- First Things First: What’s It To You?
I’ve been living in New York a long time (and am reluctantly about to leave it). One of the most useful sayings I’ve picked up here is, “What’s it to you?” *
That handy phrase pretty summed up my first reaction to reading Monica’s post about fat and health. Why, if she doesn’t experience any kind of weight-based discrimination at the doctor or elsewhere, does she get invested in defending the BMI against feminist criticism?
And then I got to the donuts, and all became clear. Monica appears to have fallen into the trap of conflating weight and health, and attributing moral laxity to the overweight — who of course couldn’t have gotten that way had they just eased off the donuts. Donuts being the go-to shorthand for the moral failings of fat people. Oh, sometimes it’s pie, occasionally it’s cake, but it’s usually donuts, those tasty little rings of deep-fried sloth.
While I don’t relish having to address such misconceptions again, it’s worth doing the pushback. However, I don’t want to do a point-by-point fisking of Monica’s piece, partly because comments are closed and I missed the window when they were open. Partly because it’s somewhat jumbled, and there were some points raised in comments that throw a different light on the original post. Also? The commenters did a pretty damn good job of refuting particular points. I also don’t want to make this about Monica.
Instead, I want to talk a bit about fat and health and why fat hatred is a feminist issue.
- Fat Hatred’s Just Another Form of Body Policing
Feminists typically agree that body policing is a bad bit of business, correct? That trashing women for their appearance is doing the work of the patriarchy, which has appearance-based norms for women and which enforces those norms by rewarding women who comply with them and punishing women who either fail to comply or who reject them outright. Compliance isn’t exactly a ticket to ease, though: it costs a lot to comply, in money and time and energy, and there is no resting on one’s laurels. There’s always someone who’ll criticize the texture of your hair, your skin color, the size of your breasts, the shape of your eyebrows, your clothes, the size of your lips, the way you apply makeup.
Not to mention your weight. You can’t escape criticism of your weight even if you’re running for President or nominated for the Supreme Court.
Why is it that calling someone fat is such a powerful insult in this culture, especially when the person so targeted isn’t actually fat (or their weight is unknown)? Because we’re saturated with fat hatred. One of my earliest experiences with Feministe, as a commenter, was responding to a thread in which Jill had posted some appearance-based insults she’d received — most likely from those AutoAdmit doofuses — which included calling her fat. Which she’s not. I became uncomfortable with the way that the commenters assured her that she wasn’t fat, which to me — a certified fat person — read as assuring her she was okay *because* she wasn’t fat. And I said so.
The pernicious thing about fat hatred in American culture is that because the consequences of being fat are so severe socially, it makes a great club with which to enforce appearance-based norms and sow self-doubt. Not to keep picking on Jill, but she’s been very open about her insecurity about her weight, even though she’s thin. Now, why would a thin person be so susceptible to weight-based insults when they are manifestly not true? Because the line between not-fat and fat is not clearly defined, and because fat people are gleefully treated like shit. And who wants that?
And look at what happens when someone who’s fat is publicly comfortable and confident with her body, or when a clothing manufacturer starts making attractive clothing for fat women. There’s a lot of panic about Encouraging! Obesity! Because shaming and limiting clothing choices to polyester circus tents are such effective diet aids. I’d blame this sort of thing on Puritanism, but I know there are plenty of other cultures where shaming is employed as a means of fat policing whose shores the Puritans never reached. But isn’t it interesting that in American culture, fat women are considered creatures of unrestrained appetites, including sexual appetites? Not that anyone would want to fuck a fat woman, of course — and your worth is determined by your fuckability.
When you look at it that way, doesn’t fat hatred start looking more like exactly the kind of appearance-based body policing that feminists in general frown upon?
- Fat and Health: My Own Medical Anecdote
As I said, I am a certified fat person. But I haven’t really had that many dealings with the medical profession in the 10 years or so since I gained a lot of weight and crossed the Rubicon into the Obese category of the BMI. Part of that was being uninsured, part of it was being generally healthy. But a big part of the not-dealing-with-doctors business was that I did gain a lot of weight, and I didn’t want to hear about it. ESPECIALLY since the whole Obesity Crisis™ became an issue around that time, and I kept hearing things about doctors who ignored medical problems in fat patients or treated fat patients with contempt.
