Cases of Women Diagnosed with PCOS who got a Cushings Diagnosis Later

Cushing's syndrome in women with polycystic ovaries and hyperandrogenism

 

"How might polycystic ovarian syndrome and Cushing's syndrome be distinguished?

The menstrual cycle of individuals with PCOS is likely to have always tended towards irregularity (the amenorrhea in this case developed after years of a regular cycle).¹ The onset of PCOS is uncommon after the age of 30 years. Both PCOS and Cushing's syndrome are associated with obesity, an increased risk of hypertension and impaired glucose tolerance or secondary diabetes.^{4, 7, 9} Clinical and/or biochemical hyperandrogenism with menstrual infrequency is found commonly in women with Cushing's syndrome. In fact, there are data to suggest that menstrual irregularity is linked to the level of glucocorticoid excess rather than to androgen levels.⁷ Ovarian cysts are certainly not discriminatory; they are present in almost half of women with Cushing's syndrome.¹² It is also noteworthy that cysts, in isolation, do not predict the development of PCOS;¹³ furthermore, whereas imaging the ovaries can help to exclude a tumor, our experience would suggest that identifying cysts either laparoscopically or by ultrasound scanning can inappropriately curtail the search for alternative causes of clinical and/or biochemical hyperandrogenism.

Virilization in PCOS, characterized by a deepened voice or clitoromegaly, is highly unusual and more in keeping with an androgen-secreting tumor (none of the cases illustrated in Table 2 experienced virilization).⁷ Other clinical features lend support to the diagnosis of Cushing's syndrome, but these can be absent, especially in the early phases of cortisol excess.⁹ Biochemically, relative luteinizing hormone excess has been reported in patients with PCOS,¹⁴ whereas low gonadotropin levels might increase the suspicion of Cushing's syndrome (as in Case D in Table 1, who presented with primary amenorrhea).¹² None of these features is absolute, the overlap between syndromes is large and, thus, screening tests are needed to exclude Cushing's syndrome (Table 3).

I'm being tested for out and out Cushings now.

Remember this entry...

Pursuing an Out and Out Cushings Diagnosis?

They are doing a Urine Free Cortisol check. I took in the records [some even from years ago] where I was diagnosed with the high cortisols and told them how the doctors then considered me as having pseudo Cushings but severe PCOS too. The endocrinologist seemed very knowledgeable. I told him how I was unable to get a pituitary MRI. I think they are paying MORE attention now because of the insane kidney stones and I told them I literally got handfuls of these things. I had a high ACTH which is a marker for Cushings years ago. I hope they can get somewhere. I am getting so sick. So much fatigue I can't even explain it all to you. I'm in bed now by the way. I told him I have felt exhausted. If answers came after this many years it would be nice. He told me my parathyroid levels are normal now and does not see my low Vit D as a present parathyroid issues. My body is so tore up. They have ordered me lymphedema care at home and some occupational therapy too, it is getting harder for me to get tasks done, I am not sure if it's the fatigue, bad balance or what. I am not keeping up. Oh one thing he brought up, is wondering where all my severe lymphedema has come from. That puzzled him. Oh if only I could get more answers after all these years. I know I am not going to last long at this weight. My weight was 519, 5 days ago it was 513, three months ago 486. It always frightens me.

I know there are many women diagnosed with PCOS who find out it is actually Cushings, maybe a few have both.

Anyhow I hope they find the reason for the kidney stones. He did tell me genetic testing was very expensive. I am afraid of this weight and how much I am holding on. I just want the nightmare to be over after all these years.

http://www.medscape.com/viewarticle/565417_3

An Interview with a Friend About Life, Fat, and Supersized People.

INTERVIEW WITH PAM

Pam was a friend of mine now deceased. I miss her very much. She did endure a lot of what I have and at one point was near 700lbs as well. She knew what it was to face severe weight issues into her 60s. She was a very funny, kind and loving woman. We shared many struggles and she was a life line to me for very years. It was a blessing to know her.  I remembered I was interviewing her in future hope of writing about weight, which I obviously did on this blog. :) I still own the tape and transcript typed out back then, and decided I'd share it here. At the time she gave me permission to use this for any writing. I am happy to share her words here. The conversation brings back fond memories for me not for what we went through but that that we were there to support one another. Of course since 2004, some of my views have changed which is the year this interview was done.

FIVEHUNDREDPOUNDPEEP: How old are you?

PAM: How old, or how moldy?

FIVEHUNDREDPOUNDPEEP: [laughing] No, how old?

PAM: Old enough to know better, but too young to resist.

FIVEHUNDREDPOUNDPEEP [laughs]: That’s funny. What’s the highest weight you’ve ever been?

PAM: Boy, this is a personal interview – is this gonna be on “20/20”?


FIVEHUNDREDPOUNDPEEP: No.

PAM: My highest weight was 600-plus in 1980, but they weren’t sure…one doctor said, as far as an actual weight, closer to 700 [pounds], and congestive heart failure, and they’d mainline Lacix – which drew a lot of water off of me in one week’s period of time.

FIVEHUNDREDPOUNDPEEP: OK – yeah, you said you got lots of water taken off of you.

PAM: Uh-huh. I didn’t know I had congeestive heart failure. I was 33, at that time.

FIVEHUNDREDPOUNDPEEP: OK. OK. And what’s the lowest weight you’ve ever been?

PAM: You mean, birth weight, or adult weight?

FIVEHUNDREDPOUNDPEEP:  I was two pounds in the womb! I was born weighing 200 pounds [laughs] – that’s what I’d tell people!

PAM: As an adult – I think when I was 19, 18 ½, I was going to a doctor that was giving everybody all these – you know, it was like a diet clinic, and I got down to 123 pounds.

