Friday, June 16, 2006

Feeling 0.2 pounds too heavy? Time for micro-lipo

Part of the problem I discussed yesterday, about non-comprehensive approaches to obesity, stems from the fact that many people don't understand the pervasiveness and harmfulness of our cultural attitude towards fat. We're so thoroughly acculturated that the idea becomes transparent. If you're not a woman, if you're not American, or if somehow you've managed to have a perfectly culture-approved body all your life (not too fat, not too thin, no lumps or stretch marks -- yeah, like you exist), it's possible to be incompletely attuned, even insensible, to the very real tyranny of looks. Things that fat activists take as axiomatic -- that it's seen as acceptable and even expected to make fun of fat people, that fat people are perceived as sexless or unattractive, that magazines and television promote unrealistic goals that young women genuinely expect themselves to achieve, that doctors are unresponsive to legitimate health complaints from fat people, that gyms are inhospitable places for the overweight -- may strike others as overblown. They are not. American culture's relation to looks and weight is a terrifically dysfunctional one, and is visited on almost all women (and many men) who grow up here.

As a conveniently-timed illustration, here's an article from the New York Times about increasingly specific plastic surgery. Where desperate and unhappy people once resorted to liposuction for their spare tires and badonkadonks, now they're going for their bra fat or their overly fleshy knees:
Last year, Americans had about 455,000 liposuction operations, making fat removal the most popular cosmetic surgery procedure, according to the American Society for Aesthetic Plastic Surgery. But in the last two to three years, liposuction, once used predominantly to reduce the flabby abdomens, hips and thighs of average Americans, has become a tool to enhance the near-perfect body parts of the already fit.

For this designer-body approach, an increasing number of doctors are using a technique known variously as precision, selective or micro liposuction. The goal is to remove an ounce or three of fat from ankles, knees, chins, necks, backs and upper arms, according to some prominent plastic surgeons and dermatologists.
There's an example of the feared and hideous "bra fat" (the term seems to be applied to flesh near both the armpit and the back strap) at the top of this post. I got that image from a site that was advertising, instead of highly specific liposuction, a procedure called mesotherapy, in which chemicals are injected under the surface of the skin. I'm not sure about the risks of this procedure, since many of its practitioners are outside the US and thus outside the jurisdiction of the FDA. Complications from lipo include infection, necrosis, and embolism, and smaller and trickier procedures carry more risk: "Ankles have superficial nerves and arteries that can be damaged, [Dr. Fodor] said. Fat on the back or kneecap is very fibrous and can be difficult to remove evenly. And kneecaps have sac-like cavities that can be easily traumatized." But come on... you might have a knee pooch!

Even more upsetting, some of the "fat deposits" that these women are spending thousands of dollars to remove seem to be the result of ill-fitting clothes. The woman in the lede, for instance:
"I had a little roll of fat hanging over the back of my jeans, like a spare bicycle tire in the back," said Dana Conte, a bartender in Manhattan. It was so obvious that her mother constantly came up behind her and pulled her shirt down over it, Ms. Conte said. "When your mother is doing that, it means there's a problem."
Last August, she had liposuction on her lower back around her waistline, and in January, she had liposuction again, this time on her mid- and upper-back to eliminate "bra fat," bulges that can occur when "your bra pushes lumps of fat down your back and up over the bra fastening and to the sides right near your arms," Ms. Conte said.

The total fee for both procedures, $10,000, was well worth it, she said.
Yes, when your mother pulls your shirt down to cover your back bump, it means there's a problem: your shirt is too short and your jeans are too tight. And that so-called "bra fat" is the result of wearing a bra with a too-small band size. Cost of a new bra, a complimentary bra fitting, and a new pair of jeans? Oh, probably $150 tops, if your jeans are not redonkulous. Not spending $10,000 on risky cosmetic procedures? Priceless.

What I found particularly interesting was that one of the women in the article requested a procedure to remove fat from her mons pubis. She claimed that "a little bit of fat stuck out over her bikini." In this case the doctor refused to do the surgery, but it brings up an interesting question: where do you draw the line between culturally unacceptable fat deposits and parts of your body? The mons pubis is a body part, not a body flaw -- it's intended to provide cushioning during sex. It's as though someone went to the doctor and said "I have these fleshy excrescences hanging off the bottoms of my ears -- can you lipo them out?" Cosmetic surgery is usually considered to be up to the individual, but doctors can't legally remove healthy body parts. When we become so image-obsessed that we start removing functional fat, have we crossed that line?

My overall point is this: when you think about obesity, don't just think about the headless bodies that lumber through news reports. If you want a picture of weight in America, imagine a skinny woman staring at her kneecap chub forever.


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6/16/2006 5:23 PM  
Anonymous Daisy said...

This is an excellent article. My son sent me the link, knowing I'd be interested.

You're right that the problem is ill-fitting clothes, in the instance above. How foolish to spend so much money and risk one's health on such a miniscule "problem." What a superficial culture we have here.

6/29/2006 4:22 PM  
Blogger Cody said...

I think when it comes to a world of cosmetics, "functional" fat has no "intentions" at all. After all, to say that it's "intended" for a specific purpose is tantamount to saying someone or something chose to create the fat for that purpose. If that's the case, as so many religions suggest, then we should just "Love what God gave us." And now that's really the only argument you have to make. That a higher being made you, as is, and you should just tough it out. But we don't live in a world like that. Making the effort to look good can be just as important as say, making the effort to learn enough to reach societies standards. So it comes down to a question of the people not making the effort being upset by the people who are.

And no, I'm not some drop dead gorgeous model. I'm a physically insecure homosexual man who just knows that how the world is. Get over it. Leave people alone and let them do what they want. If you're insecure, it's your fault (I accept that I feel this way because of my own insecurities). Cause if you can't take responsibility for the way you see yourself, what can you take responsibility for?

11/06/2007 2:55 AM  
Blogger Georgiana said...

Thanks for the interesting post.

I think some people spend so much time, money and pain obsessing about their looks because it keeps them from having to think about other issues that they would ultimately find disturbing.

I'm confused by Cody's comments, which seems to lack a basic understanding of any scientific principles.

>>After all, to say that it's "intended" for a specific purpose is tantamount to saying someone or something chose to create the fat for that purpose...That a higher being made you, as is, and you should just tough it out.<<

Two words to research - evolution and anatomy.

I'm not really sure how avoiding what is essentially a type of genital mutilation is toughing it out...

I'm not even going to address his concept that we all have a responsibility to live up to some people's idealized body images and we're not just at fault for failing, we need to sit down and shut up.

1/19/2008 12:41 PM  

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