Not All Thin People Are Like That

SupportLet’s start with something that happened on my Facebook page today, and then we’ll talk about it. I posted my blog from yesterday including the phrase “One of the most frustrating things to me as a fat person is that we are constantly told that we are not the best witnesses to our experience and that thin people -who are all experts on weight and better than us by virtue of their thinness – should be allowed to speak for us.”

Kayla posted:

Not all thin people are like that. This person who stole the photo probably has quite the ego and needs to learn some compassion and acceptance. I am thin and I think everyone is beautiful no matter what their size is. Society keeps forgetting that being happy is the most important thing in the world, and if you are happy with your body, fucking rock it sista. I’ll be cheering you on.

Courtney responded:

You know what I hear when someone insists on going “not all ___ are like that!” ? I hear “but but I need to be validated that I’m a good person! Stop insulting people I identify with and validate me!”

This is not about you, thin people who are not like that. Keep up the good work – do you want a freaking cookie for treating us like human beings?

Before Kayla could reply, 10 more posts went up educating her about how the posts’ authors found her comment inappropriate/derailing/privileged etc. and comparing her comment to unintentional racism and misogyny.  (Several posts did go up suggesting that people were being too hard on Kayla.)

Kayla apologized:

I apologize that my support has caused a stir and I’ll remove myself from the conversation. I didn’t mean to cause such a problem.

Two more educational posts went up.

I want to talk about this but before we get into it I want to be clear that I am not in the business of telling oppressed people how to respond to oppression, and I’m not suggesting that the way I do it is better or worse than anyone else,  everyone who commented had every right to their comments and the beliefs and reactions that fueled them.

I see the situation differently.  My original phrase, though meant to point out that our society elevates the voices of thin people and silences those of fat people, wasn’t clearly stated and could easily have been read as a sweeping generalization of thin people, which is even more problematic since stereotyping is what I was railing against.

I see Kayla’s post as saying “You seem to have a belief about all thin people.  There are thin people who aren’t like that, there are thin people who support you, here is an example of that, I stand with you.”

Still, even if she did a poor job of being an ally based on the theories of oppression (and I don’t necessarily agree that she did), I choose to contextualize that within the reality that she tried while there are people who are epically not trying, on a global scale.  There are people who are stealing our photos, slapping stereotypes on them and using them to sell diet products.  There are people e-mailing me saying “Kill yourself you useless fucking fat fuck,” so when someone says “I think everyone is beautiful no matter what their size is…I’ll be cheering you on” I personally have a difficult time mustering a lot of offense, and I want to be careful not to take my frustration out on “imperfect” allies  because they are around, and the people I’m really angry with aren’t.

I am a very outcome-based activist so even if I am well within my rights to call someone out on the imperfection of their attempt to be an ally, my question is always “will that get me closer to my goals?”  The diversity work that I was trained on taught me that “calling people out” is likely to cause them to become defensive, more sure of the beliefs I am trying to challenge, and less likely to come to the work.  That has been my experience (though that doesn’t mean it’s everyone’s experience, or anyone else’s experience.)

Just to restate – my way is not the right way, not the only way, and not better or worse than any other way, my goals are mine and don’t have to be anyone else’s. After a lot of thought here is what I believe for me and my work at this point in my life:

I choose to believe that if someone isn’t completely against me, maybe they could be with me.  In a world where I get death threats for suggesting that fat people are human and should be treated as such, I choose to look for any glimmer of an ally and treat it like a precious spark which, if nurtured, could turn into a huge flame.  So if a thin person says “I know how you feel because sometimes I feel fat” I consider that an invitation to activism, so I’m likely to say “yes, see how this oppression that I’m fighting hurts us all? Here’s how you can help!”  There’s plenty of time to explain the difference between feeling fat and being fat, I don’t need to jump on their first overture as an ally to tell them how they’re doing it wrong and insist that they acknowledge their privilege.

I 100% agree that members of an oppressed group have absolutely no obligation to educate their oppressors ever.  I’m personally not super excited about groups of would-be allies trying to figure out how best to support me without my voice at the table, so let me be clear that I’m offering to help.  I can only give you my opinion which, obviously, is only one of many, but I’m here – ask me anything.

