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219 Responses

  1. Naamah
    Naamah September 7, 2010 at 5:49 pm |

    I am quite satisfied by this response, and will mark it for use as a future resource. Thank you very, very much. This was wonderful to read.

  2. Bushfire
    Bushfire September 7, 2010 at 6:29 pm |

    Wonderful! This just says it all.

  3. Ajh
    Ajh September 7, 2010 at 6:29 pm |

    Perfect response. Unfortunately, yeah most doctors seem to be like that these days. They’ll focus on your weight and ignore your non-weight related problems if you have them. (I’ve had weight loss suggested to get rid of dust mite allergies. Really.)

    It’s one of those things that people never see as a problem or that bad, but it really is. Especially when they do things like deciding, based on my weight alone, that I won’t be a good worker at a job. What’s that got to do with work ethic?

  4. kloncke
    kloncke September 7, 2010 at 6:31 pm |

    Daaaaaamn! :)

    As my friend Abel would say, “That’s hella clean!”

    Especially appreciating the “It’s Not Just You” personal/political section.

    I’m curious about your politcs, zuzu: what do you think are the best mechanisms for changing these structural/systemic problems around health? Do you think it’s about electoral politics? Getting the right people in office? Getting rid of corn subsidies? I’d love to know what you and others think about the best mechanisms for change.

    Because the way I see it, as long as classes persist, the pendulum just keeps a-swingin’. Every progressive win eventually gets rolled back. And by locating the change within electoral politics, I think we mistakenly cede our own sense of direct power as workers, as the people who make the economy (and the state) go.

    Do you see potential for fat people and allies to organize as workers? To strike for better conditions in some way? Kind of the way that immigrant labor has had some success with recently?

    Again, many thanks.

  5. Bagelsan
    Bagelsan September 7, 2010 at 7:02 pm |

    Lovely post — I have nothing substantial to say about it, atm (too tired…) except that I really hope all 4 of those NYC phrases are regularly used all strung together. :D

    Oh, and also the donut-demonization is just odd to me… bagels are what get me! Donuts I can kinda take or leave but I have cheerfully eaten a half dozen bagels in one sitting more than once (I’m not saying I didn’t regret it half an hour later, I’m saying they were fresh and blueberry.) And I know I’ve had smoothies that are far more carbolicious than anything a donut could offer… but those are “healthy” right? Somehow?

    Clearly rationality plays no part in this. “Donut” is like a weird shorthand for “fat person food” now, I guess.

  6. Charity
    Charity September 7, 2010 at 7:08 pm |

    Rock on, thank you Zuzu for this post – I will also return to it as a reference.

  7. BHuesca
    BHuesca September 7, 2010 at 7:12 pm |

    Thank you for your response. However, I was very disappointed to see you characterize the rude and hateful comments addressed to Monica on her post’s comment thread as an ‘adequate response’ and not as the terrible rudeness they were. According to Jill’s introduction of the guest bloggers, all bloggers deserve respect, choose their own topics, moderate their own posts, and may not even (gasp) be feminists – but are there and are writing because the Feministe team chose them for that purpose. Why has the commentariat rudeness not been addressed?

    Thank you very much.

  8. BHuesca
    BHuesca September 7, 2010 at 7:13 pm |

    http://www.feministe.us/blog/archives/2010/06/04/project-guest-blogger-2010/

    “Please think of our guest-bloggers as invited guests who are staying over at our house, and think of yourself as a friendly neighbor dropping by. Show them the attendant respect. All of the permanent Feministe bloggers will have far less patience with rudeness to guest-bloggers than we have even to rudeness directed at us. “

  9. zuzu
    zuzu September 7, 2010 at 7:14 pm |

    Oh, just a note in case discussion goes somewhere: I have to get up at oh-dark-thirty tomorrow morning to head West to find an apartment in my new town. So I won’t be around much if anyone wants me to respond to comments. Sorry!

  10. Thomas
    Thomas September 7, 2010 at 7:28 pm |

    Brilliant.

    That is all.

  11. Roschelle
    Roschelle September 7, 2010 at 7:35 pm |

    I’m a registered nurse who would not be considered fat by most standards today. not thin but not fat. I am also a woman of color, a group targeted constantly by fat hatred.

    I come from a long line of big girls! My mother, my aunts, my grandmother, my sister – all are overweight.

    I’ve realized over time that everyone isn’t meant to be thin and thin is more a frame of mind than a objective observation.

    What’s thin to me most certainly doesn’t imply that it’s what’s thin to twenty other people.

    My only is my family’s health. I’ve seen the effects of obesity on the human body via chronic medical conditions and the impact they have on the person suffering and the family members (children, parents, spouses) affected by this suffering. Some might argue that a person doesn’t have to be overweight to be diagnosed with hypertension, non-insulin dependent diabetes, arthritis, congestive heart failure, or hyperlipidemia. But excessive weight over a period of time certainly contribute to every one of these. And if there’s something…anything you could do to prevent having these problems in the future – would taking those measures be considered beneficial.

  12. Lauren
    Lauren September 7, 2010 at 7:47 pm | *

    BHuesca: According to Jill’s introduction of the guest bloggers, all bloggers deserve respect, choose their own topics, moderate their own posts, and may not even (gasp) be feminists – but are there and are writing because the Feministe team chose them for that purpose. Why has the commentariat rudeness not been addressed?

    This probably isn’t the thread for it, but I do have plans to address this in the future.

  13. BHuesca
    BHuesca September 7, 2010 at 7:53 pm |

    Thanks Lauren! Then I shall shut up about it:)

  14. Miss S
    Miss S September 7, 2010 at 7:54 pm |

    Now, given that my weight tends to rise when I’m not in a healthy place, am I unhealthy because I’m gaining weight, or am I gaining weight because I’m doing unhealthy things?

    This is a very good question/point. I’m not obese, but I absolutely do go up and down the scale depending on stress levels. I think a lot of people do. For me, this connects to my anxiety. When I exercise, do yoga, and eat healthy, I really am less stressed. More often than not, it’s the cause. I can use these tools to improve my physical and mental health. (Yoga is much cheaper than medication). So I would argue that it’s two- gaining weight is often a result of unhealthy things. That would explain why weight and health often correlate. It also would explain why overweight people are not always unhealthy- it’s likely a result of their genetics.

    It also suggests that we shift the discussion from weight in exact numbers to a discussion on healthy ways of living- both physically and mentally. My anxiety disorder (unfortunately) isn’t cured by certain activities, but it is controlled and it makes a big difference in my life.

  15. Shut Up, Foodies! » Blog Archive » That’s What She Said

    […] of a righteous post by Zuzu on Feministe that pertains to a lot of the issues we talk about here: [W]henever we start focusing on the health […]

  16. Miss S
    Miss S September 7, 2010 at 7:59 pm |

    OT- I’m glad to see that someone is going to address the comments in Monica’s thread. I’ve seen two discussions (Monica’s and Mai’a’s) turn downright mean and vicious. Both of them may have differing viewpoints (which isn’t a bad thing) but comments should abide by the blog policy of showing respect to guest bloggers.

  17. zuzu
    zuzu September 7, 2010 at 8:04 pm |

    BHuesca: Thank you for your response. However, I was very disappointed to see you characterize the rude and hateful comments addressed to Monica on her post’s comment thread as an ‘adequate response’ and not as the terrible rudeness they were.

    I don’t blog here anymore, so this is just my own opinion: I don’t see the commenters’ expression of anger at someone expressing hatred for them as rudeness, terrible or otherwise. I’m not big on civility trolling.

    I mean, what were people supposed to do, politely ignore what Monica had said? It had nothing to do with her feminism or not, and everything to do with her falling back on tired old donut tropes while dismissing the experiences of a whole class of people because she herself hasn’t experienced the same thing.

    However, I did say I didn’t want to make this about Monica, so that’s the last thing I’ll say about it.

  18. Alara Rogers
    Alara Rogers September 7, 2010 at 8:11 pm |

    But excessive weight over a period of time certainly contribute to every one of these.

    To the best of my knowledge, we don’t actually know that. What we know is that there’s a correlation, but I’m not sure we have, in fact, ever identified causation… at least for diabetes in particular.

    Because my mother yo-yo dieted her whole life, and while she got up to 180 lbs (at 5’3″) while pregnant with my little brother, she was not, in fact, particularly overweight when she was diagnosed with diabetes at the age of 33… nearly thirty years ago, when type II diabetes at 33 was really rare. Whereas I have the same hypoglycemia she had, had gestational diabetes with my pregnancies, am 170 lbs at 5’0″, and I’m 41 and not a diabetic… but I have *never* gone on a diet any more strenuous than “Weight Watchers for breastfeeding mothers” (Weight Watchers gives you a lot more points if you’re breastfeeding), and I didn’t go on any diets whatsoever until I was already in my 30’s.

    Correlation or causation? My mom can’t lose weight anymore. Diabetes requires that you eat, and her metabolism flat out refuses to eliminate the pounds no matter how much she diets, and she can’t exercise because the diabetes has given her too much pain. Does weight cause diabetes, or does pre-diabetes pack on the pounds, that diabetics then can never lose? Does yo-yo dieting, something that women who think of themselves as fat are much more likely to do than women who think of themselves as thin, make people more prone to metabolic disorders such as diabetes?

    I think it’s quite possible that being overweight does result in cardiac problems, because it’s logical that the heart might have to work harder with more mass to push blood through. But again, if you have a weak heart or you’re getting insufficient oxygen because of clogged arteries, you are likely to have a weaker metabolism and be less able to burn calories. So which comes first, the fat or the ill health?

    Based on the different health outcomes of my mother versus myself, I am convinced that metabolic disorders are exacerbated by dieting, which means that the thing most people think they need to do in order to lose weight and be healthy is actually the worst thing for their health they could do.

  19. zuzu
    zuzu September 7, 2010 at 8:15 pm |

    kloncke: Daaaaaamn!:)I’m curious about your politcs, zuzu: what do you think are the best mechanisms for changing these structural/systemic problems around health?Do you think it’s about electoral politics?Getting the right people in office?Getting rid of corn subsidies?I’d love to know what you and others think about the best mechanisms for change.Because the way I see it, as long as classes persist, the pendulum just keeps a-swingin’.Every progressive win eventually gets rolled back.And by locating the change within electoral politics, I think we mistakenly cede our own sense of direct power as workers, as the people who make the economy (and the state) go.Do you see potential for fat people and allies to organize as workers?To strike for better conditions in some way?Kind of the way that immigrant labor has had some success with recently?Again, many thanks.  

    I think we need to organize. But that’s something that takes a lot of effort, and effort is something people who are already overburdened don’t like to expend.

    I do think that things have to get worse before they get better — it’s not a coincidence that immigrant laborers, who probably have nothing else to lose at this point, have successfully organized. But the middle classes have been kept very carefully on edge by the corporate overlords for so long that they’re still fighting for crumbs, and still at a point where they don’t want anyone else to have something they don’t (like union contracts or what have you). But these people often change their tune if they fall into bad luck. I just saw a really good expression of what’s going on in comments to this thread at alicublog. I don’t think I can link to individual comments, but I’ll blockquote the exchange:

    aimai: I like to read the current incarnation of Ann Landers, even though the answers given by the “annies” are often useless and stupid. But the blog comments on the new blog version are always fascinating glimpses into america’s psyche. I’m amazed at the number of people who post, in response to any work related problem, that the worker has “union protections.” Its really clear that in the vast majority of work related letters there is simply no way that the worker has any kind of union protection, its clearly not that kind of office, and yet some readers continue to believe that workers have protections against arbitrary firing, harrasment, demotion, exploitation. Its unionism without unions, like “I’m not a feminist but…” is feminism without feminism. And like feminism without feminism it takes for granted the freedoms other people fought for, and refuses to fight to extend and protect those freedoms. [my emphasis]

    Doc Amazing: it takes for granted the freedoms other people fought for, and refuses to fight to extend and protect those freedoms.

    This part cannot be repeated often enough. One area that has a lot of ongoing union organization is health care, and that’s one reason that you see a lot of health care workers agitating for single-payer–they know that organizing is hard work that needs to be slogged through, but is ultimately effective. That’s one reason a lot of us in health care get righteously pissed when “pragmatists” who aren’t involved in organizing are eager to compromise basic principles–it undercuts the leverage of those who do organize.

    Fighting for necessary things–patient care, fair labor conditions, and so on–is work. People who benefit from that work but who undermine it–wittingly or not–are doing the malefactors’ work for them. Purity trolling? Well, tell that to someone holding a sign and staring at a (unionized) cop.

  20. Jadey
    Jadey September 7, 2010 at 8:24 pm |

    Roschelle: My only is my family’s health. I’ve seen the effects of obesity on the human body via chronic medical conditions and the impact they have on the person suffering and the family members (children, parents, spouses) affected by this suffering. Some might argue that a person doesn’t have to be overweight to be diagnosed with hypertension, non-insulin dependent diabetes, arthritis, congestive heart failure, or hyperlipidemia. But excessive weight over a period of time certainly contribute to every one of these. And if there’s something…anything you could do to prevent having these problems in the future – would taking those measures be considered beneficial.  

    I do not in any way want to belittle or dismiss anyone’s experiences of illness or pain, but I do want to make the point that while obesity can have one kind of effect on how our bodies grow and age (and fall apart, which is kind of an inevitability of being alive – bodies are made to fall apart and lose function over time), it is not the only body weight that does. Being obese may be harder on the joints (as well as contribute to or exacerbate the other conditions you describe), but there’s evidence to suggest that being underweight has just as many negative health associations. (And note that we are still talking about correlation data – these findings may still not capture the full contextual detail of why. But it’s damn sure enough to complicate the picture of “fat is bad for our health”.)

    From the abstracts of several recent articles:

    BMI and all-cause mortality among Japanese older adults: findings from the Japan collaborative cohort study.: “The underweight group was associated with a statistically higher risk of all-cause mortality compared with the mid-normal-range group (BMI: 20.0-22.9); resulting in a 1.78-fold (95% confidence interval: 1.45-2.20) and 2.55-fold (2.13-3.05) increase in mortality risk among severest thin men and women (BMI: or =30.0) elevated the risk among men; however among women, HR was slightly elevated in the obese group but not in the overweight group compared with the mid-normal-range group. Among Japanese older adults, a low BMI was associated with increased risk of all-cause mortality, even among those with a lower normal BMI range. The wide range of BMI between 20.0 and 29.9 in both older men and women showed the lowest all-cause mortality risk.”

    BMI and mortality: results from a national longitudinal study of Canadian adults.: “A significant increased risk of mortality over the 12 years of follow-up was observed for underweight (BMI <18.5; relative risk (RR) = 1.73, P 35; RR = 1.36, P <0.05). Overweight (BMI 25 to <30) was associated with a significantly decreased risk of death (RR = 0.83, P 0.05). Our results are similar to those from other recent studies, confirming that underweight and obesity class II+ are clear risk factors for mortality, and showing that when compared to the acceptable BMI category, overweight appears to be protective against mortality. Obesity class I was not associated with an increased risk of mortality.


    Excess Deaths Associated With Underweight, Overweight, and Obesity
    : “Underweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category. The impact of obesity on mortality may have decreased over time, perhaps because of improvements in public health and medical care. These findings are consistent with the increases in life expectancy in the United States and the declining mortality rates from ischemic heart disease.”

    High body mass index does not predict mortality in older people: analysis of the Longitudinal Study of Aging.: “Death occurred in 38% of the cohort: 54% of the thin (lowest 10% of the population, BMI 28.5 kg/m(2)), and 37% of the remaining participants (normal) died. Adjustment for demographic factors, health services utilization, and functional status still demonstrated reduced mortality in obese older people (hazard ratio 0.86, 95% confidence interval (CI) = 0.77-0.97) compared with normal. After adjustment, thin older people remained more likely to die (hazard ratio 1.46, 95% CI = 1.30-1.64) than normal older people. Sensitivity analyses for income, mortality during the first two years of follow-up, and medical comorbidities did not substantively alter the conclusions. … Obesity may be protective compared with thinness or normal weight in older community-dwelling Americans.”

    I’m not opposed to preventative healthcare. I’m not opposed to seeking health and well-being. But I think we need to consider A) how much ill health and discomfort and death that we can realistically prevent and attenuate, and B) what are the broader ramifications of how we go about doing this. I think there are lots of things (see: access and poverty) that all societies could be doing better at in terms of improving health outcomes. However, I have yet to see an anti-obesity initiative that didn’t seem to be doing more to worsen people’s quality of life than improve it. I also want to continue to mention that poor health does not preclude the possibility of a happy, fulfilled, satisfying, and/or worthwhile existence. (Again, not to erase or dismiss anyone’s specific personal experiences of pain, suffering, illness, or disability.)

    (I realize this is a very long comment, and I apologize, but I’ve been getting the feeling that unless I reference this stuff very specifically, not many people are going to bother checking it out. C’est la vie.)

  21. Roschelle
    Roschelle September 7, 2010 at 8:40 pm |

    Jadey: (I realize this is a very long comment, and I apologize, but I’ve been getting the feeling that unless I reference this stuff very specifically, not many people are going to bother checking it out. C’est la vie.)

    actually very informative and thank you!

  22. Miss S
    Miss S September 7, 2010 at 8:45 pm |

    As for the concern over health, I both agree and disagree. While we don’t need ‘health police’ and advanced screenings, it would also help to be proactive. Decreasing the number of people who get diseases and treating those with them is better than just treating those with them. I’m not sure how the ableist argument applies. For example, decreasing the amount of women who get breast cancer, finding a cure, and increasing early diagnoses is not the same as saying ‘women with cancer are worthless.’ I think most people can separate the two. I know women who have suffered from breast cancer who volunteer with organizations that seek to find a cure or preventative treatments. They obviously view ‘cancer’ as objectively bad without viewing themselves as worthless human beings. (I’m not in any way correlating breast cancer to weight, I’m using it as an example of something that is worth attempting to prevent if possible).

    I don’t want to see public health dismissed in feminist spaces because there are public health issues that feminist groups are involved in. Maternal health is one of them. It makes no sense to dismiss the health of others as ‘not my problem.’ And whether it’s unhealthy habits or the weight itself, they should be addressed as a means of preventative care.

  23. Catherine
    Catherine September 7, 2010 at 8:47 pm |

    I’m really glad you posted this, Zuzu. Fat hatred is a nasty, evil thing, heavily tied to racism and sexism in North America, and it’s a prejudice I’ve had to work hard towards overcoming myself.

    Two years ago this week, I was fairly horrified to learn that thin privilege was even a thing, when an ongoing health problem was finally diagnosed.

    “They probably didn’t think to look for this, because YOU’RE SO FIT,” the second specialist I went to said to me, as I sat there with my cane and inflamed joints due to massive drug-induced muscle atrophy, exacerbated by a complete lack of exercise.

    Right. “Fit”.

    “Well, you know what I mean,” he stammered out when I pointed out that I most certainly was not.

    Yeah. I know what he meant.

    I was shocked to realize that if I’d been a foot shorter than I am, some doctor would have ordered a simple lab test while berating me for not taking care of my body…even if my problem HAD been the sports injury they each wrongfully assumed at first glance.

    And I’m ashamed that THAT’S what it took for me to even start thinking about my own issues.

  24. Miss S
    Miss S September 7, 2010 at 8:54 pm |

    but there’s evidence to suggest that being underweight has just as many negative health associations.

    Yes, but it not’s an either/or issue. I can’t dismiss the argument that smoking is unhealthy by pointing out other things that cause health complications. Why can’t we address different issues separately instead of using them to try and cancel each other out? I have yet to hear anyone suggest that being massively underweight or anorexic is good for your health.

  25. Mo
    Mo September 7, 2010 at 9:34 pm |

    Thank you for talking about why it’s not the best idea to hold up yourself as a healthy example and exception. It’s so very hard to not say, “yes, but I’m fat AND I’m healthy!” Even if it feels like educating them, it really isn’t. I see that now.

  26. Maia
    Maia September 7, 2010 at 11:57 pm |

    Great post Zuzu!

    I really like the way both this post and the last one have managed to interact with the minefield of fat and health.

    I want to respond to this part of Roschelle’s comment:

    And if there’s something…anything you could do to prevent having these problems in the future – would taking those measures be considered beneficial.

    Leaving aside whether we know how to make a fat person a thin person, or whether a fat person becoming a thin personreduces their health risks (and there’s no evidence to back up either point, to be clear). No I wouldn’t do “anything” to avoid health problems in the future. I live in the now, with the resources and needs I have now. For example, I personally wouldn’t do anything that would decrease my mental health now, in order to reduce future physical health risks. For example, I take melatonin when I’m having sleeping problems, even though there is some scary research about it’s physical dangers, because everything about my life goes to custard when I don’t sleep. To suggest that people should do ‘anything’ to reduce certain future health risks – is to deny people’s ability to prioritise their own needs.

    Another answer would be to say that the point, and I may develop this more in response to Kloncke’s question on the other thread, of fat-shaming is partly to re-inforce the idea that we can control our health. That your relatives if they tried harder, if they acted better, in some way that better is defined, then they would not have the health problems. This lays the blame of health problems at the feet of individuals rather than society.

    I’ll admit that I’m still exploring how to say this. I am white from a middle class background and the women in my family live forever. But just like I condemn nonsense economic advice “You can get out of poverty if you just do X Y and Z.” even though those who believe it are often in an ecnomically less secure position than me. I think that it is important to demonstrate the damage and inaccuracy of the fallacy that we can control our health, even though I don’t have the same personal health risks that people who are more oppressed than I am do.

    [note these two points may seem contradictory, but they’re not. I think people don’t have control of their health, in the same sense that they don’t have control of the wealth. While some individuals may be able to do limited things to change either, whether they succeed will depend much more on luck than their own actions.]

    BHuesca – I think if you continue the metaphor of guest in someone’s house the response was perfectly reasonable. I wouldn’t accept fat-shaming comments from my friend’s guests – and I wouldn’t consider those who expected me to tolerate fat shaming my friends. But I’ll guess I’ll wait to see what Feministe’s take on that is.

  27. shah8
    shah8 September 8, 2010 at 12:27 am |

    I am rather firmly in the weight matters category. I, like Rochelle, have interacted with far too many people who are negatively impacted by their weight. It’s generally a pretty serious problem in minority populations and nobody benefits by minimizing the damage. When mamas are dying at your workplace from sudden heart attacks and leaving little kids to the vagaries of aunts and uncles, you might tend to be extremely unsympathetic to people who go past the anti-fat-phobia into denialist territory. Much of the feedback cycles surrounding body image has everything to do with class, and it has always been my perception that the unreasonably vicious nature of weight in left dialogues derives from a memory of other people assuming defenselessness socially and taking an opportunity to “put someone in their place”.

    You can be fat and be relatively healthy. You can be thin and be relatively healthy. However, just as much as someone would do as much intervention as morally feasible with a woman who’s suffering from anorexia, one should do so when a woman is morbidly obese. Not fat. Morbidly obese. That’s the sort of fat that usually have tons of health and mobility problems with it. It’s not just getting plus sized clothes. Last I have ever checked, which would be a while ago, I admit, there are strong correlations with degenerative conditions. Bodies are very, very, complex, and there will NEVER be one to one causative factors for most common degenerative conditions. There is just no guarantee of long health despite what you know. All you can do is try and figure out best practices and keep habits that makes you *feel* healthy day to day.

    I very much would like to stop fat phobia, just so we can actually deal with some *real* problems with obesity–the majority of which is kind of *imposed* and not people just eating too much. However, again, we have to consistently keep in mind the class (and race) issues involved, ok?

  28. banisteriopsis
    banisteriopsis September 8, 2010 at 3:41 am |

    As ugly as things have been here lately, it’s been really instructive to me to see how some issue push my buttons, and others are like, “what, this offends you?” when other people get up in arms about it. Just seeing the blowups, and the patient, tireless people who respond cogently has been really helpful to see my own prejudices, and work through them. Particularly with the fat thing, it forced me to take a critical look at my own feelings, and see that I was just trying to make excuses for my own bigotry.

  29. Heather Aurelia
    Heather Aurelia September 8, 2010 at 4:47 am |

    Wow, amazing post!!!!! @_@

  30. ellid
    ellid September 8, 2010 at 6:18 am |

    My regular doctor never, and I mean NEVER, brings up my weight. She treats my complaints, not my weight, and that’s one of the reasons I see her.

    I’m lucky, I know it, and my experience with her is so good that I went to see a surgeon about my hemorrhoids and he immediately brought up my weight, I never went back. The surgeon refused to listen when I told him that my very thin mother had had exactly the same problems and the same surgery. That’s when I decided that I’d rather suffer and bleed and let my condition get worse than have him touch my body.

    I eventually went to another doctor, who treated me, not my weight (which he never once brought up). I’ve already decided that any specialist who *does* make an issue of my weight, with the sole exception of a cardiologist should I need one, is going to be fired.

  31. Atheling
    Atheling September 8, 2010 at 7:52 am |

    Excellent! Thank you. Also, “tasty little rings of deep-fried sloth” is a wonderful phrase.

    @shah8, I think one of the biggest problems around the fat/health intersection is people serially misunderstanding the terminology involved. People conflate ‘overweight’ with ‘obese’ and ‘obese’ with ‘morbidly obese’ and also appear to have no idea how wide these classes are, or where they start. Somehow they hear “wears plus-sized clothes” as “is going to be dead within the year” (like whichever fashion retailer it was who wouldn’t carry above a UK14 in case it encouraged! obesity! Not that a 14 is plus-sized, but it seems to be in fashion-land.) There’s a huge, huge gulf between ‘is visibly fat’ and ‘is in actual danger’ and yet people too often act as if they’re the same thing.

  32. chava
    chava September 8, 2010 at 8:00 am |

    Rock on, zuzu!

    Every time I see one of these threads (with the attendant lack of safe space) on Feministe, I miss SP with the fire of a thousand burning suns.

  33. Maia
    Maia September 8, 2010 at 8:27 am |

    Shah8 – I can see where you’re coming from, and share your concerns, but reach different conclusions.

    I am (maybe there seem to be three different definitions and I don’t know how much I weigh so I can’t be sure where I fall) DEATHFAT. I have never had any health problems associated with my weight (all the health problems I have had have quite a clear history). But I don’t have many of the stresses of poverty – I don’t have to worry where my next meal is coming from. I have never worked as a waitress or a cleaner, or a physical always moving, stressful joy. Poverty and racism damage your body, and I’ve never had to deal with any of that.

    I believe that the situations you are describing are attributed to fat, actually come from poverty. Which is why I haven’t suffered them and people you know (and people I know) have. I also believe that the reason they are generally attributed to fat rather than poverty, is because that way individuals are held responsible for their bodies – rather than society being held responsible for what it is doing to individual’s bodies.

    I strongly object to your equating obesity and anorexia – anorexia is a behaviour and an illness, fat is neither.

  34. Jadey
    Jadey September 8, 2010 at 8:53 am |

    Miss S: but there’s evidence to suggest that being underweight has just as many negative health associations. Yes, but it not’s an either/or issue. I can’t dismiss the argument that smoking is unhealthy by pointing out other things that cause health complications. Why can’t we address different issues separately instead of using them to try and cancel each other out? I have yet to hear anyone suggest that being massively underweight or anorexic is good for your health.

    My point was not that these cancel each other out. My point was that the picture is more complicated than it is often made out to be (which makes sense – simple is simple and complicated is complicated). I wanted to get the idea out there that while fat has it issues, so does lack of fat, because *bodies* have issues, and to build on an earlier point that we are getting away from ourselves when we talk about body size, which is a bad metric for health, instead of taking on more accurate and less shaming targets, like access. (And fwiw, those studies *weren’t* talking about people with anorexia. They were talking about low BMI. Low BMI is as related to anorexia as high BMI is related to uncontrollable eating – occasionally, but hardly exclusively. Pathologizing skinny people as eating disordered is as much of a pain in the ass as pathologizing fat people as being lazy.)

  35. evil fizz
    evil fizz September 8, 2010 at 9:08 am | *

    When mamas are dying at your workplace from sudden heart attacks and leaving little kids to the vagaries of aunts and uncles, you might tend to be extremely unsympathetic to people who go past the anti-fat-phobia into denialist territory.

    I suppose I must have missed the part in popular discourse where we gave up policing, shaming, and moralizing in favor of denialism.

    I understand you’re making a somewhat different point, but the “but there are really, really fat people who eat nothing but Big Macs and are so unhealthy that they’re going to drop dead in fifteen minutes, but not before they use up more than their fair share of my precious tax dollars (and possibly have a special dedicated to them on the Learning Channel)!!” is a complete and total red herring when talking about fat, weight, and health. It’s just a tiny, tiny portion of the wider dialogue, but it garners such disproportionate attention that it’s hard to get a sense of what’s really going on.

    If left to their own devices, people do make spectacularly lousy choices. It happens. But at what (if any) point are we going to intervene and why?

  36. Aunti Disestablishmentarian
    Aunti Disestablishmentarian September 8, 2010 at 9:58 am |

    Brilliant post. One for the 101 site, fer sure.

    We miss you around these parts, Zu!

  37. Niki
    Niki September 8, 2010 at 10:19 am |

    The doctor situation makes me think of one time when I had to laugh at a nurse’s ridiculousness. She took down my height and then weighed me on one of those complicated doctor scales. And she said, “OK, so you’re a little overweight, that’s something you should talk to the doctor about.” And then she frowned, readjusted something, and said “Oh wait – never mind, you’re in the healthy range.”

    I’ve always been someone who’s sort of on the cusp between “healthy” and “overweight” on the BMI scale, so the initial error wasn’t really surprising or anything. It was just funny how calculated everything was – there I am, standing right in front of her, and weight is supposed to be something you should be able to see (and, more importantly, judge) with the naked eye, and the nurse can’t decide whether I have a problem I need to talk to the doctor about. It really shows how arbitrarily we draw these lines – they’re so often meaningless. Like, if I gain two pounds, suddenly I’m in the danger zone? I mean, what?

  38. Sheelzebub
    Sheelzebub September 8, 2010 at 10:23 am |

    I will point out, as someone who just got up to a “normal” weight and who spent her teen and a good chunk of her adult years underweight that no one EVER policed me or gave me grief about what I was eating. No one EVER asked me when I planned to gain some weight (stupid and childish cracks about eating disorders aside). I was not treated like a subhuman due to my size. My doctors, while concerned about my weight, did not focus on it. In fact, most people assumed I was healthy because I was so thin. The reality was that it wasn’t healthy at all.

    We couch fat-hatred in pro-health rhetoric. But if we are that concerned with health, then we can promote more access to better healthcare, more access to affordable and GOOD, healthful food, more walkable (and safe) cities and towns, and a living wage so that people are not working until all hours and are too tired to cook something besides pasta and butter (my favorite go-to comfort food, BTW).

    But no. We focus on ZOMG TEH DEATHFAT!!11! ELEVENTY because it’s a nice, easy way for us to feel superior. When people lecture others about what they need to do to lose weight, they aren’t helping. When people insult fat people for being fat, they aren’t actually showing concern for good health. When we have self-righteous chefs berate a poor, rural mother about how she’s killing her children and then goes on to sniff about the bad choices all of these silly poor people are making (yeah, I’m looking at YOU Jaime Oliver), it doesn’t help. When someone makes snotty and simplistic cracks about eating donuts, guess what? IT DOESN’T FUCKING HELP.

    Here’s the deal: When I was underweight, I inhaled fucking donuts. I inhaled cake and sugar and pasta and chocolate chunk cookies and coffee. Yet according to the deathfat moralists, that was fine because I was “healthy”–I was thin. Too thin, actually, but what the hell, that was a gold star among some folks. Occasionally I’d get a warning–“Start eating right because that will catch up with you and you’ll be fat by middle age.” NOT “Start eating right or you’ll have a fucked up immune system and crappy health.” No. It’s “you’ll be FAT.” Which is apparently worse than actually being unhealthy.

    My “numbers” were good (thanks mom and dad) but my overall health sucked. No endurance, no aerobic endurance, or muscle tone or strength. But no matter, because I wasn’t fat, so the folks who indulge in the fat moral panic didn’t think it mattered.

    If people were really concerned about good eating habits and health, they’d lay off the deathfat moral panic and focus on, well, eating habits and access to good food (especially the poor–food deserts and the grocery gap aren’t figments of our imagination) and walkable cities and towns and a decent quality of life for all people (including the poor) so that we could all live healthier lives. For everyone. But that would be no fun, then, would it? Because then they wouldn’t be able to sniff and roll their eyes and feel terribly righteous and superior compared to Those People. Addressing structural problems with individual solutions allows us to feel very virtuous, but it doesn’t actually solve any problems.

