Some Things I Don’t Understand

There are some things about weight and health in our culture that confuse me:

Why is it accepted that some people who eat a ton of food can stay thin, but not accepted that some people who eat a small amount of food can be fat?

Since thin people get diabetes, heart disease and high blood pressure, why is becoming thin suggested as a cure?

Why bother using BMI as a substitute for metabolic health measures when we can easily test metabolic health measures?

Doctors treat thin people for joint pain with options other than weight loss, why don’t they give fat people those same treatments?

Why do we believe that doing unhealthy things (liquid diet, smoking, urine injections coupled with starvation, stomach amputation) will lead to a healthy body?

If the diet industry’s product actually “cured fatness”, wouldn’t their profits be going down instead of up as more and more people were permanently thin?

Isn’t it medically unethical to prescribe something without telling your patients that it works less than 5% of the time with a much greater chance at leaving you heavier and less healthy than when you started?

Why do people continue to think that shaming people will lead them to health?

Why do we accept wide variations in things like foot and hand size, nose and lip shape etc. but expect every body to fit into a very narrow proportion of height and weight?

If weight gain isn’t proven to cause diabetes, high blood pressure etc., why would weight loss be recommended as a cure?

Since weight loss ads have to carry a “results not typical” warning, shouldn’t doctors have to give patients a similar warning?

Why do people take the time to come to my blog and make death threats?

Does anyone really succeed at hating themselves healthy? If so is it worth it?

If we’ve been prescribing dieting since the 1800s and still can’t prove that it works, shouldn’t we be trying something else?

How is it possible that suggesting that healthy habits are the best chance for a healthy body is controversial?

I’m sure I’ve forgotten some but that seems like enough nonsense for now. Obviously some of these are oversimplified, but so is the relationship of health and weight in current culture and medical practice.  Sometimes things just aren’t simple. And at some point it’s time to say that what we’ve been trying is wrong, and it’s time to look at other options. It seems to me that it’s about time for some of that.

40 thoughts on “Some Things I Don’t Understand

  1. Great points, there are indeed many more questions than we have answers. And that for every bit of research ‘proving’ one tiny bit of a massive puzzle, there is also research that shows just the opposite? Mmm interesting, we don’t hear about that so much. Don’t get me wrong I love science, I have a science degree and am doing masters in nutrition and dietetics – more science, but most of what anyone with something to sell (product or service) in health is they seem to pick the bits they want to use from science to achieve their aim. Much of what is used is based around assumptions, and we all know the definitions of assumptions!! They are taken out of context, not used in context with other tools and resources etc etc. It is maddening. This is why when people discover they have the ability to be in touch with their own minds and bodies, often they get better answers than what the world is throwing at them.

  2. Loved this. I am very sorry you have received death threats, but not at all surprised. People are so berserk about women of size they will say ANYTHING, including “you don’t deserve to live.” If you are a white Republican male however – Chris Christie – they are oddly silent. Thank you for being a voice of sanity!

  3. I’m so sorry that you and other people ‘of size’ go through this. I really do believe and wholly endorse your beliefs and the way you raise awareness. I agree that acceptance of our bodies needs to be in a healthy way.

    I’m coming from the other side of the coin, having battled anorexia and bulimia for many years. It’s not as visible as for ‘fat’ people, but it’s there – those who are very underweight also face the same sort of discrimination. I’ve been spat on, punched, had my shopping rifled through or stolen from me, pushed out of lines for things, etc, just because I was too ‘thin’ and people no longer respected me. I was treated like a creature because to them, I didn’t look human any more. It was almost impossible to eat and drink in public because of the comments I got, or to shop for food, because I was attacked by people telling me that I was selfish and wasteful to BUY FOOD FOR MYSELF despite the fact that I was starving because obviously I didn’t eat it…
    (and I did, actually.)

    When it comes to medical attention – I too have been denied treatment in so many ways for things that have not much to do with the eating disorder and sometimes nothing at all. Or that needed prompt attention despite the fact that they were caused or exacerbated by my weight. Some examples –
    Despite complaining and begging for bone scans for 3 YEARS because I was in so much pain – I was ignored. When they finally did bone scans they found that I’d been literally walking on broken legs for those three years, perhaps longer, from the stress fractures that did not show up on normal x-rays.
    I was in pain for almost a decade from my wisdom teeth – all four extremely impacted and often infected – because they refused to even take them out one at a time under a local as I was ‘too thin’.
    I have been taken to the emergency room of my local hospital with heart pains by another professional. The doctor didn’t even bother to check me out but sent me home with a lecture about being a manipulative spoilt little anorexic brat and to go home and eat a sandwich (his actual words). A few days later I was in CCU with fluid around my heart and very gravely ill.
    I have battled from severe, chronic depression since I was a child, for far longer than my weight has been a problem. Despite this, any pleas for help with depression, anxiety, etc are met with “Well, if you would eat properly, you wouldn’t have this problem…”

    I’m so over it.
    I can so well imagine what you must go through and I’m sorry people are so ignorant and just plain nasty.