I think it would be fabulous if everyone understood thin privilege, how feeling fat and being fat are different, how the suggestion that fat people need thin people’s validation is problematic etc.,  but those concepts can be really dense and can take time to understand, so if someone can get to “everyone of every size should be treated with respect, free to enjoy their rights to life, liberty, and the pursuit of happiness, and what can I do to help?” then I think we’re at a pretty good starting place and I’m willing to give them the benefit of the doubt (and possibly a cookie because they had to overcome a lot of societal shit and programming to get to the point and it may well be cookie-worthy) and gentle education in due time as we work toward larger goals.

In the end maybe Kayla will really appreciate all of the education that she received today and become an even stronger fat activist. Maybe she will feel attacked and be put off of fat activism all together.  There’s no way to know what will happen until it’s over and we can’t be responsible for other people’s reactions, so all any of us can do is respond to our oppression and our would-be allies in the way that makes the most sense and feels the most authentic to us.

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Published in: on June 29, 2013 at 10:48 am  Comments (54)  

In Our Own Damn Words

Plus size model Heather from http://fatgirlposing.blogspot.ca. Used with permission.

Heather is a plus size model – that picture to the left, that’s her.  Earlier this week a Facebook page called “Fit for Fertility” posted this picture with the text “Everyone has to start somewhere.”

To be clear, Heather is not a beginning exerciser – the person who runs the page had no permission to use the picture, and no knowledge of the fitness level of the model, she just assumed fat=beginner and put it up on her page (her page that she uses to sell her multilevel marketing diet products.)

People started sharing the picture, either because they were comfortable with blatantly stereotyping someone based on their body size, or because they assumed that the person who posted the picture actually knew something about the person in the picture and hadn’t simply stolen it and applied a cheap stereotype for her own purposes.

The picture started to get lots of hits and the owner of the page, Jaime Milano Smith, bragged on her personal page that the picture (that, remember, she had stolen) had gone viral “Is it dorky that I’m super excited because a picture I posted on my like page went viral? This is fun!”  To which someone replied “Congrats the exposure will be great for your business!! Keep up the great work.”

Heather found out and asked Jaime to take the picture down.  Jaime refused.  Heather’s friends, including the Rolls Not Trolls community, went to work leaving comments explaining that the picture wasn’t her property, that the person pictured wasn’t a beginner exerciser, and that she wanted it taken down.  Jaime chose to delete the comments, block the people, and leave the picture up.  Heather filled out a request with Facebook and they finally forced Jaime to take the picture down.

Jaime then took to Heather’s Facebook page and wrote, repeatedly,

Heather, you talk about bullies but that’s what you and your ignorant friends have been doing to me. You’re all hypocrites. I’ve reported all of your nasty, harassing messages and did you know bullying is illegal? I found that picture on Facebook, in fact it’s all over Facebook still. I’m wondering why you haven’t harassed those other pages that I actually got the picture from? It was a positive statement that was made. I’m not “fat shaming” how ridiculous?…

So let’s take stock of the things that Jaime feels she knows better than Heather:

  • Who owns the copyright on Heather’s picture
  • How long Heather has been exercising
  • Whether Heather feels bullied by having her image used as an “inspirational” “before” picture
  • Whether or not Heather has been fat shamed

This is one of the most frustrating things to me as a fat person -that we are constantly told that we are not the best witnesses to our experience and that thin people, who are all experts on weight and better than us by virtue of their thinness, should be allowed to speak for us – telling us who we are, how we think, and how we should feel.  A good example of this is the credence given to reports by thin people who wear fat suits of what it’s like to be fat, when in fact we have plenty of credible reports by fat people of what it’s like to be fat that are doubted or ignored (ie:  “I’m not “fat shaming” how ridiculous?”) EDIT:  To be clear, I’m not suggesting that every thin person does this on purpose, my point is that our fat prejudiced society elevates the voices of thin people and devalues the voices of fat people, whether we want it to or not.

I think that it is vital to the fat rights movement that we stand up to people who do try to substitute their idea of what it’s like to be us for our actual experience, and fight to be seen as the best witnesses to our experience and have our voices heard as Heather and the people who supported her did. To that end, I wanted to let you know about one of the two blog projects I’m super excited to be starting this summer:

Fat Activism History Project

This one has been in the works for almost two years.  I’ve been contacting many of the people who were part of the beginning of the fat rights movement. I’m going to be doing in-person interviews with them about their experiences, then posting those interviews on a dedicated YouTube channel where everyone can watch them for free.

