't withdraw money" -- an impossibility if the person is living. A living organism burns calories -- perhaps not much, but they're always "withdrawing money". Therefor, this part: "No matter how little you get paid each time: even if you get one cent more than you need to spend, into your bank account it goes" is fundamentally flawed.

Show me a person who burns no calories, and I'll show you a very nice plot of land with a big piece of granite on top of it.
posted by Civil_Disobedient at 9:34 PM on July 19, 2004


FFF - Oh, it's eating itself alright. I should have specified that my body won't likely be eating it's own muscle during such a relatively short fast. My ass will just get bonier and I'll lose some fat off my head.
posted by troutfishing at 10:05 PM on July 19, 2004


Civil - Sure, agreed - but, I think what's more at issue is the rate.
posted by troutfishing at 10:07 PM on July 19, 2004


aeschenkarnos, how can we make people like you understand that, disorder or not, if she was really on a 550 calorie-per-day diet, she would have lost weight?

Well, because it's bullshit. I lived off of two bowls of ramen a day for months (around 600 calories) and didn't lose any weight that I noticed, and this is when I was doing physical labor for a living.
posted by IshmaelGraves at 10:27 PM on July 19, 2004


Seems your grasp of basic biochemistry, as distinct from a Newtonian physics model of how the body operates, is about as good as your grasp on well-mannered discourse, Curley.

Civil Disobedient, the person eats food and burns calories, you're absolutely right about that, but what happens in between is the question. The answer is the bloodstream - a person eats food, it goes into the bloodstream, and what is excess to the body's requirements at the time is stored, as fat. In the normal metabolism, if a person is hungry and there is not enough energy in the bloodstream, fat is broken down to provide it. Can you see that there are two kinds of processes there, for fat storage and fat breakdown? My point is that some hyperobesity could be caused by a failure of some of the fat breakdown processes. Reasons for that could be a disease, or a genetic abnormality, or whatever.
posted by aeschenkarnos at 10:37 PM on July 19, 2004


I suppose the bank account analogy (slightly flawed, as it is) accounts for the recommendation of 6 or 7 small meals during the day as opposed to 3 larger ones. By spreading out you caloric intake over the time that you actually need it you prevent some of those calories from being stored as fat in the first place, where they might be hard to break down again.

This is probably why I am gaining weight right now, although my activity levels and food intake haven't changed much. I have been working a lot which means coming home late and eating my wife's dinner just before bed, when I don't need the energy. Unfortunately, getting to sleep while hungry is not easy, especially with that plate sitting there in the fridge.
posted by bashos_frog at 12:47 AM on July 20, 2004


Are you saying that the social workers didn't know what they were doing?

That's generally how it works in most countries. Is the system different there?
posted by wackybrit at 3:40 AM on July 20, 2004


bashos_frog - Do you know the "Sumo Wrestler Diet" ?

It's the way Sumo wrestlers gain weight to bulk up for their sport.

The main principle - beyond simply eating a lot of food - is this : don't eat until noon. At the end of the day, excess, uneeded calories (for metabolism or for cellular/tissue/muscle repair) get turned into fat.

Eating late in the day is a fat gain diet.
posted by troutfishing at 8:20 AM on July 20, 2004


mayorcurley ... i believe you have a severe attitude problem towards people that is bound to be imitated by any children you have, making their lives much worse ... i think a call to child protective services is in order
posted by pyramid termite at 5:59 AM on July 21, 2004


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