    No, this “concern” is all about the Cult of Personal Choices. I don’t see nearly the same level of “concern” for people who endanger their health in other ways. And that’s pretty telling.

  39. groggette
    groggette September 8, 2010 at 10:23 am |

    Maia: I strongly object to your equating obesity and anorexia – anorexia is a behaviour and an illness, fat is neither. (Quote this comment?)

    Thanks for saying that, Maia. The “opposite” of obese is BMI-underweight, notanorexia.

  40. nobody
    nobody September 8, 2010 at 10:31 am |

    I have to say that I’m very disappointed by this entire discussion. I am obese. Yes, obese. That’s me: Fat, fat, fat. I shouldn’t feel like I have to offer up my bona fides to be allowed to participate in this discussion, but the situation has been brought to the point where I feel like I’m not allowed to chime in without saying so. I’m not just obese, my doctor says I’ve got to lose weight (in case being obese isn’t enough).

    I thought Monica’s post dealt fairly with the issue and was very empowering. She talked about BMI and what it really meant scientifically. She criticized folks in the media and doctors (who in my experience are usually woefully informed about how science actually works) who misapply BMI (which only tells us about the health of the group, not the individual) to individuals. People are pissed because they seem to have ignored her explanation of what BMI really means and how it is really supposed to be applied and instead have decided that because she endorsed it being applied as appropriate that she was somehow anti-fat and endorsing it being applied to individuals. That’s pretty much the exact opposite of what she said. The responders didn’t seem to have read her post for content, and instead posted their reactions to every bad experience they’d ever had with the fat = bad crowd. I have trouble understanding why it’s bad for Monica to say that it’s bad for doctors and the media to talk in terms of BMI in terms of individuals when it’s a group measure and it’s increase points to large scale societal problems but it’s somehow fine when zuzu talks about systemic problems as the source of obesity. Did you not notice that you’re saying the same thing?

    We can’t have any sort of reasonable intellectual discussion if people disregard content and argue from emotion. And we can’t have any sort of intellectual discussion if people fixate on a few catch phrases and decide that anyone who uses those words must believe a whole litany of things that they may or may not have been arguing for or against.

  41. Whit
    Whit September 8, 2010 at 10:32 am |

    Roschelle: I’m a registered nurse who would not be considered fat by most standards today. not thin but not fat. I am also a woman of color, a group targeted constantly by fat hatred.I come from a long line of big girls! My mother, my aunts, my grandmother, my sister – all are overweight.I’ve realized over time that everyone isn’t meant to be thin and thin is more a frame of mind than a objective observation.What’s thin to me most certainly doesn’t imply that it’s what’s thin to twenty other people.My only is my family’s health. I’ve seen the effects of obesity on the human body via chronic medical conditions and the impact they have on the person suffering and the family members (children, parents, spouses) affected by this suffering. Some might argue that a person doesn’t have to be overweight to be diagnosed with hypertension, non-insulin dependent diabetes, arthritis, congestive heart failure, or hyperlipidemia. But excessive weight over a period of time certainly contribute to every one of these. And if there’s something…anything you could do to prevent having these problems in the future – would taking those measures be considered beneficial.  (Quote this comment?)

    I’m also a WOC healthcare worker. I’m fat. Fat, fat fat fat fat.

    My thin, clinically underweight grandfather died of CKD (chronic kidney disease), congestive heart failure, and pnuemonia (had a 2 ppd history of smoking for 60 of his 72 years). My cholesterol, blood pressure, fasting glucose, heart rate, pOx, and so on are FANTASTIC. Please look at any number of research papers on the subject like this one or this one, or THIS ONE.

  42. martini
    martini September 8, 2010 at 10:59 am |

    Miss S @ 21: “And whether it’s unhealthy habits or the weight itself, they should be addressed as a means of preventative care.”

    I really disagree that it doesn’t matter if we address unhealthy habits or peoples’ weight. On the micro level, it’s possible for some of us to change our habits or add new healthy ones (obviously, there are constraints like poverty that also act). However, if I eat more vegetables, I can’t make my body take that healthy habit and translate it into weight loss. So, focusing on my weight and telling me to change it to be healthier, when we don’t really know how to make fat people thin, is an instruction with which I have serious issues (and it’s the reason I avoid going to the doctor).

    On the macro level, fine, address food additives and farm subsidies and food deserts. But again, I think you get more mileage out of taking away the constraints and enabling people to make healthy choices than simply focusing on how much the population weighs, and trying to make us all thinner, since as far as I can tell, we still don’t really know how to do that effectively.

  43. geo
    geo September 8, 2010 at 11:26 am |

    i’ve done a fair amount of EMPIRICAL research using various weight indexes, such as BMI, waist-to-hip ratio, and waist circumference, to understand the relationship between weight and chronic illness. Every study I’ve worked on has shown that an increase or elevation on at least one of the weight measures (BMI, WHR, and WC) is linked to, predicts, or increases the likelihood of developing hypertension, type 2 diabetes, kidney disease, cardiovascular disease, orthopedic issues, and other health problems. So even if you refute the utility of BMI, other weight measures show similar results of being more likely to develop chronic illness than those in the normal range of WHR and WC. What people seem to be ignoring is that being overweight and obese puts one at a *HIGH RISK* for developing chronic illness. I know people will want to believe this, but there is a consensus among the scientific and medical community that people who are overweight and obese, by any measure, are at risk for developing chronic illness. The problem isn’t that you’re healthy right now. The problem is that you are *likely* to not be healthy in the near future. The goal of the scientific community is to prevent or at least help slow the progression of chronic illness in society, and a way to do is to curb the obesity and overweight rate.

  44. Jim
    Jim September 8, 2010 at 11:44 am |

    “she was not, in fact, particularly overweight when she was diagnosed with diabetes at the age of 33… nearly thirty years ago, when type II diabetes at 33 was really rare. Whereas I have the same hypoglycemia she had, had gestational diabetes with my pregnancies, am 170 lbs at 5′0″, and I’m 41 and not a diabetic… ”

    Alara, pardon a personal question; ignore it if it’s rude or better yet point that out to me for futrue reference, but what’s your ancestry? That pattern is typical of Scandinavians and related populations – North Asians and Native Americans. It’s an adaptation to lack of access to high quality carbs. A modern diet with lots of simple carbs is slow poison for people with the adaptation (and perfectly healthy for people without it.)

    It’s not hard to adjust for it – rye bread instead of wheat and rice, sweet potatoes instead of white potatoes, that kind of thing. Corn is not particularly healthy either, as I remember.

    The point is that no one diet is healthy for everyone.

  45. Zuzu
    Zuzu September 8, 2010 at 12:01 pm |

    Shah8, forgive the formatting, but I’m on a phone. Just a couple of things: 1) Given that there are population-based differences in obesity rates, isn’t it worth looking at why that is? We don’t do that when we focus on individuals. 2) Morbidly obese isn’t as big as you think. I was MO at the appointment described in the post. I’ve lost some weight but am still obese. If I lose just 30 more, I’ll be overweight. Clothing sizes 22-18-14 for these stages (I’m 5’9″).

    shah8: I am rather firmly in the weight matters category.I, like Rochelle, have interacted with far too many people who are negatively impacted by their weight.It’s generally a pretty serious problem in minority populations and nobody benefits by minimizing the damage.When mamas are dying at your workplace from sudden heart attacks and leaving little kids to the vagaries of aunts and uncles, you might tend to be extremely unsympathetic to people who go past the anti-fat-phobia into denialist territory.Much of the feedback cycles surrounding body image has everything to do with class, and it has always been my perception that the unreasonably vicious nature of weight in left dialogues derives from a memory of other people assuming defenselessness socially and taking an opportunity to “put someone in their place”.You can be fat and be relatively healthy.You can be thin and be relatively healthy.However, just as much as someone would do as much intervention as morally feasible with a woman who’s suffering from anorexia, one should do so when a woman is morbidly obese.Not fat.Morbidly obese.That’s the sort of fat that usually have tons of health and mobility problems with it.It’s not just getting plus sized clothes.Last I have ever checked, which would be a while ago, I admit, there are strong correlations with degenerative conditions.Bodies are very, very, complex, and there will NEVER be one to one causative factors for most common degenerative conditions.There is just no guarantee of long health despite what you know.All you can do is try and figure out best practices and keep habits that makes you *feel* healthy day to day.
    I very much would like to stop fat phobia, just so we can actually deal with some *real* problems with obesity–the majority of which is kind of *imposed* and not people just eating too much.However, again, we have to consistently keep in mind the class (and race) issues involved, ok?

  46. Alara Rogers
    Alara Rogers September 8, 2010 at 12:11 pm |

    I have yet to hear anyone suggest that being massively underweight or anorexic is good for your health.

    No. But studies have shown that having an “overweight” BMI correlates with a lesser mortality/morbidity rate than an “underweight” BMI to the same degree. (In fact, actually, I think it correlated with a lesser rate than a “normal” BMI.) So being slightly overweight is better for you than being slightly underweight, but which is likely to get people yammering at you about your health?

    There are some things that I fear it is almost impossible to discuss rationally, because the environment surrounding them is so toxic. Yes, I think that people becoming morbidly obese at high rates is a problem, and that it correlates with higher death rates, and that it would be a good thing if people were not becoming morbidly obese at high rates and also having higher death rates. However, I believe there is also very, very little evidence that the problem *itself* is the obesity, or that treating the obesity makes the problem go away.

    If chicken pox killed you, putting anti-itching creme all over your skin to alleviate the itching that chicken pox causes before you die would probably not prevent you from dying. Treating symptoms instead of causes is generally ineffective. But I believe that all of our social discussion of fat is poisoned by a mostly unsupported belief that the fatness *itself* is the problem, whereas I believe the evidence suggests that the fatness is a symptom. And, even in cases where the fatness itself heavily exacerbates the problem or is the problem, the recommended treatments for being fat do not work.

    If there were environmental toxins that were leading people to develop metabolic disorders, and as a response to their slowly worsening metabolic condition, people were putting on weight, the weight would appear and then the metabolic disorder would get bad enough that it would be diagnosed, so it would look like one caused the other. But actually, the same root cause would have caused both, and losing the weight would not prevent the metabolic disorder. Since many metabolic disorders cause your own food to poison you slowly via byproducts you can’t break down, reducing the amount you eat will alleviate the damage your metabolic disorder is doing to you, because it will bring the levels of whatever it is you have a hard time digesting/using down to the levels where your body can handle it… but that doesn’t *cure* your disorder.

    So let’s use diabetes as an example because it’s the one I’m most familiar with. Diabetics don’t produce enough insulin, and are often resistant to the insulin they do produce, so they cannot process carbohydrates. In the absence of insulin, the carbohydrates circulate in the bloodstream, poisoning the diabetic. So let’s say that there’s a toxin that slowly induces a biochemical change in the body where the cells become insulin-resistant. The pancreas produces more and more insulin to overcome this resistance (producing hypoglycemia, or low blood sugar, which causes mood swings, temporary dementia, unconsciousness and death, and is treated by eating RIGHT NOW — hypoglycemics cannot go on starvation diets), until it essentially burns out and starts producing very little insulin.

    The same factor that is making the cells insulin resistant could be inducing fat cells to multiply and take up more fat, converting more and more carbohydrates to fat. If you don’t have the insulin to process your blood carbs into energy, you *need* to turn them into fat to get them out of the bloodstream, because they are poisonous otherwise, causing lactic acid buildup (physical exhaustion and muscle aches), overproduction of urine (need to drink more and more water to help purge the body of the sugars, which taxes the kidneys), and direct cell damage, including nerve damage and slowing the rate at which cells can replicate themselves (in other words, you heal any damage more slowly and you take nerve damage that doesn’t heal ever.) So your insulin resistance may directly cause you to convert carbs to fat, or the same metabolic process caused by toxins that was causing the insulin resistance might be inducing your body to make more fat.

    Here you go! You were getting heavier, then you became hypoglycemic, then you got obese, then you got diabetic. Now, you go on a strict diet to control your diabetes and reduce your weight. Well, calorie restriction does make most people lose weight… but reducing the amount of carbohydrate that converts into blood sugar will reduce your need for insulin, keep sugars out of your bloodstream and alleviate your symptoms of diabetes. Since most of us eat most of our calories as carbs, this is also a low-cal diet, and unless you’ve lost your body’s ability to let go of fat as the result of your metabolic disorder, a low-cal diet will make you lose weight. Great! You lost weight, and your diabetes got under control!

    But one did not cause the other.

    In this model, you didn’t get diabetes because you gained weight, and you didn’t get diabetes under control because you lost weight. You got diabetes from some kind of environmental toxin; you got overweight because of the same toxin and because of the effect of the diabetes, but because diabetes isn’t usually diagnosed until sugar poisoning symptoms show up, and diabetes itself might be a symptom of something else (such as slowly developing insulin resistance), you could have very easily have had the underlying metabolic disorder that causes diabetes long before you were diagnosable. The treatment for diabetes restricts how much you can eat, and how much of *what* you can eat, in order to control the amounts of nutrient-chemicals that your body needs to process because as a diabetic your ability to process them is limited. Restricting how much you can eat usually results in weight loss. You gained weight as a symptom of diabetes and you lost weight as a symptom of treating diabetes.

    So, if someone invented Fat Melting Pills that instantly convert the fat in the fat cells to circulating blood sugar, which your body is expected to burn off, and your doctor prescribed them to you, a diabetic, so that you would lose weight and get your diabetes under control… you would DIE. Damn near immediately. You wouldn’t be able to handle the blood sugar surge and it would poison and kill you.

    And if you were developing the metabolic disorder of diabetes and as a result you were gaining weight, but your metabolic disorder wasn’t severe enough yet to be diagnosable, and your doctor was concerned that the weight gain was going to give you diabetes, and gave you Fat Melting Pills so that you would not retain fat and therefore your weight would remain low… you’d die. Eventually. Or the doctor would figure out that it was killing you. Because if you couldn’t convert blood sugar into fat, and you were developing insulin resistance, you’d be thin and svelte and sexy-looking and the sugar in your bloodstream would *still* be killing you, because in fact the diabetes was already there, already developing, and hiding the symptom of your fat ass didn’t change the fact that you’re getting diabetes.

    But hey, at least your corpse will totally look good in your best clothes when they bury you.

    The problem with *any* sort of concern about weight is that we do not yet know what is causing America as a whole to get fatter, and we do not know if the surge in various disorders such as diabetes and high blood pressure that coincides with America getting fatter is actually *caused* by America getting fatter, or if it’s *causing* America getting fatter. And our cultural scripts still come out of the ancient days of food scarcity and hard labor where if a person was fat, it could only be because they are not doing productive work *and* also eating extra food that could be going to more deserving, harder workers. Nowadays, the majority of the Western world’s productive work does not burn any more calories than watching TV would, and the food is actually designed to deliver as many calories as possible in as small a dose as possible. Bulky food with less calories per weight is more expensive and harder to get than calorie-dense food, and people who work hard all day to earn a living aren’t burning any calories doing it. So, in fact, people who are thin because they make plenty of time for physical exercise are selfish, lazy people who are taking time that they could be working hard and making money, or taking care of kids, to goof off running and jumping and playing ball games.

    Of course, no, they’re not. Actually, we all deserve time to be able to physically exercise. But in order to have such time, you actually have to be somewhat selfish — you have to be able to carve out time in your day to say “This is for me. This makes no money, this doesn’t take care of other people, this is just for me.” And you have to have both money and time to do that. The hard-working mom who works three jobs to support her kids? She doesn’t have that time, or that money. So most likely she’s fat. And most of our discussion of fat centers around the idea that she is a BAD PERSON for not taking the time to exercise, for not taking the time to eat low-density bulky food instead of high-calorie dense food she can chow down quick, because she is a FATTY FATTY FAT and that means she is LAZY and SELFISH and GREEDY and EATS TOO MANY DONUTS. But if a mother who needed to work three jobs to keep her kids fed quit one of those jobs so she could go jogging, and spent money on expensive produce that takes a while to cook and provides little calories for the amount you have to eat, so she could lose weight, we would vilify her as a bad person because she’d be starving her children to do it. (In fact, our urge to not starve our children even if it means becoming fatty fat fats is so profound that you actually never *hear* stories about bad mothers who spent their time working out and spent their money on rabbit food so their kids were starving, despite the intense social pressure to be thin. Either that, or we simply can’t recognize that MeMe Roth is starving her children because she’s rich enough to do it in style.)

    So we have a plague of fatness, and a plague of metabolic disorders, and we’re convinced that the first causes the second but there’s actually awfully little evidence that that’s so. And we have people working damn hard, busting their asses to make the money they need to survive and keep their kids fed and clothed, getting fat, while people of leisure can afford to take time and go to the expensive gym, but fatness is all about being lazy and wanting self-gratification. And we have a definition of “overweight” that has significantly better health outcomes than an equal definition of “underweight”, but underweight is sexy so we’ll just ignore that. We’ll admit that anorexia is bad for you, but obsessing over your food and counting every calorie and not chewing a bite until you’ve figured out exactly what the impact on your weight plan is going to be isn’t anorexia or even evidence of an eating disorder, it’s just good common sense.

    In this environment, I can’t see any point to discussing obesity as a cause of public health problems. How about we fix our concept of overweight so “healthy weight that causes less death” is not defined as overweight, stop asking people to lose weight via diet control as a means of preventing disease because evidence suggests it doesn’t work, start defining fat people as “people who work too hard to exercise” rather than “people who are too lazy to exercise”, stop assuming that people who are thin are necessarily healthy, and THEN maybe we can have a conversation about whatever it is in the environment or the food we eat or the lives we live that is causing both weight gain and rising disease?

  47. shah8
    shah8 September 8, 2010 at 12:41 pm |

    Alara Rogers, the trouble with environmental toxins is that there are a great number of suspect vectors, almost as many as the various finished products that have bio-mimics as a byproduct, like many plastics, pesticides, or preservatives–not to mention the obvious like hormoned up cows. Then there are *routine* based vectors like sleeping patterns, watching too much tv (because you’re stiller for that than anything else), or not getting enough sex. The sheer complexity of our environment generally leads to the public taking something simple and blowing it up beyond all belief, like visible obesity (no one ever minds the tuberculosis chic body image either, it seems). Turning it around the other way is only going to result in similar crazyness, whether that be willful blindness to some of the harder possibilities in favor quick quack solutions or paranoid style debates on the harmfulness of something most people have to get but don’t want to (dental fillings, vaccinations). We simply have to have a manageable conversation that *includes* everyone who has a real point, and almost as important, *excludes* people who want to rant. This is a very toxic topic that requires strong moderation, really.

  48. Kira
    Kira September 8, 2010 at 1:35 pm |

    Thank you, thank you, thank you for writing this post and for sharing it in this Feministe space.

  49. Paraxeni
    Paraxeni September 8, 2010 at 2:18 pm |

    shah8 you might tend to be extremely unsympathetic to people who go past the anti-fat-phobia into denialist territory

    The problem is that unless you’ve personally experienced the mortifying shame of being told, by a healthcare professional, that your clothes size is responsible for everything from alopecia to getting the flu – you cannot begin to understand why people want to go into that “Listen, I don’t care, I’ll live how I want to” place.

    I know for a fact that in my country, the UK where healthcare costs nothing, there are women (myself included) who will not see a doctor unless they become seriously ill, because of the fat-shaming they’ve experienced. If they lived in the U.S. and essentially had to pay their own hard-earned money, often making their immediate situation pretty dire, to be told “Fuck off fatty”, then the disincentive to even bother must be massively strong. I know if I was feeling ill enough to see a doctor, then I wouldn’t relish the thought of paying for a dose of fatphobia along with my symptoms.

    Also, poor, fat WOC in any place have the odds stacked against them. They’re usually doing the shittiest jobs for the lowest pay, living in grocery deserts and struggling, alongside their poor, white sisters. It’s poverty that’s killing people, not their weight. It’s doctors seeing women as inferior not-men, seeing fat women as lower down the ladder, then poor people, with WOC struggling to reach the bottom rung that’s killing people. And finally, it’s the fear of being ridiculed, of being shamed, of being othered that’s preventing people going to the doctor sooner rather than later, that’s killing people.

    I have health problems because of my weight – but the weight didn’t make me disabled, the doctor that assumed that young+fat+woman+poor+queer+clinically depressed = timewasting fatty attention-seeking hypochondriac did that. He did that when he shrugged me and my symptoms off for four years (constant severe headache, seizures, sight loss, permanent nerve damage in limbs, vomiting and losing consciousness on a daily basis) and diagnosed me as “Lazy and mental” rather than “having an incurable neurological condition” as I made weekly hysterical visits to his office (remember, that was for four years), terrified because at 20 I was losing function by the day. He did that by prescribing “A diet of under 500 calories a day” instead of “neurosurgery”. If he’d looked in my eyes just once in that first year, I wouldn’t be sat here now, I’d be working. Instead I’m pretty much confined to one room with my body and senses broken beyond repair and in constant pain, due to a combination of his attitude, and the emergency treatments needed to save my life. The only reason I was ever referred to a neurologist (because my GP still didn’t look in my eyes) was because I started to make daily appointments and then threatened suicide in his office. He had to rule out a physical cause for my “little headaches” before he was allowed to have me sectioned (placed in a secure psychiatric facility) under the Mental Health Act. Even after my diagnosis when I had to see him for painkillers, he still said “Your head hurts because you’re depressed. You’re depressed because you’re fat. Lose weight and you won’t need to see me again.”

    That’s the most pernicious way that fatness damages health. That’s how my mother-in-law died of a combination of oesophageal cancer and stomach cancer, because when she presented to her GP with a visible tumour he said “It’s just fat, you’re menopausal, change your diet habits.” That’s why she was thrilled when the weight kept dropping off her, that’s why up to the week she died she was secretly proud that she’d never been thinner, even if it was just from the effects of the chemo and the giant tumour blocking her throat.

    That’s why I understand denial, and defensiveness, and anger. That’s why I totally get the “Fuck it, I’ll do whatever keeps me happy and sane” attitude, because ultimately it’s about self-protection.

    Sorry this got long – it’s a very hot topic.

  50. Kristen J.
    Kristen J. September 8, 2010 at 2:51 pm |

    Miss S: I don’t want to see public health dismissed in feminist spaces because there are public health issues that feminist groups are involved in. Maternal health is one of them. It makes no sense to dismiss the health of others as ‘not my problem.’ And whether it’s unhealthy habits or the weight itself, they should be addressed as a means of preventative care.

    The difficulty here is that none of us have a vested interest in another persons health. That is the core of bodily autonomy. My body, my choice. Your concern is better addressed as access to healthful options. If everyone in the world had access to healthful options (in all that the word “access” means), then those that prefer healthful options would make those selections.

    But in no event there should be moral value attached to health or healthful choices any more than there should be moral value attached to other choices people make that another might disagree with. People jump out of planes, pay others to poke them with needles, and enjoy stressful careers. None of those things make any sense to me and they sound unnecessarily dangerous to me…but do we condemn skydivers, acupuncture patients, or doctors for those choices? No…so why do we care about the healthfulness of people except as a means of body policing?

  51. Zuzu
    Zuzu September 8, 2010 at 3:11 pm |

    It’s a little hard to believe that someone who makes donut jokes is arguing in good faith.

    Geo, did any of that EMPIRICAL research find a causative, rather than a correlative, relationship between the presence of body fat and all those diseases you mentioned? Because you didn’t mention that. And you seem to be ignoring that poor health habits may lead both to disease and to weight gain. In some cases, the disease may actually cause the weight gain, but it’s not discovered when the patient is thin, because thin people don’t get diabetes!

    nobody: I have to say that I’m very disappointed by this entire discussion.I am obese.Yes, obese.That’s me: Fat, fat, fat.I shouldn’t feel like I have to offer up my bona fides to be allowed to participate in this discussion, but the situation has been brought to the point where I feel like I’m not allowed to chime in without saying so.I’m not just obese, my doctor says I’ve got to lose weight (in case being obese isn’t enough).I thought Monica’s post dealt fairly with the issue and was very empowering.She talked about BMI and what it really meant scientifically.She criticized folks in the media and doctors (who in my experience are usually woefully informed about how science actually works) who misapply BMI (which only tells us about the health of the group, not the individual) to individuals.People are pissed because they seem to have ignored her explanation of what BMI really means and how it is really supposed to be applied and instead have decided that because she endorsed it being applied as appropriate that she was somehow anti-fat and endorsing it being applied to individuals.That’s pretty much the exact opposite of what she said.The responders didn’t seem to have read her post for content, and instead posted their reactions to every bad experience they’d ever had with the fat = bad crowd.I have trouble understanding why it’s bad for Monica to say that it’s bad for doctors and the media to talk in terms of BMI in terms of individuals when it’s a group measure and it’s increase points to large scale societal problems but it’s somehow fine when zuzu talks about systemic problems as the source of obesity.Did you not notice that you’re saying the same thing?We can’t have any sort of reasonable intellectual discussion if people disregard content and argue from emotion.And we can’t have any sort of intellectual discussion if people fixate on a few catch phrases and decide that anyone who uses those words must believe a whole litany of things that they may or may not have been arguing for or against.

    1. Lauren
      Lauren September 8, 2010 at 5:34 pm | *

      @Zuzu, Because she is a Feministe guest with whom the Feministe team is familiar, we are positive that she was acting in good faith. Sure, she stepped in some shit, but let’s not act like she came here to stir up trouble. C’mon.

  52. IrishUp
    IrishUp September 8, 2010 at 5:11 pm |

    @ paraxeni “He did that by prescribing “A diet of under 500 calories a day” instead of “neurosurgery”.
    Oh, FFS! That, as I’m sure you know, but for the benefit of the cheap seats, was malpractice. Coupled with some prejudice and malfeasance. I’m so sorry for the harm you and yours have suffered.

    Sorry, but these two threads have made me ranty.

    There is a misconception that (western) medicine understands nutrition and metabolism. We do not; the understanding of human physiology at this level is in it’s infancy. We’re good at surgery- anatomical studies are thousands of years old. We understand discrete pathologies – like solid tumor cancers – pretty well. But our atomistic approach to nutrition is inherently flawed, and impedes our understanding in this realm. Your regular US trained GP got maybe MAYBE 5hrs total specifically in nutrition. (My understanding of UK training is that it’s not much different). That is how come a Dr. can recommend a calorie level 40% BELOW what the WHO has established as starvation level – 800kcal/day. 800kcal/d is considered insufficient to support health and life over a prolonged period. But stories of MDs and even RDs telling people to eat such levels ABOUND.

    The problem that always crops up is discussions of the ZOMGOBESITYEPIDEMIC BOOGABOOGA is too much conflation of human rights, public health, and workable solutions. Each is very important, but they must be separated out in order to respect their importance.

    See, we’re not talking about THINGS, we’re talking about actual, valuable, lovable and loving human beings. Each human being has an equal claim to the same basic human and civil rights. Full fucking stop. Discrimination and violence visited on any person is wrong. Full fucking stop. Shaming and bullying and putting people at economic disadvantage are all serious forms of violence.
    So, there is no Yeahbuts to be had here.

    Ok, next is the public health end. Violence visited on people is life-threatening and life shortening. The stress of discrimination, poverty, class disadvantage, et cetera ad nauseum are ALL BY THEMSELVES known CAUSES – not correlations!!!!!!! of early morbidity and mortality. So, fat shaming and discrimination have no fucking roll in any discussion of public health.

    Generally speaking, people have a genetic set point that has a 10-20lb range – ABSENT any other kinds of stressors like meds, diseases, etc – and varies over time and with developmental stage. The real number of the populational difference associated with the ZOMGOBESITYEPIDEMIC BOOGABOOGA? 15lbs average. So, what we’re really talking about is that as a population, we’ve drifted towards the top of our natural ranges. And is that so surprising in our current culture?

    Now, besides that fact that preponderance of the primary literature does not show a causal roll of fat and disease, TONS (har!) of data support that weight GAIN is much more likely to be SECONDARY to underlying disease processes, than the CAUSE. But, humans are systems. So what often happens is a vicious cycle like this: underlying disease –> weight gain —> reduction in health preserving behaviors*/increase in health reducing perturbations to the system* –> further exacerbation of disease –> further weight gain …… It’s a cycle and a system that can get entered at any point.

    Lastly, on the public health side is that the preponderance of the evidence supports that the things we do to effect weight loss – bariatric surgery and dieting – ARE IN FACT PRIMARY CAUSES OF DISEASE AND DEATH. Bariatric surgeries have morbidity and mortality rates that EXCEED cardiac surgery. Believe me, if a hospital’s cardiac surgery had the mortality rate that bariatrics does? The state DPH would have it SHUT DOWN in a week. And bariatric patients are younger and healthier at baseline. After all, cardiac surgery patients are in their mid-sixties with heart disease. Diets are the gateway drug to Eds – >80% of ED sufferers dieted, and >5% of the population has an ED, compared to <1% being in the morbidly obese group with similar risk of early mortality from the last NHANES study. Diets cause kidney failure, osteopenia, osteoporosis, GI and dermatologic complications, among other complications. OH, and they CAUSE WEIGHT GAIN.

    Shorter me: shaming is wrong, fat is not bad, human health is complicated, diets harm people but make BigPharm rich.

    Fucking stop with the donut shit.

    Unless you’re gonna pass me a hot-buttered-baby-flavored one. Then I’ll take two – they’re small.

    *NOT due to people choosing to not be healthy (though yes, sometimes it is) but often due to things like new physical limitations, loss of employment, medications, change of life issues, etc.

  53. Bagelsan
    Bagelsan September 8, 2010 at 5:32 pm |

    @Zuzu 49: I have seen some more causative studies, where the actual fat cells themselves seem to be affecting their people detrimentally. I don’t know if it’s behind a paywall, but I found a nice review that tries to address some of that: http://www.ncbi.nlm.nih.gov/pubmed/18456027

    Some excerpts:

    The renin-angiotensin system is activated in obesity despite an increase in intravascular volume and sodium retention. There are at least 3 mechanisms of renin-angiotensin system activation in obesity: secretion of angiotensinogen from adipose tissue resulting in increased activation of the local and systemic renin-angiotensin system; the action of an adipocyte-derived factor that enhances the release of a hepatic stimulator of aldosterone synthesis; and increased circulating renin levels, which might stimulate increased sympathetic nervous system activity.

    Local and systemic renin-angiotensin system up-regulation and angiotensin II promote cardiac hypertrophy, vascular hyperplasia, endothelial dysfunction, increased tissue reactive oxygen species, and cardiac fibrosis. … Local renin-angiotensin system up-regulation in adipose tissue causes hypertension to worsen by activating angiotensin I receptors present in adipose tissue.

    and

    Obesity is sometimes referred to as a low-grade inflammatory condition because adipose tissue in general and visceral adipose tissue in particular are rich in inflammatory cytokines such as tumor necrosis factor-alpha, interleukin-6, C-reactive protein (CRP), and PAI-1.32 These cytokines, in turn, are considered major regulators in the production of acute-phase reactants such as CRP, PAI-1, and fibrinogen by the liver. …

    There are numerous cytokine hormones secreted by adipose tissue that play an important role in the regulation of energy homeostasis, insulin action, and lipid metabolism. …

    Acylation-stimulating protein is a lipogenic adipocytokine whose precursors, complement (C3, adipsin, and factor B) are synthesized and secreted by adipose tissue in a differentiation-dependent manner. Acylation-stimulating protein is linked to the pathogenesis of obesity via its action to enhance triglyceride synthesis and storage in the adipocyte. Elevated levels of this adipocytokine are observed with obesity, diabetes mellitus, and insulin resistance.

    TL;DR = there is soooome evidence that fat itself can cause health problems, but yeah, mostly it’s correlative rather than causative (so far.*)

    *causation is harder to establish, of course, so the fact that there isn’t much established in no way means there isn’t causation there.

  54. Bagelsan
    Bagelsan September 8, 2010 at 5:49 pm |

    On a different note, I’m a little sad that people seem to have started playing “good fatty” again, a bit.

    It’s been established pretty well on this thread that there exist people who are currently various levels of “overweight”/”obese” and who are also currently healthy. But continuing to list examples over and over doesn’t make it “data” — I think it would be more valuable either to focus on the research (in which case anecdotes are pointless) or on the theme of the piece (in which case it doesn’t matter how much any of us weigh/run/bench/eat because it is our personal business.)

    Trying to mix these types of discussion seems like a recipe for disaster, to me… Because then you have population stats going up next to personal health records as if they are “nuh-UH”ing each other, which they aren’t and can’t. It’s just too easy to conflate population with individual in that kind of format. My hours on or off the treadmill do not refute population risk-factors, and vice versa. They should be completely separate conversations.

