Not a Moment of Peace

ConcernRecently I re-posted my blog about being comfortable in a swimsuit to Facebook in response to a day in which I had been barraged both by ads for diets that counted on my being  terrified of wearing a swimsuit, and companies trying to sell me bathing suits by suggesting that I would look less like me if I wear them (though who, precisely, I would be trying to fool with a suit that makes me “look 10 pounds slimmer” is difficult to say.)  It got a lot of views (hi new readers!) and many people re-posted it to Facebook (thanks y’all!)  One of the common responses to the post was something like “Body acceptance is ok, but we can’t ignore the health dangers of being obeblah blah blah blah concern troll blah blah blah.”

I think this idea – that we can’t say anything in appreciation of fat bodies without someone making an unsolicited comment about our health – is deeply problematic. There’s often a predictable trifecta of concern trolling – VFHT (vague future health threats), erroneously conflating body size with health, and confusing body size with behaviors/eating disorders (ie:  I would be just as upset if you were glorifying anorexia…)

Peter Muennig from Columbia University did research around weight and stigma and  found that women who were “concerned about their weight” had more physical and mental illness than women who were fine with their size”, regardless of their size. He also found that the stress of the stigma that fat people face was correlated with the same diseases with which being fat is correlated.

So this hand-wringing, wailing insistence that fat people never be allowed, even for a moment – even for a single facebook post – to appreciate or be happy with our bodies without unsolicited opinions about our health may not just be incredibly irritating and indicative of a person with boundary issues, it may be actively harming us.

Studies of weight and health that take behaviors into account (Wei et. al, Matheson et. al, Cooper Institute Longitudinal studies etc) have found that habits are a far better predictor of future health than body size, and that people with similar habits had similar risk of all cause mortality and health hazard ratio regardless of their body size.

Meanwhile researchers are finally being honest about that fact that there is not a single study for which weight loss worked for more than a tiny fraction of people (which means that it doesn’t meet the requirements of evidence-based medicine) and that even among those who did lose weight there was no correlation to better health that could be credited to the weight loss independent of behavior changes (Mann and Tomiyama 2013) Sometimes when people change their behaviors, their health improves and sometimes they also lose weight. We often erroneously credit the weight loss, rather than the behavior, for the health changes but the above research shows that healthy habits, not the manipulation of body size, are what are likely to support health (though of course healthy habits are not an obligation, barometer of worthiness, or a guarantee.)

Body size is not health, it’s not behavior, and it’s not a diagnosis of any illness – physical or mental. To paraphrase Marilyn Wann the only things you can tell from someone’s body size are the size of their body, and your particular prejudices and preconceived notions about their body.

But even if all of that wasn’t true, even if the concern trolls were right about whatever they believe about our health – and setting aside the questionable idea that if they convince us to hate our bodies we’ll somehow take better care of them – we still have every right to refuse to put up with concern trolling.  Because our bodies and our health are our business, and so is who gets to comment on them. Contrary to some people’s beliefs, public health should be about making information and options available to the public, not making the individual’s body the public’s business.  We don’t have to allow anyone to comment on our health, not even if they are well meaning.

We each get to deal with this in any way that we want.  We can let people say what they are going to say and just let it go in one ear and out the other, we can try to educate them, we can tell them to drink a big steaming mug of shut the hell up.  Regardless, I think it’s important to be clear that our fat bodies are not the problem, the problem is people who insist that we shouldn’t have a moment of peace living in them.

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Published in: on June 17, 2014 at 7:49 am  Comments (40)  

40 CommentsLeave a comment

  1. What I just don’t get is: Why are people so obsessed with other people’s health anyway? And especially about fat people’s health. I have never heard anyone say to a smoker “but your health!”, regarding smoking what I hear is “but it stinks, I don’t like the smell, please go outside”. And if someone tells about a disease he/she has, people are full of pity if the person is thin, as if some evil alien force has put that harsh fate upon him/her, but if the person is fat, all you hear is “It’s because of your weight”. Gosh, I am so sick and tired of this… Hell, even if I decide to leave this life at an early age, it is MY decision or problem and mine alone. Who are these people who think that it is ok and even well-meaning to bully total strangers?
    Thank you, Ragen, for constantly reminding us!