My goal is to move forward through time interviewing as many activists as I can to build a non-academic verbal history specifically about fat rights activism in our own words that is accessible to as many people as possible (which is why I’m going with YouTube instead of a traditional documentary format)  I’ll also be looking into other uses including compiling a documentary style DVD to be used by school and workplace diversity offices to discuss the history of the Fat Rights Movement. I’ll be starting fundraising on this in a couple days, for now if you want to get involved you can:

Support the project by clicking here

Connect:  Help me connect with people who were involved in the early years, I’m especially interested in those who were part of The Fat Underground and authors from Shadow on a Tightrope as well as activists of color, queer, trans* and disabled activists and fat men.

In the meantime, I want to say thanks to Heather and those who got involved to help for their work on behalf of everyone who wants to be able to put photographic representations of our fat bodies into the world without having them usurped and used for the exact opposite purpose.  For the record I got Heather’s permission to blog about this and use the picture, and you can read her blog about it here and you can find her on facebook at https://www.facebook.com/fatgirlposing

If you want to let Jaime know how you feel, you can e-mail her at jmilano2000@yahoo.com

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Published in: on June 28, 2013 at 8:38 am  Comments (45)  

King of Nothing

Nothing to proveSo there’s this song I love called “King of Anything” by Sarah Bareilles.

The video is posted below but the lyrics that pertain to this blog are as follows:

You’ve got opinions, man
We’re all entitled to ‘em, but I never asked
So let me thank you for your time, and try not to waste anymore of mine
And get out of here fast

I hate to break it to you babe, but I’m not drowning
There’s no one here to save

Who cares if you disagree?
You are not me
Who made you king of anything?
So you dare tell me who to be?
Who died and made you king of anything?

I think it’s important to remember that in typical relationships it’s usually within our ability to set boundaries for who talks to us about what subject and when.

Different areas of my life have very different boundaries:

When I give a talk or do a panel, I tell people that they can ask me anything and I’m serious about that.  It’s my goal to give people an opportunity to ask a question without being scared of hurting my feelings.  99.9% of the time people are intending to be respectful and the rest of the time I’m confident in my ability bring someone’s jackassery into sharp relief, while looking calm, logical and reasonable.

Outside of those talks, I have very different boundaries.  There seems to be a pervasive myth that since I “let myself get fat”, I must need someone to help me.  The truth is that Health at Every Size is my well researched decision, my body size is a reflection of many things within and outside of my control, but is not a barometer by which you can judge my health, intelligence or decision making ability.  I’m happy, and if I needed saving please rest assured that I would be yelling for help.

I actually enjoy discussing health, weight, health at every size etc., and I’m perfectly happy to have discussions about these issues even with people who have different opinions.  However, I’m unwilling to argue about my personal health choices, especially to someone who isn’t backing up their divergent opinion with some serious facts.

Comments on this blog are another really interesting area for me.  When I started out I thought that it was important to post all the comments that weren’t overt spam because I didn’t want to censor people, and I wanted to show the kind of violent, reflexive reaction you can get when you question the status quo or dare to suggest that fat people are human and should be treated as such. Plus I’ll admit answering those people is often entertaining for me.  At some point I realized that people are allowed to be jerks, but I’m not obligated to give them a forum to do that. I’ve decided that I don’t have an obligation to give someone an audience on this blog just because they managed to get their comment submitted correctly.

The same thing applies in my life – it doesn’t matter to me what someone’s intentions are, I decide who talks to me, about what, and how.  This idea that a fat body is suddenly a public body up for discussion and debate is bullshit.  The idea that a fat body is indication that we need advice is bullshit.  The idea fat people should have to listen to anyone who considers themselves well meaning is bullshit.

So this song goes out to everyone whose sense of self-importance is so exaggerated that they actually think should be obligated to care what they think.

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Published in: on June 26, 2013 at 12:45 pm  Comments (13)  

Dealing with Unwanted Concern

beeswaxI thought that with everything that’s going on around Obesity being considered a disease,  it might be a good time to talk about some strategies for dealing with unwanted, unsolicited concern or advice.

Often this comes in phrases like “I’m just worried about your health” or “Somebody has to say something to you about this” or “Don’t you know that blah blah blah is unhealthy”  or “I knew a fat person who had a terrible health problems and I don’t want that for you.”  Sometimes these phrases are used by people in a tacky bid to soften expressions of hate for fat bias.  Those can often be dealth with using an eyeroll and exclamation (try “bullshit!” or “Jackass!) and/or reminding them that jerks raising your blood pressure is bad for the health they are so concerned about.