Interestingly, the few medical professionals I did deal with between, say, 2000 and 2008 never mentioned my weight, even though it might have been relevant to their treatment — these include my orthopedic surgeon, who fished some bone chips out of my ankle after I messed it up while running by falling in a ditch, and a couple of chiropractors who helped fix the damage I did to my knees, hips and spine by limping around on the bad ankle for two years before getting enough insurance to get it fixed.
Had my medical experience been limited to these medical professionals, I could have been inclined to dismiss the stories I’d heard about fat-phobic doctors. After all, knowing something happens isn’t the same as having it happen to you. That changed, however, in 2008.
In 2008, I applied for a graduate program in library science. The school sent me a package of forms to fill out and a list of records to supply before I could be admitted. Among the required hoops I had to jump through? A physical. I’m still a little unclear about whether state law required the physical or just the proof of immunization against measles, but in any event, my school wasn’t going to let me start if I didn’t have a doctor sign off on the forms. So I found a city health clinic (remember, still uninsured at this point, so no regular doctor), made an appointment, and showed up with my forms.
How blissfully ignorant I’d been. This doctor took one look at me and decided I was going to drop dead on the spot. She took the suggestion on the form that she could run any other health checks she deemed necessary beyond the minimum required, and she ordered every possible test she could. She was convinced, absolutely convinced, I was in terrible health because of my weight. EVERYTHING was brought back to my weight. She blamed my hay fever on my weight. When she told me — not asked me, told me — that I was short of breath while climbing stairs and I responded that I was a runner, so no, she told me running was bad for me at my weight. I found myself getting angrier and angrier with her as the exam went on, and feeling more and more humiliated.
If Dr. McJudgypants was typical these days, I didn’t want to go back to a doctor at all.
I did have to go back, though, since she kept the form and wouldn’t release it to me until the test results came in. That’s when the tables were turned. She actually looked visibly angry as she went through my results, which were absolutely perfect for Every. Single. Test.
Still slapped me with the Scarlet O, though.
- So I’m Healthy. But What If I Wasn’t?
I owe my good health to good genetics, which I don’t have a lot of control over. My weight is more within my control — when I eat better and exercise regularly, I tend to drop weight, and when I don’t, I either stay where I am or gain.
Because I have a really good base of health, and 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. Which might happen for a variety of reasons, including stress, depression or substance abuse. When I feel best is when I’m eating right and exercising — and when I’m free of depression and low on stress, both of which help me keep my head in the game as far as treating myself right.
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?
And more to the point: what does it really matter? In other words, what’s it to you?
Anyone who looks at me out on the street is going to see a fat person. It’s not going to matter what I’m doing to keep myself happy and healthy, or what I’m not doing. They’re going to judge me based on how I appear to them. If I’m walking into Dunkin’ Donuts after a run for an iced coffee, they’re not going to see a runner getting some refreshment after a hard workout; they’re going to see a red-faced, sweaty fat woman in tight pants going into a donut shop.
Most likely, they’re going to decide, based on what they see, that I “shouldn’t” be eating donuts — even if I’m not actually in there to get donuts. Because I’m unhealthy. Because I’m fat. Because fat people are unhealthy, and donuts are tasty little rings of deep-fried sloth. But only when fat people eat them; they’re just part of a balanced breakfast when thin people eat them.
It’s tempting, as some of the commenters in the Fat and Health thread pointed out, to protest during these sorts of “I’m really only concerned about your health” discussions that one really *is* healthy, to throw out information about your workouts and your cholesterol levels to show that you deserve to be taken seriously. That you’re a good fattie.
But you know what? That’s a temptation it’s wise to resist. Because there are no good fatties and bad fatties. To the thin world, ALL fatties are bad, morally lax and “unhealthy.” Yes, you too.
Moreover, by defending your health and habits, you’re buying into the framing — just as the people who rushed to assure Jill she wasn’t fat and therefore not bad bought into the framing.
There are two major problems with that: One, it relies on the notion that there are, in fact, bad fatties who deserve whatever bad treatment is reserved for bad fatties because they’re not “healthy”; Two, it puts the focus on the worthiness of the individual rather than on the unjustness of the bad treatment.
Doesn’t that sound a little familiar in the feminist context? In an antiracist context? Shouldn’t we, as feminists, be mindful of unthinkingly doing the work of the patriarchy?
