Estigma en la obesidad: La perspectiva del paciente

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Hello, my name is Vicky Mooney. I am the Irish Patient Council representative on the ASO Patient Council panel. I’m here to give you my experience of what it is like as a patient who has suffered with discrimination and stigma all of her life. Si ven la imagen que tienen delante, soy yo a los 28 años. Pesaba 400 libras, o algunos dirían 180 kilos, o en Irlanda diríamos 28 stone. Así que pesaba 28 piedras y tenía 28 años en 2005. De hecho, mucha gente se pregunta cómo llegué a ese punto de mi vida. De niño, ¿tenías sobrepeso de adolescente? Literalmente, he tenido sobrepeso toda mi vida. De niño comía a gusto para sobrellevar la vida cotidiana y el estrés de una infancia difícil. And as the years went on, my weight gained probably a pound per month. So it’s not an awful lot when you actually think about it. Some people say you can lose a pound in a month. It’s quite easy. And for some people it is. But as a child, if you’re gaining a pound a month, you’re gaining 12 pound, 14 pound a year. Así que cada edad que tenía, tenía la misma piedra. A los 15, pesaba 15 kilos. A los 20, pesaba 20. The teenage years as an obese girl was quite harrowing. People didn’t see this part. They didn’t look at your eyes. They didn’t see your smile. They just seen from the waist down and they just seen what other people would say is fat or lazy. The girl they don’t want on the team. People laugh, they bully, they slag. And it wasn’t just friends you’d have. I suppose teachers would have preferences to the student who seemed more perfect and normal body type. And I certainly wasn’t that. So the teenage years were pretty harrowing. And unfortunately, the vicious circle of comfort eating was that the more depressed I became myself, the more withdrawn I became, the more I was bullied or slagged off or discriminated against. The more chocolate I ate or the more food I ate to comfort myself. I didn’t eat five burgers and drink two liters of Coca-Cola, but I comforted myself with food to feel that little bit better. So when we talk of discrimination, stigma for young people, it can be spoken of, but when you have the reality of it, that this is what it had done to me, I think it can be quite tough. When I think back to the years of my doctor with my mom going to address my weight issue, it was something I never ever wanted to do. The most demoralizing feeling is walking in to your GP who you see as this high professional, godlike figure who knows everything and can fix everything. And realizing that you’re being judged and looked at as if you’re lazy and you should be ashamed of yourself because you’ve eaten too much and you’ve brought this on yourself. Nadie quiere provocarse la obesidad a sí mismo. Así que a los 28 años, ya ves la foto, pesaba 400 libras y estaba muy, muy deprimido en mi vida. Estaba casado con dos niños pequeños y la vida era bastante dura. I didn’t exercise. I loved to swim, absolutely adored to swim, but I was so aware of the stares and the looks I would get going to a pool. I loved to be out with friends. Me encantaba pasear. Me encantaba estar en el parque. Me encantaba pasear con mi perro. I didn’t want to because I was so embarrassed. There’s that shame because as an obese person, we wear our disease, our obesity on our sleeve for everybody to see and everybody to judge. And people judge, they looked and they stared and they nudged friends. And even the subtle little looks where somebody would look, but they wouldn’t look at your face and they’d look at your tummy. And your awareness is so heightened. Walking into a shopping mall, thinking it’s going to take me about 400 steps to get to the shop where I can buy some clothes where maybe I won’t look as obese. And all the way there, your awareness of people staring at you, judging you, thinking that you’ve eaten three meals in the last one hour, when in actual fact you haven’t. I thought I had the solution when I was 28 years old and I’d heard of bariatric surgery and I went to my GP and finally verbalized what had been eating me alive quite literally for years, which was that I needed to do something about my weight. I couldn’t manage this by myself. Y me dijo: "Hay una clínica de control de peso con un equipo multidisciplinar que está ahí para ayudarte, orientarte, hablar contigo, ayudarte a entender por qué tienes este peso, qué te pasa". Así que pasé un año y medio en la clínica y, al cabo de ese año y medio, me sometí a cirugía bariátrica. Y en 14 meses, perdí 14 piedras, que son 200 libras o 90 kilos. Perdí la mitad de mi peso corporal. Y