But sometimes they come from family, friends,  or people who feel that they are well meaning.  This can be difficult to deal with because, since people seem well intentioned, we can feel obligated to appreciate what they are doing or accept it as ok.

Like everything, it’s your choice how to deal with it, but for me this is not ok.  People are allowed to be concerned about whatever they want, but it is not alright for them to unburden that concern onto me. Whatever my level of health, it’s highly unlikely that it will be improved by having people tell me over and over that they assume it’s poor.

It can also be a quiet way to try to say that I am not a competent witness to my own experience, and let’s not forget that however well-intentioned it might be, this kind of “concern” is based on all kinds of myths, misunderstandings, and misinformation and conflates weight and health in a way that isn’t supported by actual evidence.

There are lots of reasons that people may choose to express their concern.  There are some who are truly  well-meaning, for others it’s about feeling superior, feeding their ego by trying to be the hero who saves the fatty, or something else.  For me it doesn’t matter why someone does it, it does not fit within what I consider acceptable behavior.  The way that I handle this is by setting boundaries.  Of course this is just how I handle it, there are many, many ways and they are all valid.

“I’m just concerned about your health”

Basic responses:

  • Don’t be.
  • I appreciate your concern, I’m happy with my path to health and I’m not interested in discussing it.
  • I’m not soliciting outside opinions about my health.
  • My health is none of your business.
  • According to research out of Columbia, people who are concerned about their weight have more physical and mental illness than those who are ok with their size- regardless of weight.  So every time you try to make me concerned about my weight you may be putting my health in more jeopardy.
  • My health is none of your business, but maybe it will comfort you to know that weight and health are two completely separate things and there are healthy and unhealthy people of all sizes.

The things I think but do not say when I’m having a bad day:

  • I’m going to need you to start citing some credible sources or shut up.
  • I’ve spent hundreds and hundreds of hours researching this – are you an expert on this as well or can we just assume I know more than you about this than you and move on.
  • Really. Coincidentally,  I’m concerned that all of your worrying will affect your health.  Please feel free focus your concern somewhere that is else.

“Somebody has to say something to you about this!”

Basic responses:

  • I appreciate your concern but you are out of line.
  • I don’t accept your premise, I’m fully capable of making my own decisions and I’m not looking for input.
  • No thank you.

The things I think but do not say when I’m having a bad day:

  • Perhaps,but it’s not going to be you.
  • I disagree.

“I knew a fat person who had terrible health problems and I don’t want that for you.”

  • I’m very sorry for your friend but people of all sizes and shapes get sick and it’s not appropriate to assume that everyone who looks like your friend will have the same issues.
  • I’m sorry to hear that but I’m not interested in discussing my health with you.

The things I think but do not say when I’m having a bad day:

  • Do you give these same warnings to people with the same hair color or  height as your friend?  If not feel free to go tell some of them and leave me alone.

Regardless of how you deal with it, remember that you have every right to set boundaries and decide who gets to talk to you about your health and how they get to talk to you.

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Published in: on June 24, 2013 at 9:41 am  Comments (20)  

No Shame in Disease Diagnosis

ShamelessI’ve been thinking about the responses to the ADA’s misguided classification of obesity as a disease, and in retrospect I am really concerned that, at least in my own work on the subject, I didn’t do a good enough job making sure that I didn’t stigmatize people who are living with a disease.  I’m concerned that when I say “my body size does not constitute a disease,” people who are living with actual diseases might hear “I don’t want to be like you” or “I think that being diagnosed with a disease is shameful.”  Today I wanted to both apologize to anyone who may have been stigmatized by work, and attempt to clarify my concerns.  (Note: There are plenty of conversations to have about disease theory in general, but for this blog I’ll discuss diseases within the context of how they are currently treated by Western Medicine.)

Let me start here.  There should be absolutely no shame in having a disease.  None.  It does not matter what disease someone has, they should never be shamed for it.  I advocate for nothing less than shame-free, blame-free, future-oriented healthcare.  It does not matter why someone has a disease, it matters what happens moving forward.  We can never change the past so after a diagnosis it’s all about options and choices, not blame or shame.  People who are diagnosed with a disease should be given true information, all of their options, and compassionate care on their terms based on their choices.   There is no shame in being diagnosed or  living with a disease and I am extremely sorry that I didn’t do a good enough job saying that in my blogs on the subject.  I fucked up and I’m sorry.