- There’s No Duty of Health
“Health” seems to be a codeword these days. It’s something to throw around when you get busted as a fat-hater: “I’m just concerned about your health!”
Well, let’s talk about health. First off, why is any individual obligated to be healthy in order to be accorded all the rights and dignity accorded to all human beings? What is this, “Starship Troopers,” with health substituted for military service? If you argue that fat people don’t “deserve” certain rights because in your judgment they aren’t “healthy,” then how do you feel about disabled people and their rights? If your argument is that the disabled can’t help it and fat is a choice, do you make the same argument for religious discrimination? Because religion is a choice, too.
Second, what the hell is the fat person supposed to do about their weight on the spot, anyhow?
Third, you can’t tell if someone’s healthy just by looking at them. God, I’ve known some cancer patients who looked fabulous and were dead within three months. You can’t even tell a person’s BMI by looking at them. But when we conflate fat and ill health, we do something that ill-serves thin people, too: we conflate thinness and good health. So maybe we aren’t looking for signs of pre-diabetes in thin people. Or maybe we’re not really concerned about what’s in school lunches as long as the kids don’t gain weight. Or maybe we don’t think about the distribution of resources or the way that farm subsidies distort food prices as long as it’s just poor people who are getting fat from eating shitty cheap food.
Sure, there’s the whole “taxpayer dollars” argument when Medicaid is involved, but I just won’t take that seriously until people stop treating Defense Department expenditures as if they’re not part of the federal budget and have no effect on the deficit. In any event, wouldn’t it make sense to increase preventive care and screenings so that we’re not catching chronic diseases only when they reach advanced stages, and only when the patient has perhaps gained weight from insulin resistance or from chronic pain that’s gone untreated, so now it can be blamed on the fat?
But most importantly, why in the hell should anyone have to prove their worth by achieving health? Where does that leave the people who can’t, or who just feel that it’s not anyone else’s business what they do with their bodies (and doesn’t that sound familiar, this bodily autonomy thing)?
- It’s Not Just You: The Personal Really Is Political
I’ve written about this before, and it ties into the whole good fattie/bad fattie defensiveness thing, but whenever we start focusing on the health of the individual, we erase the systemic problems that contribute to health issues. This is a perfect example of the personal being political.
Institutions love to shift the burden onto the individual, because it means the institution doesn’t have to examine its own behavior or its own contribution to a problem. Let’s look at bullying. States and schools love to have zero-tolerance policies so they can look like they’re being tough on bullying — but then when bullying incidents happen, they just don’t define it as bullying, and suggest that the victim change his or her behavior. Problem solved!
Then we have childhood obesity prevention programs. Sure, they sound good, but ultimately, they put the burden on the kid to change while leaving intact many, many things that contribute to the problem. This may include fat-laden agricultural surplus products that find their way into the school lunches; vending machines and bake sales used for fundraising because taxpayer funds are unavailable; cutbacks in physical education and extracurricular sports; lack of safe spaces to walk or exercise; lack of sidewalks; corn subsidies that result in high-fructose corn syrup showing up in everything; high housing prices that lead to long parental commutes and thus a reliance on takeout over freshly-prepared foods; food deserts; aggressive marketing by fast-food outlets; food-assistance programs that are designed to dump agricultural surplus rather than provide good nutrition; agricultural subsidies that mean that vegetables are more expensive than cheap fatty meats; lack of access to affordable preventive health care; lack of education about nutrition; and on and on.
An awful lot for a little kid to carry on his or her shoulders, don’t you think?
And it’s not just kids that get this kind of treatment, it’s adults as well. How dare you be fat at me, Ms. Medicaid Recipient? Maybe they should cut your food stamps off if you’re going to be so fat! That the face of poverty is widely considered to be black, female and fat — today’s version of the Welfare Queen in her Cadillac — just makes the problem more intractable.
But it’s a fight worth having, and it’s a fight that feminists should be waging. So instead of scoffing next time you see someone criticizing the use of the BMI as an indicator of individual health, try listening, and considering. You might just see that the problem is bigger than you realize — and it might even hit home for you.
* Other useful phrases include, “I’ll have a bagel with a schmear,” “Stand RIGHT, walk LEFT,” and “Fuck you, you fucking fuck.” I’m going to miss this town.
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