One of the ways in which diet culture harms, and can even kill, fat people is its perpetuation of the idea that a fat life is more risk-able than a thin life. The underlying belief of diet culture is that it’s better to be miserable, or even dead than to be fat.
We see this in lots of ways.
Medications being prescribed to fat people that risk our health and lives for a few pounds lost (and quickly regained.)
Gruesome and barbaric recommendations, like pumping food out of our stomachs into a bucket, are seen as totally reasonable, without any regard for how they will affect our physical or mental health.
And of course there is the horror of stomach amputation and binding (aka “bariatric” or “weight loss” surgeries.):
A pretty clear example: a thin person and a fat person go to the same doctor. Both have elevated blood sugar. Their numbers are exactly the same. The thin person is prescribed medication with few side effects that is shown to help control blood sugar. The fat person is referred for a surgery during which most of their stomach will be amputated causing a risk of death on the table, short- and long-term death from complications, and horrible lifelong side effects. The fat person is asked to risk their life and quality of life to control blood sugar. The thin person is asked to take medication.
The same thing happens when a fat person who actually needs knee surgery is told that they can’t get it because knee surgery is too dangerous, and then they are given the recommendation to have stomach amputation surgery, which is far more dangerous with far worse possible side-effects.
Sadly this isn’t limited to adults, in Australia the “Fast Track to Health” study will literally starve children, despite the fact that the evidence does not suggest that it will do anything to change their weight, there are serious questions about severe food restriction during children’s growth years, and the study perpetrators know that they are risking inducing eating disorders. (There is a fantastic take-down of this here.)
I’m writing about this because I think it’s important to realize that when we are advocating for our health and healthcare, we are often advocating against a system that thinks that it’s worth killing us, or ruining our lives, to make us thin – no matter what we think.
Fat people have the right to exist, in fat bodies, and it doesn’t matter why we’re fat, what the “consequences” of being fat might be, or if we could (or want to) become thin. Fat people have the right to healthcare that supports our actual bodies, rather than insisting that we risk our lives to be thin before we are treated as human beings, worthy of appropriate, evidence-based healthcare
Nobody knows what fat people’s health outcomes would look like if we lived in a society that celebrated the diversity of body sizes, gave us the opportunity to love our bodies and see them as worthy of care, and the access to take good care of them. I’d like to find out
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Eventually all this horror will be added to things like bloodletting to the point of death as examples of completely wrong.
“The fat person is asked to risk their life and quality of life to control blood sugar. The thin person is asked to take medication.”
This. What people don’t seem to understand is that medical fatphobia isn’t doctors telling you to lose weight while they give you evidence-based medicine, it is doctors telling you to lose weight INSTEAD OF giving you evidence based medicine. It’s not a “hurshtrooth” that “hurts our tender fee-fees,” it’s a de facto denial of healthcare.
Yes—and we are old to be more active without any questions about our current activity level, told to eat less junk food whether we eat it or not, etc etc etc. assumptions abound.
I’ve also been running into this response to statistics on dieting and surgery: “It’s true weight loss is dangerous. I’m not trying to minimize the danger. But you have to balance the risks and the rewards.”
So… weight loss is about balancing the risk that I lose my life, quality of life, and/or health with the reward that you THINK I’m a healthier, better, prettier person? In the actually rational world, this is what we call a “sucker bet.” You are asking me to bet something of great value on something of no value. How about instead I get some antibiotics for the infection I’m actually here to get treated? Or if you’re gonna insist on giving fat people consolation prizes instead of medical care, maybe go the traditional route and send us home with Flokati rugs and copies of Operation instead of sales pitches for Jenny Craig?
Well said!
Yeah, this. When I was diagnosed with diabetes, it was all about my weight and diet. When I pointed out that every member of my family who is over 50 has diabetes, regardless of weight, and that I was diagnosed pre-diabetic when I was in my 30s with a “normal” BMI, that was ignored. They said I needed to eat less carbs. I told them I’ve been cutting out sweets since I was diagnosed pre-diabetic 8 years prior. Hey, I love salads! That’s a free pass, right? 🙂 We talked about what can raise blood sugar, and the doctor mentioned stress. I said that I had been under a lot of stress lately, what with handling an estate settlement for my mother-in-law who has dementia, and handling that mother-in-law’s finances. I was told to eat fewer carbs and lose weight. So known factors – genetics, stress – were ignored in favor of incorrect assumptions about diet and weight.
But at least I was prescribed medication!