To clarify, my concerns with obesity being classified as a disease center primarily around the fact that the sole diagnostic tool, and the sole measure of treatment progress, for the “disease” of “obesity” is a simple ratio of weight and height.  So when fat people go to the doctor for actual diseases I am concerned that they will be diagnosed with “obesity” as the primary disease and their healthcare provider will prescribe weight loss in lieu of actual health interventions that are proven to help the disease they actually have.  For example, if a patient goes to the doctor for Type 2 diabetes, they doctor might consider the T2D to be a symptom of, or secondary diagnosis to, the “obesity” diagnosis and suggest that they ignore interventions that are shown to help control T2D in lieu of attempting weight loss.  This is a dangerous practice that is already happening (I was once prescribed weight loss for strep throat), and I’m afraid that the ADA’s decision will lend legitimacy to the practice.)

The major problem with that is that there is not a single study where more than a tiny fraction of participants have succeeded at long term weight loss, and there are certainly no studies where more than a teeny tiny fraction of participants lost enough weight to change their BMI longterm.  Often “success” in a weight loss study is defined as 5% of body weight, or any weight loss at all (which for many fat people doesn’t create a shift in BMI which, remember, is the sole diagnostic tool and the sole measure of “progress” in treatment.)  Almost everyone loses weight in the short term and almost everyone regains the weight in the longterm and while they are busy not succeeding at long-term weight loss (which shouldn’t be a surprise since it’s exactly what the research tells us will happen) their actual health issues may go untreated.

The diseases correlated with being fat are not actually fat people diseases.  Thin people get them too and, when they do, they are given treatments that are shown to treat the actual disease. My concern is that fat people’s medical treatment will be compromised because they will receive different care than thin people who have the same diagnosis simply because of their size, again this is a dangerous process that is already happening and that I feel will be exacerbated by the AMA’s poor choice.

I also feel that calling body size a disease risks putting a very finite pot of research money to very poor use. The AMA’s bad decision gave 30% of Americans a disease, and I am concerned that the diet and pharmaceutical companies will jump on this to say that the sheer volume of people with the “disease” justifies spending a ton of money on weight loss interventions.  My concern here is that funding will be pulled from actual diseases and put toward weight loss research on the basis of the “prevalence” of this disease, which would be a crime against humanity as far as I’m concerned.

I hope that makes things a bit more clear, and I am reminded that activism requires constant vigilance to make sure that we’re not trying to solve one injustice at the expense of creating another.

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Published in: on June 22, 2013 at 12:11 pm  Comments (34)  

When Activism Seems to Fail

Truth GI’ve been hearing from a lot of people who are really upset and hurt by the American Medical Association’s ill-advised decision to call obesity a disease, I’m definitely upset myself.  I think it’s particularly hard because first we found out that the Council on Science and Health that had been charged with studying the question for a year had made their recommendation that obesity should NOT be classified as a disease.  It was all over my Facebook, readers sent e-mails to me and there was such a sense of happiness and relief. Then the next day we found that the AMA had over-ridden the recommendation of their Science and Public Health council and it made the situation that much more painful.

Today as I was driving, a song came on the radio – the first lyrics were “When I was in the 3rd grade I thought that I was gay.” I was absolutely riveted – how was this going to go?  It quickly became apparent that it was a song in support of queer people and queer rights.  I started to tear up – a hip hop song supporting queer people on mainstream radio.  Then the lyrics “The same fight that led people to walk-outs and sit ins.  Human rights for everybody, there is no difference…I might not be the same, but that’s not important.  No freedom ’til we’re equal, damn right I support it.”   I just started crying in earnest, I pulled the car over to listen to the rest of the song.

I suddenly had the strongest memory.  When I was in college my friend Tom and I had a radio show on KVRX, the University of Texas’s radio station.  The show was called Out Loud and the slogan was “Coming in Loud and Queer All Over Austin.”  We did interviews and commentary about gay rights.  It was 1996 and in Hawaii the case of Baehr v. Miike was playing out – same-sex couples suing for the right to be married.