FIVEHUNDREDPOUNDPEEP: Wow, you’ve been smaller than I ever have…

PAM: Very, very…I was skinny, but I got pregnant, and I gained 60 pounds with the pregnancy…that was with my son, and, after that, I just kept going up. I was at Weight Watchers, and Overeaters Anonymous, to try to – you know, stay around 250 [pounds], because I was selling ads, and you have to make a fairly decent appearance, plus, you’re on the go all the time.

FIVEHUNDREDPOUNDPEEP: Yeah, that makes sense…what have been some of the challenges to you, in terms of being overweight?

PAM: Well, employment, housing – now, because I’m in a wheelchair. I don’t have to be in it all the time, but – getting older, disabilities are harder to deal with, as you age.

FIVEHUNDREDPOUNDPEEP: That’s true.

PAM: That’s a big challenge, aging; I’m facing that now – I’ve outlived a lot of people that are in a similar situation, that I knew. I’ve watched people just dwindle down, you know, under a system that’s not too kind. There’s not a lot of help for women in my age group, in the 50s – you know, if you’re disabled, if you don’t have a spouse with a good job, or a family that can help…and a lot of people don’t…or they have ‘em, but they’re not willing to get involved…so that can be quite a challenge to be in this age group, before retirement age.

FIVEHUNDREDPOUNDPEEP: Kind of like, you fall through the cracks, right?

PAM: Right, and fall through the cracks of what’s happening now…I just read an article about a county out here in rural [state] – the waiting list for people that are of retirement age, that are on Social Security, and not because of disability, but need services because they’re aging…they have medical needs…the waiting lists are getting longer and longer, because of the aging population. So, by the time I get into the next age group, if I live that long, I’ll be just one of those people on the waiting list [laughs] – so, I don’t know what it [the solution] is.

FIVEHUNDREDPOUNDPEEP: Let me ask this question – what would you say are the special challenges of the supersized, the 200- to 300-pound person? {I consider supersized to be 350lbs and above today}

PAM: That’s supersized?

FIVEHUNDREDPOUNDPEEP: Yeah, the supersized, the people who are on the upper end of the scale, like me?

PAM: You mean, 200 to 300 pounds?

FIVEHUNDREDPOUNDPEEP: Yeah, people who aren’t 200 to 300 [pounds]?

PAM: People that have lived at 600, 700, 800 pounds? I don’t weigh that now, but that could happen again in five minutes – you know, once you’ve been that big, you could go back there, because of medical conditions, food-related things, whatever…I’m not real clear on that question. Do that one more time.

FIVEHUNDREDPOUNDPEEP: OK. What would you say are the special challenges that the supersized fat people have to deal with…

PAM: That the moderately overweight don’t have to deal with?

FIVEHUNDREDPOUNDPEEP: Yeah, that the moderately overweight don’t have to deal with. PAM: Well, I mean, like we’ve talked about – personal things, personal hygiene. It’s amazingly hard for moderate overweight people to realize that people, once they get up over 400, 500, 600 pounds, that there are landlords – if they see the person, they’re gonna assume that they’re not gonna pay their rent, that they probably don’t keep their apartments clean, because they’re too big to run a vacuum, or whatever…

FIVEHUNDREDPOUNDPEEP: That’s true; they won’t rent to you. {I was refused an apartment once due to weight}

PAM: There’s rental discrimination…there’s people that are supersized, and they keep their apartments immaculate. You know, I’m not supersized – well, I’m borderline supersized – I consider anybody over 200 pounds to be supersized. But, super-super-sized people…it was a struggle to do some of the things thin people take for granted, when they clean, or bathe, or have a bowel movement. You know, we talked about the toilet paper sponges, for the reach, and the bidets, for the overweight – even umbrellas. An umbrella for an average person won’t keep a supersized person dry.

FIVEHUNDREDPOUNDPEEP [laughs]: Yeah, you’re right, I was thinking about that – you’re right, it won’t.

PAM: Yeah, when it rains, and you use a regular umbrella, all it does is bring the rain down on your shoulders, and it drips down on your body.

FIVEHUNDREDPOUNDPEEP: That’s true. That’s actually something that frustrated me. I didn’t know anybody else that noticed that.

PAM: There’s all kinds of different things…thank God that people challenged it, and there’s more big people now – there’s money to be made off of us, so the fashion industry opened up, but it still has a long way to go -- there’s things that I need, that I can’t from Roman’s, and Lane Bryant’s. They don’t seem to carry pantyhose, and brassieres, and girdles that’ll fit real big women -- or women, even my size, with the loose skin. I still need a gigantic girdle, if it’s gonna be on me, and support me, but you can’t buy them.

FIVEHUNDREDPOUNDPEEP: I know, they just don’t have them – I had to give up wearing bras long ago. Do you think discrimination against overweight people is getting worse?

PAM: I think, because there’s so many overweight kids and adults – you would think it would be getting better, but I think it’s an unpopular group to be associated with. People, even if they are heavy, or supersized – they may find friends in that weight range, they can relate – but I think the discrimination is still there. You know, if we walked in on an interview, and had degrees, and a thin woman that had the experience, and [only] some degrees, based on appearance, they’d pick the thin one. I mean, it’s been proven.

FIVEHUNDREDPOUNDPEEP: Yeah, they have done studies on that – they have done studies on that, and they’ve definitely have always picked the thin one.

PAM: Well, they did a study, too, with little children – five-year-olds – and they used dolls. One doll was disfigured facially, like a burn patient; the other one was without limbs. I forget the others. You know, there’s different disabilities that can come upon a human being…and then one was just huge, just a big fat doll baby. Of all these disfigured dolls, even though the obese wasn’t burned, or limbless – the one that none of ‘em wanted to be was the obese doll.