I am so very lucky to have a primary care physician who is NOT a fatphobe. She is very slender herself but she is completely supportive of me and believes me when I tell her what I eat and how much I exercise. When I was diagnosed with diabetes, after 3 years of prediabetes and following a careful regimen of restricted carbs and lots of exercise to keep it in the pre-stage, I burst into tears in her office and wailed “But I’ve tried so hard!” She handed me a kleenex and let me cry, but she also said “And if you hadn’t tried so hard, you probably would have been fully diabetic years ago. You’ve done everything you could to slow it down. You can’t outrun your genetics.” I am so lucky to have her. I live in an isolated rural town, and as soon as I retire at the end of this year we’re moving to an urban area where we’d both much prefer to live — but I really worry about finding another doctor this good.
Find the doctor before you move. That way, you can still see the good doctor, right up until the end.
My doctor is O.K. too. I get the idea she almost believes me but knows telling me to do anything would be futile. I know from comparison that she is a good doctor because when she isn’t available I almost always here the standards: “Have you tried any of the weight loss programs, they’re all pretty good?” Pahahahaaaa! Have you considered weight loss surgery, they’re all pretty good?” “Have you thought of maybe just killing your self?” Alright, haven’t had that one yet, but I have seen enough nurses annoyed I have low BP, BS and cholesterol levels. I mean po’d.
I think eventually bariatric surgery will be looked on the same way we now look at performing frontal lobotomies for psychiatric illnesses.
It’s a sad fact that surgeries and procedures are reimbursed at much higher rates than other medical treatments like giving medications, so I think it’s ALWAYS a good idea to be skeptical when that is the first thing a physician brings up.
Modern day science has had trouble finding living subjects for questionable and necessary studies since people got so squeamish about medical testing and clinical trials that might main and kill. BUT there is a silver lining. A viable source of cross the board testable subjects has arisen! Fat people. Hey, they’re here, they’re alive (sort of) and we don’t give a shit if these unwanted people die during the course of needful studies for the betterment of humanity! You might not want ’em testing mascara by smearing it in bunnies eyes and checking the level of damage but fat people are a growing (and happily disposable) section of society ready for the plucking, slicing, gutting all in the name of science and improving the lot of humanity!
And they’re so cheap to keep, too! After all, everyone knows that “healthy” food is so much more expensive than that cheap processed stuff that fat people inhale. People with lower levels of income tend to have higher levels of fat because they can’t afford the good stuff.
So, ditch the expensive pet food, load up on canned goods and junk food, and start moving in your “human” herd. You’ll save so much money on food, and security, because no eco-warriors are going to break into your research labs and free the subjects! It’s win-win!
Way! If I never have to hear a rich thin celebrity tell me how to eat well on the cheap…
If I never have to hear another rich thin celebrity telling me how to do ANYTHING on the cheap. I’m sorry, but “It’s easy to save money! Just don’t buy that second vacation home in the Cayman Islands!” is not relevant advice to someone struggling to keep ONE roof over their heads.
Hold on hold ON! I just read about that Fast Track to Health experiment, and they are conducting this CRUEL experiment WITHOUT A CONTROL GROUP! They have two groups – one that practices fasting on alternate days, mixed with “following normal guidelines,” and the other with constant calorie restrictions, but they aren’t comparing to unrestricted eating AT ALL!
What the heck?! Cruel AND bad science?!
I can’t even.
Siege mentality, saving the world, saving people from themselves. Nothing is too extreme under these odds. We have to keep education people. Even when the SCIENCE doesn’t hold up the weight bigots revert to too much food, not enough exercise, no will power, blah blah blah. Drastic fixes acceptable before they use all the health insurance, squish another innocent on a plane, make a drag on the dating pool, bother me personally. Like when they tell me they are entitled to be treated decently. I mean as if! Their comfort with insulated contempt is what freaks me out. To be angry and ignorant is one thing, but happily so is frightening.
*dons tinfoil hat*
Hey, remember that “whole systems approach to obesity” Harry Minot brought up and Ragen blogged about that one time? This thing?
https://danceswithfat.wordpress.com/2017/12/15/weight-based-oppression-is-not-a-public-health-intervention/
The initiative that said *right in its own text* that bad science and failure to make a single fat person thinner or healthier was okay because the programs’ actual purpose was to normalize cruel “obesity treatments” like starvation and social isolation; to get society thinking of them as appropriate and even compassionate things to do to fat people, thereby reducing potential future blowback to potential future “anti-obesity programs” that might “need” to include them?
Does The Fast Track to Health smell like it may have come from that sewer to anyone else? Doesn’t need to produce any usable data or improve any of the subjects’ lives; just needs to seem legit enough to get parents comfortable with the idea of handing their fat kids over to the authorities to be starved?
Be afraid, be very afraid when anyone starts talking about curing the world of whole swaths of people…for their own good…