In December the judge ruled that the state had failed to establish any compelling interest in denying same-sex couples the ability to marry.  The next day he stayed his decision to prevent a situation where people would be married only to have his decision overturned.  On November 3rd, 1998 voters in Hawaii were deciding on an amendment to their state constitution to “reserve marriage to opposite-sex couples.”  They voted yes.  It was heartbreaking and that night Evan Wolfson (an attorney who was leading Lambda Legal Defense and Education Fund’s Marriage Project) was kind enough to be a guest our little radio show.  He sounded tired, he sounded disappointed, but he emphatically told two college activists, and anyone who was listening to our show, that we must not give up.  Soon after he formed Freedom to Marry, saying “I’m not in this just to change the law. It’s about changing society. I want gay kids to grow up believing that they can get married, that they can join the Scouts, that they can choose the life they want to live.”

As I sat in my car listening to the song again (having downloaded it immediately onto my iphone) the memory of Evan Wolfson hit me and I started crying anew, knowing that gay kids can join the scouts, and they can get married in 12 states.  There’s still lots of work to be done but it’s a lot of progress from the punch in the stomach feeling of November 3, 1998 to today when I heard a hip hop song supporting gay marriage on commercial radio

The thing about civil rights activism is that the minute you realize the need for the activism you step through a door and become ahead of your time – privy to the horrible acts being committed by those who either don’t know, don’t care, or who profit from the status quo.  Sometimes it will seem unbelievable that people can’t see what’s going on and aren’t convinced by argument, evidence, or tearful impassioned plea.

When it comes to civil rights activism, history is on our side.  But the victories can be a long time in coming and in the meantime civil rights activism can be fun, exciting, and invigorating.  It can also be painful, heartbreaking, and make you question your faith in humanity and yourself.  But for me, once I walked through the door, there was no other way to go.

Here’s the link to Macklemore’s Same Love

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Published in: on June 21, 2013 at 11:54 am  Comments (30)  

The War on Obesity Is a War on Fat People

End this warIn response to my blog about the inconsistencies with the way obesity is treated when compared to other people who are viewed, whether correctly or erroneously, to not prioritize their health, reader Anna responded:

I have never taken the statement “war on obesity” as a war against a group of humans. So, although I get your post and where you are coming from, I believe the statement has been misconstrued.

I’ve heard this sentiment repeated many times and of course Anna is allowed to believe whatever she wants, but let’s examine the situation.

Let’s look at some ways in which the war on obesity is fought:

Now let’s examine how this plays out (aka, the casualties of the war)

  • Fat people are policed by others on their bodies, food and movement
  • Fat people are shamed, stigmatized, and bullied – the Journal of Pediatrics has identified bullying of overweight/obese children as the number one type of bullying that takes place
  • Fat people’s parenting abilities are called into question
  • Fat people experience stigma from their healthcare practitioners
  • Fat people get hired less and paid less than their thin counterparts
  • Fat people who suggest that they are human and deserve basic human respect get hatemail and deathreats
  • Studies find that “Those who are obese are reminded through their everyday encounters with family members, peers, healthcare providers, and strangers, that their being deviates from social norms.”
  • Studies show that even if fat people manage to lose weight, they are still subject to discrimination based on being previously fat

Maybe the people who started the War on Obesity thought that they could wage war against people’s fat without waging war on the fat people, but that’s just not working out.  Maybe those who started a war on obesity didn’t intend for this to happen, but intention isn’t everything and, at this point, it’s almost nothing.  Maybe people think I should be okay with them hating my current self but being willing to love the thin person they believe I could become, but I refuse to participate.

I think the belief that you can have a war on obesity without creating a war, and subsequent casualties, out of fat people is at best naive and at worst intentionally obtuse.  We cannot separate people from their bodies and any war on people’s fat becomes a war on fat people. Luckily the first step of the solution is pretty simple – end the war on obesity.  Right now. Then we have all kinds of options to make public health about providing information, access, and options without actively contributing to stigma, low self-esteem, and poor body image.

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Published in: on June 20, 2013 at 8:36 am  Comments (45)  

AMA Says Obesity is a Disease

Bad DoctorA year ago the American Medical Association charged its Council on Science and Public Health with studying whether or not obesity should be considered a disease.  Today they ignored that council’s recommendation and now, per the American Medical Association,  Arnold Schwarzenegger, Tom Cruise, Barry Bonds and I all have the same disease.

To be very clear, there is no shame in having a disease, I think that there is shame in the actions of the AMA.