  55. PM
    PM September 8, 2010 at 6:02 pm |

    Kristen J.: The difficulty here is that none of us have a vested interest in another persons health. That is the core of bodily autonomy.(Quote this comment?)

    But was long as we pay taxes Medicare and Medicaid, we do have a vested interest. I’d like to see the U.S. go to single-payer, which would mean as an American I’d have even more vested economic interest in the health of others. I don’t have that “fuck you, got mine” to people who aren’t as physically healthy as I am (and if we get universal mental health coverage you can bet I’ll be using it), but just as it’s reasonable to pass universal healthcare for the public good, I think it’s reasonable to expect my fellow citizens to be proactive about their health and their children’s health so as not to drain the system.

  56. Maia
    Maia September 8, 2010 at 6:18 pm |

    Bagelsan – I don’t know if you were talking about my post – but I wasn’t trying to play good fat with my note that I don’t have health problems related to my weight. I do think emphatic statements like Sha8’s:

    Not fat. Morbidly obese. That’s the sort of fat that usually have tons of health and mobility problems with it.

    Need to be replied to. I was trying to do the opposite of good fatty and say hey look I don’t have health problems relating to my possible deathfat – and that’s nothing to do with my personal virtue, and everything to do with my privilege.

    Lauren – can you give a clear indication of whether or not discussion of Monica’s post is considered off-topic? My comment in reply to yours didn’t go through.

    1. Lauren
      Lauren September 8, 2010 at 6:21 pm | *

      Discussion of Monica and her post is off-topic. If you want to follow up with her directly, there is a lively, respectful discussion occurring on her home blog. Email me if you need a direct link.

      Thanks for asking!

  57. shah8
    shah8 September 8, 2010 at 6:19 pm |

    Okay, well, I *had* withdrawn from this debate because I find it (and responses to me) teeth-clenching stupid and I didn’t trust myself to make a clear response about how deeply wrong Kira and Paraxeni‘s rebuttal other than mutter something about kyriarchy.

    However, I do want to end this one thread of “Libertarian for a Day Feminism” logic right here and now. Health is a fucking moral right, and the STATE is a key agent in enforcing such moral rights. If people didn’t think of such things in this way, we wouldn’t have clean water/sanitation for all in urban populations. We wouldn’t consider access to medical care a personal right. There would be no FDA and no school lunches. Do you know why? Because people who are making soi distant, zero sum, and narcissic class arguments could only get shouted down by forcing clear moral parallels in understanding what a State is for. Yes, there is all that crap that surrounds abortion–but all of it is of such cheap and shoddy quality that more of the same–that people have a right to be able to pursue their interests without other people’s interference remains the most effective means of shutting those guys up.

    As far as crappy doctor mentalities go…guess what? It’s what almost all visible minorities have to deal with. But no, instead of wanting the medical profession to change their *professional* demeanor and make them treat everyone as if they are fully human, some of you guys want some crappy media crusade on how fat is not so bad built out of personal stories about how some random assholes did you wrong. Which is, in the context of diseases like AIDS in the 80’s, unbelievably narcissic. Public health officials like epidemiologists and practitioners like primary care doctors by now all have the latest understanding about obesity. People who want to hurt others (or deny service to the best of their abilities) because they are fat are pretty much the same people who want to hurt others because have have kinky hair and they have the same backing from that media saturaculture. Balanced and patient anti-kyriarchy mindsets are the only approach that might make this less Sisyphean. Not idiotic rage-posting on some board.

  58. Miss S
    Miss S September 8, 2010 at 6:26 pm |

    Jadey- my comment came out much snarkier than intended. My apologies. Also, I agree that anorexia should not be conflated with being underweight. One is (often) a form of anxiety, and should be treated as a mental health issue as well as for the physical implications.

    Honestly, I think there is a serious level of denial about the implications of being overweight. It does correlate to health problems- regardless of it’s the result of the weight itself or the unhealthy habits that created the weight. (Research does suggest that the weight itself creates problems). But it makes no sense to say “what’s it to you” and “don’t worry about the health of other people” when we should care about the health of others, especially those without access to healthcare and healthy food.

    Also, I think it doesn’t help that we use overweight to include people who are anywhere from 10 pounds overweight to 700 pounds overweight. If I go by that little chart I’m about 10 to 15 pounds overweight for my height, but my doctors always tell me that my weight is fine. I would imagine that if I were 250 pounds over the number on that chart, it would be different.

  59. Bagelsan
    Bagelsan September 8, 2010 at 6:34 pm |

    Maia, I didn’t really have an individual in mind, I just felt like that was the direction the comments were going a bit. Maybe I should say it’s more like people playing “individual fatty” rather than “good fatty” — lots of anecdotes, which totally have their place, but which also often seem to dominate discussions of fat. I mean, there’s a fair amount of “I know/am a fat person who [blah]” where “blah” is just about anything under the sun (is healthy, is unhealthy, is dead, can fly) and is also kinda irrelevant to the OP as I read it, where the “blah” should be switched out for “is a person, so fuck you, who cares?”

  60. Charity
    Charity September 8, 2010 at 7:00 pm |

    Miss S, please see Kristen J’s comment at 48. The bodily autonomy issue is critical here. Further to the bodily autonomy issue is the presumptuousness issue, I think – we may not agree on the research findings’ validity, but perhaps we can agree that one additional level of offensiveness in sharing these findings with “the overweight” is presuming you are telling people something they have not already heard before and either a) have made their own informed choices about, or b) are blocked from doing anything about due to lack of access to alternatives?

  61. Naamah
    Naamah September 8, 2010 at 7:11 pm |

    How in the everloving fucking fuckhell did this wonderful post about fat as a feminist issue, and the many ways in which fatness and body policing are used to shame women, turn into a “YES YOU ARE” “NO I’M NOT” back and forth going-nowhere ridiculous and disgusting crap-pile of whether or not FAT IS DEADLY OMFG!?

    Do we REALLY need to have this conversation again? Because I am burning up Sanity Watchers points just *skimming* the comments.

    This is fucking ridiculous. Jesus Christ, people. Jesus fucking Christ. I love this post, but the comments are fucked. The hell is going on with y’all? It’s getting uncivilized in here.

    WE DO NOT KNOW FOR SURE whether fat causes people to be unhealthy or whether it is correlative. For every study that concludes something is there, there’s another that concludes there’s nothing.

    WE ALSO CANNOT MAKE FAT PEOPLE THIN. Weight loss works for a tiny number of people, and for the rest, it’s just a mess of yo-yo dieting, which HAS been proven to be very bad for the human body. So even if it is causative — which I doubt — losing weight for most people IF it is even possible for them is a temporary measure at best (and at worst is hideously destructive) and is not the answer we are looking for to correct health problems that correlate to fatness!

    So how about in the meantime we focus on measures of health that don’t involve fatness, and ways to make people healthier that don’t involve “Lose weight, fatty!”?

  62. littlem
    littlem September 8, 2010 at 7:18 pm |

    And if there’s something…anything you could do to prevent having these problems in the future – would taking those measures be considered beneficial.

    @Roschelle –

    Yes.

    I’m in a similar space as you, at least on half the family side, on each side. (I’m mixed-race.)

    You can work out regularly, and you can eat differently.
    A lot of the “soul food” that came over from Africa — yams, greens, protein — is basically low-carb eating.

    A lot of people either don’t realize that, or don’t want to know from it — or, as I’m about to rant a little about below, don’t want *other* people to know from it.

    I don’t eat “food” products manufactured by corporations who are deliberately trying to poison me and my own, if you know what I mean, and I think you do.

    I read every label — my dermatologist coached me to become a compulsive label-reader — and if I can’t pronounce, let alone identify, half the things that are on the label of the thing in the food store? Back on the shelf it goes.

    A 100-calorie pack of Oreos is still 100 calories of crap food that somebody made whom I seriously doubt had my best interests at heart. With all the drama I have to have the energy to deal with in this life, I’d rather have 600 calories of as much real food as I can afford.

    I drink enough water.

    And you notice NONE of the above has *squat* to do with body size per se. I didn’t even mention it.

    Now granted, some of these habits *will* get you sneered at (y/k, the old “acting white”) by some members of your own family.
    But they have a lot less to say about it now after fifteen or so years when I have the best internal (hb1AC, HDL, LDL, etc.) numbers in the family, in addition to a single-digit size.

    (Okay, it came up one time.)

    There’s something else, though, and I think it has more to do with trying to find some peace of mind as anything.

    I’m sure you know that, as a WOC, the world is going to try to stress you. It just is.

    You probably know also — did I read that you’re a nurse? — that cortisol, the hormone the body produces under stress, adds the ‘bad kind’ of body fat, the kind that stresses your organs.

    So when my own folks — in addition to the “white girls”, but for different reasons — make fun of the way I eat? I just shut it off. I’ve been known to walk right out of the room and cut off the conversation, because you know what? I don’t have the time or the energy for the drama. Not in this recession.

    But there’s something else to peace of mind, and I think this is the scary, hard, counterintuitive part.

    My grandmother was never overweight (though she was a drinker) … and she was just as diabetic as others in her/our family that carried much more on the frame.
    My granddad was a big strong baseball-playing man, and he needed oxygen at the end of life (which, basically, was still a loong one).
    I have an aunt that probably weighs in at around three hundred, and she’s *not* diabetic (though she struggles with other health issues). Her daughter, my cousin, was always “the athlete” in the family — tall, lanky, skinny — while I was the chubby little bookworm, but she messed up her back, which started with an early injury, and in the meantime I learned about a strong core for dance, and weightlifting, and now I’m one of the last female athletes in the family (on the days I call myself that).

    This is a long-winded way of saying:
    You can have the best or the worst health habits in the world, but you can’t control it.
    We really can’t control what’s going to get us in the end.

    We fight that here in America, I think. It’s that Horatio Alger in charge of one’s destiny BS.

    All that’s true to a point, but you as a fellow WOC know — at least I think you do — that, especially in this country, you just can’t control every variable.

    And once you integrate that, and I mean truly integrate it, that brings more peace of mind — and therefore, less stress — to be able to deal well with the rest of the BS and do the best you can with what you have.

    (And that doesn’t mean I don’t still make desserts for family gatherings, even though I don’t eat it in my own house. I just use a lot of nut crusts, instead of white-flour-based things, and add Splenda if things need to be sweetened, which they don’t always. And at first I didn’t tell anyone, till they started asking me to bring those desserts. And then I told them. And they still always eat it all.)

    /rant

    Whew. That was a long one. I guess I’ve been holding that in awhile and didn’t know it.

    Anyway, I hope there’s something in it all that’s helpful.
    Take what you can, leave the rest.
    :-)

  63. Charlotte
    Charlotte September 8, 2010 at 7:23 pm |

    I really liked this. I especially appreciated how it pointed out that it’s really not about health but fatphobia, and it’s no one else’s business whether you’re “good-fat” or “bad-fat”. Because thin people who eat lots of junk food and don’t exercise much? Don’t have to deal with any of this. I say this as someone who sometimes falls into this category.

  64. Jadey
    Jadey September 8, 2010 at 7:56 pm |

    littlem,

    Thanks for referencing stress. There are so many different lines of arguments going on, it’s hard to address them all, and one that I feel like I’ve let slip by the wayside is one that should be very simple for all anti-oppression oriented people to understand: discrimination and oppression are harmful and deadly.

    Hatred, abuse, deliberate harm, denial of services, etc., and, yeah, basic stressful life conditions. Stigma isn’t just about hurt feelings, it’s about creating conditions destructive to life. Anti-obesity measures aren’t just misdirected, they are actively harmful. I’m honest to god too tired to type out another link right now (never thought I’d see the day), but some of the original research I linked to (general stuff on the Fat Nutritionist website for one) and other google-able stuff demonstrate empirically some of the ways in which fat stigma and discrimination makes life harder and more dangerous for fat people.

  65. littlem
    littlem September 8, 2010 at 8:04 pm |

    Here’s the deal: When I was underweight, I inhaled fucking donuts. I inhaled cake and sugar and pasta and chocolate chunk cookies and coffee. Yet according to the deathfat moralists, that was fine because I was “healthy”–I was thin. Too thin, actually, but what the hell, that was a gold star among some folks. Occasionally I’d get a warning–”Start eating right because that will catch up with you and you’ll be fat by middle age.” NOT “Start eating right or you’ll have a fucked up immune system and crappy health.” No. It’s “you’ll be FAT.” Which is apparently worse than actually being unhealthy.

    I’d submit this is also about gender and capitalist policing.

  66. littlem
    littlem September 8, 2010 at 8:07 pm |

    But continuing to list examples over and over doesn’t make it “data”

    @ Bagelsan –

    Why not?
    How else would you construct a qualitative sample size?

  67. Bagelsan
    Bagelsan September 8, 2010 at 8:58 pm |

    …so why do we care about the healthfulness of people except as a means of body policing? Kristen J.

    I’m kinda with shah8 on this aspect — statements like the above sound almost sociopathic (or, at the very least, cynical to the point of uselessness.) Really? There is no reason in your mind to care about the health of others except as a way to sneakily hurt them? And, what’s more, the answer to this question was just a paragraph above it:

    Your concern is better addressed as access to healthful options. If everyone in the world had access to healthful options (in all that the word “access” means), then those that prefer healthful options would make those selections.

    The “obesity epidemic”? The correlated upswing in rates of a lot of obesity-associated diseases? Are a big sign that an increasingly vast number of people are not able to access healthy options. Caring about “the healthfulness of people” is caring about that massive lack of access. It’s not body policing to say “Hey, are you alright? Hey, is our population doing okay? Are they ill? Why?” it’s medicine.

    Yes, along with genuine health concerns there is also body policing. But I can’t believe that some people see absolutely no difference between the two. If it’s now oppressive to give a crap about the well-being of anyone but ourselves, why do we even bother having science and medicine (and all of society)? Just because the medical profession often concerns itself with health in the wrong way (or the wrong people are in that profession to start with) doesn’t mean that we shouldn’t do it at all. If a doctor does not care about the “healthfulness” of her patient, she is a bad doctor.

    Individual to individual (with the possible exception of a doctor-patient relationship) saying “what’s it to you?” is absolutely correct — no one “owes” another person their own good health. And no, no individual “owes” society their good health. There is no moral imperative to be healthy. But society sure as hell “owes” good health to its individuals. And that’s the problem that the “obesity epidemic” highlights; society is not holding up its end.

  68. Living the Questions
    Living the Questions September 8, 2010 at 9:17 pm |

    Apologies for the long post.

    I’ve been thinking a lot about the statements in the thread that seem to protest that it’s necessary to find some way to talk about the health effects of weight.

    First, I wonder a lot about context: if this is a necessary conversation to have, okay, but where and when?

    Because many fat people can only hear that discussion in the context of the fat-shaming that we deal with daily. And in that context, the discussion of the health effects of fat can be absolutely ineffective in a positive way, and are often detrimental. In the news daily, in many television shows, in our workplaces, in our doctors offices, at family dinners, in gyms… we are told that our fat is unhealthy. I’ve never met a fat person who has not heard this message.

    This does not help me to find joy (and to make healthy choices, which do tend to give me more joy).

    What has helped me to find joy is avoiding those who criticize my body or warn me that my fat is dangerous. I have found joy by getting rid of my scale, refusing to engage in any discussions about dieting or about exercising for weight loss. I have found joy by moving my body in playful, productive, happy ways on hikes and kayaks and tennis courts, and by eating food that I have grown or procured at farmer’s markets and cooked, and sometimes by eating food that is mass-produced and marvelously crunchy and salty. By eliminating the idea of forbidden foods (which just leads many humans to make fetishes of those forbidden foods, anyway) and embracing a relationship with food that engages my creativity, gratitude, and taste buds.

    I can imagine that there are places where a nuanced discussion of the dangers of fat needs to be discussed. But I won’t trust those discussions until I sense that those conducting them are well aware of the tremendous role that fat stigma plays in our culture and in their own lives… until the scientists discuss the ways in which their own bias may affect the research. And the ways in which biased research or biased reporting about research can do serious harm. (The research might still be excellent… fine… but as long as we live in a fat-hating society, in which So Much Money is poured into studies about the danger of fat, I want to see scientists discussing openly the role that bias could play in their work.)

    One more thing: commenters up thread talked about 700 lb women dying and leaving their children. I don’t know any 700 lb women. But I do know a couple of women who weigh about 450 lbs or so… a big difference, but I believe what I’m about to write could apply. The women whom I know who weigh so much do not need information about diets. They have been expert dieters. Their metabolisms have been blown to smithereens by dieting, and by metabolic disorders. Approaching them with the sense that they need to learn how to eat would be cruel and condescending.

    The best way to help the very, very fat: respect them. Because generally, people won’t look at them, shout cruel things at them, mutter about them.

    Of course, this would mean that they goal really is to help; I doubt that it is, much of the time. I echo what others have said: many expressions of concern for folks’ health are just ways of judging virtue and vice. Where the concern is true concern and a desire to help, I recommend beginning with respect and curiosity and as few assumptions as possible.

    When I was a teenager, I had friends who were evangelicals, who believed that their job is to convert others to Christianity. When I was that young, my main way of voicing objection to this was that it did not seem loving to me to begin a relationship with someone with the assumption that I needed to change them. Building a relationship with someone means getting to know them, as they are, with curiosity and openness and with no need to change them. This seems analogous to me: it is condescending and rude to begin a relationship with a fat person with the assumption that you need to educate or change them. Begin with curiosity: what can I learn from this person? A far more respectful approach.

    And I dare say that it’s much less stressful… much healthier… to have strangers respect us than to have them ready to educate us.

    So long as fat people live in such a toxic environment, discussions of the health effects of fat are very, very tricky: insisting that they must be had, without understanding that context is hugely important, is misguided.

  69. shah8
    shah8 September 8, 2010 at 9:29 pm |

    Huh, a couple of things… Bagelson sez it nice and sharp as a tack instead of my meandering and obtuse habits.

    second, it was Kirsten J and not Kira that I meant to mention at post 54, sorry Kira.

  70. Aunt B.
    Aunt B. September 8, 2010 at 9:54 pm |

    Bagelsan, it’s like you say. The medical profession often concerns itself with health in the wrong way. What you’re hearing on these threads? Are the voices of the people who have been at the painful ends of those wrong ways.

    It does make no sense for someone who has met maybe one bad apple in the healthcare profession to reject discussions about health. But go back and look at what people are saying–about how they’ve been repeatedly harmed by healthcare providers because of their weight.

    I had a gynecologist wait until he had his hand inside me to tell me that God doesn’t want fat women to have babies (to make a long story short). It took almost ten years and and a major medical event before the fear of not going to the gynecologist outweighed the fear of going and I met my current doctor. I had to write her a note about why I was there and what my previous experiences were, because I wasn’t sure I could get through the initial consultation without sobbing incoherently (and, in fact, i couldn’t).

    So, what I would ask you folks who are asking “But why can’t we talk about health without people going all crazy about it?” is that, in part, you’re dealing with people who have experienced a lot of trauma around this very issue. And it’s hard to talk about the trauma you’ve been through in a dispassionate way. Plus the language with which your trauma was explained away was “for your health.” The same language people want to use and be trusted as not meaning harm is the same language used to justify harm.

    I agree that society is not holding up its end of the bargain to provide us with a healthy environment to live in (whether or not we choose to partake in that).

    But the health care professions have, to put it mildly, let a lot of us down. Just as another illustration, yesterday my local paper (The Tennessean) ran a story about how fat women give birth to fat babies and what a shame this is and how doctors say mothers need to do more to prevent this. As if fat women alone are the cause and sole responsible party for fat children.

    I live in a state where many counties don’t even have doctors and where a lot of people get almost all of their healthcare from the emergency room (where they are treated as you’d expect people who clutter the emergency room with non-emergencies are treated), where women of color were sterilized against their will and often without their knowledge as late as within my lifetime (there are certainly women my age whose mothers or aunts or grandmothers have experienced this), and where the infant mortality rate in Memphis is a national shame (and where it’s 25-30% in some of our rural counties in a bad year).

    The level of trust between women and healthcare professionals is very low, as it is. I don’t think that’s just here in Tennessee.

    And yet, I don’t think that’s really acknowledged in these discussions. We talk through it, like “Oh, some folks suck, but I am concerned about health.”

    But the people who broke our trust claimed that they were concerned about our health, too.

    These conversations are hard to have and the positions people take seem strange and defensive and inexplicable because, in part, some very bad stuff has gone down and people are defensive.

    I know folks probably intrinsically get that, but I just wanted to articulate it.

  71. Roschelle
    Roschelle September 8, 2010 at 10:51 pm |

    Whit: I’m also a WOC healthcare worker. I’m fat. Fat, fat fat fat fat. My thin, clinically underweight grandfather died of CKD (chronic kidney disease), congestive heart failure, and pnuemonia (had a 2 ppd history of smoking for 60 of his 72 years). My cholesterol, blood pressure, fasting glucose, heart rate, pOx, and so on are FANTASTIC. Please look at any number of research papers on the subject like this one or this one, or THIS ONE. (Quote this comment?)

    and i’m glad to hear all of that! i didn’t say being obese or fat fat fat fat was a definitive cause of any of these problems. i think i even mentioned the fact that these illnesses can affect those viewed by society as “thin” or maintain an “ideal body weight” – whatever that means.

  72. Kristen J.
    Kristen J. September 8, 2010 at 11:34 pm |

    Bagelsan: There is no reason in your mind to care about the health of others except as a way to sneakily hurt them?

    No. There is no reason to “share” your view of someone else’s healthfulness. Do you “share” your concerns over some stranger’s career choices? Do you “share” your concerns over the inappropriate literature someone reads? Do you “share” your concerns over the dating relationships a stranger is engaged in? Why not?

    Empathy requires accepting someone as they are…not in expressing your concern that they are living their lives wrong.

    Like Miss S. you are conflating concern over access to healthful alternatives with concern over a specific person’s level of health. I want everyone to have access to healthful choices. I may express concern that there aren’t fresh nutritious foods available to everyone or that not everyone has access to appropriate medical care. But I will not tell a particular woman that she needs to exercise more. See the difference?

  73. Miss S
    Miss S September 9, 2010 at 12:00 am |

    The bodily autonomy issue is critical here

    Yes, of course it is. Treating people with respect and allowing people to make decisions for their bodies is something that medical professions should do. Disregarding research to protect feelings isn’t. Why isn’t this clear? Everyone, regardless of race, size, gender, etc deserves respect from the medical community. I don’t think anyone ever suggested that we don’t. But pointing out that obesity leads to health complications isn’t being disrespectful. Medical professionals are supposed give medical advice. It’s their job.

    If a person is obese and unhealthy because they don’t have access to healthy foods, then let’s find solutions for that. If a person is obese because they are depressed, let’s make sure that people have access to mental health providers. If a person is obese because they eat a lot because of poor self esteem, let’s make sure that person also has access to mental health providers.

    NO ONE thinks that doctors should call their patients fatty and send them away. Or laugh at them or do anything else disrespectful and hurtful. I’m saying that yes, someone else’s health is our problem. Dumping toxic waste in ghettos should be an issue that we all give a shit about. Women dying frequently in this country due to childbirth should be an issue that we all give a shit about. But no. Everyone has decided, as Shah8 said, to be Libertarian for a fucking day.

  74. Miss S
    Miss S September 9, 2010 at 12:01 am |

    Bagelsan- I think that comment was directed at me, but thank you. I didn’t even know what to say to that.

  75. Miss S
    Miss S September 9, 2010 at 12:23 am |

    Also, can we acknowledge that the food we consume matters? This is more than about your dress size. It’s about the food that our society consumes and our government subsidizes. That should matter to all of us too.

  76. denelian
    denelian September 9, 2010 at 5:47 am |

    i just cheer.

    and now i’m going back to work on this complaint. against a doctor who has WATCHED me become overweight as i LOST MOBILITY [i now can walk to the bathroom – the kitchen? it’s too far away. else where, it’s that damned wheelchair or i CAN’T] and who KNOWS A) i not only am not “eating doughnuts”, because i have 3 Ensures[150 calories apiece], 2 chocolate milks [100 calories apiece] and 2 Pepsi’s [300 calories apiece, and this one is a PROCESS, i’m down from FIVE a day] and water. and that’s ALL i have a day [the meds make it impossible to eat – hell, sometimes even the Ensure is too much, and it HURTS] and B) i can’t “go do areobic exercise” but i DO do what i can – this doctor, who KNOWS BETTER, is now trying to say “just lose weight and all that nerve damage will disappear!” and is doing NOTHING to help. no, really, her answer to EVERYTHING is now “lose weight”. even though it was THESE THINGS that CAUSES me to gain it!
    i need sleep meds – “if you’d just lose weight, you’re body would restore it’s natural metabolism and then you’d sleep properly.”
    CHRONIC OMG! 8+ pain, all the time, mostly neural now: “if you’d only lose weight and put less stress on your body…” “But, look, DOCTOR, i hurt this much TO BEGIN WITH! i don’t hurt MORE now that i’ve gained 30 pounds and become “overweight!”” “tsk. lose weight and it will all be better”

    it doesn’t matter the problem – sleep, pain from nerve damage, fibro, rhematory arthritis, acute porphyrin attack – and can i just freaking note that the best way to AVOID porphyrin attacks is to be a bit overweight, and the best way to STOP them [before they get to the point of needing HEME] is consuming MASSIVE quantities of sugar?
    also; migrains, SADD [because, ya know, porphyria = bad with sunlight, so i get to have SADD all the time], PTSD, depression, carple tunnel, and my vision.

    i hate this doctor now, but i have to convince Medicaid to let me switch, so instead of just firing her, i’m writing this THIRD complaint.

    *sob*

    the worst bit is? not only is SHE overweight [look, i’m 5’8″ and i now weigh 205 – she’s at LEAST 4 inches shorter than i am, and when i hit 195 joked about how we were “weight twins”] but her HUSBAND is *HUGE*. and so is my dad, another of her patients – and, while she does go out of her way to tell him to lose weight every appointment, she doesn’t nagnagnagnag him – and he DOES have diabetes and high blood pressure and high cholesterol. it’s generally one of the last things she says “so i’m giving you this new Rx, stop that other one, and try to lose 20 pounds” and my dad says “i’m trying, no one wants it and it’s not legal to just dump it, it’s toxic waste” and she LAUGHS and says goodbye. [EVERY VISIT they have this conversation! WORD FOR WORD]

    *sob* back to writing…

  77. denelian
    denelian September 9, 2010 at 5:51 am |

    i lost a line, above. the point with say my dad has “diabetes and etc”, is that i DON’T. in fact, i’m hypoglycemic [and have scared this doctor with how low my blood sugar is] my normal BP is something like 110/70, and everything else is perfect-more-than-perfect, according to their tests. but *I* get bullied and ignored and mistreated because i gained 30 because of extreme chronic pain, and he get an off-hand “oh, yeah, lose some weight see ya later”. *sob*

    i’m having a cry-ing day. sorry.

  78. Sheelzebub
    Sheelzebub September 9, 2010 at 8:58 am |

    Actually, I don’t think this “concern for health” is genuine in a lot of cases. I think it’s a way to engage in a moral panic and feel terribly righteous in comparison to Those People. It’s a trend of shaming, and some of the OP’s and commenters’ own experiences with medical professionals bear this out. When a doctor refuses to look beyond your weight and just decides that That is What’s Wrong With You, they are actually endangering you.

    I’ve seen–even on this blog, in unrelated threads–self-righteous condemnations of the lazy, unwashed and impure plebes who suck down fast food and feed it to their kids rather than making fresh, healthy meals from scratch. And when you point out things such as the grocery gap, food deserts, the obstacles the poor face in being able to do such things, the refrain is the same: But it’s all about individual choices! These people could do it if they only tried! I don’t make a lot of money and I/i> do it! Excuses and whining!

    Facing up to structural problems, and the need for structural solutions kinda kills the joy in feeling superior. And let’s face it, anyone who agreed that structural problems need structural solutions would not be so inclined to trot out the straw fatty or straw consumerist (or straw slut or straw mama or whatever).

    I have yet to hear anyone who promotes HAES or who speaks out against anti-fat hatred say that eradicating food deserts, making healthful food more accessible, and making physical activity more accessible (safer, more walkable cities and towns, etc.) is somehow a bad thing. I can’t think of one person who has come out against structural solutions to a structural problem. They are coming out against the shaming, the disrespect, and the nasty assumptions that are made about fat people.

    And yes, they are troubled by the “good fatty” vs. “bad fatty.” You can be simultaneously for structural solutions and still not like the moral panic and unspoken demand for permission to exist. The same way I’m troubled (and frankly sick to fucking death of) the “good abortion” (she’s a married mom who was assaulted and has cancer which will kill her if she doesn’t have an abortion) and the “bad abortion” (slut doesn’t even use birth control!). Most people fall somewhere in the middle; very few of us make stellar choices all the time, and very few of us eat fucking Big Macs and donuts for breakfast, lunch and dinner.

    And you know? I would no more deny humanity or respect to the people who choices that I don’t agree with than I would go swimming in a shark tank with raw steaks stapled to my ass. This kind of thinking degrades the targets (and yes, you do tend to feel like there’s a fucking bull’s eye painted on your back)–I shouldn’t have to explain myself to fucking strangers, thankyouverymuch. I shouldn’t need their goddamn approval or have to deal with their condemnation.

    I don’t have to like someone’s choices, but here’s the thing–they are actually none of my goddamn business. That isn’t sociopathic. That’s just realistic. We, as a society, need to make access to the tools and resources all of us need to make the best lives for ourselves we can; on an individual level, we need to STFU and worry about our own damn lives and not about that fatty over there or that slut next door or that smoker down the street or that dude who likes his beer and lets his freak flag fly.

    The thing is, we are looking at fat people and creating a moral panic over someone’s perceived individual choices–and backing people into a corner into explaining why they’re fat. Who gives a fuck? It’s not my business, or yours, or anyone else’s. Individual “choices” aren’t made in a vacuum; it’s not as if outside factors don’t affect those “choices,” which are sometimes not choices at all. And yes, at the end of the day, people do have the right to eat what they want and how they want to. Just like they have the right to smoke, drink, take up risky hobbies like mountain climbing or cage fighting, or have unprotected sex. The difference is, we as a culture are quick to condemn fat people for the choices we assumed they made, and often overlook other reckless behaviors and habits.

    And again, I’ll point out–I’m thin, and was downright underweight (a BMI of 17 or so) up until I was in my mid-twenties. My habits and my choices were atrocious, but I heard nary a peep from anyone about what I should eat or how much I should exercise. It didn’t matter because I was thin. So I do tend to think that the societal story that this anti-fat feeling is really about health is just so much horseshit.

  79. withoutscene
    withoutscene September 9, 2010 at 10:33 am |

    This post is most of everything I say ever (when arguing about fat), just written by another person…institutional arguments included. Yes! Yes! Yes!

  80. Sarah
    Sarah September 9, 2010 at 11:10 am |

    Great article and great comments, first of all.

    @ Alara Rogers: those environmental toxins exist and are called phthalates, they’re found in all kinds of plastic stuff. http://www.eurekalert.org/pub_releases/2007-03/uorm-pnl031407.php

    @Paraxeni: thank you for your response in particular, it brought up what to me is the best correlation in the medical world for how fat people are treated: the issue of mental health. I am not fat. But I am disgusted by all the moral policing of fat people that goes on in the name of “health”, because I’ve been forced to take drugs and stay in a hospital where I was miserable, all so some doctor could feel he was helping to improve my “mental health”. The situations aren’t exactly comparable; “mentally-ill” people aren’t shamed about their condition the way fat people are, and nobody takes away obese people in ambulances and forces them into hospitals, but what we have in common is that certain “healthy” people feel entitled to force us to “get well”, regardless of whether the prescribed diets or mood-altering drugs actually make us thinner or healthier or happier. I don’t have much sympathy for the “concern” argument. Shaming me about my “health” or forcing me to do what you consider “healthy” is not an expression of concern. You’re not willing to be a genuine friend to me, so your “concern” rings hollow.

  81. konkonsn
    konkonsn September 9, 2010 at 1:01 pm |

    Not much I can contribute that hasn’t been said, but all the discussion in this thread made me think of a question that could perhaps be answered by someone with more knowledge (perhaps in another post or on another blog so as not to derail this thread):

    My (undergrad) college had a program with a university in Japan where about 25 of their students would come over for one month, learn a bit about America, get some abroad experience. We also had one or two exchange students from the same college a semester (we were a small school). In my interactions, EVERY year, the girls and a few boys would worry about “getting fat” while in America. Invariably, tho they spent a short time here, their relatives would comment about how much bigger they looked once they got back to Japan. One girl was my roommate for a semester, and this was her chief discussion with her parents on the phone.