    • I totally agree with this. Why do concern trolls care if we die at 40/50/whatever? What business is it of theirs? I don’t get all concern troll-y at people who snowboard or skydive or bungee jump (all things which probably increase your risk of dying younger than average) so leave us the hell alone!

    • Actually, though you may not have heard it, there are plenty of people who talk about smoking and health. But most of the talk and legislative action (not talking about private lawsuits here) concerns second hand smoke, i.e., what your smoking is doing to me. This is where it differs from concern trolling re: weight – how much one weighs has no adverse effects on anyone else, unless you count the squinching up of the facial muscles when trying to pretend to be solicitous about the OMGDEATHFATSDIABEEEEETES!!! Plus, there is TONS of scientific evidence about the bad effects of exposure to second hand smoke – the Surgeon General’s report alone is three inches thick with very small writing. But even smokers are treated better than fat people by the medical community.

      • As both a fat person and a former smoker, my experience is not in any way indicative of being treated better for one or the other. I’ve gotten concern trolled about “but it’s so unhealthy!” also.

        At least though nobody has tried to ban me from being fat in my own car yet. Yet anyway.

        • Erin, when I was in the tobacco control community, I was firmly on the side of “what you do by yourself is your own business,” AKA the Underpants Rule, as were many of my co-workers. I think some public health people go way too far, and the banning smoking in the car is an example of that. People should just be left the hell alone to do what they want, as long as it doesn’t hurt anyone else.

  2. Do you have any comments regarding this study? I’d love to hear your take on it:

    http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0061117/

    Particularly regarding the conclusion.

    Thanks,
    Dan

    • Hi Dan,

      Great question, thanks for asking. This study didn’t take behaviors into account. When studies look only at body size (including metabolic health at any given time) we see a rise in relative risk of all cause mortality and health hazard ratio in people of larger sizes (note that this is correlational so we don’t know if it’s the body size that’s the cause or something else). When studies control for actual behaviors, then those differences are mitigated and we see that people with similar behaviors have similar health outcomes regardless of size.

      There was controversy in the world or obesity research about the study you mentioned since there is such a large and consistent body of work showing that controlling for behaviors has tremendous impact on results, but these researchers chose not to do so – suggesting either that they didn’t do a good literature review, or that they were looking to get the conclusion that they got.

      I linked to Matheson et. al, Wei et. al, and the Cooper Institute Longitudinal studies in this blog, if you want to know more I would definitely check those out.

      ~Ragen

      • Interesting, I’ll check those out in more detail. Thanks!

  3. Dear d.w.f., I’m new to your blog, and a fellow fb friend shared it with me a few days ago.. I would like to give you a standing ovation for THIS post alone, but my computer won’t let me. I love this SO much, and I just thought I would tell you. Please, keep this up? You are doing this size-20 woman some serious good….and my health is crap, btw. 😛

    Sincerely, honestly, and completely your friend, Stephanie Moore

    >

  4. On the subject of the VFHT… I look about five years younger than I actually am (conservative estimate there, a new coworker genuinely thinks I’m only a year out of highschool and I ocassionally still get mistaken for being a teenager), so the usual vague future health threat talk I get involves the deadline of age 30. You know; You may not have diabetes/high blood pressure/insert disease here now but if you don’t lose weight you’ll be seeing these problems by thirty. Or the more dramatic “with your weight like it is you’ll be lucky to live to thirty”. It’s always incredibly funny when I look back on those conversations and remember the sudden backtracking that happens when I say “so I’ve got two years then?” And then suddenly it’s by 40. Or 50. Or just ‘some day’. As if non-fat people don’t develop any sort of health issues as they age.

    • I became visibly deathfatz (as opposed to “Tch, the chart says you’re overweight,” which started when I was about nine) more than 20 years ago. I have been issued dire warnings about my impending doom for all that time. Guess I’m a zombie.

      • I was huge when I was born and have always been fat. I’ve been diagnosed as “Morbidly Obese” since I was a kid, so I’ve been OMGDEATHFAT just about all my life. And as such I’ve been receiving the VFHT for the past 30 years, even though I’m healthier than most of the people in my family (most of my family is thin).