So does that mean that Tom Cruise needs to start diet pills?  Does Barry Bonds have to sign up for Weight Loss surgery?  After all, they are obese by the clinical definition and obesity is a disease per the AMA  So you can see why the Council on Science and Public Health thought this was a bad idea.  The “disease” is a body size, the “cure” is to change the body size and nobody has to take any health measurements at all. This does not have the feel of sound science.

But really it’s just the Council on Science and Public Health and what do they know about science and public health making  a profit for pharmaceutical companies?

“Companies marketing the products will be able to take this to physicians and point to it and say, ‘Look, the mother ship has now recognized obesity as a disease’” says Morgan Downey, a self-identified advocate for obese people and publisher of the online Downey Obesity Report.  I’ve got to say, with advocates like this, who need detractors.  Morgan gets paid to consult for organizations that represent companies that market these products, so it’s a good day for him.

In a blatant attempt at “if wishing made it so” the AMA resolution stated hypotheses as if they were facts:

Whereas, Weight loss from lifestyle, medical therapies, and bariatric surgery can dramatically reduce early mortality, progression of type 2 diabetes, cardiovascular disease risk, stroke risk, incidence of cancer in women, and constitute effective treatment options for type 2 diabetes and hypertension;

It’s important to note that there is not a single study that proves this.  They forgot the last sentence which is “We guess.”  They also ignore the fact that many obese people never develop these issues and plenty of thin people have them.  Not to mention that one reasons that good research doesn’t exist is that so few people have lost weight long term that there aren’t even enough to study.  That’s because there aren’t any weight loss methods that are shown to work long term for more than a tiny fraction of participants, and studies don’t have a success criteria that included a change in BMI, often the “successful” weight loss amounts to 2-5 pounds.   There’s weight loss surgery but that has a high rate of weight regain and may have a 700% greater chance of dying in the first year alone and no proof that those who underwent the surgery have any better health outcomes than they would have if they had skipped the surgery and practiced healthy habits, so that’s questionable at best.

So against their own recommendations the AMA declared body size – including my body size – to be a disease.  No actual health measurements necessary, just a quick ratio of your weight and your height and they’ve got you diagnosed.  They aren’t the first, the NIH has considered me, Mel Gibson, and most NFL linemen to have a disease for a while now. No matter how many organizations say it, I don’t think it’s medically and scientifically sound.  I do think it’s profit driven.

I’m still going to the doctor’s office as the CEO of my healthcare team.  I’m still going to say the same things at the doctor’s office, I’m still going to insist on appropriate, evidence-based health care.  I will continue to defend my amazing body from any and all attacks. So bring it on AMA, I’m a fat woman, but I will not be your cash cow.

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Published in: on June 19, 2013 at 8:21 am  Comments (44)  

We’re Gonna Need More Wars

Public HealthThere is an argument that suggests that it’s ok to body police, bully, shame, stigmatize and have a war against obese people because being fat is an indication that someone doesn’t prioritize their health and that costs taxpayer dollars, and so prioritizing health is a social obligation and the punishment for not holding up our end of the bargain is that the government has declared war on us.

For today let’s set aside the fact that body size is not an indication of behaviors, health, or prioritization of health.  Even if it were true that fat people don’t prioritize our health, the argument is still bullshit – a convenient lie used to justify indefensible bigotry. The way I know that is that if people truly believed the argument, there would be a lot more wars:

The War on Football Players:  Football players, especially at the professional level, are absolutely not prioritizing their health. When their careers end their bodies are often in horrible shape – multiple concussions, blown knees, some players admit to having had over 50 surgeries after leaving the NFL. They retire at an average age of 28 years old with no salary, studies show that 78% go bankrupt within 5 years of retirement, but they don’t get insurance until they turn 50 and then only if they are vested and qualified.  This sounds expensive, let’s get that war going.

The War on Insomniacs:  Lack of sleep has been shown to be detrimental to people’s health.  Studies suggest that most people are shown to need 7-8 hours of sleep a night. Sounds like we’re gonna need to gear up for a war on people who choose to sleep less than what is shown to be healthy.

The War on Rock Stars:  The rock star life that we celebrate as a culture includes drugs, alcohol, and a schedule of, rehearsals, shows, and appearances that runs performers ragged.  These people are clearly not prioritizing their health. Where’s the war?