    To be fair, I visited some of these people abroad, and the ones that were already “skinny” (only two or three in a group, mind you; the stereotype of Japanese people all being waifs is not true, especially considering various sub-cultures and regions) did look a bit thinner in their home country. Of course, my American standards of weight said, “Whoa, that’s too thin!” but all the girls ate plenty, so it just seemed like a difference in expectations. The rest didn’t seem to change at all even though they went on at length about how much healthier the food back home was.

    Of course, we’re talking college students, here, mostly from the Kansai region, none of which seemed to have too many money issues (not that they would have let me know if they were). When I visited Okinawa, I noticed a different standard of body type, and wonder what their expectations would have been considering the culture and American presence there.

    So, after that tangent, I guess I’m wondering how the discourse should work on a global scale, with our interactions with other countries and with the people that come to America with the stereotype that we will all be fat and that they will get fat coming here (huge topic, I know, but if anyone wants that challenge).

  82. Heidi
    Heidi September 9, 2010 at 1:51 pm |

    Living the Questions: One more thing: commenters up thread talked about 700 lb women dying and leaving their children. I don’t know any 700 lb women. But I do know a couple of women who weigh about 450 lbs or so… a big difference, but I believe what I’m about to write could apply. The women whom I know who weigh so much do not need information about diets. They have been expert dieters. Their metabolisms have been blown to smithereens by dieting, and by metabolic disorders. Approaching them with the sense that they need to learn how to eat would be cruel and condescending.

    This is beautifully and marvelously said. I don’t know what I weigh. 300? 325? I haven’t weighed myself in seven years, except for the purposes of being medicated at the correct dose (steroids for a non-weight-related autoimmune vasculitic rash) and I spent the years from age 10 to age 25 constantly dieting, mostly on Weight Watchers but also on some pretty wacky methods (acupuncture, liquid fasts, etc.). I *know* about nutrition. I know how big a portion is (meat = your palm! carbs = your fist!) and I promise you, no nutritionist could possibly educate me more on lean sources of protein, “healthy” fats, etc. I know about all of those things.

    In those fifteen years, however, I damaged my metabolism and changed my body’s set point. I remember, in high school, that even when I stopped dieting, I never went above 175 lbs. Ever. After years of dieting, my set point shifted upward and I developed compulsive overeating disorder, for which I have received help from both a therapist and a wonderful nutritionist.

    So. When people tell me that I’m OMG MORBIDLY OBESE! and going to die and leave my child motherless, what do I do? I can either accept the size I am and work to become more fit and healthy (if that’s my goal – and I’m certainly not implying that I have any moral obligation to do that), or I can go back to dieting, end up even fatter and more metabolically-damaged than I am now, along with teaching my son how his mother is self-loathing and has lost all joy in life in favor of the obscene sense of control that comes when I “indulge” in the sin of extreme calorie-counting and food obsession.

    Yes, it is an indulgence for me to diet. It is obscene, because it is a self-obsession that goes far beyond anything else I could possibly do in my life – it takes over EVERYTHING and it sucks every moment of joy out of my existence. I am NOT a good person to be around when I diet.

    So.

    Joyful, self-embracing mother learning to enjoy movement, or self-obsessed, self-hating mother?

    I can guarantee you, my son would appreciate the second option far, far less, even on the off chance that it led me to live a longer life. Part of my FA journey and my HAES choices comes in large part because I am a better mother when I live the way I do now.

  83. Heather
    Heather September 9, 2010 at 2:14 pm |

    ” He did that when he shrugged me and my symptoms off for four years (constant severe headache, seizures, sight loss, permanent nerve damage in limbs, vomiting and losing consciousness on a daily basis)”

    Ladies (and gentlemen if there are any): If you have unexplained seizures, sight loss or loss of consciousness, you should head to the hospital. Immediately. Call 911 (or whatever the emergency number is where you live.) Have someone take you, call a taxi, whatever. Just get there and don’t try to drive yourself.
    Those can be symptoms of some very serious problems. This doctor should lose his license for incompetence. Those are *not* symptoms that one should wait a few days or weeks to see the doctor about. And certainly not ones that should have been allowed to continue for years.

  84. Brio
    Brio September 9, 2010 at 2:22 pm |

    “Second, what the hell is the fat person supposed to do about their weight on the spot, anyhow?”

    Thank you. Just thank you for saying this. I wondered that every day of my freshman year of college, surrounded by thin, bright-eyed co-eds, while I starvation dieted and exercised daily. It was a ridiculous endeavor and have since stopped trying to be a size and have become more in tune with my own body.

  85. Zoe
    Zoe September 9, 2010 at 2:29 pm |

    Thanks so much for this, what an excellent article! There *are* some doctors who are not fat phobic, sometimes hard to find. My partner is quite heavy & her numbers (cholesterol, blood pressure, blood sugar) are great – she has excellent genes. I’ve also known some very thin people with very high cholesterol problems, but as you say people make all kinds of assumptions based on the way we look.

  86. Kristen J.
    Kristen J. September 9, 2010 at 2:32 pm |

    Miss S: But pointing out that obesity leads to health complications isn’t being disrespectful. Medical professionals are supposed give medical advice. It’s their job.

    Right. Except that the OP and others have pointed out that this doesn’t happen. That doctors will blame completely unrelated things on weight just to pressure and shame someone into losing weight. Moreover, here and elsewhere the information on correlations between weight and health is not presented in a vacuum. Those that believe fat people should just “put down the donuts”, some of whom are medical professionals and medical researchers, will skew the risks in order to make fat people feel pressure and shame. So, in short…who can they trust?

    Miss S: I’m saying that yes, someone else’s health is our problem. Dumping toxic waste in ghettos should be an issue that we all give a shit about. Women dying frequently in this country due to childbirth should be an issue that we all give a shit about. But no. Everyone has decided, as Shah8 said, to be Libertarian for a fucking day. Miss S

    As I said above, you’re conflating structural issues with individual issues. Try this on. What if you had two imaginary people with every option/luck in the world for healthfulness, the best food, the best medical care including mental health services, a clean environment, etc and each person preferred to eat McDonald’s every single day. The only difference between these two individuals is that one is “normal” weight and the other is obese.

    (1) Do you think you would perceive their healthiness differently? Do you think medical doctors would?
    (2) Should you, a complete stranger, be “concerned” with their health? If so, what forms the basis of this concern?

    As for being libertarian…that’s a laugh…I had no idea that the only people who didn’t engage in shaming were libertarian.

  87. shah8
    shah8 September 9, 2010 at 2:37 pm |

    I consider fat-phobia important in the scheme of dealing with the obesity problem in general. Outside of that context?

    Not.Important.At.All.

    Why?

    Because the consequences of fat-phobia is literally dwarfed by the complications of obesity. Being truly obese means being disabled, and it can mean being as disabled as people with a bad heart. People are locked in their homes/rooms by their own bodies. People can’t do the things that might make them happy if it requires much moving–even to get up and walk to the stoop in the porch or in the garden might require a whole bunch of “Do I *really* wanna?” questions that people shouldn’t have to answer. Not only are they locked in their bodies, their bodies are often painful with bad joints and poor circulation with limbs going to sleep all the time. This is not even going to all the degenerative diseases that can accompany serious obesity. Obesity of this nature almost *never* comes from personal choice. Either a serious preexisting health or societal problem existed that *removes* control from the individual. That’s why I get pissed at the trivial assertions of “autonomy”. It’s deeply offensive. About the only way many people have ever been able to fix morbid obesity with any sort of predictable success is stomach stapling which costs money and has its own serious problems. It’s not safe to lose that sort of weight with the 2x, 3x, 4x, the speed the weight was put on.

    In effect, obesity is much, much, MUCH like heart disease, diabetes, and other diseases where the only real palliative is PREVENTING IT. That requires coercive actions by the state, and do you know what? It’s mostly coercive actions that forces capitalist actors *to give the space in time and resources to care about their bodies*. Nobody has this sort of trouble advocating for maternal leave, children’s health care, wider access to daycare–even though, well, People discriminate against people, even little children, on the basis of bad teeth, unfashionable clothing, and inability to participate in social events FAR FAR FAR MORE than they discriminate against fat people. Bad teeth phobia is a far greater problem than fat-phobia, we just don’t acknowledge it or the people victimized.

    But sure as shit, when the doctor treat you as the wrong social class because you’re “overweight”, you squawk. You’re supposed to. That makes it safer for me as a minority to use that same doctor. But you squawk against BAD DOCTORS and not the overweight phenomenon itself. Just about all doctors, especially the young ones, know that serious obesity is quite a few more pounds and mms on those calipers (doctors use *those* to tell if you have a body fat problem) than the media environment would have you believe. Fat phobia as engendered by the media to promote a sense of vulnerableness so marketers can sell sell sell is a key issue. Marketing “science” made popular by acai berries is the culprit, not real science. It might be a great psychological defense mechanism to pretend your “obesity” isn’t actually a problem, but you might not *have* a serious problem, and if you do, denial is not a fucking river in Egypt!

  88. Sarah
    Sarah September 9, 2010 at 4:09 pm |

    One more thing to add: the whole moral policing that goes on around fat is counterproductive anyway. Just as being locked up in a hospital often leaves the “patient” more homicidal and suicidal than when he or she came in and with serious trust issues to boot, so being shamed for being fat can end up making the person on the receiving end feel miserable and worthless, an unpleasant feeling that can temporarily be relieved by…binge eating!

  89. tinfoil hattie
    tinfoil hattie September 9, 2010 at 4:23 pm |

    When mamas are dying at your workplace from sudden heart attacks and leaving little kids to the vagaries of aunts and uncles, you might tend to be extremely unsympathetic to people who go past the anti-fat-phobia into denialist territory.

    Goodness! How many mamas have died at your workplace?

  90. Stephanie
    Stephanie September 9, 2010 at 5:33 pm |

    It’s very odd that FA activists, who would prefer a focus on structural problems and structural solutions to health issues rather than on the alleged failings of individuals, are being labeled the libertarians in this discussion.

    I actually don’t think that those who care about the health of the population of a whole are necessarily concern trolling. I think some are, but others genuinely feel as though “fighting obesity” is equivalent to addressing the issue of toxins in our drinking water, and that both issues should be assigned the same moral weight (oy, pun definitely not intended).

    To those people, I’d request that you briefly entertain the idea that it might be possible to decouple weight and health. Just hypothetically, for the purposes of this discussion. If we wanted to help people live healthier lives without ever asking anyone to step on a scale, how would we do it?

    The answers are practically a cliché at this point: improve access to fresh and healthy food, restructure our communities to encourage walking and other physical activity, address food subsidies, reduce working hours to allow people the time and energy to cook meals and be active in a way that’s enjoyable for them, etc. (Incidentally, these are the same things we’d do to “fight obesity,” too, so it seems that everyone should be happy with this approach.)

    So let’s assume we’ve tackled these issues and are starting to see the benefits: lower blood pressure, lower cholesterol, better aerobic fitness, reduced rates of diabetes and heart disease, you name it. In other words, people are just healthier now.

    If you’re right that obesity and health are inextricably linked (i.e. that obesity is inherently unhealthy for most people), a healthier population will also, by necessity, be a thinner population. Hooray! We’re skinny now and we didn’t even need to try to lose weight! It just happened automatically while we were busy getting healthy. Mission accomplished!

    If you’re wrong, a healthier population will be a population which is just about as fat as it is now. Hooray! We’re healthier now and we didn’t even need to try to lose weight! We’re not skinny, but who cares? Our goal was to get healthy. Mission accomplished!

    Can anyone give a single reason for why we should be dusting off the scales after all? Because I just don’t see how anyone stands to benefit from that. Well, anyone except the diet industry, dudes who whine that fat chicks kill their boners, and concern trolls, that is.

  91. shah8
    shah8 September 9, 2010 at 5:33 pm |

    One was enough. The IRS is much more accommodating of people with health problems and disabilities and frankly, just weird people altogether. There is a pretty big pool of women who have to regularly use their sick days because of chronic health issues, and some that need to use the resources like the wheelchair that’s in the luncheon. I’m certainly not saying that they all suffered from obesity–it’s just one of a number of problem that urban women suffer from. Allergies and asthma are also life-complicating issues here as well.

    How about I state this another way:

    Malnutrition is a weapon that is used by an urban elite to control urban plebians, often consciously. When I think about obesity, I’m just not talking about middle-class middle aged spread. I’m talking about systematic denial of resources except the ones provided–often malign gifting, and prohibatory legal framework (German for them, Anglo for us) that prevents self-initiative and promotes turbulence that stops anyone that gets going.

  92. Lu
    Lu September 9, 2010 at 5:40 pm |

    To be fair, I visited some of these people abroad, and the ones that were already “skinny” (only two or three in a group, mind you; the stereotype of Japanese people all being waifs is not true, especially considering various sub-cultures and regions) did look a bit thinner in their home country. Of course, my American standards of weight said, “Whoa, that’s too thin!” but all the girls ate plenty, so it just seemed like a difference in expectations. The rest didn’t seem to change at all even though they went on at length about how much healthier the food back home was.

    konkonsn, I’m not sure I get what you’re saying here. They ate “plenty” while in Japan, or in America, and what was their perceived relative “skinniness” in each place?

    I’m not trying to make trouble here; I’m trying to understand your point. Thanks.

  93. trishka
    trishka September 9, 2010 at 5:56 pm |

    thanks, for this post, zuzu, and the subsequent comments. it has given me a lot to think about.

    i admit i’m feeling a little stuck and confused about the divide between caring about everyone having access to tools that will lead to good health (YAY!) and caring about people’s health (BOO! FUCK OFF!). i mean, is this just about looking at it from a macro- vs. micro- scale?

    because, on a macro- level, i don’t feel like i can disconnect the desire for access from the desire for better health for our populace, even though i realise that not everyone will take advantage of the tools. fine. and that doesn’t mean extending it to individuals in the form of fat-shaming either. (though other people certainly do this).

    to me, the eradication of food deserts, access to healthy foods, the ending of subsidies to the corn and soybean industries, building walkable and bikable communities – these are all things i advocate for, for the same reason i called my congressman and senator and told them to vote for healthcare reform. because i want to see people have better tools – because i care about our society as a whole.

    like not wanting to see toxic waste dumped in ghettos – if i didn’t care about people’s health, why would i care? why would i work to promote environmental justice? (which i do, in my free time).

    one can care about people’s health without applying it as a justification for shaming an individual. and i do hear about all the negative experiences so many have had, and why this is such a touchy subject.

    so i’m not saying i care about YOUR health, zuzu or , in so much as i care about the overall general health of all americans (a group of which you are a member) – which would likely improve if access to healthier lifestyle choices were expanded. though, you, zuzu or might not experience increased health and very likely would not lose weight as a result.

    but the “what’s it to you” and “fuckity fuck fuck off” stuff is like, well, remind me again why i work to promote new urbanism land use planning that promote walkable communities?

  94. shah8
    shah8 September 9, 2010 at 6:38 pm |

    Stephanie

    You’re making an implicit argument that:

    1) Public Health Officials and Public Intellectuals should lie to the public because of the actions of malevolent third parties like doctors engaging in malpractice, markerters hyping up the idea that 5lbs too much will kill ya, and your evil family members relentlessly concern trolls you about your declasse appearance.

    2) We should run this big experiment where lots of people are essentially experimented on with no control group because obviously with a little ideologically-based tinkering, things will be better in no time, and if it doesn’t work out? It still proves my point.

    Look, I’m used to this. I get this kind of don’t bother me with the facts shell game style from glibertarians all the time (the usual class is more important than race canard, with the added you’re really a Carlton verbal slap). They are typically ignorant of the fact that this has happened already. If you want, you can read classics of the genre by Hernando De Soto. However, the bottom line is, we can’t actually proceed with changing the reality whether that be obesity of fat-shaming or both without acknowledging the truths that has to be the bedrock of any discussion. If you want instead, you could read MLK’s Letters from the Birmingham Jail–he dealt with the exact same stupidity that’s going on in this thread. No one deserves having to shelter some middle-class fee-fees out of their reduced options while we in the public debates have to do lumbering arguments that dodges central truths.

  95. Bagelsan
    Bagelsan September 9, 2010 at 7:44 pm |

    Stephanie @ 85: I’m pretty much 100% in agreement with your 6th and 7th paragraphs — I would personally be totally stoked with either of those outcomes.

    As for your last paragraph, I think that weights are useful sort of in the same way the national census is; it can give you valuable info about what is going on with populations, how demographics are changing over time, which sub-populations might need certain services, etc. Tracking groups of weights/BMIs/whatever could be a good stat to follow, along with tracking population-wide changes in cardiac health/BP/diabetes/whatev — even if only to prove that weights don’t go down with health going up, as in your second scenario. :)

    But, I can’t emphasize enough, I really see most of the value as a population descriptor — looking at the weight of a single person seems much less helpful (aside from dramatic weight changes that might signal a health problem, obvs.) To continue my census parallel, I think that measuring things like the “browning” of children in the US is a valuable thing to do, but the problem is in keeping the moral panic out of it (“OMG teh whites R dying out!”) and keeping the individualism* out of it (“OMG, you adorable brown baby, you are personally the problem here!”)

    Which, uh…easier said than done? I’m a big fan of medicine and science and all but damn do they fuck up sometimes…

    *Which, I suppose, might be part of the problem. American individualism — thinking of ourselves as an interdependent collective is socialism, dammit! — really encourages people to zero in on the “bad ones” as if they were wholly separate entities from the rest of society, rather than be like “alright y’all, people are unhealthy, how’d we all fuck up this time?”

  96. Bagelsan
    Bagelsan September 9, 2010 at 8:04 pm |

    (Um, to be really clear: I think that the browning of American children != a problem. My sentence there was getting a little convoluted, so I wanted to clarify. :p)

  97. smmo
    smmo September 9, 2010 at 8:09 pm |

    IrishUp: There is a misconception that (western) medicine understands nutrition and metabolism. We do not; the understanding of human physiology at this level is in it’s infancy. We’re good at surgery- anatomical studies are thousands of years old. We understand discrete pathologies – like solid tumor cancers – pretty well. But our atomistic approach to nutrition is inherently flawed, and impedes our understanding in this realm. Your regular US trained GP got maybe MAYBE 5hrs totalspecifically in nutrition. (My understanding of UK training is that it’s not much different). That is how come a Dr. can recommend a calorie level 40% BELOW what the WHO has established as starvation level – 800kcal/day. 800kcal/d is considered insufficient to support health and life over a prolonged period. But stories of MDs and even RDs telling people to eat such levels ABOUND.The problem that always crops up is discussions of the ZOMGOBESITYEPIDEMIC BOOGABOOGA is too much conflation of human rights, public health, and workable solutions. Each is very important, but they must be separated out in order to respect their importance.See, we’re not talking about THINGS, we’re talking about actual, valuable, lovable and loving human beings. Each human being has an equal claim to the same basic human and civil rights. Full fucking stop. Discrimination and violence visited on any person is wrong. Full fucking stop. Shaming and bullying and putting people at economic disadvantage are all serious forms of violence.
    So, there is no Yeahbuts to be had here.Ok, next is the public health end. Violence visited on people is life-threatening and life shortening. The stress of discrimination, poverty, class disadvantage, et cetera ad nauseum are ALL BY THEMSELVES known CAUSES – not correlations!!!!!!! of early morbidity and mortality. So, fat shaming and discrimination have no fucking roll in any discussion of public health.
    Generally speaking, people have a genetic set point that has a 10-20lb range – ABSENT any other kinds of stressors like meds, diseases, etc –and varies over time and with developmental stage. The real number of the populational difference associated with the ZOMGOBESITYEPIDEMIC BOOGABOOGA? 15lbs average. So, what we’re really talking about is that as a population, we’ve drifted towards the top of our natural ranges. And is that so surprising in our current culture?
    Now, besides that fact that preponderance of the primary literature does not show a causal roll of fat and disease, TONS (har!) of data support that weight GAIN is much more likely to be SECONDARY to underlying disease processes, than the CAUSE. But, humans are systems. So what often happens is a vicious cycle like this: underlying disease –> weight gain —> reduction in health preserving behaviors*/increase in health reducing perturbations to the system* –> further exacerbation of disease –> further weight gain …… It’s a cycle and a system that can get entered at any point.Lastly, on the public health side is that the preponderance of the evidence supports that the things we do to effect weight loss – bariatric surgery and dieting – ARE IN FACT PRIMARY CAUSES OF DISEASE AND DEATH. Bariatric surgeries have morbidity and mortality rates that EXCEED cardiac surgery. Believe me, if a hospital’s cardiac surgery had the mortality rate that bariatrics does? The state DPH would have it SHUT DOWN in a week. And bariatric patients are younger and healthier at baseline. After all, cardiac surgery patients are in their mid-sixties with heart disease. Diets are the gateway drug to Eds – >80% of ED sufferers dieted, and >5% of the population has an ED, compared to <1% being in the morbidly obese group with similar risk of early mortality from the last NHANES study. Diets cause kidney failure, osteopenia, osteoporosis, GI and dermatologic complications, among other complications. OH, and they CAUSE WEIGHT GAIN.
    Shorter me: shaming is wrong, fat is not bad, human health is complicated, diets harm people but make BigPharm rich.
    Fucking stop with the donut shit.
    Unless you’re gonna pass me a hot-buttered-baby-flavored one. Then I’ll take two – they’re small.*NOT due to people choosing to not be healthy (though yes, sometimes it is) but often due to things like new physical limitations,loss of employment, medications, change of life issues, etc.  

    This thread is amazing and this comment in particular, IrishUp. There is a shitload of money to be made off TEH OBESITY EPIDEMIC OMG!!! PANIC. Capitalism for the win, as always.

    I’ve been pretty fortunate with doctors, because I’m middle class and have enjoyed good health, but we fatties always know when a doctor is disgusted by our bodies. I suspect my fancy headache doctor is upping my fancy headache medicine dosage because one of its side affects is appetite suppression. She also doesn’t look at me. She also says migraines are related to – wait for it – obesity. Duh duh DUN.

  98. pocochina
    pocochina September 9, 2010 at 8:14 pm |

    @Miss S

    Miss S: If a person is obese because they are depressed, let’s make sure that people have access to mental health providers

    I really applaud the health-positive ideas you are expressing in your comment, but I want to step in and clarify a few things for folks who are not so familiar with mental health issues.* I don’t mean to jump on you, just to draw out what I think is your point a bit further. (I’m going to discuss depression and ED below, so this might trigger.)

    A: Depression does not necessarily mean self-medication with food. This certainly happens, and I agree that people deserve help for this. But I worry about seeing these two concepts linked without further exploration, because it exacerbates the picture in the mind of some ableist folks of depression as sloth (as signified in our society by weight), and in the minds of fat-shamers of non-thin people as inherently unhappy. I am going to go out on a very sturdy-looking limb and guess that fat-shamers and ableist folks are two sets with quite a lot of overlap, since they are both groups of self-appointed Body Police. While it is NOT inherently morally bad to be over a certain weight and/or mentally ill, this is a generalization which serves to marginalize both the people it accurately describes and the people it does not, so it is important to address. Neither does depression does not even necessarily mean inactivity either, although many symptoms of depression impede on the ability of a patient to exercise in the amount that is optimal and pleasurable for hir. Neither end of the “eat less/exercise more” mantra should be assumed lacking in a depressed person, and vice versa. And this is assuming that depression itself is the overriding health concern, rather than being a symptom of, say, thyroid issues.

    B: Some depressed people will lose weight, either because of co-morbid restrictive ED or because they quite literally are too depressed to eat. This is a trenchant example of “fat hate hurts thin people too,” as the symptom of illness is applauded rather than noticed as cause for concern because someone is thinner than usual. This is of particular concern for women, who are more likely to suffer from depression and more often body-policed.

    C: Lots of effective anti-depressants cause weight gain, sometimes a lot of weight gain. For some people with this particular mental illness, weight gain as associated with medication is a marker of increased overall health because they are no longer miserable or even suicidal, which is good on its own, and on top of that also allows them to do things fat-shaming concern trolls say they want people to do (ie, eat healthfully, exercise).

    I think these are things that need to be addressed in the context of public health and health care providers. Because, lots of health care providers do “call people fatty and send them away” when this particular issue presents, assuming that fat and unhappiness are inextricably linked (because obviously, how could a fat person be happy). There are whole buckets of unjust presumptions made all around about mentally ill people and fat people and people who are both, and these presumptions are used as an excuse to deny people the care they need. Basically, if we’re going to actually deal with health on this particular issue, the issue of weight is so complex, misunderstood, and fraught with unhelpful value judgments that at least in the short term, weight should probably be decoupled from health just as a pragmatic issue of appropriate diagnosis and treatment.

    But, you know, only if the issue is actually health, and not aesthetics.

    *I would imagine this or something like this, is true for many other mental and physical health concerns, but this is the only one I think I can even scratch the surface of right now.

  99. Bagelsan
    Bagelsan September 9, 2010 at 8:37 pm |

    Empathy requires accepting someone as they are…not in expressing your concern that they are living their lives wrong.

    I think Miss S. @ 71 kind of touched on this, in her bit about the jobs of medical professionals. My concern with such a (strict?) definition of empathy is that helping someone requires the implicit judgment that something is “wrong” with them in the first place. Not “wrong” like “you are a bad person” and not wrong in a blaming way, but wrong as in “you are ill for some reason, and I want to change that.” There needs to be a diagnosis for a cure, in short. And this implicit judgment, this cruel act of diagnosing, is necessary both for real help and for health-trolling. (Which, suckily, makes it really hard to distinguish between them and makes it very easy for doctors to slip from one to the other.)

    And the diagnosis is where I think some FA stuff goes overboard and starts slipping into woo/anti-science/fingers-in-ears territory — rejection of the health-trolling (which I absolutely think should be rejected) becomes retroactive rejection of the implication that there’s a health problem at all, which becomes rejection of the actual help. Often, at the individual level, there really isn’t a health problem, but claims that there aren’t national-level health problems are just ridiculous. Ditto claims that fat can’t cause health problems, or that there has been no increase in fat among Americans at all over time, and so on.

    Some of the information and tools that FA often rejects (even the vastly-misapplied BMI!) are part of a genuine diagnosis. What’s “wrong” with our population, if anything? Decent medical professionals want to improve people’s lives — that means that (assholishly, perhaps) they are claiming that something is wrong with people’s lives.

    For me, empathy includes acknowledging that a person in not at their best/in their best environment. It’s not about withholding love or personhood until they’re at a particular BMI or anything, but it’s also not sweeping all their problems under a rug. It’s not lying, and for scientists it’s not keeping quiet about the data when their/our job is to bring data to the world. To effect a cure* or an improvement the concerns have to be expressed.

    * “Cure” != lose weight, btw. It’s whatever X action –> less sickness/dying.

  100. Sheelzebub
    Sheelzebub September 9, 2010 at 8:48 pm |

    I just want to point out a few things. And you know, pardon my tone, since this seems to be a subject on feminist blogs that requires us to chat like good little Victorian ladies with appropriate shamefacedness:

    1) Refraining from policing individuals about what they eat or making assumptions about the way they live their lives is NOT equivalent to not giving a shit about toxic waste in minority communities. It’s disingenuous to equate the two.

    2) “Concern,” when it is invasive questions to and judgemental statements about fat individuals you come across–either friends, family, or strangers–does not actually come off as concern. It comes off as self-righteousness, especially when (AGAIN) there are thin people who have atrocious eating habits and non-existant exercise habits and they are not policed this way. Kindly consider this before you go off half-cocked at those in the FA movement–since they deal with this shit EVERY FUCKING DAY.

    3) Given the larger culture–moral panics about obesity and fat people, moralistic reality shows and self-righteous lectures by so-called experts about the failings of fat people, and the vitriol lobbed against fat people, you shouldn’t be surprised when you engage in this and run into pushback. FFS. That’s not denialism or whateverthefuck. That is real fatigue and frustration with supposed allies who make incredibly nasty and bigoted comments directed at the people giving you pushback. Not to be a meanie-butt, but seriously? STFU and listen. You don’t have to agree, but it would be nice if you maybe not tell people who discuss their experiences that they are wrong (WTF?) and that they are in denial. It would also be nice if you refrained from equating people who say that fat people–or any people really–don’t owe you an explanation as to why they are fat with sociopaths or with dumping toxic waste in minority neighborhoods. FFS.

    4) If you are truly concerned about the health of people, STFU about their size and stop body policing, and start actually acting supportive. See: the previous points I, and other commenters made about unhealthy thin people, and how none of us have gotten lectures, rude or invasive questions, or cruel jokes and assumptions about our size (certainly not to the extend that fat people have been subjected to). And consider this: nagging, hectoring, and shaming people about their size isn’t going to do much to advance your supposed goal of getting people healthy. Trust me, fat people know they are fat. “Concerned” people remind them of this every. fucking. day.

    If you want people to be healthier, why not focus on access to better food, a better work-life balance, a living wage (you can’t cook from scratch and exercise when you work two or three jobs to make ends meet), less gendered roles (and the attendant shaming that goes with it when those bad! bad! strawfattymothers don’t cook from scratch) and more walkable cities and towns, etc.? Why not focus on that for ALL people, instead of assuming that thin people are healthy and fat people are going to drop dead at any minute? Why not focus on actual health, promoting a culture that makes that accessible, and stop worrying about the choices by some folks that you deem unwise?

    Do you really think that shaming people, that engaging in rhetoric that they have said (repeatedly) is alienating and hurtful, will actually accomplish your goal of Getting The Great Unwashed Masses to Listen to Reason? Do you really think that in trotting out the old tropes about the lazy fat people who suck down Big Macs or what the fuck ever, that people who are LIVING this will take you seriously? Because, you know, those rhetorical devices? Are so very, very new.

    If someone went on and on at a feminist blog about how we should talk about the dangers of promiscuity and abortion and how most women get abortions because they can’t be bothered to keep their legs closed, they’d get ripped to shreds and rightfully so. Why is it okay to be so fucking ignorant and nasty when it comes to fat people?

  101. Sheelzebub
    Sheelzebub September 9, 2010 at 8:53 pm |

    Also, I will say this: when you only focus on size as an indicator of health, people will try to get thin, not healthy. No one will give a fuck about numbers or strength or aerobic ability or flexibility; they will give a shit about sizes and pounds/kilograms/stone, and do whatever they can to get thin. Not healthy. THIN. And there are very unhealthy ways to get thin. Ironically, if you take a dangerous “supplement” and manage to lose a shitload of weight, no one will shame you about your weight or your bad health; they’ll assume you’re healthy. Even if your heart is ready to give out from those, er, supplements.

  102. Sheelzebub
    Sheelzebub September 9, 2010 at 8:57 pm |

    And I will say: my previous two posts are addressing those who insist that people who are FA are denialists or who don’t give a fuck about health or toxic dumps or whatever.

  103. closetpuritan
    closetpuritan September 9, 2010 at 9:29 pm |

    Stephanie, I agree 100%. I’ve said similar things myself.

    Bagelsan, I agree that, population-wide, an increase in BMI can be a symptom of problems.

    It’s strange to me that with all the pushing of HAES in the Fat Acceptance community–to the point where some have complained that they feel unwelcome because aren’t/can’t/don’t want to practice HAES–that people keep insisting that FA is encouraging healthy behaviors.

    OK, so the fact that focusing on obesity instead of healthy behaviors stigmatizes obesity isn’t enough to convince people that the focus should be on behaviors. How about the fact that focusing on weight tends to lead to disordered eating?

    How about “People asked to eat food labeled as “healthy” reported more hunger than individuals asked to eat the same food described as “tasty.” (Sorry I didn’t take the time to track down the original studies.)

    How about Researchers reviewed 22 studies in the 2004 issue of Obesity Research and found that that parental restriction was the only feeding strategy associated with increased eating and weight in kids.

    How about the fact that enjoying your activities is more important in sticking with exercise long-term than “shoulds” like weight loss and health?

    How about the fact that dieting is associated with higher weights in the long term?

    How about the fact that one of the stigma-things that’s worked, smoking, targets behavior, not an effect of behavior. And as elysia, on of the commenters on Pandagon, pointed out, “If we wanted to make a metaphor from tobacco to obesity the national conversation on obesity would be akin to saying that we need to act more judgmentally towards those with emphysema.”

    How about the fact that eating junk food and being sedentary isn’t good for ANYONE, and yet we’re giving people the impression that as long as they don’t get fat, it won’t really affect their health? I’ve actually heard people complain that they shouldn’t have to pay a soda tax because THEY’RE not fat. Guess what–being thin doesn’t make soda a healthy drink.