FIVEHUNDREDPOUNDPEEP: Oh, wow…

PAM: They would rather be without arms and legs, facially disfigured, whatever, than to be obese.

FIVEHUNDREDPOUNDPEEP: Hm – that’s probably because of some of the messages they hear about how bad fat people are, over and over…

PAM: Oh, sure. And then, all this stuff about the restaurants downsizing food portions – I don’t see any of that stuff happening. I don’t know what the answer is.

FIVEHUNDREDPOUNDPEEP: Actually, it’s not happening – did you know Hardee’s actually released a 1,400-calorie burger?

PAM: Oh, mercy!

FIVEHUNDREDPOUNDPEEP: That’s pretty bad, isn’t it?

PAM: Especially when they’re hyping all this, “Oh, we’re gonna try to help,” you know, especially with the next generation – which I do see some improvement. But there again, there’s gonna have to be more support groups – and God forbid, maybe even the only way that people would ever cut back, if all this stuff is gonna continue to be available, and so many people are insulin resistant from eating this way for so many generations – that it might take, whether it’d be a famine or something, for a couple generations to get back to where they’d have to plant, and harvest. Like the Bible says: “You work by the sweat of your brow.” I mean, people don’t have to do anything!

FIVEHUNDREDPOUNDPEEP: I know, that’s kind of why we’re all getting messed up…’cause, then, you burned it all off.

PAM: Everybody’s at the TV, or computer…yeah, you see some people jogging, and walking, but – you know, once you get to a certain point – whether it’s just the natural aging process, or you’re obese along with it…I mean, you’re limited how much of that you can do safely.

FIVEHUNDREDPOUNDPEEP: I actually have the belief that if you don’t exercise enough as a kid, and your life’s sedentary, you never can get to the good part. Does that make sense?

PAM: Yeah. Well, and I think, too, some people are heavy because of illness, even, from birth on – they don’t ever feel well enough to exercise. And there’s the other side, too – the other side of the coin with people – where getting that habit ingrained in your mind [is difficult]. Once you feel better, I think if you can keep with it, maybe get some support, get involved in a sport, or something – if that’s even possible – it’s just not even possible for a segment of this society. They’re not mobile enough to do it. But there’s decent exercises – there’s depression in there, too, people are battling that. A lot of times, obese people are isolated, alone in apartments, where even the most optimistic person – over the long haul, day in and day out – would be wore down.

FIVEHUNDREDPOUNDPEEP: Well, here’s the thing, too – I almost think, when there were more people around, they were a more closer-knit society. That actually gives you a chance for more movement. Does that make sense? ‘Cause you’re moving around…

PAM: Before the automobile? You know, I mean, it’s not been that long ago, maybe there weren’t even bicycles…I don’t know what the history is on bikes, or things with wheels, but you know – basically speaking, it was the only wealthy that had things like this. Your feet got you there, and maybe somebody might have an old wheel, but I don’t think they really rode ‘em – they used ‘em for farming, or transporting goods.

FIVEHUNDREDPOUNDPEEP: I think they walked.

PAM: They walked! And women lived and died within a mile of their house – I’ve read that over and over. People were born in a village, and if they maybe went to town once a year, there’d be a homecoming, or something – that was as far as most women went. A lot of ‘em didn’t know how to read, a lot of people didn’t know how to read. Maybe the priest, or the pastor, or a lawyer in town would do all the documents – poor people, especially, just the average man on the street was not that educated.

FIVEHUNDREDPOUNDPEEP: That’s true. You’re right. OK, let me ask you a new question…there’s some good stuff. Let me – I was gonna ask you about size acceptance. What do you think of the size acceptance movement?

PAM: Over the last 30 or 40 years, whenever it started – I think it’s probably getting close to 40 now, but…

FIVEHUNDREDPOUNDPEEP: Wait a minute, just a second, whoops…my microphone fell off, just a minute.

[FIVEHUNDREDPOUNDPEEPstops to get another piece of tape to hold her microphone in place.] [break and off subject conversation]

FIVEHUNDREDPOUNDPEEP: I always wonder, though, if both of us worked – all these errands, and crap, and cooking, and stuff –

PAM: Well, what happens if people don’t work on their marriage, and take time for themselves? That’s what it becomes.

FIVEHUNDREDPOUNDPEEP: I know – I don’t know how these people have any time.

PAM: They don’t.

FIVEHUNDREDPOUNDPEEP [laughs]:’Cause, I’ll tell you what, Pam – during the day, paying the bills, making the food, making sure there’s groceries, laundry, all the medical stuff, that takes up enough time, where I’m like: “What if I had a job? We’d never see each other.”

PAM: Yeah, you know, you have to be real mobile to do that, and some people do get way behind. Their kids suffer. A lot of women that are out there working are not making any money, if they’re paying babysitters…

FIVEHUNDREDPOUNDPEEP: I know – I actually think they should be allowed at home. You know what I've said about the two for one deal the corporations got, when one income used to support a family.

PAM: There are ways to have what you need, and still stay home, and be a mom to your kids – and it’s too much, ‘cause it’s the woman that ends up paying ‘em [babysitters, daycare, etc.].

FIVEHUNDREDPOUNDPEEP: I know. I think feminism screwed us [laughs], I do!

PAM: OK – you take a situation, if a woman can handle all that – of course, if you wanna get yourself into that, a person should be allowed. I don’t think there should be any restrictions set on it. But I just think a lot of women didn’t realize what they were getting into, and once they got into it…

FIVEHUNDREDPOUNDPEEP: They can’t get out.