The War on Unhealthy Thin People:  This whole idea rests on stereotypes about fat people – that you can tell by a fat body that someone doesn’t eat well and doesn’t exercise enough.  Of course that’s no more true then the idea that every thin person eats well and exercises. Everyone knows a thin person who eats a ton of “junk food” never exercises and remains thin. If we’re going to do this we’re going to need to have a war on those people too.

The potential list goes on – UFC fighters brag about not prioritizing their health, professional bullriders, X Games athletes, people who choose to work third shift, people who choose jobs with repetitive motion, people who climb mountains, Iron Man triathletes, people who don’t look both ways before they cross the street, people who buy cars that don’t have the highest safety ratings etc.

The truth is that there are many ways to prioritize and de-prioritize our health and none of them can be be judged by body size.  People of all sizes prioritize their health at different levels for different reasons.  Fat people simply make good scapegoats because we share a single physical characteristic that is easily picked out in a crowd. The prejudice is kept in place by “everybody knows” thinking, the frantic shouting down of good research, embarrassingly poor research done from a platform of confirmation bias or for profit, and lies about healthcare costs.

In what should be a blinding flash of the obvious (with a nod to my friend Stan), the solution is not to have more wars on more people.  The solution is to end the wars.

I don’t believe that health is a moral, social, or personal obligation (you can choose to prioritize things other than your health just like professional bull riders, X Games participants, stressed-out sleepless executives, those who have elective plastic surgery, sky divers, and people who don’t look both ways before they cross the street). Also, let’s not kid ourselves – our health isn’t completely within our control.  Health is multi-dimensional and includes genetics, access, stress, environment, and behaviors among other things.

It’s time to recognize that public health is not about making the individual’s health the public’s business.  It’s about removing stress whenever possible (like, say, the stress of having the government fight a war against you or hearing politicians promise that in a generation they will have eradicated all the people who look like you) and providing information, access, and options to people of all sizes.

Those who disagree with that better be prepared to police EVERYBODY and fight a war on people who don’t prioritize their health on every imaginable front because it’s unacceptable to simply pick a group of people who can be identified by sight and start “calculating their cost” to support the idea of having a war to eradicate us.

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Published in: on June 18, 2013 at 8:38 am  Comments (36)  

Hold the Concern Please

beeswaxI keep hearing people suggest that it’s their moral obligation to tell fat people that we need to lose weight, exercise more, or that if someone sees a fat child they need to say something to the caregiver. I’ve been part of any number of conversations where people who had no business or permission to talk to me about my weight or health (and let’s remember they are two separate things) did so.

First of all, we know that you can’t tell anything from someone’s body size other than what size their body is, and what prejudices you hold about that body.  Even if these people’s assumptions about fat people were true, the behavior would still not be justified.

I often respond by saying, with finality,”I’m not taking unsolicited opinions about my health, thank you.”   What I think in my head is more along the lines of No. No no no no no no no.  No. First of all, how much of an idiot do you have to be to talk to me as if I’ve never heard that I should lose weight.  Do you think I’ve never seen a TV commercial? Listened to the radio?  Looked the hell around?  Do you think I live under a very large rock?  By my count I get about 386,170 messages a year that my body is wrong.  I’ve been fat for at least 27 of my 36 years so that’s 10,426,590 times that I’ve been told that my body is wrong. If I was going to buy into that bullshit I would have done it already.  So how about you trust me when I tell you that the 10,426,591st first time is NOT the charm.

I think that when someone feels this strong of a need to “save a fatty”, it’s often really much more about their own ego than the person they are supposedly so concerned about.  Like an ambitious relief pitcher, they want to get credit for the save.  I call this “Pulling a Jillian” as in Jillian Michaels, ego maniac from The Biggest Loser, who can’t stop talking about how she’s saving lives and she’s making people healthy, she’s doing this and she’s doing that blah blah blah. Newsflash Jillian, if you really cared about people we would be hearing a whole lot less about you.

I am a grown ass woman making choices.  That is my right. Just like other people get to make choices for themselves.  You can decide that your path to health is a raw foods diet, vegan, vegetarian, liquid diet, whatever.  I don’t get to decide how you live, it’s not my business.  I get to make choices for my body and you have no right to question those choices. (And if you’re even thinking about making a “but my tax dollars pay for fatties” argument, head over here.)

The bottom line here is very simple:  This is not a tree and I am not a kitten so you can put your ladder away. Thank you.

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Published in: on June 17, 2013 at 1:31 pm  Comments (54)