    Really, it makes no sense to me why we WOULDN’T focus on behavior instead of appearance, even if you couldn’t care less about fat stigma.

  104. closetpuritan
    closetpuritan September 9, 2010 at 9:33 pm |

    shah8:
    you might tend to be extremely unsympathetic to people who go past the anti-fat-phobia into denialist territory

    Why? Do you think that all the dying mothers you know are fat because of FA “denialism”? Because I think FA is still fairly obscure, and most fat people are not members of the FA community.

  105. shah8
    shah8 September 9, 2010 at 9:40 pm |

    You know, I think it would be beneficial to strip this down to the essentials.

    There isn’t really any disagreement on the details except one.

    One side wishes to say that the truth has negative consequences.

    The other side wishes to say that the truth will set us free.

    That’s all.

  106. Kristen J.
    Kristen J. September 9, 2010 at 9:40 pm |

    Bagelsan: My concern with such a (strict?) definition of empathy is that helping someone requires the implicit judgment that something is “wrong” with them in the first place.

    Yeah, no. That doesn’t work. Helping someone (an individual) requires their belief that there is something that they would like help with. Otherwise “helping” is just being a self-righteous ass.

    Bagelsan: It’s not lying, and for scientists it’s not keeping quiet about the data when their/our job is to bring data to the world. To effect a cure* or an improvement the concerns have to be expressed.

    Except scientists and science are not objective. Researchers do not present their research in an objective manner and those results and not communicated in an objective way to everyone. Instead they are used as a cudgel to belittle and bully people.

    And there are PLENTY of people who are interested in the research…who have asked for help in becoming more healthy…to justify the “concern” of scientists. Why is there a continuing need to express this concern to people who have not asked for help?

  107. Bagelsan
    Bagelsan September 9, 2010 at 10:28 pm |

    It would also be nice if you refrained from equating people who say that fat people–or any people really–don’t owe you an explanation as to why they are fat with sociopaths or with dumping toxic waste in minority neighborhoods.

    Yeeeah. No one’s doing any of that, though.

  108. Tori
    Tori September 9, 2010 at 11:09 pm |

    “Concern,” when it is invasive questions to and judgemental statements about fat individuals you come across–either friends, family, or strangers–does not actually come off as concern.

    This, so hard.

    It’s help when it’s wanted and welcomed by the person receiving it. It’s concern trolling when the person receiving it Does. Not. Want.

  109. chava
    chava September 10, 2010 at 12:08 am |

    @ shah8:
    “Being truly obese means being disabled, and it can mean being as disabled as people with a bad heart. People are locked in their homes/rooms by their own bodies. People can’t do the things that might make them happy if it requires much moving–even to get up and walk to the stoop in the porch or in the garden might require a whole bunch of “Do I *really* wanna?” questions that people shouldn’t have to answer. Not only are they locked in their bodies, their bodies are often painful with bad joints and poor circulation with limbs going to sleep all the time. This is not even going to all the degenerative diseases that can accompany serious obesity. Obesity of this nature almost *never* comes from personal choice.”

    OK…you might want to consider that some of the people on this thread ARE the “they” you are talking about, *who are also minorities,* and you might want to let them tell you how their day goes before informing them of it, eh? I recommend living400lbs, also Womanist Musings.

    Not to mention that I don’t know anyone in the fat activist community who is remotely, REMOTELY against measures taken by the state to promote general health (eating well, getting outside and moving, etc) or any amount of activism in that direction. Just not when it uses fat PEOPLE as scapegoats for a general movement.

  110. meerkat
    meerkat September 10, 2010 at 6:44 am |

    Shah8:
    re: Doctors who shame fat patients are just like people who give others a hard time about curly hair.

    Yes, because fat-phobia is just as common as hatred of curly hair, and because doctors are always blaming hay fever on curly hair and telling you to just straighten your hair and it will go away.

    re: “True” obesity is a disability. (Trapped in house, etc.)

    Obviously “true” obesity is something very different from the BMI category, or any other definition of obesity that I have ever heard (except perhaps “whatever I personally think is way too fat”).

  111. Helen Huntingdon
    Helen Huntingdon September 10, 2010 at 9:17 am |

    Great post. The fight for proper health care is hard enough already without fat-phobia and fat myths on top of it.

    I have a hell of a time obtaining well-reasoned care for my thyroid condition, and I have thin privilege on my side. If I had to fight fat-phobia on top of everything else, there are times when I would just be too exhausted to fight my way through and would wind up settling for poor and harmful care instead. THAT is why being fat is bad for your health — because people turn it into an excuse to harm you.

  112. martini
    martini September 10, 2010 at 11:29 am |

    shah8, I disagree that the FA stance is not accepting of the truth. From what I can see, there is an acceptance that in general, high weight in the population correlates to higher diseases in the population.

    What we are saying is, what are you going to do about it?

    If you’re going to insist that everyone become thinner in order to make the population healthier, well you have a problem. Because we don’t know how to make that happen on an individual level. If you actually are aware of a diet plan that is successful for most people, you can probably make a mint, because the diet industry is making tons of money with ‘solutions’ that don’t actually work. Fat people are trying to get thinner, and it’s not working.

    As Stephanie posited, what if we instead try to make the population healthier by making systemic changes that encourage healthy behaviours, rather than focusing on the end-point of weight (since we’re not good at changing that)? What if we get everyone to excercise more, and eat better? What if we make eating better easier by stopping some of the awful practices of the food industry? What if we focus on behaviours so that fat people can feel like a success when making changes that affect their health, and stick with it, rather than feeling like a failure because they are exercising, but the number on the scale doesn’t budge, so they give up?

    Are you so invested in weight as a measure that you’re prepared to focus on it when that focus is sabotaging the quest for better health in the population that you’re going for?

  113. Shalsara
    Shalsara September 10, 2010 at 12:09 pm |

    Since I came to this discussion late, I won’t try to address some of the folks with whose positions I take issue. Instead, I’ll just quickly note that BMI makes sense as an actuarial measure in a life insurance context – it’s true that, on average, people with very high BMIs are more likely to die than people with BMIs in the “normal” range. However:

    1. BMI is a horrible way of judging an individual person’s health status,
    2. Visible fatness in a patient inarguably renders some doctors incapable of providing quality health care, and
    3. We should be working to encourage individuals to find movement that they enjoy and healthy food they like, rather than trying to shame individuals into losing weight.

    Focusing on obesity as a disease (lol epidemic) completely misses the point.

  114. Sheelzebub
    Sheelzebub September 10, 2010 at 12:12 pm |

    Bagelsan: It would also be nice if you refrained from equating people who say that fat people–or any people really–don’t owe you an explanation as to why they are fat with sociopaths or with dumping toxic waste in minority neighborhoods.Yeeeah. No one’s doing any of that, though.

    Bullshit. Read the fucking thread.

    I’m kinda with shah8 on this aspect — statements like the above sound almost sociopathic (or, at the very least, cynical to the point of uselessness.)

    I’m saying that yes, someone else’s health is our problem. Dumping toxic waste in ghettos should be an issue that we all give a shit about. Women dying frequently in this country due to childbirth should be an issue that we all give a shit about. But no. Everyone has decided, as Shah8 said, to be Libertarian for a fucking day.

    like not wanting to see toxic waste dumped in ghettos – if i didn’t care about people’s health, why would i care? why would i work to promote environmental justice? (which i do, in my free time).

    Health is a fucking moral right, and the STATE is a key agent in enforcing such moral rights. If people didn’t think of such things in this way, we wouldn’t have clean water/sanitation for all in urban populations. We wouldn’t consider access to medical care a personal right. There would be no FDA and no school lunches. Do you know why? Because people who are making soi distant, zero sum, and narcissic class arguments could only get shouted down by forcing clear moral parallels in understanding what a State is for.

    So, by saying that it’s wrong to morally police individuals for what may be bad choices, by saying that an individual’s unwise choices are none of our concern and that we have to give individuals some autonomy (you know, like everyone else who drinks and smokes and fucks around and wears high heels and microwaves organic veggies in plastic containers), we’re saying that we don’t believe in sanitation, health care, school lunches, the FDA and that we don’t give a fuck about toxic waste dumps.

    You know? You folks are being really fucking disingenuous. Cut the shit. No one here said any of that–had you bothered to read what some FA wrote, you’d see that there is a LOT of support for structural solutions to structural problems.

    The issue people have is the hyperfocus on ZOMG DEATHFAT and the moral panic that accompanies it. The issue that people have is the ridiculous attitudes from the more privileged here who back fat people into a corner by making shitty and ignorant comments about fucking donuts, lack of exercise, and cheeseburgers. No one should have to feel like they are being “the good fatty.” That they eat right, really! They exercise, really!

    What they are saying is that people–even people who do not eat the things you approve of–deserve to be treated with dignity and respect. That–and I’m going all capslock here–EVEN PEOPLE WHO EAT FUCKING BIG MACS THREE TIMES A DAY BETWEEN EACH MEAL deserve to be treated with respect, have a right to healthcare, and deserve to be treated with dignity by their doctors. That no one should have to justify their existence to you or anyone else.

    No one here is being a goddamn libertarian for a day, but thanks for playing. No one here said, hey, we should ban school lunches and nuke the FDA because it’s against FA. They said that distinguishing between the “good fatty” and the “bad fatty” is playing into the moral panic and fat hatred that makes their lives harder.

  115. Miss S
    Miss S September 10, 2010 at 12:27 pm |

    The idea that people care about public health so that they can shame people is, frankly, paranoid. I think that some of you are placing far too much importance on yourselves. No one is after you. Seriously. It’s not really about you, it’s about providing opportunities to be healthy/healthful to people. See my earlier comment about access to healthcare, mental health providers, and nutritious food, such as community food gardens.

    I’m starting to wonder if this topic is a way for otherwise entitled, spoiled women to feel oppressed. If you think for one second that being fat is anything like the kind of oppression that other people go through on a daily basis, you need to get a fucking clue. It’s not. Do we have a history of enslaving fat people? Lynching them? Advocating for mass genocide or murdering people for being fat?

    All women, all the time, are policed on their looks and no woman actually measures up. That’s the point. No one actually wins at this game. If you want to push back against the beauty ideal, go for it- but not by pretending that obesity (not 10 pounds overweight, but obese) has no health ramifications (whether that’s a result of the obesity, or the factors that led there).

  116. Miss S
    Miss S September 10, 2010 at 12:28 pm |

    Stephanie- I agree with many of your points. I was trying to point out that we should focus on underlying causes. I agree that obesity and mental health should not be assumed to go together, but I think depression and anxiety are so stigmatized that people (individuals) may be unwilling to address them. So it turns into this ridiculous thread about obesity being just fine and no one else’s concern- on a feminist, progressive board of all places. People are unwilling to see that there is a bigger picture here.

  117. Miss S
    Miss S September 10, 2010 at 12:33 pm |

    Oops, my earlier comment was for pocachina, not stephanie.

    Sheelzebub- If people are going to pretend that being 800 pounds isn’t unhealthy, they are living in denial.

    Again, I’m really not sure if everyone on this thread is using overweight to mean the same thing. Some people sound like they are referring to 10-20 pounds overweight, and some people sound like they are referring to 400 pounds overweight. Those are two very different things.

  118. shah8
    shah8 September 10, 2010 at 12:55 pm |

    Look, there is a reason why this debate is so toxic.

    Bagelsan and I do…not…disagree…with most of y’all (certainly not Kristen J and her followers because they cultural revolution) on this issue. I mean, Chava, I think there is no way you’re going to win that fight on the whole “talking to those people”. I think I’ve said this multiple times before, I actually WORK with them. Intimately. I talk to them every day, and we certainly do talk about health–not least because the IRS does try to have open dialogue about health needs. That direct experience certainly trumphs reading a blog, even though reading blogs certainly helps!

    I mean, peeps. You…Are…Not…Going…To…Win. This isn’t a game. It’s not a contest where you get get others to privilege YOUR experience and map it onto some Silent Majority. I’m scientifically literate. I can read and understand undigested material straight from the source. I can correlate what I see in those statistics to facts on the ground (and fucking unwillingly too!). This means that I believe that the weight gain in the population is indicative of serious problems, societal and personal health wise. I believe that we should find out more about why this is happening and that we should do our best to ameliorate the negative consequences.

    Now, the constant twisting of people’s (like nurses and scientists) words to indicate that we’re going to be rounding up fatties and sending them to the Fat Camp in the Sky…is malicious. The constant pretense that we aren’t more than aware of fat-phobia and their consequences–that other health and social health professionals aren’t aware–…is fucking malicious. You don’t give off any vibe of truthfulness or righteousness. You give every vibe of victimhood or ripe sucker. I see this crap with race. I see this crap with deaf issues. I see this crap fucking everywheres. I am…turning into Robin Gibbs and screaming “Have you all lost your goddamned minds?”

    Fat Acceptance has to be part of solutions in the feedback systems of our response to obesity. It’s mindboggling complex, but you have NO RIGHT to push that complexity onto others for your own sakes and especially not for the sakes of your egos. Not least because I can ignore your pedantic behavior, but that the deliberate and overt cluelessness will HURT the people who can’t ignore you.

  119. Cool Shit 4 — « Fierce, Freethinking Fatties

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  120. ARP
    ARP September 10, 2010 at 1:15 pm |

    I don’t have much to say on the main subject, but after seeing a few comments along these lines, I have to push back:

    I was not treated like a subhuman due to my size. My doctors, while concerned about my weight, did not focus on it. In fact, most people assumed I was healthy because I was so thin.

    Ironically, if you take a dangerous “supplement” and manage to lose a shitload of weight, no one will shame you about your weight or your bad health; they’ll assume you’re healthy

    Everything is anecdotal, yes – but please don’t imply that thin people are either never or very rarely bothered about their weight. As someone who was diagnosed as an anorectic for a few years a while back, and who has recently lost a decent amount of weight and is now very close to that diagnosis again – this is far from a rule. Maybe many thin people aren’t bothered, but when you start to even creep into “too thin” territory (and to a lot of people, “too thin” is like, size 4) people feel plenty free to comment. I cannot tell you how many people asked me if I was okay, told me I looked so thin and they were worried about me, asked me if I’d eaten anything, pushed food in front of me, commented on what or how much I was eating at a meal…it happened a lot, from various people. Family, friends, coworkers, and yes, strangers felt it was perfectly fine to make loud and rude comments about how thin I was and how little I was eating, all under that same guise of “concern” that people use when addressing heavy peoples’ bodies and food. For anyone that sort of commentary can be embarrassing and difficult, but for an anorectic, to have someone loudly discussing what you’re eating or what your body looks like is pretty much anxiety-attack inducing, at least for me and many other ED sufferers I know.

    Yes, there is thin privilege. Having thin privilege as a result of an ED is not exactly the same thing, and plenty of so-called “too thin” people get the exact same style of shit as so-called “too big” people. Is it as common? Probably not, overall, but the comments here that have seemed to indicate that it never or very rarely happens are just wrong, and also, if you haven’t been there, how the hell can you claim to know? And if you have been thin and didn’t experience it, well lucky you – just like the fat people who say they’ve never had a doctor be rude to them, it’s anecdotal and it does NOT mean no one has had that experience.

    I deal with bullshit comments and staring and such from people. I won’t tell you your reality is bullshit if you don’t tell me mine is. Experiences are anecdotal no matter whose experiences they are.

  121. closetpuritan
    closetpuritan September 10, 2010 at 1:35 pm |

    “Often, at the individual level, there really isn’t a health problem, but claims that there aren’t national-level health problems are just ridiculous. Ditto claims that fat can’t cause health problems, or that there has been no increase in fat among Americans at all over time, and so on.”

    Bagelsan, I’ve NEVER heard ANYONE say that “there has been no increase in fat among Americans at all over time.” It’s hard to accept that someone’s arguing in good faith when they use strawmen.

    As for the other positions you mentioned, agreement with them in the FA community is mixed; those are more fair to go after. Except I’m not sure that I’ve ever heard someone say that fat “can’t” cause health problems; it’s usually expressed as either “we don’t know that fat causes health problems,” or “fat can cause health problems, but it is overly blamed for causing health problems”. I can see why you’d have problems with the former (but, to use your word, “ridiculous” to disagree with the latter), but again, it’s a case where you’re (perhaps unintentionally) exaggerating the other side’s positions and making them easier to take down.

  122. Stephanie
    Stephanie September 10, 2010 at 1:39 pm |

    Bagelsan @ 93:

    I hear you, and I completely agree. Collecting demographic data for the purpose of tracking changes in the population is useful, and I actually did consider mentioning that in my previous comment, but it was getting a bit long already. I do think it’s possible to collect that data in a way that wouldn’t lead to any stigma; presumably it would simply be entered into a database, to be analyzed at a later date for some specific purpose. No one would need to be told their “number” (though they could have it if they wanted it). More importantly, no one would be shamed for it, or told that they need to change it in this or that way.

    shah8 @ 92, your interpretation of my comment was… interesting:

    “We should run this big experiment where lots of people are essentially experimented on with no control group because obviously with a little ideologically-based tinkering, things will be better in no time, and if it doesn’t work out? It still proves my point.”

    The “big experiment” you’re referring to is, presumably, my suggestion that we make it easier for people to access fresh and healthy food, encourage enjoyable physical activity, reduce working hours so people have time to cook and be active, that sort of thing. Yeah, I guess you’re right. That does sound pretty unethical. Maybe I should write a letter to Michelle Obama? She’s not even using a control group!

    Oh, wait, sorry– it’s the “ideologically-based tinkering” you disagree with. I see your point. If we do all of the things I mentioned above without also weighing people, no one will see a single health benefit! It’s Scientifically Proven™.

    Thing is, you’re projecting. The ideologically-based tinkering comes in when you want to force people to stand on a scale even though that’s never done a single thing to improve health outcomes. If you really cared about health and you were as sure as you claim to be that FA is completely wrong, my suggested approach would seem like a guaranteed win for you: it would lead to a healthier population while also (inevitably!) leading to a thinner one, and then all of the FA stupidheads would have to admit they were totally wrong about everything. And I’m willing to take that risk, because a healthier and happier population is completely worth the risk that I might end up with egg on my face if it also ends up being a thinner population.

    Fact is, you’ve had your chance. We’ve tried your “Make sure people know how fat they are or no one will ever eat a single piece of broccoli!” approach, and it’s been a complete and utter failure. No one’s any thinner or healthier for it– they’re just completely effing miserable. Time to consider the possibility that your strategy totally sucks.

    The truth shall set you free.

    [/glibertarian]

  123. BStu
    BStu September 10, 2010 at 1:40 pm |

    when you only focus on size as an indicator of health, people will try to get thin, not healthy.

    This is one of the real, concrete ways fat stigmatization harms health. Even from those pushing “enlightened” fat stigmatization. What they are doing is creating real disincentives for people to do things that can improve their health, because those things don’t actually reduce weight in any reliable way.

    The health care needs of fat people are a major concern within Fat Acceptance. We are not in denial at all. We recognize that stigmatizing our bodies and ourselves does nothing to address that. We recognize that our health care concerns are not a reason to shame or stigmatize us anymore than the health care concerns of any other group. Including thin people! There are a host of health problems correlated with thinness. They are never used to justify disenfranchisement or stigmatization. THIS is what FA is arguing for. Not the pithy characterization of denial, but a recognition that focusing on weight has failed fat people. It has been the absurdly dominant view point and it has failed to make fat people healthier or even less fat. Do not tell me I am in “denial” while you refuse to acknowledge that your preferred response has been the only response for decades and has accomplished none of it what it claimed it would do. Because I care about the health of fat people, I say we need to stop this failed approach.

  124. closetpuritan
    closetpuritan September 10, 2010 at 2:00 pm |

    shah8:
    “There isn’t really any disagreement on the details except one.
    One side wishes to say that the truth has negative consequences.
    The other side wishes to say that the truth will set us free.
    That’s all.”

    Really? Because this:

    “However, just as much as someone would do as much intervention as morally feasible with a woman who’s suffering from anorexia, one should do so when a woman is morbidly obese. Not fat. Morbidly obese*.”

    makes it sound like you think that telling morbidly obese people that they’re morbidly obese is somehow going to help them and actually give them new information, and as I think has been made quite clear, a lot of people here equate that with concern trolling and/or feel it would be better to focus on systemic changes to give people a true choice to engage in healthy behaviors. Systemic changes!=an “intervention”.

    *which you define as “not being able to leave one’s house”, rather than using a BMI definition.

    Also:
    “But no, instead of wanting the medical profession to change their *professional* demeanor and make them treat everyone as if they are fully human, some of you guys want some crappy media crusade on how fat is not so bad built out of personal stories about how some random assholes did you wrong.”

    …I think you’re trying to argue that FA primarily cares about about convincing everyone that fat is not unhealthy and cares about anti-fat prejudice only secondarily or not at all? Or that they think that if the medical community decided fat is healthy then all fat stigma would go away? If that’s what you think, then you don’t know much about FA.

  125. Alara Rogers
    Alara Rogers September 10, 2010 at 2:22 pm |

    Shah8:
    There isn’t really any disagreement on the details except one.

    One side wishes to say that the truth has negative consequences.

    The other side wishes to say that the truth will set us free.

    No, I think there’s considerable disagreement on the details.

    The things that both sides agree on are:
    Obesity is a correlate with poor health.
    It is bad for people to be in poor health.
    As a society, we should help people to be in better health, if it is possible.

    The medical community, and the general population, interpret these premises as:
    Obesity is a cause of poor health.
    We should help people to be in better health by encouraging them as individual persons to engage in healthy behavior.
    Healthy behavior is any behavior that will help them lose weight, because obesity is a cause of poor health.
    Shaming people for their unhealthy behavior may be an effective means of getting them to engage in healthy behavior instead.

    The fat acceptance movement is saying:
    Obesity is a correlate of poor health, but is not necessarily a cause of it; in many cases it may be caused by it, or the poor health and the obesity may be caused by the same factor.
    Obesity is a known cause of socially inflicted distress, such as people being discriminated against, treated badly, having poor mental health due to self-hatred over being obese, or not getting timely treatment from doctors for issues unrelated to obesity.
    The standard mechanism for the progressive movement to fight the suffering caused by socially inflicted distress is to fight people’s desire to cause the distress, not to recommend that the victims conform better in order to avoid the distress.
    Obesity itself is almost impossible to “cure” on an individual level. It is also quite possibly a symptom rather than a cause.
    Therefore, since the only suffering and ill health obesity is *known for a fact* to cause (rather than being the result of, or being correlated with) is the social distress suffered by fat people, the way to improve health outcomes is to eliminate the social distress, by recommending that people do not inflict it.

    One side thinks that obesity is *the* medical issue and “curing” the obesity will cure the problems that correlate with obesity, and that this can be done on the individual level by any person who is motivated to do it.

    The other side thinks that obesity is just as likely to be a symptom as it is a cause of poor health, and that steps to “cure” obesity will either cause significant poor health in and of themselves, or are ineffective, or are ineffective and will cause significant distress… or they are tactics that could very well improve health but not necessarily cure obesity, in which case they should be employed by everyone, whether obese or not, and the target for their employment should be to achieve health, not thinness.

    So I would say that the two sides have a dramatic disagreement about what the truth actually *is*. If the larger community is correct, then if people can just be shamed into taking the steps they need to take to lose weight, all the problems that are correlated with obesity will go away. If the fat acceptance movement is correct, then the problems correlated with obesity will be largely unchanged by any effort that targets weight loss specifically, and new problems will be created by those efforts.

    The evidence, thus far, seems to point in the direction of the FA movement. Efforts specifically aimed at weight loss appear to cause disordered eating, and either do not cause weight loss, or cause considerable health complications, whereas efforts aimed at increasing health seem to have more effectiveness at increasing health than they do at controlling weight.

    This isn’t academic for me. My mother dieted all throughout her childhood and ended up with diabetes at the age of 33, twenty years before it was common for people to get diabetes before 40. I’m 41 and still don’t have it. I’ve got the same risk factors she had. I’m as heavy (or heavier, in proportion to my size) as she was. But I have never gone on a starvation diet in my life.

    My mom is always nagging me to lose weight because she’s terrified I’ll get her horrible disease. And I can’t help but think, but what if the steps you took to lose weight — the steps that didn’t work, in the long run — sped up the progress of your disease? What if the yo-yo dieting you engaged in and I didn’t was why I am 8 years older than you were when you got diabetes, and I don’t have it yet? Does it *really* make sense for me to be super-focused on my weight in order to avoid diabetes, when as far as I can see, all the focus you put on your own weight may have given you the disease *sooner*?

    My *life* may depend on whether obesity causes disease, or whether obesity correlates with disease, and if one of the mechanisms by which obesity correlates with disease is that people who consider themselves overweight are more likely to engage in dramatic dieting over the course of their lives and do damage to their metabolisms in that way. So believe me, there is no sense in which I believe that sticking heads in the sand and pretending that reality doesn’t exist is a good idea. My future is on the line. But one side is probably right, and the other side is probably wrong, and from the evidence *I* see… I think the FA people are closer to right than the “solve all your problems by losing weight” people are. Anecdote’s not the singular of data, but I look at the data, too, and I don’t see causation. I see correlation. And I see that tactics to control weight don’t control weight. So I’m gambling my life on the belief that rigid dieting to try to get my weight down will kill me faster than trying to generally eat a balanced diet but not letting myself go hungry will. Because that’s what the evidence suggests to me.

  126. Athenia
    Athenia September 10, 2010 at 2:42 pm |

    @ konkonsn

    Living in Japan changed how I view the US food industry and our concepts of weight.

    It was horrifying to see Japanese weight loss ads—their “fat” was our “skinny.” And in that way, weight issues are always going to be relative to the people who surround you—no matter what the baseline for “fat” and “skinny” is.

    Also, having foods that I normally ate not available for me really highlighted how horrible our food system/culture is. On one hand, it’s such a systematic issue–if corn syrup is in everything, how are we expected to take care of ourselves on an individual level?

    Moreover, how can individuals take responsibilty for themselves when they don’t know or choose not to do what’s best for them?
    How can we get people to realize that the size of a MOS burger is better for you instead of a Big Whopper? Or 3 glasses of bitter green tea is better than 3 cokes?

    On the other hand, Japan showed me that it’s possible for people to lose weight if their diet and lifestyle changes. However, are we going to expect America to move to Japan or something? I’m not sure of the answers.

  127. piny
    piny September 10, 2010 at 5:41 pm |

    Sheelzebub- If people are going to pretend that being 800 pounds isn’t unhealthy, they are living in denial.

    Eight hundred pounds? Where do you live, on Jupiter? How many people in America weigh eight hundred pounds? How many people in America weigh half of that?

    Talk about fucking outliers. How much is that in doughnuts?

  128. Shalsaran
    Shalsaran September 10, 2010 at 5:59 pm |

    Again, I’m really not sure if everyone on this thread is using overweight to mean the same thing. Some people sound like they are referring to 10-20 pounds overweight, and some people sound like they are referring to 400 pounds overweight. Those are two very different things.

    Some people in this comment thread are saying that everyone, no matter their weight, deserves to be treated with respect, and that doctor(s) have a duty to provide proper health care as opposed to assuming that everything wrong with a fat patient stems from their weight. Some people in this comment thread are saying that the obesity “epidemic” is massively overblown, and that in fact visible fat is a very poor measure of an individual’s health. Some people are saying that while very high BMI does correlate with increased risk of death in some populations, the medical profession (oh, and popular media, and friends, and family members, and random individuals on the street) tend to take this correlation as justification for a moral crusade in furtherance of which they must identify others as being ZOMG DEATHFAT and browbeat those individuals into Mending Their Ways. These are all very reasonable points and it would be great if you could acknowledge them.

    Thanks in advance,
    Shalsaran

  129. Sheelzebub
    Sheelzebub September 10, 2010 at 6:28 pm |

    Ms. S., I call bullshit. (I know! I’m part of that toxic culture of calling out! I hang my head in shame.) You seem to have your own issues with denial, since you refuse to acknowledge–and completely dismiss–the experiences of fat people on this thread.

    Zuzu posted about being degraded by a doctor and blaming everything (including her hay fever) on her weight. Kindly note that Zuzu, a runner and a generally athletic person (something her doctor couldn’t fathom) is not 800 pounds, or even 400 pounds. Kindly note that this often happens to people who are overweight, but not overweight at those levels. (And that even if they are overweight at those levels, they still deserve to be treated with dignity and respect.) Kindly note also that while you or Shah8 may differentiate someone who’s 5’6′ and 230 pounds and someone who’s 400 pounds, a lot of people don’t. A 230 pound woman still gets a ration of shit, is still degraded about her weight, dismissed, and pilloried.

    The idea that people care about public health so that they can shame people is, frankly, paranoid. I think that some of you are placing far too much importance on yourselves. No one is after you. Seriously. It’s not really about you, it’s about providing opportunities to be healthy/healthful to people. See my earlier comment about access to healthcare, mental health providers, and nutritious food, such as community food gardens.

    I’m starting to wonder if this topic is a way for otherwise entitled, spoiled women to feel oppressed. If you think for one second that being fat is anything like the kind of oppression that other people go through on a daily basis, you need to get a fucking clue. It’s not. Do we have a history of enslaving fat people? Lynching them? Advocating for mass genocide or murdering people for being fat?

    You know, I am agog at the tone lectures leveled at the FA folks here when you and other commenters feel free to say vile, ignorant shit like this. Just in case you missed it:

    Fat people DO face discrimination, as a group are more likely to be poor, and as a group are more likely to get sub-standard medical care.

    And you–yet again–refuse to actually read for comprehension. If you read the fucking posts, you’d see that most if not all of the FA on the thread were advocating for the very public health and food access policies you promote. They take exception to doctors dismissing their symptoms (such as, you know, hay fever) and focusing on them losing weight. They take exception to the deathfat moral panic that is sweeping the country. They take exception to people making assumptions about what their habits are and public shaming. They take exception to the pressure to identify oneself as a “good” fat person who eats right and exercises as opposed to a “bad” fat person who makes bad choices. They believe that people’s private lives are their business, and that while we can and should make good health a priority, and access to good food and physical activity open to all, that it doesn’t extend to policing the fat people you meet or know. They have pointed out that the fat people who make unvirtous choices still have the right to good healthcare, dignity, and respect (which got them called sociopaths). They have pointed out that in some instances, yo-yo dieting and struggling to be thin actually fucked up their health and contributed to fucking up their metabolism.

    When someone’s LIVED experiences include dismissal and degradation by doctors, invasive and vitriolic questions and comments about their bodies from strangers, public condemnations based on their size, and open and unapologetic discrimination, they are not being paranoid or–what was it you said? finding “a way for entitled, spoiled women to feel oppressed.”

    But you know–since you care so fucking much, how about you drop the self-righteous bullshit and actually read what people who are fat wrote about their experiences. And you know, not dismiss it or deny it. (Denialism, indeed.)

    But no worries! FA is not in any danger of taking over the country right yet–people are still damn near killing themselves trying to get thin, or get thin enough, rather than be healthy, because doctors and friends and family and strangers and popular culture all deem thin as healthy and overweight with ready to drop dead and horribly undisciplined, and they must tell these fat people that they are fat and need to diet right away! So they starve themselves or take phen-phen and if they’re lucky they only develop some minor physical issues, or if they are unlucky they die of heart attacks or their metabolism is fucked up or they develop heart problems.

    ARP, I was one of those very thin women (now just thin) who got a lot of body policing, comments about my eating, and snide jokes about anorexia. It was annoying as all fuck, I was self-conscious about it, it was the other side of the policing women’s bodies coin, but it was not oppressive. There isn’t the institutional discrimination against thin people that there is against fat people. It’s no coincidence that the go-to insult flung to women is that they are fat (and when I had my blog, I got that a lot). Being fat is apparently the worst thing in the world.

  130. Sheelzebub
    Sheelzebub September 10, 2010 at 6:35 pm |

    Ironically, when I did gain weight and got to something approaching normal, it was when I lived in Japan.

    NO

  131. shah8
    shah8 September 10, 2010 at 6:45 pm |

    Alara Rogers</strong…
    you said

    One side thinks that obesity is *the* medical issue and “curing” the obesity will cure the problems that correlate with obesity, and that this can be done on the individual level by any person who is motivated to do it.

    Seriously though, I've never thought that obesity is *the* issue. Bagelsan has never thought that obesity is *the* issue. Moreover, there are specific situations where obesity are a direct causation. We can’t actually state that obesity is *not* an issue, and one thing that routinely happens in FA threads is the use of correlation as a way to deminutize evidence–it’s a classic denial tactic because causation? Really, really, really hard to prove.