PAM: Yeah, it’s like an addiction – it can be more fun to go to work, than taking care of two- and three-year-olds – preschoolers, you know? It’s hard work. [(337 feet): Discussion turns to difference between modern life, and level of activity in older, agrarian-based society.]

PAM: Today, if you use a towel, then it goes in the laundry, instead of hanging it up, and using it for a week – because it was clean when you use it. Unless it’s like a hand towel…

FIVEHUNDREDPOUNDPEEP: I know – I do too much laundry, ‘cause I always have to wear different clothes – I smell really easily, so I can’t even repeat a wearing of anything.

PAM: They say it’s the foods we eat, and if you take medicine, and have illness, you’ll have a body odor difference, sometimes.

FIVEHUNDREDPOUNDPEEP: Actually, I believe PCOS makes you stink, especially if it’s uncontrolled. It makes you smell lot. It really does.

PAM: Huh! I don’t perspire, or anything – sometimes, because you’re round yourself… [Of subject conversation PAM says. “Some of these people are so competitive, even if it’s to advance the cause…”

PAM is more enthusiastic about nominating MICHAEL MOORE: “He’s a tub! He’s one of our brothers in fat. I tell you what – that man could help us.” PAM and FIVEHUNDREDPOUNDPEEP then briefly talk about merits/demerits of weight loss surgery, before going back to list of interviewees.] PAM [after suggesting Ricki Lake, who’s gotten heavy again:] There are people, believe it or not – I know a couple of ‘em – they’ve finally got a handle on it, finally got some kind of exercise in their life…


FIVEHUNDREDPOUNDPEEP: I think if people have an eating disorder, and just eat too much, and they don’t have the metabolic issues – if they get treatment and are able to quit eating too much, and they exercise, they can get at least some of the weight off. But if it's metabolic it's far far harder.

PAM: Yeah, I think so, but if there’s a lot of medical history – and also, if you get to a certain point where you lose mobility, it’s hard to ever get it back, or keep it.

FIVEHUNDREDPOUNDPEEP: I know. Look at me, with all the breathing problems, and stuff – how am I gonna go burn it all off?

PAM: Yeah, if you don’t move around – I mean, can you imagine how many calories you burn, just walking to get out of your apartment?

FIVEHUNDREDPOUNDPEEP: Probably a lot.

PAM: Yeah, you do. My doctor told me, just to be alive – when you’re over a certain amount of weight, the tremendous amount of calories [needed] just to keep this machinery going – the breathing, the digesting of the food, all of it, any movement at all…like, say, when a thin person gets up off of a chair, it’s nothing.

FIVEHUNDREDPOUNDPEEP: I know – I do move around a lot for someone [my size]. I’ve been told that by people at offices. I’m kind of a fidgety person – like, even now, I got my leg hanging over the end of the bed, going back and forth.

PAM: Yeah, well, you probably have a lot of energy trapped inside of you, you know, where…

Adiposopathy

Adiposopathy 

That's a new word to me...

"metabolic syndrome is something I've heard doctors toss out, it goes with insulin resistance and PCOS.

Adiposopathy {"sick fat"} and it's relationship to metabolic disease.



Is adiposopathy (sick fat) an endocrine disease?

Obesity Risk May Be Lowered By Moving Into A Better Neighborhood

"Obesity Risk May Be Lowered by Moving Into a Better Neighborhood"

see here too

"Obesity rates are about one-fifth lower in women who moved from poor neighborhoods into low-poverty neighborhoods than those who did not move, according to results from a federal housing program initiated in the mid-1990s."

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I found this one really interesting, it seems living in a dangerous crime-ridden neighborhood heightens obesity risk. I wonder how much of this is increased cortisol from the constant 'fight or flight" feelings one has living in such a place. When I had my weight gain, I lived in a more dangerous 'inner-city" neighborhood for around 4 and half years. Three of those years, I worked, but the last was when I was disabled.

One had to be tough to survive, we are talking a place where beggars would come up to you daily at the local bus stop, and where you could get jumped. I saw an armed robbery, got attacked--was able to fight off my attacker whose intentions were rape before anything too bad happened, and life was spent with constant crime, stress and knowing that your neighbors were not there to "help" you but often there to rob or take you for a ride. The times of being followed or being set up as a "would be" victim, were incredible. There was a meanness in every place, no mercy, no neighborly kindness just cruelty, get sick in a store and ask to use a bathroom, they would send you away. By the way, the most dangerous place was the subway stands and daring to leave the house after dark. Even the cab drivers and cable companies avoided my then neighborhood. One I befriended from meeting his cab in a neighboring better area, provided a lot of my transportation while others refused.

  For many in these bad neighborhoods, life itself is filled with daily danger. Gang-bangers in the streets, beggars, and would be hustlers on the take everywhere you turn does not make for a pleasant life. Even the closed Chinese restaurant across the street from my ghetto apartment had homeless people sleeping on it's ledge with their shopping carts. Police cars filled the streets to bust the drug dealers across the way. It was despair, depression and fear all rolled up in one. When you did meet the occasional kind face, they were beaten down and poor too.  Home life wasn't much better, I would see around 6-8 mice and rats a day run across the floors in the cramped 2 room apartment. Well at least with the rats and mice, there was no cockroaches.

Some may be in shock, that I would admit such poverty, often times in this culture, one is told to hide such a thing, lest it be a negative reflection on you, but I lived it, and it played an integral part in my health collapse and severe weight gain. 

I did not end up there by choice, I moved to that big city to avoid homelessness after a teaching job lay off which led to a year of unemployment and underemployment, piecing together sub teaching jobs and fast food work, hoping I could jump onto a career track in social work and finish an already started paralegal degree. My first teaching job was grant-based and the grant had ended. [I had a bachelors degree from earlier on]. I did not drug or drink my way into this life, but slipped through the cracks and then some.