realmente pensé que me habían dado como una nueva oportunidad de vida, que esto era todo. Esta fue la solución a mi obesidad, pensé. So here I am 11 years later and I’ve regained back 25 kilos in weight or about 65, 70 pounds. And I’m still struggling with obesity. On a daily basis now, I attend a gym every day for an hour, an hour and a half because I’ve had bariatric surgery. I still eat small meals, small portions, I can’t overeat. And I suffer an awful lot with dumping syndrome, which is when you eat too much sugary food, particularly, and you feel quite literally nauseous and sick. So I cannot overeat and I do overexercise. I can leg press 200 kilos. I’m quite proud of my physical achievements, but yet I’m still struggling with my obesity on a daily basis. And more so the obesity in correlation with lifestyle. People assume that it is my lifestyle choice to be like this, when in actual fact, it’s not. When I lost 14 stone in weight, I became a plus size model. And I was the largest plus size model in Ireland for many years. And although I felt wonderful in myself that I’d achieved this and I’d made it this far and people were telling me I was beautiful instead of telling me you need to do something about that weight, I still found it very, very hard to change my mindset because when you’ve spent 28 years of people not addressing your face or listening to your words, but rather judging you, it’s very, very difficult to change that feeling in your mind that are how you feel in yourself and that perception. There’s oftentimes that people ask me, how can you explain what it is like as a patient, as an obesity patient? And I taught a lot about this. And if you can turn the tables, you will realize that if you were to walk out every day with something that you’re ashamed of, something that you’re embarrassed about. So if you think of one thing that you’re incredibly embarrassed about in your life, one thing that hangs with you and you’re very ashamed of or you’ve been made feel ashamed of more so. And if you had to write that down and walk around for a whole day with that banner and see everybody looking at you and know that everybody is aware of it, the whole world can see it. That is what it is like for an obese person, for an obese patient. So how can we change things? I suppose when I look at some of the slides, being a plus size model, the media has glamorized what the perfect body is the perfect woman, even as a plus size model. There’s a slide there I’m showing you. And there’s a beautiful woman in a bathing suit. And yes, she has fat. She isn’t fat, she has fat, but she is still a very beautiful, fit, healthy plus size model. And yet the image beside it is what the media has done to it. Y cuando pienso en mí misma como una mujer que se sentía muy empoderada y aceptando mi cuerpo después de perder tanto peso y aún luchando y peleando cada día, imágenes como esta pueden quitar todo ese trabajo. Pueden meterlo debajo de la alfombra tan fácilmente. La gente nos percibe a las personas de talla grande o a las personas obesas o gordas como vagas, indisciplinadas, indiferentes, desagradables, sin motivación. And too often it comes from family and people that we hold in high regards, teachers, people in the healthcare professional. When you go in for an operation and the doctor comes in and instantly he looks you up and down and you know he’s thinking, okay, well, your weight has something to do with whatever’s going on here and he probably hasn’t seen your chart. And this is something that many patients speak of. Entonces, ¿qué podemos hacer para cambiarlo? Creo que la educación, la educación para nosotros es la única manera. Si podemos educar a nuestros profesionales sanitarios, a los profesionales médicos, a nuestra familia, a nuestros amigos a través de las escuelas, a través de la enseñanza y podemos llevar historias como la mía a la gente para que se den cuenta del impacto y del daño que hace el estigma y la discriminación. Lo mucho que puede hacer retroceder a una persona. I’ve come so far and I’m one of the patient council members that speak so openly about my life with obesity and there are an awful lot of people who cannot do that, who cannot verbalize that they are obese, let alone have somebody judge them. It’s like when somebody takes so many steps forward, it only takes one small comment to knock them all the way back and knock the wind out of their sails. So really education is a way to open up people’s minds to the fact that obesity is not my lifestyle choice. I have a disease that I’m wearing for the world to see. I’m fighting it on a daily basis and it is not my choice. Thank you.