        What makes me angry though is that we ALL get sick or get health problems as we get older. And I just know that when that day comes it will be “I told you so”, as if being thin I could avoid any and all health problems. It pisses me off that no matter what I end up getting sick with or what kind of health problems I’ll get (as everyone gets sick eventually) it will be blamed on my weight. And in fact whatever I end up dying from eventually probably will be put down “died of complications due to obesity”. Thin people are afforded the dignity of proper health care dealing with sickness and health problems that comes with age, fat people will always be told it’s because of their weight.

    • I get the same guff about looking young! I think it’s the primary reason for not getting jobs after the interview. I look 14.

  5. This is sort of a sidebar, but…yesterday I was flipping through the radio dial and caught part of a call-in show. A young girl (turned out she was 15!!) was talking about how she was a recovering anorexic/bulemic and had been in two courses of rehab (I kept thinking that at 15, my biggest worry was the frizziness of my bad perm and whether or not I should try out for the school play). I felt so badly for her but nearly put my fist through the radio when the announcer said..

    “This is so awful for you, and I’m so sorry. Can you think of any incidents that set off the eating disorder? Anyone one thing, or was it a combination?”

    And I yelled, “HOW ABOUT SOCIETY IN GENERAL? How about every single magazine cover, every ad, every biased news report, every Yahoo headline, every store in a mall, every swimsuit advertisement, every supermarket shelf, every comment ever made in a school hallway, doctor’s office, and just about anywhere else saying YOU’RE NOT GOOD ENOUGH THE WAY YOU ARE, YOU TAKE UP TOO MUCH SPACE, YOU MUST BE SMALL, DELICATE, AND FIT INSIDE A TINY BOX LIKE A PIXIE, AND YOU WILL NOT BE BEAUTIFUL TILL YOU DO??”

    At which point my daughter looked a little scared, so I turned off the radio and muttered under my breath for another 5 minutes, vowing I would raise my daughter to know the difference between the power she has in her own existence and what the world thinks she should be.

    • I don’t know if she realizes it now, but your daughter is lucky to have a mom who yells at the radio like that.

    • I once briefly worked with a cardiologist (long enough to help him get set up with my company’s services and hire people to work with him long-term) who gave every patient who was even slightly overweight a weight-loss lecture. Then one patient came in, and, when he asked her how things were going, started talking about how her 10-year-old granddaughter might have to be hospitalized for an eating disorder. The doctor looked genuinely concerned (aside from the weight-loss lectures, he was a kind man who cared about his patients, and they loved him) and said “Oh my goodness, at TEN? I’m so sorry! This type of thing is just happening younger and younger these days, isn’t it? I wonder what that’s about?”

      It was all I could do not to scream out in the middle of the office, “People like YOU, in part, that’s what it’s about! You can say it’s about health all you want, but you’re still sending the message to your patients loud and clear that there’s one “right” type of body and they don’t have it. And I know your patients are adults, but they take that message home to their kids and grandkids. You are DIRECTLY contributing to the culture that puts 10-year-olds in the hospital with eating disorders, so for God’s sake STOP acting like this is some baffling phenomenon you can’t understand!!!”

      • It’s an awful situation when doctors are so divorced from society and they don’t understand or know about trends that occur in the “real world”.

  6. Ah, swimsuit shame commercials, how I freaking hate thee! And then it’s slim down for that first day of school, rapidly followed by lose weight for the holidays… while you bake lots of hi-calorie goodies for the people who do deserve them, and then you have to work off those extra holiday pounds you packed on by actually eating more than air during all those food-related holidays, and then it’s so you can look good on your cruise, and then we’re back to desperately needing to look ‘right’ in an itsy bitsy, teenie-weenie yellow polka dot freaking bikini.

    I have a swimsuit. It fits my body just as it is right now. It works for the small amount of time I actually get to spend in the water. What’s more, the color is one I rock.

    My bright red and white swimsuit makes my eyes sparkle and my cheeks glow. It does not make me look thin. I don’t give a flying fig about that.

    If anyone else does give a flying fig about it, I cordially invite them to keep that to themselves.

    • I don’t swim. Lakes are full of squishy, bitey, slimy things, and pools turn my *ahem* naturally beautiful auburn hair green and the sun turns my white skin the color my hair should be. Plus I don’t like it. But if I ever do, I hope I can find a swimsuit that makes me look as good as yours does you! Mine would be green or purple to go with the aforementioned red hair.