Later my family would help, but a older male relative at that time, was of the "let them sink or swim school" blaming me for my then growing weight, career failures and health problems. Looking back, even the pictures of my swollen face, hands and feet were extreme, I was sick before the move to this place even happened. My health had been rotten since college, denying me even regular teaching jobs from failing medical exams. This was during my mid 20s and during the mid 1990s.

My low residential counselor wages, while offering me training in self defense ironically and experience working with the very violent and mentally ill youth which served as being useful for street survival, just didn't pay the rent in a better part of town. $350-450 dollar a month rent in that particular metropolitan city meant living in dangerous neighborhoods. My take home pay was a lousy average $1000 a month. Transportation was very expensive as well, even a trip just down the road could cost 6 dollars to even just get there. Which made life much more narrow, and activities more dear. I know that impacted things too.

I do believe that my weight gain came about from severe economic stresses and what I faced day to day, and my endocrine system saying "I am out of here!"

That is one thing they do not tell people, live in a constant state of vigilance, and fear and the body is pumping cortisol like gang-busters even in normal healthy people. This is one reason I believe obesity is far higher in impoverished populations in America. Add to that endocrine disease and the use of steroids to control serious breathing problems and it was the set up for the snowball to run right down the hill. They should do a study of the obesity differences between huge teeming cities and more rural areas, would be of interest. When humans live in concrete jungles, health diminishes. How much of the obesity epidemic is based on the bad environment so many are being forced to live in? In other words, its not you that is "sick", it is your surroundings and their impact on you.

They mention the lack of access to healthy food, that plays a part. In the ghetto, you have the corner stores full of snack foods and the food is of far lower quality even in the bigger grocery stores. That's where they send the rotten produce and meat. I have seen it with my own eyes. No cab money to get to the decent grocery store in the neighboring suburbs? You are stuck with the little store across the street that sells ramen noodles and hotdogs and one dying onion in the bin by the door.  By the way, the poverty brokers like the food pantries and rest, aren't passing out fresh fruit and vegetables, you are getting the most processed carbohydrate rich foods possible. This is true across the board and even applied to later communities. Who decided the poor should just eat endless boxes of spaghetti, beans, and rice?

I believe poverty itself in this society which does not offer strong social networks, stable jobs or communities anymore, jacks up ones cortisol levels to the ceiling especially when crime rates rise. I know how I feel when the budget is always strained to the breaking point or weeks where I am trying to assemble meals from the dregs from the refrigerator, and it's always the good stuff that disappears the fastest. Often the very poor do not have resources to even cook decently. Slumlords do not care about making sure your stove works. I was forced to cook with an old microwave and one plug in spiral during these years. No baking bread, I didn't have a bread pan, or gardening there either, there was no land to be had or patio.

Life in the ghetto stunk. I often think to myself if I had been a woman of normal socio-economic means, that my life would have turned out far different. For me obesity is automatically tied to food insecurity and opening an empty fridge and realizing that week there is no money for food. Some may say, how does one get so fat, having no food? Wouldn't it be the opposite, but I often wonder how my 1 meal a day lifestyle, during my worse years of poverty affected my metabolism? Even now, during the wealthier times, I know the weight dips. More food and more variety for me means, better weight loss and control of hunger. More money means more activities. Today I am provided for and God responds to my needs, but those times have stayed with me.

There is a reason I escaped to a very small town, a town I still miss right now. Watching its economic demise, was very difficult. This place is too urban for my tastes though I live in a safer more affluent neighborhood here by default. But I know it's important to pay more rent even for my health and well-being, but live with a life long fear now of living in a place where just leaving your front door, means the predators are upon you. I have decided if I am ever that poor again, that I will hop on a bus to a middle of nowhere small town and rent a room. Learning the hard lesson that peace and safety come first came too late for me.

The night before we escaped to a small town for almost 10 years, I still remember the gun shots at 5 am. Bang Bang Bang! probably some sort of gang fight down the street. I was very glad to be getting out.

Being poor does make you fat. The elitist size acceptance types can claim that obesity isn't a disease or ignore the poverty and obesity quotients. No hobbling to the bus stop for them worrying about getting jumped. They live in another world. Sadly because of their elitism, those who suffer from obesity and are poor and who live in neighborhoods like this still will go unheard. At least I am one of the lucky ones who escaped.

One of the Best Articles on PCOS I've Seen

PCOS: How Does It Affect Women?

As I detailed in my 400lb weight gain blog entry, I am diagnosed with PCOS, and also two other thyroid and endocrine conditions, mine is so bad, they considered adrenal tumors, and I do have high cortisol though one Cushings expert I consulted with considered that as coming from other factors including the severity of my PCOS.

I am glad this article, talks about how PCOS needs to be taken seriously as a life long illness not just a "mild" condition that interferes with fertility. In my case, at least three endocrinologists have told me I have PCOS in one of it's most severe forms and could have one of the worse cases in the country. My signs of the condition actually showed up with brown spots, even while I was near normal size by the age of 13 but I would not be diagnosed til age 30, after my severe weight gain. Endocrine and autoimmune diseases in general are in my family.

Psychologically, PCOS is a brutal condition.

In its most severe form, a woman is stripped of nearly everything that society sees as womanly, a "theft of womanhood," as some sources call it. She probably is very fat, balding, has a mustache or other facial hair, has acne and body tags, doesn't cycle regularly, and has difficulty having children. She is seen as sexually unattractive, epitomizes the image of the "ugly" woman in our society, and is the object of many jokes and much derision in the media. Is it any wonder some women find this condition incredibly demoralizing?