    It says more about THEM than it does the people they are nasty to and or exclude.

    Thank you for a fantastic blog that is helping me to accept myself at any size because it’s about being healthy and happy and enjoying LIFE, not what size I am.

    1. Wow. You have endured a great deal in your life, and I hope things are going better for you now! Thank you for telling your story here, it’s good for all of us to hear how it is at the other extreme. I already knew that being superskinny is no picnic either but I had not heard about the kind of discriminatory behavior you described. God bless you and I hope you win your fight to be healthy.

      1. Thank you – I think that there are people with eating disorders who share many of the same problems, the only difference is that they happen to be at different places in the weight continuum. And yet they are treated so differently depending on their size. I really get a LOT from this blog and others like it, because it helps me remember that we are all still ourselves no matter what our bodies are doing – we are all still human and worthy of respect and good health. It can be just as unhealthy to be too thin as it is to be too fat. But it’s also possible to be VERY unhealthy in the ‘perfect’ weight range. True health comes from how we treat our bodies and live, and being able to be kind and caring for ourselves comes more easily and naturally with self respect and self acceptance.
        I’m ready to be healthy – I’m ready to face up to my own fears and LIVE through my pain. I’m also ready to accept that I might not be able to please everyone with whatever size I am at ‘healthy’ – but to say to the world – take me as I am, or get the hell outta my way.
        God bless you, too.

  4. Ignoring and hiding the answers to these questions is what maintains the medical industrial complex. It’s important that individuals constantly expose their lies.

  5. You won’t answers, Ragen, because medicine seeks solid answers–take this pill, do this, have that surgery–and obviously the reasons for obesity elude them. So they do what religion, politics, and playgrounds have been doing for generations: the find one bogeyman and blame him. Got diabetes? You’re obviously a fattie…quit eating them Philly cheesesteaks, you trougher. Drink too much? Then stop,alkie. DUUUUUHHHHH…

    Along those lines, I was reading the ever sunny, fluffy, sunshiney goodness of Ladies’ Home Journal yesterday and saw an interesting juxtaposition of article and advert. On the left was a recipe for a pink lemonade cake “so decadent you’ll never buy a bakery cake again” RIGHT across from an advert for a new diabetes medication, showing a fat guy smiling and triumphantly stating, “I BEAT my type II diabetes!” It happens so often in these magazines I thumb through that I’ve stopped writing letters to the editors and just toss them in the recycle bin unopened. I happen to stumble across this one because I had a wicked case of insomnia last night and needed something to help me drop off!

    Once we get our printer hooked up, I’m bloody printing this entry out, along with your entry about tax dollars paying for my obviously crappy eating, and carrying them in my wallet like bullets for a loaded conversation. Maybe I’ll even make multiple copies and post them around my new town. Whatever I do, I’m glad you wrote all this down and are able to verbalise the hard know of ill feeling I’ve carried around my entire life.

    1. @Yorkie, I laughed out loud when I saw the expression “you trougher.” I’m American and I’d never heard that one before. I’m thinking about putting it on a t-shirt (I’m 4X, so it’ll be nice and big across the front :~).

      Also, I agree about printing these out and carrying them with, to responses ready to go. “Uh, f*** you,” is often all I remember to say.


    2. Mmm, pink lemonade cake. Sounds yummy.
      Society loves to give us mixed messages, doesn’t it? We’re being squeezed between the food industry trying to sell us every crappy food product they can come up with and the weight loss industry telling us to dietdietdiet.

  6. Hi Ragan,

    I’ve been reading your blog for quite awhile now, and enjoying it very much. I feel terrible that you get death threats. I’ve been a fattie all my life, since babyhood, and at 210 all my fat is in my boobs and middle. But oddly, I get no grief from anyone about it. I read bloggers that say they have strangers making comments about what they eat at restaurants, what’s in their shopping carts, strangers making comments on the street, etc., and it really breaks my heart that anyone has to put up with that. No one has bugged me about my fat since I was a kid. The only thing similiar I can think of, is a time I was in the grocery store a few years ago and a young man asked me what aisle the cookies were on. He said “I know YOU know where the cookies are!” That had me pissed off the rest of the day and I know how very mild that comment was compared to what other people have to deal with. The only thing I can think of, is I must have a very bitchy face and people just leave me alone!