    Alara and every-fuckin’ else. We, meaning scientists and public health officials, and I guess me as an uninfluential public intellectual for blog purposes, don’t approve of yo-yo dieting. It is malicious to say that we do. Please direct that ire at marketroids. Or is it that we’re just soooo much easier to reach through the intertubes and throttle? And you all think I’m some commenter who has always been distant from this issue and telling you off. I’m not going to tell you everything about my life. I’m not interested in showing scabs and bragging about whose is bigger. I want to argue from the evidence and from reality.

    closetpuritan, are you seriously trying to say that my definition of “intervention” is telling sick people that they are sick? I said that because there were jokers who were going around saying that morbidly obese people should have “freedom of choice”. Nobody ever chooses to have a BMI over 50, and no serious professional would ever tell that person to “lose weight”. When it gets that bad, it’s all about managing the damage. Fat phobia certainly gets in the way of treatment in terms of discrimination and uncooperative workplaces and the usual jeers from random assholes. Do you seriously think that I’m going to tell a person like that to lose weight? The primary intervention is preventing that shit. That means empowering people in various way, usually. That also means making inroads *against* fat-phobia, but doing that is practically a matter for the FCA rather than the FDA. That means clean lines of argumentation, because otherwise, the media will preach the controversy rather than inform. The persistent tendency of people to conflate not worrying about weight and saying weight isn’t a problem works *against* stopping fat-phobia because it plays into well prepared bipolar debates where no-one ever gets convinced. It *should* be easy to work that out if you’re not empathy impaired!

    Stephanie, I could hardly give a shit. If we do what you suggest we do, we win. My objection was to your rather transparent attempt to elide the fact that the issue is that we (scientists and other people who know better) have to *not say fat is a problem*, regardless of whether that is true or not.

    /me snorts

    It’s hard to get that to happen with the underpants gnome’s theory of project management. We should stop food deserts! Why? Because people aren’t getting enough food! Naw, take a look at all those Snickers bars! No! People aren’t eating enough apples and lettuce and shit! Man, that 711 got apples and lettuce. But those are nasty! People deserve better food! Well, if they can pay for it, I’m sure some Publix or Kroger put a store there, law of economics! Well Kroger refuses to put a store there! I guess those people aren’t interested in paying for something better than nasty apples and wilted lettuce.

    Conversations aren’t going to wind up like this. There are many different iterations, but as I see it, showing that there is a problem with people gaining unwanted weight, and showing how there is a weight of issues that are associated with people gaining weight. Then we show that weight causes problems with personal issues like health, social issues with fat-phobia, and issues with national finances like Medicare cost increases. There are ways to push these ideas truthfully and sensitively. We move the conversation along and we refuse to embroil ourselves in tangental controversies. There does need to be an awareness, people, that many corporations make a tremendous amount of money off of people’s lack of choices. There will be firm opposition.

    Most of the great progressive stuff? They happened with systemic bodies of evidence persuasively argued. The legal team behind Brown Vs Board, the fight against drunk driving and smoking, various legal movements around the world that forced *some* respect for the environment by plantation owners and big ag.

    They aren’t won by shouting your damned feelings. Or by nitpicking science articles you barely understand. I’m actually trying in this thread because there are real consequences to getting bogged down on Fat Causes Cancer! This sort of thing has gone on in *many* movements, and sometimes it was disastrous, like the early infighting about AIDS in the 80s and the current effort to deal with heterosexually transmitted AIDS in the black community now.

  132. Kristen J.
    Kristen J. September 10, 2010 at 7:38 pm |

    Miss S: I’m starting to wonder if this topic is a way for otherwise entitled, spoiled women to feel oppressed. If you think for one second that being fat is anything like the kind of oppression that other people go through on a daily basis, you need to get a fucking clue. It’s not. Do we have a history of enslaving fat people? Lynching them? Advocating for mass genocide or murdering people for being fat?

    Wow, really. So the only people who experience oppression have to fit your definition? People on this thread have expressed their lived experience of being denied appropriate medical care among other things and your response is “shut up you aren’t really oppressed.” Congratulations, you are dropped any pretense of being concerned with the “health” of other people and are firmly acting like a privileged asshat.

  133. Politicalguineapig
    Politicalguineapig September 10, 2010 at 7:49 pm |

    Pocochina: One word: Paxil. It’s been eleven years since I was on it, and I’ve yet to lose the weight I gained on it. I have to admit though, I don’t think going to college helped. No time to cook + little money means one gets virtually held hostage by the cafeteria. (I’m not even going to discuss the dorm kitchen. Eh-yuck.)

    Also on the doctors: I wouldn’t even go if I could get birth control any other way. I’m fairly healthy, but I got smacked with the diagnosis hammer at a young age, and it didn’t help that I was a persistently chubby kid. All this has kind of contributed to a growl growl gnash teeth attitude toward any and all doctors, even the nice ones.

  134. denelian
    denelian September 10, 2010 at 8:12 pm |

    a thing to add…

    about 2 years ago, i lost 60 pounds in 2 months. i was throwing up multiple times a day [THANX, pain meds. sigh]. every. single. doctor. i saw was cheering this on. EVEN WHEN i pointed out that i was essentially [if not really, because i DID NOT want to throw up!!!!!!!] bulemic.

    so, i got put on phenegrin [anti-nausea, mostly works] and the weight came back.

    and doctors FREAKED – to the point of wanting to take me OFF the anti-nausea meds. [and… look, 6 months of throwing up, which is how long in total, DESTROYS YOUR TEETH. then i got MRSA and the meds to combat it finished the job. i currently have FOUR teeth that are worth keeping. FOUR TEETH WORTH KEEPING IS NOT WORTH LOSING WEIGHT!]

    but the thing is… before i started taking ensure, ALL i was eating was NOTHING.

    i *really* gained weight because my stomach is STILL not recovered from those months of vomiting and etc. so i may have been consuming a thousand calories or LESS [mostly less – some days, i had ONE pepsi for the whole day, which 300 calories, and THAT’S IT].
    so i *REALLY* gained weight because my body thought it was STARVING and turned EVERYTHING IT COULD INTO FAT!!!

    and that’s what MOST *DIETS* do to those who diet – they convince your body that you’re starving, and so any extra calorie gets converted to fat so you don’t DIE. not that you ARE dying, but YOUR BODY doesn’t know that! all it knows is that you USED to give 2000+ calories a day, and now your giving it 1000 or LESS, and it A) slows your metabolism [making it impossible to “burn” calories] and B) stores EVERYTHING IT CAN as fat.

    if you want to lose weight, DO NOT cut calories by more than 10% – any more than that, and you’ll make yourself GAIN weight! and really, it’s not the calories, it’s not. there are ways to trick your body into thinking those 400 calories total of salad are 2000 – but it takes more than just eating nothing but salad. it’s HARD. and often self-defeating.

    i know that there ARE ways to “lose weight”. i just don’t know of any that i, personally, can do, because the ONLY thing available to me is “diet” and cutting calories ends up making me gain weight – and most people [not all! just most], especially those who can’t work on multiple methods of weight loss at the same time, are the same.

    sigh

  135. Bagelsan
    Bagelsan September 10, 2010 at 8:44 pm |

    Bagelsan, I’ve NEVER heard ANYONE say that “there has been no increase in fat among Americans at all over time.” It’s hard to accept that someone’s arguing in good faith when they use strawmen.

    I’ve absolutely seen people say that (not so much on this thread, but definitely on other FA-ish ones.) Several times, when it’s been mentioned that there’s been an increase in obesity in the US over the last few decades, someone has brought up the “but there hasn’t really ’cause they changed the definition of obesity!” argument, or “but my family/people have always been fat, that hasn’t changed at all!” and the like. I’ve honestly seen people write it off as being purely attributable to the changes made to BMI categories or to an aging population.

    As for the “sociopath” thing that Sheelzebub is so very worried about, that was in response to this kind of stuff:

    The difficulty here is that none of us have a vested interest in another persons health. …

    … why do we care about the healthfulness of people except as a means of body policing? Kristen J.

    I’m seriously on board with the idea that people don’t have to justify personal decisions/health/lifestyle/etc. to each other. I’ve even said that very thing several times. What I called “sociopathic” (I never personally said Libertarian, though I don’t think it’s completely off-base) is the attitude that no one can (or should try to) truly generously lovingly care about the health of another person. The idea that the only reason for concern is for use as a weapon. That is just way too far for me.*

    I’m not saying fat (or any) people who aren’t explaining themselves 24/7 are sociopaths. I’m saying the claim that a non-shaming concern for healthfulness is impossible is way too darn cynical (really? No one cares about anyone unselfishly and unoppressively?) Not only do I believe that genuine concern can exist on a personal level, but I believe that as a society we really do have a vested interest in the health of the people in our society with us.

    I read the toxic waste comparison as following up on that idea of collective/unselfish concern. I mean, come on, you excerpted quotes like this: “Health is a fucking moral right, and the STATE is a key agent in enforcing such moral rights.” Do you really disagree with this? Do you honestly think that is equating FA with dumping toxic waste? Seriously now.

    *Kristen’s later point about not sharing your concern uninvited makes much more sense, frankly, and as a general rule I agree. It’s not like I think she’s a sociopath! (Kristen, I don’t!) I just thought she was stating the “hands off” approach much too strongly.

  136. Meowser
    Meowser September 10, 2010 at 10:42 pm |

    It’s interesting that people would bring up “intervening” on someone with anorexia nervosa as a corollary to “intervening” on someone for being fat. Aside, of course, from the fact that one of those things is an illness manifested by a specific cluster of behaviors, and one is an outcome based on factors that differ dramatically from one fat person to the next.

    The most famous case of AN is probably Karen Carpenter. If you’ve ever read the Carpenters’ authorized biography, you know this: People did nothing BUT pressure that poor woman to eat, for eight fucking years. She simply could not do it, not even with the best “help” in the world. Even if you could successfully attribute all fatness to disordered eating — and you can’t, not by a long shot — how is “how dare you wear pants size X” supposed to be curative? Do people really think people binge or starve or purge because they don’t hate themselves enough to quit?

    THAT is the problem with body policing and shaming individuals, right there. If being fat made me ipso facto self-destructive, I would never have taken the medications that made me this way, the medications that made it possible for me to put away the threat of taking my own life. I would have been significantly thinner if I had never seen a doctor in my life; there’s also a pretty good chance that all that would have meant was my family getting to buy me a smaller coffin. Even at my very lowest point, even I, Ms. Fat Acceptance, was reluctant to go back on the Evil Brain Drugs of Doom because without them, I was losing weight, and almost everyone thinks weight loss for a fat person equals wellness and trustworthiness. That’s how thick the fat hate is out there. In order for me to pull myself out of the hole, I had to believe there were far worse things — in fact, far less healthy things — in life than being “morbidly obese.” I HAD to.

  137. nolachub
    nolachub September 10, 2010 at 11:01 pm |

    “…because I’ve been at various points on the weight spectrum, everywhere from just slightly overweight to morbidly obese, I can pretty much say that when I feel my shittiest is when I don’t take care of myself.” Zuzu, I dug your article plenty, but can’t help but think that this statement veers awfully close to moralizing too. This lady is fat, but not because I do not take care of myself. Also, does the stress of good genes as a virtue imply other fat people without “good” genes should be regarded differently, like those Starship Troopers? Shout out to Shezelbub, and to Shah 8; I think y’all should work together and get some things done!

  138. Miss S
    Miss S September 11, 2010 at 12:05 am |

    I was trying to differentiate between overweight (which can mean 5 pounds overweight) and obesity.

    Alara- I don’t think that anyone here thinks shaming people is the answer, so I don’t think that’s where the conflict is coming from. I do think that some of us are discussing societal problems and solutions and some people feel ashamed.

  139. smmo
    smmo September 11, 2010 at 3:13 am |

    Miss S: The idea that people care about public health so that they can shame people is, frankly, paranoid. I think that some of you are placing far too much importance on yourselves. No one is after you. Seriously.It’s not really about you, it’s about providing opportunities to be healthy/healthful to people. See my earlier comment about access to healthcare, mental health providers, and nutritious food, such as community food gardens.
    I’m starting to wonder if this topic is a way for otherwise entitled, spoiled women to feel oppressed. If you think for one second that being fat is anything like the kind of oppression that other people go through on a daily basis, you need to get a fucking clue. It’s not. Do we have a history of enslaving fat people? Lynching them? Advocating for mass genocide or murdering people for being fat?
    All women, all the time, are policed on their looks and no woman actually measures up. That’s the point. No one actually wins at this game.If you want to push back against the beauty ideal, go for it- but not by pretending that obesity (not 10 pounds overweight, but obese) has no health ramifications (whether that’s a result of the obesity, or the factors that led there).

    I do feel your sincere concern for my well being when I read your remarks, Miss S. I really hope you’re in some sort of public health role professionally, cause I can see you’d have a real knack for it. /sarcasm.

  140. sannanina
    sannanina September 11, 2010 at 4:02 am |

    Sheelzebub- If people are going to pretend that being 800 pounds isn’t unhealthy, they are living in denial.

    Reality check: I am currently classified as “morbidly obese”. I weigh approximately 290 pounds which at my height translated to a BMI of about 44. Compared to this chart this would put me near or in the 2% of the population with the highest BMI if I lived in Mississippi (which I don’t, but last time I checked, Mississippi was not known for the relative thinness of its people compared to the rest of the US or, indeed, the world). If I weighed 350 pounds I would already be pretty much at the very right end of the distribution which means that anyone weighing 800 pounds would be an extreme outlier.

    I do not argue that weight at the level I am at does not play any role in health (which, let me repeat IS already quite unusually high – most “obese” people have a BMI between 30 and 35). It might even play a causal role in health problems I will encounter in the future. However, I claims like this one by sha8 just don’t apply to me or many other very fat people, and we undeniably ARE truly “obese” to the prevailing standard:

    Being truly obese means being disabled, and it can mean being as disabled as people with a bad heart. People are locked in their homes/rooms by their own bodies. People can’t do the things that might make them happy if it requires much moving–even to get up and walk to the stoop in the porch or in the garden might require a whole bunch of “Do I *really* wanna?” questions that people shouldn’t have to answer. Not only are they locked in their bodies, their bodies are often painful with bad joints and poor circulation with limbs going to sleep all the time. This is not even going to all the degenerative diseases that can accompany serious obesity.

    As a person who is fat, and (just to repeat it) much fatter than most of the population this might describe the stereotype of me, but it doesn’t describe my life AT ALL. In fact, the greatest obstacle leaving the house is not my body but the attitude of the people around me towards my body.

  141. Kristen J.
    Kristen J. September 11, 2010 at 4:51 am |

    Alara – That was brilliant. You cut through all the bullshit and laid it out perfectly.

    Sheelzebub: What they are saying is that people–even people who do not eat the things you approve of–deserve to be treated with dignity and respect. That–and I’m going all capslock here–EVEN PEOPLE WHO EAT FUCKING BIG MACS THREE TIMES A DAY BETWEEN EACH MEAL deserve to be treated with respect, have a right to healthcare, and deserve to be treated with dignity by their doctors. That no one should have to justify their existence to you or anyone else.

    No one here is being a goddamn libertarian for a day, but thanks for playing. No one here said, hey, we should ban school lunches and nuke the FDA because it’s against FA. They said that distinguishing between the “good fatty” and the “bad fatty” is playing into the moral panic and fat hatred that makes their lives harder.

    Yes, times a million. ‘Cause it’s impossible to believe that someone might support universal healthcare, tighter food regulations, a higher minimum standard of living, a stronger EPA, better nutrition education programs AND treating individual people with dignity and respect. God forbid we want people to have healthy options without feeling that we have a right to bully people into making the choices we think are appropriate.

  142. Julie
    Julie September 11, 2010 at 7:36 am |

    I don’t understand how publicly shaming people for their weight and their choices is the same as caring about their health. I care about the health of people in general and I want everyone to have access to high quality food and health care. How do I accomplish that by shaming people about their weight? No is saying you can’t care about people’s health. What they are saying is that systemic approaches to health work better to address the problem than by telling people who are overweight that they are lazy and need to put down the donuts. I’m a size 18, so I definitely fall into “OMG Fat!” category and there’s a huge difference between my doctor talking to me about health/weight/nutrition (which she doesn’t by the way because she is ok with my weight as it is stable and not affecting my health in any way) and shaming me about how I am going to die any minute and not taking my health concerns seriously. My sister weighs just a little bit more than me and we had our annual exam/pap smear around the same time and while I was told that as long as I felt good and my weight remained stable, I didn’t have to worry about trying to lose weight my sister was told that she was going to have trouble finding someone to marry her while she was so fat (yes, seriously!), that her menstrual problems (which she had even when she was much thinner) were solely caused by her weight and so on and so forth. It’s ridiculous. Now take that shaming coming from a virtual stranger and it becomes even more offensive. No one in the FA movement is saying you can’t care about people’s health or work to improve the choices available to people. What they are saying is that fat people deserve decent health care and basic dignity and respect, just like everyone else.

  143. zuzu
    zuzu September 11, 2010 at 9:10 am |

    Damn, I missed all the fun while I was traveling. I lost the ability to post anything for a while there.

    Just a few things. @shah8: You really should watch the pot-and-kettling on the stupid comments, because The Stupid Is Strong In This One (that would be you). You love to sling around the “glibertarian” canard, don’t you? You may not have checked the links in the post, but two were to pieces I wrote about Megan McArdle, an honest-to-fuck Randian (who, btw, is currently getting her ass handed to her by Real Live Economists). You may have noted that one of the defining features of libertarianism/Randianism is a horror and disdain for collective solutions. And yet, here we are in this thread advocating… collective solutions. Which would be those “structural” and “public health” things people are talking about. Do try to keep up.

    And what, exactly is “true” obesity? Because as I said, there’s a world of difference between someone who’s just over the BMI level that gets you classified as “obese” and someone who’s 800 pounds and immobile. And yet both are obese, though only one is an extreme outlier. I’m currently “truly” obese, because you either are or you aren’t. Your “concern” for my health is noted, and given the proper consideration, which is none, considering you think I must be ready to drop dead.

    @Miss S: I will not engage your huffing about how fat hatred really isn’t so bad for those who experience, except to point out that a) way to dismiss the experiences of others who aren’t like you; do you do that with other groups? and b) Given that fat kids have a quality of life comparable to those with cancer due to teasing and bias from peers, parents, teachers and others, your opinion is worth the same amount of consideration as shah8’s on this issue.

    Lauren: @Zuzu, Because she is a Feministe guest with whom the Feministe team is familiar, we are positive that she was acting in good faith.Sure, she stepped in some shit, but let’s not act like she came here to stir up trouble.C’mon.

    I will agree that she didn’t come here to stir up shit. Yet shit was stirred.

  144. zuzu
    zuzu September 11, 2010 at 9:16 am |

    Oh, and I’m not going back through the thread to pick out individual comments at this point (I’m recently off a red-eye and haven’t slept for 36 hours), but I just want to reiterate what others have said: You can be concerned about public health trends and advocate for solutions to said public health trends without shaming individuals for the size of their asses.

    One way you do this is to make changes that apply to the general public and don’t just hector individuals. So you offer tax incentives to grocery stores that open in underserved areas, or you ban trans fats in a city or require disclosure of nutrition, or you require health education in schools with a nutritional component. You don’t follow around fat people and yell at them for eating things you don’t approve of.

  145. shah8
    shah8 September 11, 2010 at 10:05 am |

    Pot and Kettle, Zuzu?

    Fine, I’m pretty much done then.

    I did a bit of browsing on the fat-acceptance movement. Completely okay with the manisfesto, but again, I see the same sort of nastiness and disingenuous argumentation in other parts of the web with strong elements of denialism, depending on the sophistication of the audience. I’ve since come to the conclusion that FAM umbrella shelters large pockets of toxic people seeking followers and codependencies. Also, as a person who has books like Doubt Is Their Product by David Michaels and Bending Science by McGarrity and Wagner on his bookshelf, some of the advocacy on the web is tingling my paranoid sense that this is astroturfing at its finest.

    At this point, I’m forced to not care. Y’all will get laughed out from every office, whether that be the First Lady’s, all the way to the local poverty advocate’s run down corner of the world. It’s not as if it’s isn’t easy to bring out the ideological crazy, and it’s not as if there aren’t gaping holes in your plans that indicate some of y’all’s unseriousness about actually helping other people.

  146. zuzu
    zuzu September 11, 2010 at 10:10 am |

    nolachub: “…because I’ve been at various points on the weight spectrum, everywhere from just slightly overweight to morbidly obese, I can pretty much say that when I feel my shittiest is when I don’t take care of myself.” Zuzu, I dug your article plenty, but can’t help but think that this statement veers awfully close to moralizing too. This lady is fat, but not because I do not take care of myself. Also, does the stress of good genes as a virtue imply other fat people without “good” genes should be regarded differently, like those Starship Troopers? Shout out to Shezelbub, and to Shah 8; I think y’all should work together and get some things done!

    Uh… no. I took pains to point out that I *feel* shitty when I don’t take care of myself; I also pointed out that the things that make me feel shitty also tend to make me put on weight. But I was also at pains to point out that being in a place where I don’t take care of myself is a complex matter, mentally and emotionally. The other part of that is that when I’m treating myself well, I may be doing healthier things that tend to make me lose weight — because I am in a mental space that allows me to care for myself — but even as I’m doing those good things, I’m still fat. I’m fat whether I take care of myself or don’t.

    I think you also missed the point about my good genes. I’m healthy because of my good genes; this doesn’t make me a worthy person or a good person or a good fatty. As far as the world is concerned, I’m a fat person and therefore unhealthy. And as I also said — it’s right there in the subhead — even though I’m healthy, it wouldn’t matter at all to my argument if I wasn’t, because no one has a duty of health or an obligation to be healthy in order to be considered a good person/citizen.

  147. zuzu
    zuzu September 11, 2010 at 10:14 am |

    Miss S: I was trying to differentiate between overweight (which can mean 5 pounds overweight) and obesity.
    Alara- I don’t think that anyone here thinks shaming people is the answer, so I don’t think that’s where the conflict is coming from. I do think that some of us are discussing societal problems and solutions and some people feel ashamed.

    Obese isn’t as big as you think, considering there are athletes and actors who are, by BMI, obese. Brad Pitt and George Clooney are supposed to fall into this category, and Sylvester Stallone definitely does.

    It’s not like there’s nothing between 5 pounds overweight and “we’re gonna need a crane here.” Yet somehow, in these discussions, it’s always the outliers, who are rare by definition, who are the image of what “obese” is.

  148. Living the Questions
    Living the Questions September 11, 2010 at 11:09 am |

    @zuzu: Thank you, thank you. AND I am all for societal changes… fresh fruits and veggies for all, enough time for everyone to get good sleep, lots of opportunities to move and play and challenge our bodies. I do think that the FA movement might be *misunderstood* to be against those sorts of things because of the statement I’m about to make, but… I’m not sure right now about requiring nutrition education in schools. (a) In the current climate of moral panic over obesity, and (b) given the many problems with nutritional science (which, actually, Michael Pollan details nicely in In Defense of Food, I think), I wouldn’t want to be on the receiving end of the nutrition education many schools might dole out. I just don’t trust them to do it, even though I’m a teacher who very much believes in schools.

  149. Sheelzebub
    Sheelzebub September 11, 2010 at 11:11 am |

    You don’t follow around fat people and yell at them for eating things you don’t approve of.

    And I’ll say, a lot of thin people eat stuff fat-hating moralists don’t approve of. However, since their BMI is low, no one notices. And if we started butting into everyone’s personal business–every damn lunch or dinner or breakfast or snack they had, people would be up in arms about it. But it’s okay to do it to fat people, apparently.

    And THAT, Bagelsan, is where the attitude about why should I concern myself with what private individuals do with their bodies comes in. We all seem to save this “concern” for fat peoople who don’t eat lots of leafy greens and lean proteins and complex carbs. I’ll again, point out to you, that I was quite able to eat fast food and fried shit and sugar and pasta with butter and a metric fuckton of salt (and still am) without gaining a lot of weight. And no one expressed “concern.” No doctor assumed I was unhealthy or ready to drop dead at any minute. No one got into my business. Fat people are “visible” that way, but we all assume we know what they’re eating or why they’re eating it.

    I have friends who, the few times they go out, will indulge in nachos or a cheeseburger, but keeps it to the “good stuff” on their own (even if they invite me over to eat in–it’s all kale and salmon and a smidgen of wild rice and fruit for dessert). Still big. Still fat. When we go out, who do you think gets comments about their menu choices–the 127 pound woman who’s inhaling nachos with the steak chaser, or the 180 pound woman who’s eating nachos and a burger? Take a wild freaking guess.

    You know? It’s great to be concerned. But if you give a shit, be supportive, not policing. At the end of the day, people are autonomous, and they will make choices you or I or the woman next door may not approve of. And we will each make choices others don’t approve of. I don’t like policing when it comes to my sex life, yet that’s currently in fashion. Why should it be any different when it comes to food, or more accurately size (see the point I’ve reiterated oh, a hundred times above)?

    It wasn’t oppressive when I’d get cracks about ED when I was just north over the 17 BMI, but it did piss me off. I didn’t want to explain that I ate freaking constantly and ate high fat sugary stuff to boot, that my metabolism was off the charts, that really, I was okay! I didn’t think I should have to explain myself. Given the fact that usually my size was also met with approval (along with this weird ED gossip/concern), it was disorienting, but not oppressive. Fat people don’t get approval or encouragement–they get moralistic lectures and shitty comments and discrimination and assumptions and dismissal. We don’t have reality shows that focus on underweight people gaining weight on TV (thank the FSM). Fuck, we don’t have reality shows or programs showcasing people just getting fit and healthy and learing “good” eating habits. What we have is the Biggest Loser, Shaq’s Big Surprise (or whatever that show was called), some craptastic show about losing weight or getting money. . .but it’s weight focused, not health focused. People get praise for dropping pounds, not for say, gaining strength or being more active or learning to love wild caught salmon and spinach salad. And the rapid rate of weight loss has actually caused serious damage to people. As in, pissing blood. As in, further metabolic damage.

    And Meowser made an excellent point–whether it’s with an ED like anorexia or bulimia, or with the (assumed) disorder of compulsive overeating, hectoring and lecturing and nagging people doesn’t actually work. In fact, it often has the opposite effect.

  150. sannanina
    sannanina September 11, 2010 at 11:12 am |

    Miss S:
    Alara- I don’t think that anyone here thinks shaming people is the answer, so I don’t think that’s where the conflict is coming from. I do think that some of us are discussing societal problems and solutions and some people feel ashamed.  

    Miss S., I actually still do feel shame for my body. I do feel shame for it, because I have been taught to be ashamed of it since I was about four years old, and the message is still reinforced daily.There are plenty of studies showing that many medical professionals have overwhelmingly negative attitudes towards fat people. There are studies that show fat people are discriminated in the work place. There are studies that show fat children are teased by family members and are more likely to be bullied. Even preschool children prefer to befriend members of pretty much any other group to befriending a fat kid. It is actually quite hard not to internalize shame in such an environment. The irony of your comment, though, is that it seems to imply that the people feeling most shame are the ones most likely to “live in denial” and that is just bullshit.

  151. Sheelzebub
    Sheelzebub September 11, 2010 at 11:14 am |

    Just also wanted to follow up–even if my friend who indulges the few times she eats out didn’t eat “good” food, and wasn’t so “virtuous,” it really wouldn’t be my place or any one else’s to lecture her about her habits. We don’t do this when it comes to other things–credit card balances, savings accounts, life decisions, clothing, sex lives, high heels or whatever. Be concerned all you want but realize that you don’t have the right or the power to dictate another person’s choices.

  152. closetpuritan
    closetpuritan September 11, 2010 at 1:12 pm |

    “Several times, when it’s been mentioned that there’s been an increase in obesity in the US over the last few decades, someone has brought up the “but there hasn’t really ’cause they changed the definition of obesity!” argument, or “but my family/people have always been fat, that hasn’t changed at all!” and the like. I’ve honestly seen people write it off as being purely attributable to the changes made to BMI categories or to an aging population.”

    Bagelsan, I guess I’ll have to take your word for it. I’ve seen all those arguments brought up, but they’ve been used to argue that people’s idea of the obesity epidemic is exaggerated rather than that it doesn’t exist, or to counter the argument that there were no fat people in the past. (Yes, seriously, I’ve seen that claim.) I will say, though, that the same point could have been made better and more succinctly by saying that the average weight gain during the obesity epidemic has been roughly 10 lbs (with people at skinny weights gaining less, people at fat weights gaining more, and people in the middle of the bell curve gaining about 10 lbs). Which, you know, as an average over the entire population is pretty significant, but it might get people past the idea that their country has been overrun with newspaper-photo-style-Headless Fatties.

    I guess the main point of disagreement between the two of us is how much the minimization/dismissal of a direct link between fat and health (individually or at the population level) in a small group of people matters. Because I see so much hype about obesity and the obesity epidemic, and so often see oversimplification-to-the-point-of-inaccuracy of both the link between weight and health and the mechanics of weight loss and gain, that I think maybe it’s not such a bad thing–they may not be right, but if they can get people to at least start questioning exactly how weight and health are linked and what the mechanics of weight loss and gain are, maybe we can finally admit that it’s more complicated than the magazines would have us believe. And I think that in general, scientists who study these issues know that it’s more complicated. But the public thinks that following tips to “drop 20 lbs in 2 weeks!” is a way to get healthy. (Experts have told them you should aim for no more than 2 lbs a week, but it just doesn’t sink in–even among some MDs–e.g., the one denelian talks about in her comment.)

    And then of course there’s the fact that Health At Every Size is constantly brought up in FA, including among the “denialists”… If Americans started following HAES, I think that at the very least it would be a damn sight better than following magazine advice and other mainstream sources of “health tips”.

  153. Stephanie
    Stephanie September 11, 2010 at 2:54 pm |

    I read the comments on this same post on zuzu’s personal blog, and I noticed one that I thought was particularly illuminating (posted by a Ted Stein; I’m not sure if that person is reading over here or not):

    “One minor quibble: What’s it to you? Health matters and a decent society owes it to its citizens to allow them the chance to be healthy. Too many today don’t have that opportunity. Please note that I am not saying people owe it to society to be healthy, but society does owe people that chance at being healthy.”

    I think this is a really excellent way of clarifying the issue of whether concerning oneself with the health of society as a whole is intrusive or simply ethical. I’d posit that it can be either, depending on whether you’re looking at health as something individuals owe to society, or the reverse. I think people are talking past each other here in comments a bit for exactly this reason. FA activists are saying that our energy should be spent on making structural changes such that healthy choices are possible rather than onerous; one should have that “chance at being healthy” that Ted refers to without being blocked at every turn. Right now, this isn’t the case– everything from food subsidies to zoning laws to a lack of funding for education has combined to create a toxic environment which denies that chance to everyone except the very privileged (who can use their resources to clear those hurdles and then claim that “anyone can do it”).

    What FA activists are also saying is that beyond working to ensure that everyone has the same access and options, our involvement should be limited. It’s really none of our business whether people avail themselves of those options once they exist, because there’s no way to make it our business in a way that’s consistent with the belief that individuals have agency and the right to make decisions about their own bodies. And I think that’s being interpreted by others as FA activists simply not giving a shit about public health.

    Obviously, some do feel that individuals do owe it to be society to be healthy. Others are just assholes who want fat people to stop being fat and don’t care in the slightest about health. But I don’t want to write off the possibility that some of this might just be a misunderstanding over definitions.

  154. Stephanie
    Stephanie September 11, 2010 at 2:57 pm |

    Just to clarify: by “some” in the last paragraph, I meant “some people in this thread,” not “some FA activists.”

  155. PrettyAmiable
    PrettyAmiable September 11, 2010 at 2:57 pm |

    Sheelzebub: sex lives

    I definitely get lectured on my sex life, haha – and even on this site, a few weeks ago. Actually, I think this is a point made in the other response where they compared slut-shaming to fat-shaming. I, too, am supporting a lifestyle that encourages diseases! And high healthcare costs! Don’t I know it’s bad for me?? Think of the children! However, I agree with the general point you were making and apologize for the derail.

    Miss S: All women, all the time, are policed on their looks and no woman actually measures up. That’s the point. No one actually wins at this game.

    This isn’t about women getting policed for their looks. All overweight people feel this discrimination regardless of gender. Maybe there’s some compounding effects if you’re also a woman because of the patriarchy (and I’m not sure we’ve touched on being an overweight transgendered person in this super long comment thread), but I know fat dudes and they get shit for being fat and in public too.

  156. PrettyAmiable
    PrettyAmiable September 11, 2010 at 2:58 pm |

    Also, zuzu, loved the post.