Adding into this is the lack of understanding around PCOS as a condition. Even when you have an official diagnosis, some friends and family consider it a dubious finding. In their view, you're just looking for an excuse for being fat, crying about how your "bad metabolism" causes your obesity, instead of taking responsibility for your supposedly poor eating. They roll their eyes or accuse you of closet binge-eating instead.

My periods had totally disappeared by age 19 unless I took a drug like birth control pills or Provera to force one.

I have to admit this part is very true. I know most except my husband, best friend, and relatives who have lived with me, do not believe me about my eating habits. Some of the better doctors admit my severe metabolic problems but information about PCOS is woefully limited even in the medical community:

Doctors often don't believe you if you tell them you eat normally either, thinking you must be in denial about your eating, or that you are too uneducated about "proper" nutrition to really understand how to eat healthy. Furthermore, the shopping cart and food intake of a woman with PCOS are under continuous scrutiny and criticism, adding constant stress to daily life. The "obese" woman with PCOS always feels on the defensive about her food or exercise habits.

This disbelief about their experiences and the burden of constant surveillance often takes a considerable toll on PCOS women's self-esteem. And for those who truly do struggle with eating disorders after years of dieting, the shame around dealing with that on top of PCOS can be overwhelming.

She goes on to talk about educating care providers and others about PCOS. Her summation is very important here. I would like to see that change too.

Because of its implications for long-term health, PCOS deserves to be taken seriously, regardless of the patient's age or whether or not they want children. It needs to be seen as a life-long condition, not just a concern tied to pregnancy.

I am going to print this article out when I get a chance. Please do read it.

Do You Have PCOS?

I'm putting this up for my readers, every now and then, I see a woman, that definitely looks like she has PCOS, and most do not know about this. I am diagnosed with PCOS, had the dark skin patches by adolescence and disappeared periods even way before I got very fat, and was told my case is one of the worse in the country, of course with me there is overlap with other endocrine problems.

If PCOS is caught early enough though life can be FAR BETTER. If you are young and see these symptons to get tested, ask your parents to help you if you still live at home. I had all the worse outcomes of this condition for literally years, before I got help, symptons by age 12, and not diagnosed until my early to mid 30s!

My Life As a Fat Teen #2

From seventh to tenth grade, I suffered a reverse invisibility. I wasn't deemed fat enough to warrant my previous diet of elementary school torture, but I wanted no one's attention, and did little to attract it and I still remained fat enough to be DIFFERENT from all the ultra-thin lithe girls around me. I rarely spoke and always sat in the back, as long as there wasn't a seating chart to ruin my best intentions.

I felt my residual bottled-up anger would take time do dissipate. Try delivering a speech before a class notorious for making earthquake noises as you'd walk up there: by eight grade, I'd take the F and stay in my seat.

Better yet, try walking onstage to collect an award for tackling the most books in the summer reading program, with the entire school jeering, and laughing at once: what you feel goes beyond all academic study. Like many teens, I was sensitive to the constant scrutiny, especially when I started high school. The halls would close in as I took stock of the jeering faces, pointing fingers, and whispered words. I'd seek refuse in the remote Science Hall bathroom, where I'd be guaranteed an hour of solitude reading a book.

Such disconnection suited me while sitting in the back with my nose in Stephen King's [books I cannot tolerate now] latest novel, having finished all my homework before the day ended. From there, I'd look forward to afternoons of television and never ending household chores from my perfectionist parents. When I turned 16, the endless grind of salad girldom and fast food work which did more to train me to be a future member of the impoverished working class, rather then learning any real job skills, at least gave me a bit of spending money. The music I listened to was rot as well, a headbangers ball, of AC/DC and Def Leppard, that would pave the way for even darker and worse music tastes by college with a little bit of Duran Duran to lighten things up.

Other times, I'd be riding my bike, or reading or collecting stickers which my sister with whom I shared a bedroom. I could handle being an outcast since I had two siblings only a year apart in age each and jobs that filled my time.

By mid-high school, I weighed in the low to mid 200s and stood almost 6 feet tall. Being so large and invisible had a price. I soon learned unlike the small private school where I went to elementary, I no longer even had the couple close friends to pass my time.

For openers we moved from a huge metro city, to a more medium town, where everyone had been born there, and been together in school from kindergarten on. My siblings still hung out with me but their company seemed to come more cheaply and dearly as my new "nerd" status reached greater heights.

One horrible joke in my high school would be the boys comparing girls to dogs as they walked down the hall. I didn't have an ugly face, but was fat enough to earn barks, as I walked to class. It didn't take a rock scientists that especially by the halcyon days of the 1980s, that looks were the female sex's hottest currency: instead of Harriet the Spy Adventures, I'd find myself overtaken by Sweet Valley High nightmares.

In late junior high school I approached one of my other "Fat" classmates only to have her yell: "Get away from me!". Years later, I'd see her red-haired, freckled face in a magazine, talking about those teenage battles with anorexia.

As a first hand witness to her constant teasing, I wasn't surprised but wondered "What was wrong with me"? I couldn't walk into a classroom without someone trying to trip me, or muttering "boom, boom" under their breath. I knew by then, something was very wrong with me, and dieting, exercising since I spent literal hours on my bike, walking, and at the restaurants working on my feet, that nothing was doing anything to touch it.

When my weight went up, my treatment would go down accordingly, as my bowling partner, Stephanie, demonstrated, she'd hang out with me at home but pretend not to know me at school, even though our parents were friends. My sociosexual development slowed to a crawl. I had no interest in makeup or dating and by then had equated all boys with teasing tormentors. Even at 13, I knew things were more dangerous for fat girls who were seen as easy pickings.