  7. Too bloody right. Out of the park as usual.

  8. I have several swimsuits in lovely colours and bright patterns and having been going in the pool several times a week for 2 years, people have stopped saying I am brave or telling me to keep it up! BUT I have also noticed that friends away from gym now recognise that I am a physically fit fat person. Probably fitter than they are, since they choose not to go to exercise.

  9. Thanks for this post. Its hard enough, sometimes, to give OURSELVES that moment of peace. I don’t need the world giving me more of a hard time.

  10. Word.

  11. In doing research about a lot of current issues, I discovered that people will obstinately hold the same beliefs they had before even if you have a ton of valid data that says “hey, you’re wrong”.

    Why aren’t they concerned about skinny and sick people and their bikini bodies? Right, because they are hypocrites and honestly they only care about appearances.

    I recently discovered a note from my highschool nurse saying that I needed basically to lose weight. She knew nothing about my habits, my diet, if I exercised or not. She made the decision to write a note about my health purely based on my weight/height ratio, treating my body as if it were a disease. This honestly needs to stop and I’m afraid that if doctors don’t change their attitude neither will people.

    P.S I know skinny people get mean comments and fake concern talks from others as well, it was just an example.

    • Yep, if people have some kind of emotional connection to an issue, using facts to try to change their minds will pretty much usually backfire, unfortunately. This article covers that pretty well. I just wish there were a way to undo the “everybody knows” concepts that are out there.:/

      http://www.newyorker.com/online/blogs/mariakonnikova/2014/05/why-do-people-persist-in-believing-things-that-just-arent-true.html

      • Thank you for the article. It’s true that if you challenge someone’s beliefs, in many cases there won’t even be a dialogue about it. Instead we have violent opposition.

        To be honest, I’d be happy if more and more fat people would realise that and stop hating themselves even if others don’t “get it”.

        • “To be honest, I’d be happy if more and more fat people would realise that and stop hating themselves even if others don’t “get it”.”

          I totally agree. I think that’s why Ragen’s work is so important. Because the key to change is first getting fat people to stop hating themselves and realize that we are worth that societal change. Nothing will change until people stand up and demand the change. I know that having “allies” (thin/average sized people) on our side is important but the most important thing, imo, is getting fat people themselves to stop buying into the bullshit fat phobic messages our media and diet culture constantly pushes out. Once that happens, more people will have the courage to stand up and demand the change that needs to come.

  12. I get these wretched Facebook spam adverts about “I was ashamed to be seen in public because of my size blah blah blah” and “Miracle diet yada yada” all the time too – I’m seriously thinking of quitting the site because they piss me off so much.

    Goodness knows how the targeting works, for there is nothing on my Facebook ID that could give advertisers the idea that they might be able to persuade me to go on a diet/give my credit card details to purveyors of quack supplements, and the photos I’m tagged in don’t show someone who minds being seen out in her vest and shorts.

    I can only guess that they’re making assumptions based on my gender, for my husband gets completely different spam.

    • If you aren’t using Chrome or Firefox, you might want to switch to them so that you can use Adblock Plus – I never see any of those advertisements on Facebook, and it isn’t something complicated to install/maintain — just a simple download off the Chrome Webstore (for Chrome) and it’s done and just sorta hangs out in the background and doesn’t need much further attention. Disabling it on a couple sites like Hulu is about it.

      • Erin, Deenie, thanks! I use Chrome on both my home and work computers and will install Adblock. And make sure my girls do the same, because the less potentially triggering stuff pops up on their screens, the better.

    • If you are using your own computer you can install an ad blocker. I use a little program called AdBlockPlus and I don’t see any ads unless I allow it. You can opt to allow ads, but the default is ads are blocked. Some of my fav blogs earn their revenue through ads, so annoying as they are I allow them.

  13. Thank you for this, Ragen. I hadn’t been swimming since high school, and it took having a charming little 3-year-old boy who LOVES the water to get me back in the pool this year. I haven’t lost any weight, but I’ve lost all the fucks I have to give about what people think. Swimming is way too much fun, especially with my little guy, and I won’t be giving it up again.


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