  157. Kristen J.
    Kristen J. September 11, 2010 at 2:59 pm |

    Bagelsan: Not only do I believe that genuine concern can exist on a personal level, but I believe that as a society we really do have a vested interest in the health of the people in our society with us.

    “Vested interest” essentially means the right to control. Which I why my original statement was actually pretty mild. You don’t have the right to control another person’s health. You can wish them the best. You can provide them with every opportunity (and I do mean every opportunity, including the ones you don’t agree with but cause you no harm). But ultimately, what they do is their decision and that decision should be respected.

    There has to be a sharp and unbendable delineation between actions we take to promote the well-being (in a totality sense, not just a health sense) of people and the choices individual people make that cause no direct harm to third parties.

    The problem with metrics like the BMI is not that they exist, its that people don’t understand how statistics works…that you can aggregate data to come to a broad conclusion, but you can “de-aggregate” data to apply to a single individual. Its an almost universal flaw in our reasoning, like our inability to process probabilities. Given that statistical measures like the BMI are used to bully and oppress people, it seems reasonable to say…Stop using them wrong. Every time your doctor calculates your BMI to put on your chart…ze’s doing it wrong. Every time an insurance company asks for your BMI….they’re doing it wrong.

  158. Kristen J.
    Kristen J. September 11, 2010 at 3:10 pm |

    zuzu: Obese isn’t as big as you think, considering there are athletes and actors who are, by BMI, obese. Brad Pitt and George Clooney are supposed to fall into this category, and Sylvester Stallone definitely does.

    Exactly…I used to get BMI lectures from my doctor even though I had a 20 inch waist…it just so happens I also have ginormous breasts. It took years for me to stop starving myself (literally…eating less than 600 calories a day) trying to get my weight to the ideal. It wasn’t until I moved and my new doctor thought I had an eating disorder when I explained my diet that I understood that I wasn’t supposed to weigh 115lbs.

  159. Sheelzebub
    Sheelzebub September 11, 2010 at 7:12 pm |

    @PA–

    I definitely get lectured on my sex life, haha – and even on this site, a few weeks ago.

    PA, you’re right–it was definitely an oversimplification. Heck, I even made a comment about how it has become fashionable to police women’s sex lives later in one of my comments (refusal clauses, slut shaming, etc.). Except it’s not fashionable–that would imply it’s relatively new. Sigh. I guess I just figure that among feminists, someone freaking out over me taking the Pill or getting an abortion or having a one-night stand would be/should be looked at as a bit retrograde (not quite the case, just new and inventive ways of shaming–like the fact that I am apparently destroying the environment by insisting on using hormonal BC).

    You know everyone, I’m reading everyone’s experiences with doctors–praises for losing weight after puking constantly for six months, lectures about BMI even though most of the weight was in your breasts, dismissal of neurological symptoms, and I’m sickened and disgusted. No one should have to go through that shit. No one.

  160. Miss S
    Miss S September 11, 2010 at 9:00 pm |

    Sheelzebub- I have said repeatedly that everyone deserves respect. Everyone. I said it is unacceptable for medical professionals (or anyone) to disrespect or degrade someone.

    They believe that people’s private lives are their business, and that while we can and should make good health a priority, and access to good food and physical activity open to all, that it doesn’t extend to policing the fat people you meet or know.
    I agree with all of this. I said that there is a much bigger picture than someone’s individual weight- including healthcare (including mental), access to nutritious food, etc. Where is your reading comprehension?

    I reject the idea that anyone who cares about public health is really just trying to shame people. It is a ridiculous and paranoid thought. There is a big difference between looking at social and economic factors and calling someone on the street fat. I never said that calling someone names or being disrespectful to someone because of their weight was okay. I don’t know how anyone could draw that conclusion based on what I’ve posted here.

    I said: it’s true that the factors that cause obesity may cause the health problems for some individuals, as opposed to the obesity causing the health problems.
    I said: Access to physical and mental health care plays a role. (I also said that it has for me)
    I said: Access to nutritious food plays a role.

  161. Miss S
    Miss S September 11, 2010 at 9:06 pm |

    PrettyAmiable: Really? I read somewhere that fat men are perceived differently than fat women because of the expectation that women are supposed to maintain a very specific appearance.

  162. CassandraSays
    CassandraSays September 11, 2010 at 9:21 pm |

    You know, I’ve been really reluctant to dive into this mess this time because although I’m pro FA, I’m also very nutrition conscious and so I sympathise with the desire to talk about nutrition on a macro level. But the thing is, there’s a difference between “a large percentage of the population does not have access to healthy food, and this is a problem” and “people are just so fat and that’s bad, they should stop being fat”. And any time anyone tries to have the former conversation, it always devolves into the latter conversation. Which is pretty much an indication that FA activists are correct when they say that society suffers from scary levels of prejudice about fat people, so to see people denying that is frustrating.

    The thing is, whether or not being very fat is unhealthy isn’t actually relevant to the larger question of whether or not it’s OK that prejudice against fat people exists. Also, as several personal stories posted here can attest to, often being very fat is a result of ill health rather than a symptom of it. Which means that addressing the issue as if fat were the cause is completely ass-backwards.

    Also, and this is why I was sort of reluctant to jump in here, but I don’t see anyone else putting it out there so I will…having an atmosphere in which it’s considered acceptable to question the health of strangers and get nosy/interfering about their diet and how it relates to their health isn’t just damaging to fat people (though they’re by far the most injured party). It’s also really, really distressing to people who’re not fat but who suffer/have suffered from eating disorders.

    So I used to be anorexic. I’m not fat – in fact I’m a size 6, at age 37. Logically of course I’m aware that the concern trolling about fat and health isn’t aimed at me, but because I was anorexic, as soon as I hear people doing it I get kicked right back into the state of mind that I worked so hard to escape from. It doesn’t make me feel validated as a relatively thin person, it makes me feel like that “you’ll never be thin enough, and if you were to gain weight people would despise you” voice in my head is entirely logical and correct. In the past reading those sort of comments has in fact triggered a few minor relapses.

    I think this is a lot like discussions about sexism, where men come in and act as if all the stuff women are complaining about was taking place in a vacuum. There is a context in which commentary about women’s bodies and health exists. It’s a context in which women feel under the microscope all the time, and in which our feelings of self worth are often directly tied to other people’s perceptions of our appearance. So, when someone makes comments about women’s weight and health, no matter how well intentioned, that’s going to set off a lot of other associations in the heads of women reading. It’s reinforcing the status quo, basically, and women’s sense that it’s vital that we be attractive or we may as well just not exist. It’s happening in a context in which, when teenage me went on a diet of under 300 calories a day, not a single person other than my swim coach questioned whether that was a good idea. OK, so I told people I was eating 700 calories a day because even then I realised 300 would freak people out, but still, a context in which a healthy, athletic 14 year old can tell people she’s eating under 700 calories a day because she needs to lose weight and only one person even questions that, even though she’s not remotely overweight? That is not a context in which “well, but think about your health, being fat might make you sick” is going to be recieved as a neutral comment that’s just about health by any woman, regardless of her weight.

    For a lot of women, fat and thin, these conversations are one giant trigger. Add the actual discrimination most fat women have encountered from doctors (and I believe them, because I’ve been concern trolled by a doctor about my weight and my BMI is normal – she had apparently decided that any BMI over 21 is unhealty for women and the up-to-25 recommendation is only for men), and is anyone really surprised that fat women push back hard against the “well I’m just concerned about your health!” comments?

    I really don’t believe that kind of commentary is making anyone healthier, physically or mentally.

  163. Bonn
    Bonn September 11, 2010 at 9:27 pm |

    I’m skipping about a million comments, so apologies if this was covered.

    It is extremely disingenuous to point out that being underweight causes death more than being overweight.

    Why?

    Because a lot of fatal diseases are wasting diseases. Officially, my aunt died from a lack of nutrition. Really, it was the cancer in her thyroid. There aren’t many diseases that will make you fat before they kill you, but there are plenty that will pick at you until you’re so underweight your body just gives out.

  164. CassandraSays
    CassandraSays September 11, 2010 at 9:45 pm |

    RE The question someone asked about Japanese exchange students…hmm. I work with a lot of Japanese people (entertainment industry), and in my experience what’s considered a normal weight in Japan is probably a good 30 pounds lower than it would be in the US, at least. Example – there’s a guy whose band I just covered a few days ago. 5ft10, 125 pounds. That is not his natural weight (nowadays he barely eats). When he was at his natural weight (about 145 pounds) people wrote letters to his record company complaining about how fat he was. And this is a man with an unusually big frame – tall, big shoulders, broad chest. No one in America would have called this guy fat, in fact most people would have called him thin, and the weight he’s at now is usually percieved as much too thin by Americans, but as ideal by Japanese people.

    Basically anything over a BMI of about 23 for a man, maybe 21 or so for a woman, seems to be percieved as fat in Japan. It’s regional though – the expected normal weight is at it’s lowest in Tokyo, Kyoto, etc, and the rural areas/outer islands are less extreme, and people on average a little heavier. A friend of mine who’s from Hokkaido says it’s OK for people to be what Americans would consider average there, but definitely not OK to be what Americans consider fat. She gets concern trolled about her weight there, and she’s about a size 10 and quite tall.

  165. Jadey
    Jadey September 12, 2010 at 12:40 am |

    Bonn: I’m skipping about a million comments, so apologies if this was covered.It is extremely disingenuous to point out that being underweight causes death more than being overweight.Why?Because a lot of fatal diseases are wasting diseases.Officially, my aunt died from a lack of nutrition.Really, it was the cancer in her thyroid.There aren’t many diseases that will make you fat before they kill you, but there are plenty that will pick at you until you’re so underweight your body just gives out.  

    I sympathize with not having the time or energy to read a long and convoluted thread, but your interpretation of that aspect of the discussion is not accurate. The issue is not whether being “underweight” causes more death than being “overweight”, but that being classified as overweight is not itself a death sentence, and that “healthy” weight is in fact a very broad category if we use it descriptively (e.g., the weight of a healthy body), rather prescriptively. In fact, your point about wasting diseases may be part of the protective aspect of fat: nutritional reserves. (I am aware that somewhere on another thread someone suggested using being fat as a health standard – this also fails to accurately represent the research and is just the fat-reversed equivalent of the problems we already have. Whenever we employ prescriptive standards for weight, appearance, and health, we will end up policing the bodies that do not meet these standards.)

  166. April
    April September 12, 2010 at 2:19 am |

    What would be awesome is if people would stop talking about the morality of being fat, but the necessity of being healthy. There’s no reason why we can’t talk about how to be healthy without making fat people feel sad. Everyone can own their identities, be happy with who they are, and own their own future.

    Welcome to Pipe Dream USA.

  167. BStu
    BStu September 12, 2010 at 2:23 am |

    Bonn, would it be disingenuous to point out that there is always an excuse to make thin-unfriendly science disappear? And yet when Fat Acceptance activists suggest possible factors being ignored on the other side of those reports, we’re in “denial”? Why do you have the privilege to “deny” science?

  168. Sheelzebub
    Sheelzebub September 12, 2010 at 7:30 am |

    Oh, indeed, Miss S. Yet when fat people on this thread tell you that their LIVED experiences are that people dismiss them, deride them, disrespect them, and discriminate them and use this “concern” as a cover, you dismiss it and deride it. When fat people on this thread say that their experiences with public policy that focuses on size and not so much health has actually made their lives and health worse, you shrug it off and call them paranoid. You say that of course it’s terrible that there are bad doctors and that no one deserves to be made fun of or discriminated against, but that it’s really not that big of a deal. If you gave a flying fuck about public health, one would think you’d be glad to see so many FA agreeing with you on structural solutions–but instead, you dismiss the very problematic and destructive ways pro-health rhetoric has been used to hurt fat people and to actually ignore health in general (see: the policing of what people eat if they are fat but not thin, the assumptions that thin means healthy, the dismissal of illnesses by doctors who decide that the problem is deathfat). And then, to cap it off, you ignore what fat people on this thread have been telling you about their lived experiences, about their worsening health due to the fat-phobia couched in concern and procliam that they are paranoid, that they are just entitled, spoiled women looking for a way to feel oppressed. That they aren’t “really” discriminated against because they don’t fit the criteria that you have personally selected for what constitutes a less-privileged group.

    For someone who claims that of course we should respect fat people, your dismissal, your disrespectful and hateful comments show the opposite.

  169. Living the Questions
    Living the Questions September 12, 2010 at 8:30 am |

    @Bonn: I’ve always thought, when seeing those numbers, that the underweight category includes cancer victims and so forth, so I agree with you. Except I don’t agree with the comment about it being disingenuous… because the same thing influences the way we see the deaths of those in the obese categories, doesn’t it? If an accurate understanding of the data on mortality and weight means taking out all of those with wasting diseases from the group of underweight folks, we would also need to take out those from the obese category whose weight is a symptom of disease, yes? We would struggle to do that, though, because we have a much better sense of how starvation works… we’ve been worried about that for millennia. But there’s evidence to suggest, for example, that diabetes and obesity are caused, at least in part, by the same genetic factors, and so we would need to take deaths related to diabetes out of the mix, if we were to take wasting diseases out of the mix for the underweight? These are genuine questions, I’m asking, by the way, not rhetorical ones, though our ability to agree on answers to them probably depends on whether we can agree that obesity bears a correlative relationship to disease (as you so rightly point out that underweight does), rather than a causative relationship to it.

  170. closetpuritan
    closetpuritan September 12, 2010 at 9:51 am |

    Bonn, scientists do in fact have ways of statistically correcting for such things. It is disingenuous to pretend that they don’t, or to imply that based on the scientific evidence, “underweight” is healthier than “overweight” in the absence of a disease that is causing someone not to be a normal weight.

  171. William
    William September 12, 2010 at 11:43 am |

    I reject the idea that anyone who cares about public health is really just trying to shame people. It is a ridiculous and paranoid thought. There is a big difference between looking at social and economic factors and calling someone on the street fat. I never said that calling someone names or being disrespectful to someone because of their weight was okay. I don’t know how anyone could draw that conclusion based on what I’ve posted here.

    You can reject the idea all you want, but that doesn’t change the fact that public observation and judgment against norms necessarily leads not only to shaming people who fail to meet those normative standards but to actual coercion being used in order to enforce those norms. Thats the way it works.

    See, in this thread we’ve had a lot of dog whistles being blown. People are using words like “concern” and phrases like “vested interest” in relation to the bodies of others. Those are words which imply a stake, an element of ownership, a right to influence outcomes. Smart people, people who definitely understand why treating bodies as public objects is problematic, are tossing those words out with quick little “well obviously I don’t mean we should be calling fat people fat to shame them” caveats in order to stave off some of the dissonance they’re experiencing.

    The problem with “public health” is that there is always a norm being enforced, always an ideal. You don’t have to have cops pulling the burger out of someone’s hands and dragging them off to fat camp for public health aimed at the specter of obesity to be deeply problematic. Talk about obesity as being expensive? You’re shaming fat folks for being a drain on the system (even though, statistically, they aren’t). Talk about obesity in children? You’re exposing ever younger people to the anxiety of what being fat means in our society. Talk about “encouraging healthy choices?” You’re telling fat people that they’re going to die and, probably, at some point talking about discouraging some choices that you don’t like through taxation or outright prohibition. At each step of the “public health discussion” you’re shaming fat people because you have a massive amount of hand wringing, public concern trolling, and always a few people who say the really nasty things that everyone else tries so hard to distance themselves from, directed at eliminating fat people. How is a fat person supposed to feel from a discussion which revolves around making them not exist anymore?

    The real bottom of it, though, is that the moral panic over obesity was never about health. Its about controlling bodies and behaviors. A lot of people think us fatties are ugly and most people don’t want to look at ugly people. Everything else in what passes as the obesity debate is theater.

  172. Maia
    Maia September 12, 2010 at 6:57 pm |

    I reject the idea that anyone who cares about public health is really just trying to shame people.

    People have had many great responses to this. But I also think you’re possibly misunderstanding . As far as I know no-one is arguing that the *intention* of public health is necessarily to shame people. What people are talking about is the *effect* of public health measures. Particularly, (or at least this is the argument I would make) public health measures that focus on individual change rather than structural change, and those that focus (and also those that pathologise certain types of bodies in order to justify their treatment).

    I would probably go a little further and talk about the ideological purpose of this approach to health (in terms of the role it plays in upholding capitalism – there has been a brief discussion about this on the shameful bodies thread). But in saying this, I’m not arguing that that’s the intention of those who use this rhetoric, but making a structural argument.

  173. Orangeblossom
    Orangeblossom September 13, 2010 at 10:06 am |

    I can relate to the issues with doctors. I’m in Canada, with easy access to medical care and even found a decent family doctor; but he was obsessed with weight.

    I gained 40 lbs during my first year of university and was showing every sign of hypothyroidism. When I went to see the doc, he ordered the test; the only thing it showed was that I had low iron levels. Even after I pointed out that I have a fairly high iron diet because every blood test I’ve had (even one as an infant) showed low levels, he told me that I just needed to add more iron and lose the weight.

    Now, I don’t even want to find a new doctor to find out if my new theory of what is wrong is correct. I’ve since learned that celiac disease in a mild form can mimic thyroid disease because the body is unable to get the nutrients it needs (maybe that’s why I’ve always had low iron?????). From having removed gluten from my diet, I have more energy and am for the first time in 7 years losing weight. I also figure I’m just doing what that first doc told me to do; change my diet and lose weight :S

  174. trishka
    trishka September 13, 2010 at 1:04 pm |

    You don’t follow around fat people and yell at them for eating things you don’t approve of.

    zuzu, honestly do you see anyone on this thread advocating that? or even implying that it is acceptable?

    “Vested interest” essentially means the right to control.

    okay, that’s a logical leap that i am not prepared to accept at face value.

    But the thing is, there’s a difference between “a large percentage of the population does not have access to healthy food, and this is a problem” and “people are just so fat and that’s bad, they should stop being fat”. And any time anyone tries to have the former conversation, it always devolves into the latter conversation.

    really? who is having the latter conversation? i’m not reading anyone saying anything so simplistic. is this something that someone actually wrote, and i skimmed over it, or is it an echo of statements made elsewhere that is being triggered?

    FWIW, what i see is many people actually trying to have the former conversation, but it devolving into other posters saying “but you’re saying …” (the latter).

    either way i guess we can all agree that the former conversation isn’t happening. which is too bad – it’s one i would love to engage in.

  175. Sheelzebub
    Sheelzebub September 13, 2010 at 1:24 pm |

    Trishka, did you not read the accounts of fat people’s experiences with their doctors? Doctors who were so obsessed with size, as opposed to actual health, that they didn’t bother to check out the symptoms of illnesses and chalked it off to deathfat? Doctors who praised patients for losing weight, even though it was due to vomiting from painkillers? Doctors who refused to give tests for serious conditions/symptoms, telling people to just lose weight (and making their chronic conditions much worse)?

    It’s all well and good to be for health–but when anti-FA folks here deny the experiences of fat people and then declare that the problem is obesity (and not, perhaps, the causes of it, which actually are complex), it doesn’t actually help solve the problem. Again: focusing only on size will get people trying to lose weight, but not be healthy. When doctors only focus on size, they often do so at their patients’ peril. When you only focus on size, and people who are fat are judged for being fat, it doesn’t matter if your weight gain is due to overeating, a chronic condition or medication or environmental factors.

    People on this thread HAVE pointed out how public shaming affects them–and even if the anti FA folks here don’t advocate shaming (though some of them engaged in it), the hyperfocus on size as a barometer for health does encourage that.

  176. Alara Rogers
    Alara Rogers September 13, 2010 at 1:39 pm |

    @LivingTheQuestion: diabetes causes weight gain, or at least makes weight loss damn near impossible. It’s currently believed that it can go the other way around, and maybe it can, but I do see proof, in the form of my mother and her struggles with weight, that diabetes impedes *any* effort to lose weight. You cannot cut your calories past a certain point if you’re a diabetic, you suffer weakness in your limbs when your sugar is high so you can’t exercise then, you suffer dizziness and fainting when your sugar is low so you can’t exercise then, you recover much more slowly from any illness or injury at all than a non-diabetic… so “diet” and “exercise” are not techniques a diabetic can necessarily employ to lose or even maintain their weight. So for a *fact*, if a person who is overweight becomes a diabetic, and remains a diabetic for many years, they will not be able to lose weight if they put it on. Not temporarily, not at all. And that’s just ignoring the possibility that the metabolic processes that cause diabetes in the first place could also cause weight gain; I’m just talking about what’s observable and directly obvious in diabetics.

    Also, weight gain may be symptomatic of a physical disability that impedes the person’s ability to exercise; it may be symptomatic of a heart condition that impedes the person’s ability to exercise; it may be a medically-induced side effect of medication taken to correct a different problem, such as anti-depressants; and it may in and of itself be caused by certain conditions such as low thyroid, PCOS, etc.

    So, yeah, I agree. If you take out the people who are super-skinny because they’re dying of cancer, you also need to take out the people who are super-fat because they had a heart condition and therefore were unable to exercise, or the people who have a thyroid condition, or the people who are on medication for a differnt problem and the medication is causing weight gain. But as you said, we have a lot less clear of an idea how to do that, because we don’t really understand the causal relation between weight gain and disease.

    I actually thought it was a “well, duh” that underweight is more likely to kill you than overweight because underweight can kill *directly*, whereas overweight could only kill through slowly impeding some other process you need to live. So, yeah, “underweight” is deadlier than “overweight” because starvation causes death. But I believe that they’ve controlled for that to the extent that they’ve discovered that NORMAL BMI, which is not starvation for the vast majority, actually has slightly poorer mortality outcomes than the category called “overweight”, and you do not get to die sooner than the “normal” people until you fall into “obese”. (And “obese” ranges from Sylvester Stallone to 800 lbs, so it’s really almost meaningless.)

  177. Bagelsan
    Bagelsan September 13, 2010 at 2:43 pm |

    I guess the main point of disagreement between the two of us is how much the minimization/dismissal of a direct link between fat and health (individually or at the population level) in a small group of people matters. Because I see so much hype about obesity and the obesity epidemic, and so often see oversimplification-to-the-point-of-inaccuracy of both the link between weight and health and the mechanics of weight loss and gain, that I think maybe it’s not such a bad thing–they may not be right, but if they can get people to at least start questioning exactly how weight and health are linked and what the mechanics of weight loss and gain are, maybe we can finally admit that it’s more complicated than the magazines would have us believe.

    Hmm, I guess the harm I see is that I would like the generally-pretty-on-track FA group do it right. The “popular” opinion of fat and health is so ghastly wrong that I really agree there needs to be pushback against it, but it needs to be the right pushback, not the kind of pushback that devolves into “nuh-UHs” and doctor-bashing and using personal anecdotes as “proof” of anything.

    I don’t think scientific inaccuracy can be properly combated by more scientific inaccuracy, I guess I’m saying. Just like when discussions of the increasing medicalization of childbirth turn into rants about how women used to crawl out into the woods and bite a stick for the pain and that was fine and OBGYNs only care about their golf games… It just gets way too woo. And way too ridiculous, even for people who are basically sympathetic to the cause.

    I don’t think science works on a “bargaining” method — you can’t have one side start with extreme claims in one direction (fatness will kill everyone everywhere tomorrow!) and be met with extreme claims in the other (fatness has never killed a person ever, and it never will!) Or, at least, you can do that but no one will ever give a fuck because you will sound like a dumbass. (And it’s not fair, because both arguments are stupid, but one is entrenched so the other one is the one that gets dismissed.) I’m not saying that pure logic has ever won the hearts and minds of Americans, but an obvious contempt for science and the medical profession isn’t going to do any good at winning slightly more knowledgeable people’s hearts and minds either.

    When it comes right down to it, I’m currently critiquing some of the FA stuff because it’s closer to being right than the mass-appeal diet-palooza quackery. And it’s really painful seeing basically-correct groups get bogged down with cheapshots like doctor-hating (which I understand, but it isn’t the basis for a public education campaign or anything, yanno?) or fingers-in-the-ears lalala-ing about BMIs. There’s a place for that, but that’s also some of the only stuff I hear out of FA.

    So…maybe I’m just in the wrong thread. Maybe the point of this thread is group-hugs and doctor-hating-until-everyone-feels-better, ’cause that stuff’s important for group unity and everything, but that’s not the kind of stuff that will create genuine firmly-grounded and smart scientific pushback against the fatphobic dieting culture. Which is of much more interest to me.

    (And — this directed at Kristen J. — I think it’s ridiculous to get bogged down, in a post that dealt a lot with philosophies of health, in sniping about how people who have very slight philosophical disagreements with you are obviously just in it for the control and gloating. Are we here for a good-faith discussion or a close-reading exercise? Interpret “vested” however you like, it doesn’t mean I hate fat people.)

  178. Sheelzebub
    Sheelzebub September 13, 2010 at 3:09 pm |

    OK, you know, Bagelsan, these “doctor stories” aren’t just anecdotal. There is research to back it up. The Yale Rudd Center’s done a lot on this, actually. Doctors openly admitted to viewing fat patients as undisciplined, unhygienic, lazy, unintelligent, and hostile, among other things. (And when you view patients that way, you aren’t actually going to bother listening to them.) Sixty-nine percent of fat women said they experienced bias from their doctors; 52 percent said this happened on more than one occasion. Almost one-third of the nurses surveyed said they’d rather not treat obese patients.

    And what is the result? Doctors spent less time talking to/listening to their overweight patients, were reluctant to do basic preventative health screenings–you know, the things that we are supposed to get every year–and just spent less time with them overall than most patients.

    This is not just some anecdotal thing. These are not figments of the commenters’ imaginations.

    I think it’s ridiculous to get bogged down, in a post that dealt a lot with philosophies of health, in sniping about how people who have very slight philosophical disagreements with you are obviously just in it for the control and gloating.

    Kinda like sniping about how FA are in it for the doctor bashing and group hugs?

    Oh, and to anyone who thinks that fatphobia isn’t as important as battling obesity (or that it’s not really a problem and that fat people are complaining over nothing)–fat people were far more likely than thin people to encounter discrimination on the job. It most states, is perfectly legal to refuse to hire someone–or to promote someone–based on their weight, and it’s also legal to fire someone for not losing weight.

  179. Bagelsan
    Bagelsan September 13, 2010 at 3:40 pm |

    Yeah, I know, I’ve seen that doctor-attitude research before and it’s truly shocking. There’s no doubt in my mind that stigma against fat people exists, even among the medical profession. And yes, that research is not anecdotal. The anecdotes are — I don’t disbelieve them, but they are anecdotes. What do you want me to say? I’m glad you’re bringing research into this. I want the mechanistic/causative side of things to be addressed with research also.

  180. trishka
    trishka September 13, 2010 at 3:58 pm |

    sheelzebub: my question above referencing where these conversations were occuring was intended to be with respect to this thread only. i hear that many people here have been the recipients of problematic treatment at the hands of medical professionals. i am not ignoring that.

    i’d still like to see systematic institutional changes in our society that would result in a reversal of the current trend of higher diabetes rates. whether obesity causes diabetes or diabetes causes obesity, either way diabetes is a problematic, expensive disease, and having more people be diagnosed with it is not good for anyone.

    but then: that’s a public health ideal.

  181. Kristen J.
    Kristen J. September 13, 2010 at 4:23 pm |

    Trishka & Bagelsan,

    Vested interest is a technical term.

    Bagelsan,

    I pointed out the meaning of vested interest because you misinterpreted my original comment.

  182. zuzu
    zuzu September 13, 2010 at 4:25 pm |

    Bagelsan: fingers-in-the-ears lalala-ing about BMIs.

    Who’s doing that? Cites, please. I’ve seen a lot of people saying that the BMI is not a useful proxy for health of individuals, because it was never designed for individuals. It’s a population-measurement tool that’s being misused as a way to bully people who don’t fit into the narrow categories into losing (or in some cases gaining) weight.

    The problem that I have with the reliance on the BMI is that it’s being used as a substitute for an assessment of an individual’s health. Remember my doctor anecdote* from the post? That’s an example of a medical professional making a decision about my health prior to conducting an examination or tests. She decided I was terribly, urgently unhealthy just by looking at me. She didn’t even admit that I wasn’t, in fact, unhealthy, when she had the results of the tests she herself ordered right in front of her, but she at least went no further than telling me I should lose weight.

    But the part you seem to have missed — which is common to many of these stories — is the result that this encounter had on me. It made me reluctant to go to another doctor. And I’m not the only one who’s been turned off from seeking health care by this kind of treatment. I’m lucky in that I am very, very healthy and can get away with avoiding the white coats. But others wind up leaving untreated conditions that can kill them because they have been so humiliated.

    * Ooh! An anecdote. Shameful of me to use one of them. Remind me to call yours out any time you use them.

  183. zuzu
    zuzu September 13, 2010 at 4:29 pm |

    Bagelsan: Yeah, I know, I’ve seen that doctor-attitude research before and it’s truly shocking. There’s no doubt in my mind that stigma against fat people exists, even among the medical profession. And yes, that research is not anecdotal. The anecdotes are — I don’t disbelieve them, but they are anecdotes. What do you want me to say? I’m glad you’re bringing research into this. I want the mechanistic/causative side of things to be addressed with research also.  

    Is it only reliable because doctors were asked the questions, rather than the patients?

    Honestly, I’m not really seeing how you can be aware of that research, find it shocking, give it credence because it’s all scientific-like, and then discount the lived experiences of people on this thread which actually corroborates what you know from this research.

    Do you ask for peer-reviewed research on racial attitudes of white people before you give credence to anecdotes of POCs about having experienced racism?

  184. Sheelzebub
    Sheelzebub September 13, 2010 at 4:51 pm |

    The anecdotes are — I don’t disbelieve them, but they are anecdotes.

    Holy fucking shit. You are aware of the research and still decided that the lived experiences of FA on this thread–which mirrored this–just didn’t rate? What do you want? Besides the FA movement to do things according your defined parameters of Best Practices?

    I’m not the first person who linked to research or who cited research in this thread, or the two others that ran this week. People posted links to research about yo-yo dieting, the BMI, demographics, the focus on weigh (instead of health) possibly contributing to disordered eating. . .there was hardly the irrational chorus of NUH UH on the part of FA.

  185. Bagelsan
    Bagelsan September 13, 2010 at 6:22 pm |

    and then discount the lived experiences of people on this thread which actually corroborates what you know from this research.

    Look, I’m completely stumped. What am I denying here, exactly? I’m not discounting your experiences. I know that there is fatphobia, and I know that it causes bad medical outcomes, and I believe that all the things people said happened to them happened to them.

    When I’m talking about anecdotes I’m talking about stuff like “well, I’m fat and I run 5 miles each day” or “my mom dieted and now she has diabetes” and all that. And I just don’t agree that a few anecdotes are proof of anything. They don’t prove anything about how healthy fat may or may not be. Okay? Can we all agree on that much, at least? This is a basic scientific principle, that in no way reflects poorly on the validity of your experiences.

    And seriously, this is a perfect example of what I’m talking about. You are reading so many odd things into my really pretty basic point, which is that FA needs better science. When I’m talking about science I’m not trying be personal but inevitably people are getting het up about it. Clearly there can be an anecdote discussion. There can be a stats/methods/research discussion. But apparently the second we get one mixed in the other both turn to shit.

    Remind me to call yours out any time you use them. zuzu

    And yes, the next time I try to use a personal health anecdote as proof of a hotly debated medical model, please do call me out. Because that would be embarrassingly ignorant.

  186. trishka
    trishka September 13, 2010 at 6:23 pm |

    kristen, it appears that “vested interest” has two different applications, in law and in communication theory.

    as would be expected, the legal term is quite precise in it’s definition and the other one: not so much.

    Vested Interest Theory

    we could argue about which of the two definitions is more appropriate to the discussion here, but i ferar that would constitute even more of a digression.

  187. Kristen J.
    Kristen J. September 13, 2010 at 7:14 pm |

    Bagelsan: When I’m talking about anecdotes I’m talking about stuff like “well, I’m fat and I run 5 miles each day” or “my mom dieted and now she has diabetes” and all that. And I just don’t agree that a few anecdotes are proof of anything. They don’t prove anything about how healthy fat may or may not be. Okay? Can we all agree on that much, at least? This is a basic scientific principle, that in no way reflects poorly on the validity of your experiences.

    I think the problem is that you are looking at science as an infallible measure of truth. The science surrounding weight sucks. It’s biased. And when people see that science, and it doesn’t work with their personal experience…they say…”Hey, wait a minute…that doesn’t make sense. I’m skeptical of your science.” You’re interpreting that skepticism as “All science is bad and wrong.”