I can remember having a full figured friend of my mother at a family pool party, saying "You better lose weight, or you'll never get a boyfriend." The message came at a pool party, where I sat forlorn and vulnerable in my bathing suit, with my mother nodding in agreement, I slunk my 14 year old self into the bathroom where I cried for half an hour and wondered aloud why the boys seemed so interested in having girls be so bony?

Periods of lower weight did not cut me a break in the looks department. When that happened, I no longer was called "earthquake or Big Mama" but they would switch over to "Amazon!". I had far more hair then other girls, was larger, more muscular and had more oily skin. Being taller, more masculinzed and more aggressive, results of the high androgens racing through my body, it would take almost 15 years to find out why my body did not match those of other high school girls when I discovered the realities of severe polycystic ovarian syndrome along with other endocrine problems. Dirty brown spots starting popping up all over my body, my mother would tell me constantly to wash my neck, not realizing this was a sympton of the hormonal chaos taking over my body. Even as a teen, my periods permanently disappeared, and there was no help. By then I had thought "good riddance to bad rubbish", the doctors never did any tests. They'd just send me home and say Diet!

It is strange to look back, and think if only I had known.....

Soy is Bad For You

It kind of freaks me out, how come America ignores thousands of years of Oriental culture where they FERMENTED ALL SOY, and sells soybeans in fresh form for Americans to eat? The Asians fermented soy because of it's toxins, but in America, they ignore that wisdom and sell us boatloads of the stuff:

However, according to the extensively researched book, The Whole Soy Story: the dark side of America's favorite health food, by Kaayla T. Daniel, PhD, CCN, (this month's Book of the Month), the Chinese first started eating soybeans about 2,500 years ago, after they figured out how to ferment it. Somehow, the ancient Chinese knew that soybeans still contain many toxins after cooking and thus avoiding eating it until they learned to neutralize those toxins through fermentation. And in traditional Asian diets, soy is only used in small amounts as a condiment, with pork, seafood and other animals providing the bulk of the protein.

I used to eat tofu burgers, textured vegetable protein made out of soy and fake soy sausage hoping to save on calories and fat, and I noticed a very bad development: my thyroid would swell up, I would feel a giant lump at the front of my throat. Of course I was diagnosed with hypothyroidism years ago and take .475 of synthroid daily but no one should be eating that stuff.

This guy too is right about the dangers of soy.

The dangers of soy include soy phytoestrogens. They are potent antithyroid agents that cause hypothyroidism and may cause thyroid cancer. In infants, consumption of soy formula has been linked to autoimmune thyroid disease.[2]

People with hypothyroidism should pay close attention to the dangers of soy because soy can cause hypothyroidism. You may have hypothyroidism and not even know it. If you are obese, there is a good chance you suffer from it to some degree.


Hypothyroidism causes weight gain because there is not enough thyroid hormone being produced. This causes the metabolism to slow down, contributing to obesity.

What is scary is when reading food ingredients, I am noticing they are pouring soy into everything, who determined this was a good idea? Add to the fact that soy is proven to affect the endocrine system and is often a genetically modified food, and think about what I have written on this blog about us being fattened up on purpose here in America.

Why are they pushing soy so much and why is it being added to so many processed foods?

Obesity and Early Puberty: They Are Missing Something!

Here is an article linking obesity and early puberty. Well as a disabled person taking a class for fun, I did a research paper on the obesity epidemic and was able to find studies that prove even just one endocrine disruptor PCP, is linked to serious weight gain and early puberty. Come on put the dots together, they are warning about men becoming more feminine via all the birth control pills in the water including estrogen and other thousands of chemicals, why not women having a preponderance of female hormones too, too much estrogen, leading to holding weight and obesity? Sure there is some gene involvement but sometimes, even their articles contradict with one another. I am going to do an more intense article, about obesity and endocrine disruptors. This is the truth they want very few to know.

Why You Got Fat!

This video has a lot of good stuff in it. Let me just say INSULIN RESISTANCE is the key that many don't know about in severe obesity. I think this video has a lot of good stuff to warn about, and goes along with the premise, that NOT everyone has the same metabolic rate, and or ability to burn food, fat and calories.

NGC Special On Obesity and Cushings

I really wonder how many others are going undiagnosed? See the interview lower down, with someone who faced Cushings. In my case, I was found to have high cortisol too, [Pseudo-Cushings] and years ago, seven times the normal amount of adrenal hormones.

One thing if you really do know you are sick, keep pushing, and find a specialist or doctors who will help you. If I hadn't done so even on two of my conditions I would no longer be here.

A Revealing Conversation On Size Acceptance and Health

I and a fellow endocrine sufferer, who I appreciate very much, shares her common experiences with hormonal health challenges and size acceptance. We agree on much. [My questions in blue] Read on:

1. Describe your experience with size acceptance, what did you find positive about it, what did you find negative?

I originally joined the size acceptance movement in 1996. After purchasing my first personal computer and joining the citizens of the internet from home, I stumbled across the Dimensions Magazine website that broadcast the statement: Where Big is Beautiful. The print magazine articles were written by men and women who took pride in themselves as a whole person. This was a new discovery for me, having been a fat teenager and dealing with discrimination, bullies, and general bias because of my size.

I spent a few years mostly reading and studying materials from the NAAFA and Dimensions Magazine, and researching the phenomenon that is fat acceptance.

Over time, I began to learn that for me, the journey to "Size Acceptance" is really a journey of "Self Acceptance" rather than coming to terms with being just fat. As a person, I learned from the SA movement that I have a right to enjoy life just as I am. Since that time, I've even been able to help friends of all sizes come to terms with their own bodies. It's been an interesting journey. When I tell women with low self esteem that I love my body and who I am-- they begin to wonder how "I" could love myself, when they see me as socially unacceptable!

Things I learned from SA:
Doctors usually believe you're fat because you're lazy. Little research and questioning is done for fat people. Diet and exercise are the common prescriptions. Many fat people then turn to alternative medicine or "acceptance" of themselves and then fail to get help! Fat and sexuality are not mutually exclusive. Many people can and so see through the fog of the myth that fat people are somehow second-rate.

My opinions matter, no matter how fat I am! The anonymity of the SA movement online has helped many fat people find their confidence and ability to speak in regards to various issues. I think this has helped the most in fat people learning to advocate for themselves. They know they're not alone, and can voice their opinions.

Society still has yet to accept fat people as the norm in America. Theater seats are uncomfortable, airplane seats and being asked to purchase two seats is the norm. Bathroom stalls are too small. Stairs are too steep. Booths at restaurants are made with fixed tables. Hospital gowns for fat patients are hard to find (and you're made to feel like a freak if you ask for a larger gown at times). Chairs at airports and doctor's office have arms that can cause physical harm to a fat person.

There's a bias in America that fat people are nonsexual. That's so far from the truth! We are human beings just like everyone else, and we have carnal desires, wants and needs to be loved, feel affection and physical attraction. The lies that are perpetuated by the media don't help any.

Size Acceptance has its own militant activists just like every other agenda.

I am still a member of the SA movement, but left my formal advocacy agenda in late 2008.


2. How did you come to be diagnosed with Cushings?

When visiting a new doctor one day in 2007, I was bemoaning to my doctor that for years I'd been battling a host of issues that I thought were just normal things for a fat person. After years of being told that I was fat, lazy, an over-eater and I would have to deal with my health issues -- this new doctor started to ask questions. Every answer I gave created a new question. At the end of an hour-long exam, the doctor asked me if I'd heard of Cushing's Disease. I hadn't yet, but then she explained the textbook symptoms.

The trouble from that point was that local doctors aren't trained in what to do with Cushing's patients, and you have to find an Endocrinologist that understands the disease. There are few specialists who truly understand the full body of research in regards to this endocrine disorder. I saw two local Endocrinologists who laughed me out of their offices despite my doctor's referral. Finally, after much research on the internet and talking to my doctor, I found Dr. Ted Friedman in Los Angeles. Dr. Friedman took the time to meet with me, look at my history of pictures from spanning from current days to my childhood, looked at all of my physical signs and symptoms and prescribed a very focused and intricate testing regimen. After only 46 days of tests, MRIs and discussion, it was decided that I had been living with this disease some call the "Ugly disease" since birth.

Since that time, I have had two pituitary surgeries to help establish a period of remission of all of the difficult symptoms. After each surgery I've enjoyed 6 months of improvement.

3. Do you feel support was lacking in the size acceptance community regarding your diagnosis with Cushings?

Once I shared my disorder, the problems it caused for me, and that I was pursuing a cure for my issues, things began to change for me. When I announced I was having pituitary surgery to work towards a cure, I was treated like someone who didn't know what was right for myself. Constantly people were telling me reconsider such a "drastic surgery" that they felt could leave me crippled for life. Despite all my assurances that I looked at every angle, I received countless phone calls, emails and visits from people who insisted I was making a wrong choice. When I needed support the most from my friends, a dichotomy arose -- that of having to deal with friends who felt I was fat for life, and that of trying to cure a deadly disease.


4. Do you agree that in size acceptance there is a lack of truth about obesity being for some people a symptom of a disease process?

Many of my fat friends categorize their fat as a physical trait, and refuse to believe that obesity is a serious medical condition.

While I personally believe a rubenesque woman can be fit and fluffy, there are many fat people who have serious medical conditions that may go undiagnosed because of their attitude towards size acceptance, their fear of the doctors being emotionally cruel to them, and that there aren't any real serious medical diseases for fat people.

In many circles in the SA community, the talk of "dieting" is forbidden. The reason being that fat people need a place of solace from the people telling them that diets will solve all their problems and they refuse to diet. I can see the point in this argument, but the people that can't diet to lose weight have serious medical issues that should be addressed! I'm sure some people who say they diet really don't and they are fooling themselves, but people like me who eat only 1100 calories a day and gain weight have metabolic disorders that need serious help!

Diseases I've seen friends suffer with from obesity related issues:

Lypo/Lymphadema
High Blood Pressure
Heart Attacks
Deep Vein Thrombosis
Diabetes
Osteoarthritis
Osteopenia
PCOS
Cushing's Disease
Hypothyroidism
Growth Hormone Deficiency

The website bigfatfacts states: Weight is not a barometer of wellness. More Americans die every year from weighing too little than from weighing too much. An estimated 25,000 people die from obesity. Moderately overweight people live longer than those at normal weight. (Flegal, et. al.) (See reference notes at bottom of report)

Weight is not a barometer of wellness! So a fat person can have normal blood pressure, activity level, blood sugar, and labwork. But notice here it says moderately overweight people live longer. Most of my friends in size acceptance are overweight into the hundreds of pounds. Dear friends of mine are over 400 pounds, and one is over 500. Somewhere fat does become a barometer for wellness!



5. Where do you think the size acceptance movement is headed today? Do you think it has a future?

Size Acceptance is splintering into various new groups and is no longer a united front. Some advocacy groups want fat to be declared a disability, yet some don't. If it's a disability, then is it not healthy then? Other groups are insisting that super-sized people shouldn't be part of mainstream size acceptance as they are the "freaks" of the movement.

These kinds of separate attitudes don't do any fat person any good, and it's a shame to see that happening. I wish to think that in the future, we'll find a better united front and be able to be inclusive again.