    I mean, take a step back and think about all the science out there about “how woman really are” and “what men really want” and “X ethnicity is really more Y.” We are automatically skeptical of any science that reinforces kyriarchial norms because it is likely biased by….wait for it….the kyriarchy!

    So why is it when you hear people being skeptical of this research which supports (whether directly or indirectly) the oppressive notion that fat people are morally awful, you can’t hear the same thing you hear when feminists say that…”No…not all women want to have babies, because I don’t want to have a baby.”

  188. Kristen J.
    Kristen J. September 13, 2010 at 7:15 pm |

    trishka,

    For the love of….I was the person who first used the damn phrase. I was trying to clarify MY meaning. I’m fairly certain I’m the foremost authority on what I intended.

  189. William
    William September 13, 2010 at 7:18 pm |

    Until the recent news articles about research study that found that “Fat Men last longer in bed than thin men” most of what you would find in a google search of “Fat Men” was horrible. Even now some of the comments in the comment sections of articles reporting on the study are very anti fat male. If you look to a early dates on Google Search you will see the normal anti- fat male activity.

    William

    Miss S: gender

  190. zuzu
    zuzu September 13, 2010 at 9:11 pm |

    Bagelsan: When I’m talking about anecdotes I’m talking about stuff like “well, I’m fat and I run 5 miles each day” or “my mom dieted and now she has diabetes” and all that. And I just don’t agree that a few anecdotes are proof of anything. They don’t prove anything about how healthy fat may or may not be. Okay? Can we all agree on that much, at least? This is a basic scientific principle, that in no way reflects poorly on the validity of your experiences.

    Oh, look at those goalposts moving. Because you earlier said this:

    Bagelsan: Yeah, I know, I’ve seen that doctor-attitude research before and it’s truly shocking. There’s no doubt in my mind that stigma against fat people exists, even among the medical profession. And yes, that research is not anecdotal. The anecdotes are — I don’t disbelieve them, but they are anecdotes. What do you want me to say? I’m glad you’re bringing research into this. I want the mechanistic/causative side of things to be addressed with research also. Bagelsan

    You know, your words don’t disappear from the screen just because you got called out and you now decide you were really talking about something else. You were talking about “doctor-bashing” anecdotes and said so.

  191. zuzu
    zuzu September 13, 2010 at 9:14 pm |

    Kristen J.: trishka,For the love of….I was the person who first used the damn phrase.I was trying to clarify MY meaning.I’m fairly certain I’m the foremost authority on what I intended.  

    Oh, come now, Kristen. Fat people don’t know what’s best for them. And if you’re not fat, then women don’t know what’s best for them. It’s a win-win, really.

  192. William
    William September 13, 2010 at 11:42 pm |

    I’m the William from #171, btw

    okay, that’s a logical leap that i am not prepared to accept at face value.

    Having an opinion means you have a desired outcome. Having a desired outcome generally means you are going to do something in an attempt to realize that outcome. Maybe you don’t see that preference as seeking control but the history of oppressed persons of all stripes doesn’t do much to support your point. When powerful persons have opinions about the bodies of less powerful persons, especially when they start to throw around words like “concern” and “interest,” that tends to come along with attempts to control justified by a belief that the powerful persons have a stake in the bodies of the powerless persons. You don’t have to look much further than the regular discussions of sin taxes and taxes on junk food designed to disincentivize certain food choices or the food options students have available to them. Not much further out than that you have bans on certain forms of food or food preparation that have already shown up in major cities.

    Maybe you don’t think that talk of “interest” or “concern” necessarily means a right to control, but maintaining the belief that such a goal isn’t a major part of the public health lobby is both historically ignorant and pollyannish. Its especially problematic when much of the public health debate is backed by junk science and whats left tends to confuse the consequences of poverty for the consequences of obesity. Its especially repugnant when we’re talking about a group that is already exposed to a constant (and traumatic) torrent of social coercion, judgment, and often violence.

    i’d still like to see systematic institutional changes in our society that would result in a reversal of the current trend of higher diabetes rates.

    And how, exactly, do you plan on making those changes without directly controlling and coercing fat people? I eat a lot of red meat, cook with enough butter to make a Frenchman blush, and like sugar in my coffee. I have a family history of diabetes. I know the risks but, truthfully, I’m always going to have a different take on the risks and benefits of my behavior than you will. I’m a fat guy who loves food and honestly believes that I’d rather be happy now than live to my 80s or 90s. Education isn’t going to change that. At some point, if you want to control people like me (and there are a lot of us), you’re going to have to start forcibly limiting our choices. Thats the only possible conclusion to a public health program that isn’t either strictly voluntary or masturbatory.

    but then: that’s a public health ideal.

    And thats the center of the problem with the public health ideal: it requires that you believe government agencies and social forces which have shown an all but unmitigated history of abuse and oppression will somehow not abuse their authority and power in order to make the world appear the way the would like it to appear under the guise of whatever health issue you’re handing them to use as a shield.

    Also, lets not forget the sense of middle class entitlement and class warfare you’re invoking when you talk about the financial costs of a disease like diabetes. You’re on the razor’s edge from some pretty vile fellows once you start down that path.

    For the love of….I was the person who first used the damn phrase. I was trying to clarify MY meaning. I’m fairly certain I’m the foremost authority on what I intended.

    I couldn’t have imagined a better critique of public health logic.

  193. trishka
    trishka September 14, 2010 at 12:04 am |

    kristen, i lost track of the thread. i didn’t realise that you were the first one to use the phrase. sorry.

  194. sannanina
    sannanina September 14, 2010 at 1:31 am |

    Bagelsan: Look, I’m completely stumped. What am I denying here, exactly? I’m not discounting your experiences. I know that there is fatphobia, and I know that it causes bad medical outcomes, and I believe that all the things people said happened to them happened to them.When I’m talking about anecdotes I’m talking about stuff like “well, I’m fat and I run 5 miles each day” or “my mom dieted and now she has diabetes” and all that. And I just don’t agree that a few anecdotes are proof of anything. They don’t prove anything about how healthy fat may or may not be. Okay? Can we all agree on that much, at least? This is a basic scientific principle, that in no way reflects poorly on the validity of your experiences.And seriously, this is a perfect example of what I’m talking about. You are reading so many odd things into my really pretty basic point, which is that FA needs better science. When I’m talking about science I’m not trying be personal but inevitably people are getting het up about it. Clearly there can be an anecdote discussion. There can be a stats/methods/research discussion. But apparently the second we get one mixed in the other both turn to shit.Remind me to call yours out any time you use them.zuzuAnd yes, the next time I try to use a personal health anecdote as proof of a hotly debated medical model, please do call me out. Because that would be embarrassingly ignorant.  

    Bagelsan, actually I agree that we need better science, and yes, sometimes some people in FA say something that is… hmm… not supported by science which is pretty much what the majority of the rest of the population does, too. Hell, I am a scientist, and I try really hard to back up my opinions with science, but sometimes I just fail at it – because I lack the time or because the relevant science simply does not (yet) exist. However, existing research that is “FA friendly” is very often dismissed. For example, there is study by Linda Bacon and her colleagues supporting the idea that an HAES approach is better for health in the long term than dieting, and that although people in the HAES group did not lose weight. Pretty much every time I mention this study outside of FA it gets completely ignored. What is worse is that very, very few scientists seem interested in replicating and extending this finding while there are many scientists investigating the supposed health risks of “obesity” and at investigating new ways to make people lose weight through diet, or surgery, or whatever, even though dieting has proven ineffective over and over and over again and even though bariatric surgery is a rather drastic and risky thing. Plus, there are still scientists spouting off stuff like “obesity increases your risk for mental health problems” which might be technically true but completely ignores a very important moderator: stigma. I have a very hard time to remain calm and argue my point in this environment. I try, but I constantly get questioned when I do – and outside of a very narrow circle of people who are convinced that I am smart and generally someone that has really looked at the data I actually get dismissed as stupid and in denial. Most people don’t ever go and look up the studies that I cite. Even good friends who are themselves scientists and who generally respect me usually aren’t truly willing to discuss these things – and this gets extremely tiring. (I should add that neither I nor these friends work on anything “obesity” related – I don’t because I know that my weight would make it easier to dismiss my work in the minds of many people, even many scientists, they don’t because it simply is not one of their main interests. But that does not keep them from saying ignorant things about diet and weight.)

    The issue with doctors is similar. I, like many other fat people, have experienced a lot of trauma related to medical care, in fact so much trauma that I sometimes get crying spells before a doctor’s appointment. Ironically enough, I am sure that a lot of the medical professionals inflicting the trauma “meant well”. But that does not exactly help me to a) bring up the courage to go and see a doctor or therapist when I need one and b) make them listen to my point of view. Unfortunately, even well-meaning doctors usually proof very reluctant to listen to my point of view concerning my weight (namely that I would rather focus on nutrition and movement and other health-relevant factors INDEPENDENT of weight loss and that talking about weight loss is extremely stressful for me). When they listen they usually don’t get it. And yes, I do feel angry about that. I understand that (except for some assholes that exist in every profession) it is not the fault of the individual doctors, but has to do with how they are educated as well as with factors like how much time they can spend with an individual patient. But I am helpless to change those factors. And I am very frustrated and angry about that.

  195. Bagelsan
    Bagelsan September 14, 2010 at 4:29 am |

    zuzu: I think there is some confusion about who has been arguing what. As far as I can tell, first Sheezlebub was pissed at Miss S. and trishka for “discounting lived experiences” and then she lumped my discussion of the uselessness of anecdotes as a substitute for good science into that general complaint. Then I responded to her when she talked to me about anecdotes, even though she actually kinda meant different anecdotes (crappy doctors) than I meant (awesome fitness), and she meant them to be used for different purposes than what I was talking about. Okay? That’s my take. I made the mistake of responding to her doctor experience comment when I should have just said “that’s not what I’m talking about.” That was my bad.

    Until I foolishly mixed into the discussion y’all had going about doctor-related anecdotes I had pretty much spent the entire thread saying “doctors are doing this wrong” and so forth (in other words, I’ve unreservedly accepted the doctor anecdotes) and trying to push back against the use of personal health anecdotes to “prove” biological mechanisms. That’s what the “goalpost moving” you’re accusing me of is, it’s me trying to clarify what I’m talking about. I’m not talking about the doctor stuff except accidentally. Alright? The doctor research was a total tangent I shouldn’t have even gone off on because Sheezlebub was just confused about my point (which isn’t about doctors.) I got distracted because that was an interesting study she brought up and I like studies — I didn’t mean for it to come across that the study validated the personal experiences for me ’cause those experiences were already valid.

    I totally don’t care about anecdotes about peoples personal experiences with doctors one way or another. They are not being misused in science-y ways (they are sweet, sweet icing on that study, and vice versa) and I do not hold personal experiences with doctors to the standards of “data.” I care about the anecdotes I’ve been arguing against the entire rest of the thread — personal fitness/health/medical ones. Which I think have been misused and treated like data. ‘K?

    Kristen J: I understand what you are saying. I agree that counterexamples can absolutely be used to disprove something; like, if the hypothesis is that “fat always causes ill health” then a counterexample is valid and disproves that. You only need one example where that is not a true statement to kill that hypothesis.

    I just don’t think that the current models are as straight-forward as any kind of “always” statements… I mean, “always” is almost never true in biology anyways. (The research field, if not the public –and if not the perpetually delayed medical field– has moved past that simplistic view.) So I think that, beyond the initial debunking of “always” statements, anecdotes and individual cases studies aren’t as useful. If the current hypotheses are more along the lines of “fat often causes ill health” or “fat increases the risk of ill health” then anecdotes where it doesn’t do that no longer affect the hypothesis in any way because they can easily fit the model; the data don’t contradict it anymore. That’s the point the research is at, imho. At this point there are decent studies out there that don’t rely on unsophisticated models like “fat –> death!” and so the critiques of these studies have to likewise become more sophisticated than simply “fat -X-> death!”

    To take your example: ”No…not all women want to have babies, because I don’t want to have a baby.” That “all women want babies” hypothesis would be an “always” statement where you can disprove it with just one counterexample. But once the hypothesis is “most women want babies” then just a few women saying “no I don’t!” is no longer sufficient to disprove it. At that point you have to get populations and stats and whatnot involved — anecdotes are no longer helpful. And you have to start digging into the studies and saying “well, this one shows that most female mice want babies” or “this one shows that most white women in the Midwest want babies” etc. And all of this digging can be completely motivated by your intense dislike of babies (;p) but cannot be substituted for by it.

    So that’s what I think we need, at this point, is to intensify the science. And be stricter about it. Rather than continue to rely on anecdotes for anything other than debunking stupid easy targets like “always” statements.

  196. Sheelzebub
    Sheelzebub September 14, 2010 at 5:42 am |

    Jesus Bagelsan. You dismissed the posts about the discrimination and dismissal fat people experienced at the hands of their doctors as “anecdotes” (after I posted the link to the research). You’re the one who made a snide comment about doctor bashing and group hugs. FFS.

    And not for nothing–but again–people in this thread and in other threads DID post links to research about fat, nutrition, dieting, etc. Did you just completely skip over them?

  197. CassandraSays
    CassandraSays September 14, 2010 at 6:23 am |

    Bagelsan, one of the problems with your argument is that right now in America we have a situation where the general public and the media don’t really believe “fat increases the risk of ill health” so much as they believe “being fat in and of itself IS ill health”. Which is why the “well, I’m fat and my health is fine” anecdotes are in fact relevant, and why people are giving them.

  198. Bagelsan
    Bagelsan September 14, 2010 at 10:00 am |

    Ok, Sheelzebub, I give up on you. I’m sorry that I offended you by calling anecdotes “anecdotes,” which is apparently “dismissive.” Using precise terminology was very wrong of me. Whatever exactly it is that you’re arguing now, I concede it to you; you win. Cheers.

  199. zuzu
    zuzu September 14, 2010 at 11:20 am |

    Flounce!

  200. Sheelzebub
    Sheelzebub September 14, 2010 at 12:09 pm |

    I’m sorry that I offended you by calling anecdotes “anecdotes,” which is apparently “dismissive.”

    No, you just irritate the fuck out of me because you moved the damn goalposts, ignored the actual research people linked to while acting like no one was actually bothering with research, and made comments about doctor-bashing and group hugs. I mean, what? I’m supposed to take from that that of course you know about the medical bias and you think it’s terrible?

  201. Kristen J.
    Kristen J. September 14, 2010 at 1:56 pm |

    Bagelsan: To take your example: ”No…not all women want to have babies, because I don’t want to have a baby.” That “all women want babies” hypothesis would be an “always” statement where you can disprove it with just one counterexample. But once the hypothesis is “most women want babies” then just a few women saying “no I don’t!” is no longer sufficient to disprove it. At that point you have to get populations and stats and whatnot involved — anecdotes are no longer helpful. And you have to start digging into the studies and saying “well, this one shows that most female mice want babies” or “this one shows that most white women in the Midwest want babies” etc. And all of this digging can be completely motivated by your intense dislike of babies (;p) but cannot be substituted for by it.

    *sigh* Have you ever seen a study that says “all women want babies?” They say, instead blah, blah, evo psych blah, blah, population statistics, blah, blah women want babies. And they are interpreted by society to mean…”all women want babies.” It goes back to my earlier point about humans in general sucking at statistics. We just cannot get that you cannot de-aggregate.

    Look over what these anecdotes are saying again. Not one person here has argued that the BMI is not moderately useful as a population measure that indicates that the population is getting fatter. Instead the OP and others shared their anecdotes to contradict the notion that BMI or the label of obesity in general is a useful measure of personal, individual health. Which you @100 and Monica (re: obesity) both indicated it was. AND the OP and other shared anecdotes of how BMI and the label of obesity in general is used in oppressive ways as an explanation for the fact that no only are these things not useful as a measure of personal, individual health…they are harmful.

    The idea that BMI or obesity labels are useful as a measure of personal, individual health is an “all” implied statement that people are reacting against.

  202. Heather
    Heather September 14, 2010 at 2:38 pm |

    geo: I know people will want to believe this, but there is a consensus among the scientific and medical community that people who are overweight and obese, by any measure, are at risk for developing chronic illness. The problem isn’t that you’re healthy right now. The problem is that you are *likely* to not be healthy in the near future. The goal of the scientific community is to prevent or at least help slow the progression of chronic illness in society, and a way to do is to curb the obesity and overweight rate. geo

    Thank you, thank you, thank you! This is the fact that seems to get lost in all the talk. If you look at the FA blogs out there, the vast majority are written by women in their 20’s and 30’s. Look at me they say–“I’m fat and my blood pressure is fine, cholesterol is fine, I run everyday”, etc. I have no doubt that is all true. The problem is what you have stated here. These women are relatively young–the damage their weight is causing hasn’t caught up with them yet.

    That’s what is so disappointing about FA. What all of the sites have in common is a completely rational premise–fat people should be treated, and have the same opportunities as anyone else. Fat people shouldn’t be mocked and made fun of, which is true for anyone. There’s a lot of common sense there, but it’s spoiled by a willful refusal to accept the evidence that exists.
    Some of the more well trafficked sites will trumpet the results of studies which show that fat people live longer, or have lower rates of cancer, etc. But the vast majority of the research out there shows that being obese is damaging to one’s health. Since I’m obese, I’d like it very much if that weren’t true. But it is. And denial does not help anyone.

  203. trishka
    trishka September 14, 2010 at 3:51 pm |

    william, just a couple of quick notes and then i have to get back to some other things.

    1. you act as if individuals aren’t being coerced right now! when a person walks into the only food stores they can access and the only food that is available to them is processed corn products, that lack of choice is a form of coercion. when people are forced to live in sprawling, car-dependent suburbia where their work, shopping, schools and homes are all far apart from each other, because there are no other models available to them, that is a form of coercion.

    what i would like to see is more choices for people, not less. keep the processed corn products! (they’re not going anywhere anyway). but add some fruits and vegetables into the mix, and let people choose. right now too many people can’t choose. if some/many/all people still choose the processed corn products, then so be it. (note: what research is out there that i have seen referenced suggest that the number of people will not be “all” – when offered the choice of high quality affordable fresh fruits and vegetables, at least some people choose them).

    for me, advocating for changes to our federal farm policy and also changes to our society’s current sprawl-oriented land use plannign policies is work i feel very comfortable doing – my conscience is actually pretty clear.

    (and yes, this doesn’t address the fundamental structural issues of poverty – but it’s a start).

    2. william, within this larger framework of choice that i would like to see (including, of course, world peace and ponies for everyone!), you would be absolutely free to choose to do whatever you like. you can live a short but happy life frying your steaks in butter and zuzu can continue to be a runner and not ever lose weight and it’s all fine because, as i stated above, i don’t care about you PERSONALLY, william, just like i don’t care PERSONALLY about zuzu.

    i just figure that, with a population of 300million of us, allowing access to more healthful choices, will result in SOME of us taking those opportunities, even if it is not you, william. (hint: it’s not about you!)

    and that will result in a lower overall diabetes rate in our country. which would make me happy.

  204. Bagelsan
    Bagelsan September 14, 2010 at 4:11 pm |

    zuzu: Whatever makes you happy.

    Kristen J.: Instead the OP and others shared their anecdotes to contradict the notion that BMI or the label of obesity in general is a useful measure of personal, individual health. Which you @100 and Monica (re: obesity) both indicated it was.

    I have definitely always said that BMI means nothing beyond a population measure. So everyone on this thread is saying that BMI doesn’t indicate anything about personal health. Which… I guess we all agree, then?

    My perspective was that everyone here had that understanding as their baseline, so I was hoping we could move past that and start digging into the harder stuff, like the nitty gritty of the science. Because this: “The idea that BMI or obesity labels are useful as a measure of personal, individual health is an “all” implied statement that people are reacting against. Kristen J.” is not something I’ve seen anywhere on this thread. Maybe I missed it.

    I think we are quite literally all arguing about nothing at this point.

  205. Kristen J.
    Kristen J. September 14, 2010 at 5:49 pm |

    Bagelsan: Some of the information and tools that FA often rejects (even the vastly-misapplied BMI!) are part of a genuine diagnosis.

    When is BMI part of a genuine diagnosis? Presumably by diagnosis you meant use by a doctor in diagnosing an individual patient.

    Also, this post was at least in part a response to Monica’s post which did imply if not say that health = weight. So no, apparently, we can’t get beyond that point…because this post was meant to critique that point.

  206. William
    William September 14, 2010 at 6:40 pm |

    for me, advocating for changes to our federal farm policy and also changes to our society’s current sprawl-oriented land use plannign policies is work i feel very comfortable doing – my conscience is actually pretty clear.

    I couldn’t agree more with changing our farm policy, its an enormous problem and you’re absolutely right that it serves to coerce people into certain choices.

    The thing is…thats kind of a red herring in the current public health climate. Access to food is certainly a big problem, but fixes for that tend to be aimed squarely at the middle and upper class. More than that, much of the actual legislation we see proposed or passed has less to do with increasing access than it does to do with banning certain things that have been deemed bad. The purity of your motives, while admirable, isn’t that important when you’re part of a movement that has both a history and current practice of treating fat people like lepers.

    Land use policy I’m far more suspicious of, but thats because between eminent domain and zoning board abuse I tend to suspect the worst of anyone talking about land use as a means of social engineering.

    william, within this larger framework of choice that i would like to see (including, of course, world peace and ponies for everyone!), you would be absolutely free to choose to do whatever you like.

    Snide tropes aside, I’m beginning to wonder if you live in the real world. Coercion isn’t only about someone with a badge putting a gun to your head. One doesn’t have to have a caseload full of patients with eating disorders to work out that “free to do what you like” isn’t really free when you live in a society where there is immense institutional pressure to make certain kinds of choices if one wishes to retain their value as a human being. I find it difficult to imagine that the kinds of public health measures you’re talking about aren’t going to come with education. That education, in our society with our political and cultural climate, is going to revolve around pictures pretty people with small waists. Its going to bring individual bodies into the realm of public observation. Its going to be designed to create internal and external pressure to conform to specific standards. Maybe thats not what you envision, but you’re a fool if you don’t see that its what you’re going to get.

    i just figure that, with a population of 300million of us, allowing access to more healthful choices, will result in SOME of us taking those opportunities, even if it is not you, william. (hint: it’s not about you!)

    I’m a big fan of choice and Utopia sounds nice, but you still seem to be missing the fundamental point that a lot of us fatties are making. Its not that some people might take those opportunities (and what a wonderful way to stage the discussion in such a way as to make your argument the good choice) but why they take those opportunities and in what way those opportunities are incentivized.

    And no, its not about me. I’m fat and I could give a shit what most people think because I like who I am, I’ve come to terms with my variance from the ideal, and I have the privilege to be able to tell people to go fuck themselves if they have an opinion about my body. My 19 year old sister who skips dinner because she thinks shes too fat at a size 4, on the other hand, isn’t at risk of diabetes but is at risk of a whole lot of other things that the message of the public health movement has no problem taking advantage of.

    and that will result in a lower overall diabetes rate in our country. which would make me happy.

    If someone said “and that will result in a lower overall abortion rate in our country. which would make me happy” would you take their argument at face value or would you be studying their motives?

    Fuck you for thinking that someone else’s medical status is any of your damned business.

  207. CassandraSays
    CassandraSays September 14, 2010 at 6:47 pm |

    Question for all the science-oriented people on here – have there been any good studies done on the question of whether it’s actually illness that’s making people fat rather than fatness that’s making people ill? Take the correlation between fat and diabetes. Someone posted a detailed breakdown of why it’s really hard for diabetics to lose weight. So what I’ve always wondered is, OK, there appears to be a correlation between being fat and being diabetic, but have we even examined the question of whether, if there’s a causative relationship, it might be moving in the illness results in weight gain direction rather than the weight gain results in illness direction? If not I’m not sure why, since the idea that illness can result in weight loss is a pretty well accepted thing.

    Anyone seen any good studies?

  208. Bagelsan
    Bagelsan September 14, 2010 at 7:37 pm |

    Kristen J, the very next sentence is part of the context for that:

    Some of the information and tools that FA often rejects (even the vastly-misapplied BMI!) are part of a genuine diagnosis. What’s “wrong” with our population, if anything?

    I was talking about diagnosing societal ills, not individuals. Diagnosing populations.

  209. Bagelsan
    Bagelsan September 14, 2010 at 7:46 pm |

    But I think I get where some of the confusion is coming from now, so thanks. My very-slightly-metaphorical use of “diagnosis” wasn’t perhaps as clear as it could have been. I definitely never intended to say BMI is a valid part of a diagnosis for an individual, beyond stuff like “you are in this risk group*” or “has your weight changed drastically, recently?” kind of thing.

    *which means absolutely zero about that person’s actual health, naturally, and isn’t really a “diagnosis” at all

  210. closetpuritan
    closetpuritan September 14, 2010 at 10:00 pm |

    “I don’t think science works on a “bargaining” method — you can’t have one side start with extreme claims in one direction (fatness will kill everyone everywhere tomorrow!) and be met with extreme claims in the other (fatness has never killed a person ever, and it never will!) Or, at least, you can do that but no one will ever give a fuck because you will sound like a dumbass. (And it’s not fair, because both arguments are stupid, but one is entrenched so the other one is the one that gets dismissed.) I’m not saying that pure logic has ever won the hearts and minds of Americans, but an obvious contempt for science and the medical profession isn’t going to do any good at winning slightly more knowledgeable people’s hearts and minds either.”

    Bagelsan,
    You’re kind of switching back and forth here between “how science works” and “how people will be convinced”. Obviously, “bagaining” is not how science works, but FA bloggers/commenters aren’t trying to be scientists. Ideally, it would be better if everyone understood science better (including, as BSTU and Sannanina pointed out, the fact that certain scientific findings get taken a lot more seriously than others), but I don’t think FA bloggers’ understanding of science is worse than most bloggers’.

    From a practical standpoint of lessening stigma for fat people, I think it would still be better to be more accurate, but I’m not sure how much worse a strategy it is to straight-up deny that fat has health effects. How much of the population actually falls into that “slightly more knowledgeable” category? The global warming deniers have been pretty damn successful by having a mix of “it’s cold this winter, global warming’s not real” and “there is global warming, but we don’t think it’s anthropogenic”–not so much by winning people definitively to their side, but by creating doubt and confusion. Except in this case, doubt and confusion is probably the most correct stance.

    I don’t know about “denialism” being the “only” thing you’re hearing from FA. Maybe it has to do with the quality of discussion on FA blogs vs. on non-FA sites in comments. As you pointed out, there’s been a lot of people talking past each other on this thread, so maybe there was some of that going on too? I don’t want to dismiss your experiences, but mine have obviously been different from yours.

    Also, FWIW, my understanding of your “anecdotegate” comment was the way that you explained. I think one part that contributed to the confusion was “cheapshots like doctor-hating (which I understand, but it isn’t the basis for a public education campaign or anything, yanno?)”–I guess you’re trying to say that it’s understandable because it happens, but it’s not relevant to the science and is therefore a cheap shot? Except that, since ending fat prejudice/discrimination is one of FA’s goals, why would this be a cheap shot? Except it is a cheap shot if it’s brought up as a rebuttal to the science. Or rather, it just isn’t an effective rebuttal. I don’t think it’s always clear which one people are trying to do. I certainly don’t want to go back through the entire comment thread and try to figure out what people are trying to do in each instance. I didn’t interpret zuzu’s anecdote in the original post as a scientific rebuttal, though.

  211. closetpuritan
    closetpuritan September 14, 2010 at 10:14 pm |

    “Some of the more well trafficked sites will trumpet the results of studies which show that fat people live longer, or have lower rates of cancer, etc. But the vast majority of the research out there shows that being obese is damaging to one’s health. Since I’m obese, I’d like it very much if that weren’t true. But it is. And denial does not help anyone.”

    You say that like the studies contradict each other. :)
    Seriously, they may sound contradictory, but they aren’t necessarily. BMI-obese groups have lower risk and/or survival of some forms of disease and higher risk of others. The high end of “normal” and the low end of “overweight” seem to be in the sweet spot to get some protective effects/associations of fat while keeping the harmful effects/associations of fat relatively low. And while it depends a lot on the type of cancer, my understanding is that generally cancer is less treatable and will kill you more quickly than diabetes. (I’m not as sure about heart disease.)

  212. closetpuritan
    closetpuritan September 15, 2010 at 8:42 am |

    Heather/Geo:

    Also, in the example you gave of someone who runs every day–exercise goes a long way to mitigate the risks of fat. They are at higher risk metabolic syndrome diseases than someone who runs every day and is thinner (but not too thin), but at lower risk than someone who is thinner and does not get a significant amount of exercise. (Or someone who is thin, runs every day, and smokes.)

    “The goal of the scientific community is to prevent or at least help slow the progression of chronic illness in society, and a way to do is to curb the obesity and overweight rate.”

    No, it’s not. That’s one of the goals of the part of the scientific community that investigates human health. But the primary goal of the scientific community is to advance knowledge, and people who research human health are only one part of the scientific community. And not all human health researchers are researching ways to slow the progression of chronic disease.

  213. William
    William September 15, 2010 at 7:20 pm |

    I was talking about diagnosing societal ills, not individuals. Diagnosing populations.

    The problem with that, of course, is that you cannot do one without the other. You can’t develop a picture of trends in a population without diagnosing the specific individuals within a sample group. Getting data that says “Americans are more fat” requires diagnosing a large sample of people as fat. In as large a population as the US (or, really, any population of similar size) that means getting a lot of people, making their bodies the objects of observation, and judging their bodies according to an ideal.

    The real sticking point, though, is that population-level observations are all but useless in our modern world. The US has so much within-group variance that population observations mean nothing. A white, upper class, well educated, insured, man of Irish descent living in Boston isn’t going to have the same health concerns as an uninsured, poor, black woman down the street. Diagnosing populations imagines that there is enough similarity between the two individuals to be worthwhile. I’m not convinced of that.

    Obesity isn’t like polio. Polio is going to make pretty much anyone who gets it sick regardless of how they got it, where they live, how much money they have in the bank, or where their ancestors came from. Polio is objective (no one is going to argue about what counts as polio), binary (either you have it or you do not, you can’t have a little polio), and well understood. Obesity is too subjective for it to not be politicized.

  214. closetpuritan
    closetpuritan September 16, 2010 at 10:01 am |

    CassandraSays,
    I haven’t heard about any good evidence either way. In addition to the obesity-causes-diabetes possibility (A causes B) and the diabetes-causes-obesity possibility (B causes A) (or both–B causes A AND A causes B) there’s also something-else-causes-both (C causes A and B).

    I have seen studies that show that fat and genetic susceptibility aren’t the only influences on diabetes, but that doesn’t really tell us much about the direction of causality with fat and diabetes. One study showed that exercise was able to lower insulin sensitivity even in individuals who gained weight in the course of the study, I believe; there’s also the observation that people who have undergone WLS increase their insulin sensitivity immediately, before they’ve lost any weight as a result of their surgery. Those two do suggest that things like low exercise level could make people be both more likely gain weight and more likely to get diabetes (C causes A and B), but it doesn’t disprove fat-causes-diabetes or diabetes-causes-weight-gain, it just says that those aren’t the only influences.

  215. zuzu
    zuzu September 16, 2010 at 10:03 am |

    Bagelsan: I definitely never intended to say BMI is a valid part of a diagnosis for an individual, beyond stuff like “you are in this risk group*” or “has your weight changed drastically, recently?” kind of thing.

    Just so you know, though: it *is* being used that way, which is kind of everyone’s point here with the doctor anecdotes you find so questionable. When I got the Scarlet O, that was listed on my records as my diagnosis. And how was that figured? BMI.

    And I guess, to loop it back to Monica’s post, that’s where she seemed to be having problems: she was defending the BMI as an index for populations while simultaneously acknowledging that it’s not supposed to be used as an individual diagnostic tool and dismissing the anger and experiences of those whose skepticism of the BMI arises from the fact that it *is* being misused as an individual diagnostic tool.

  216. Fivehundredpoundpeep
    Fivehundredpoundpeep September 20, 2010 at 12:35 pm |

    Interesting article, I agree one should not have to pass a “health test” to be considered a worthy human being. I may disagree on obesity not be conflated with ill health, for many its a sympton of a body gone awry. I am of the mind that illness [in more average cases then my own related to bad food and other aspects of the toxins in this society] is causing fat.

    http://fivehundredpoundpeeps.blogspot.com/2010/07/my-350-400-pound-weight-gain.html

    http://fivehundredpoundpeeps.blogspot.com/2010/07/goodbye-naafa-and-rest-why-i-left-size.html

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