    Thanks to you and many other people in the Fatosphere, I made the decision a few years ago not to worry about my weight anymore. I took a little while, but I am at a point where I don’t worry about it or think about it. At 52 now, I buy nice clothes (as nice as a fat lady can find, anyway) and do what I want without taking my size into consideration, or thinking that I’ll do it at some future “thinner” time. I feel like such a burden is off my shoulders, and I am so much happier. I eat pretty much what I want, which is not terribly healthy alot of the time, but that’s my choice, and I stay about the same 200 – 210.

    I’m surprising myself at this long comment! I think I’ve wanted to say these things for a long time. Thanks for your wonderful posts!

  7. I’ve bought many of these things. I stopped going to a doctor because I knew he’d mention weight_ but shamed myself because I believed I needed to diet and weigh less. I believed that obese and morbidly obese people were unhealthy because everyone has always told me that.
    You are the first ( well, second, because I came here through Dianne Sylvan) to tell me otherwise, and you added actual published proof!!! Facts and figures!!!! All the things I normally demand prior to believing something. Thank you.
    as soon as my internet is working again, Im going to blog about the lies I havd perpetuated and link to you. Commenting from my phone is an option….but blogging isnt.

  8. One more mystery: If a thin person who exercises dies young, people say “But they did everything right”. If a fat person dies (at just about any age), people say, “if they hadn’t been fat, they would have lived longer”.

    How long will it take people to realize that they’re ignoring the real world in favor of a fantasy?

  9. Why do people take the time to come to my blog and make death threats?

    It’s appalling that this happens, and I also know you’re not the only one it happens to. I find it hard to comprehend just why there’s so much hate out there. What exactly have fat people done that’s so awful that we deserve this? (I know the real answer is ‘we haven’t, and we don’t’, but I still find myself struggling to understand what must be going on in these people’s heads.)

  10. About the death threats: Sick people glom onto one thing (often but not always something already stigmatized by the media) and blame it for whatever problems they have, whether or not the stigmatized attribute is one that they themselves possess..oddly enough, some of them do possess it/whatever it is, which makes the death threats an exercise in extreme self-hatred as well. Deconstructing haters’ twisted logic only takes one so far in explaining.

    All this means is that your ideas are reaching enough people for some to embrace them and for others to go emo. Bravo. You’re doing something right!

    So many of us people of size/fat people continue to take heart from what you write with your inimitable verve. Keep going, keep going..

  11. All very valid points. There is something about both fat-hatred and the anonymity of the web that bring out the threats. I read a food and recipe blog that a lovely lady writes about all of the recipes she and her chef husband come up with that are gluten-free. She recently wrote an entry about how awful people are to her in the comments – about everything. Her weight, shape, her parenting, her food, it’s endless. People have make fake accounts on twitter etc. to mock her.

    From reading her blog it seems to me that she is a lovely, happy person with a lovely, happy family. I cannot imagine why any one would feel the need to visit her site about gluten-free recipes to threaten her, or the need to make fake accounts for the sole purpose of mocking her but they do. You can read her entry about it here (it starts out as a usual entry, so read down a bit):

    At any rate, it’s a terrible, awful thing, and I don’t understand it. I hope you know that you are not alone in being targeted online for such treatment. I really admire your courage in standing up for what you believe in, and I hope nothing ever discourages you.

    1. There is so much unnecessary hatred & hostility in the world. I find it so saddening that people take the time to cut someone down via a website or blog. Really? You have that much time on your hands to spread hate?! People are intolerant and it’s a pity.

  12. “Why do we accept wide variations in things like foot and hand size, nose and lip shape etc. but expect every body to fit into a very narrow proportion of height and weight?”

    Sadly, ‘we’ (read: the media/society) rarely accept any real variations. That is why plastic surgeons and cosmetic companies are rich. If there were a successful hand/foot enlargement/reduction procedure people would be doing that too. Hmmm…foot binding anyone?

    It seems altogether too many people are conditioned to accept very little about others… or themselves. That is why the self-acceptance movement is so important – and so terrifying (both to it’s supporters as well as it’s opponents).

    Don’t give up, guys. 🙂

  13. Maybe haters are mostly scared of what if they too became fat? Because they are so shallow, that they wouldn’t have any good qualities that shone through no matter what the outside packaging was. Says more about them, than about the people they are ‘hating’.

  14. As human beings we often make sense of the world through narrative, even when that narrative is wrong, e.g. all fat people eat too much and don’t exercise. In addition people often want to believe that things like getting fat/getting sick/being poor are caused by doing a, b and c and not doing x, y and z so if they don’t do abc and do do xyz they will be thin/healthy/rich etc, when the truth is often far more complicated and being fat/ill/poor/etc is often caused by many intersecting factors outside a person’s control.

  15. It goes both ways. I’m naturally thin. (5’0″ 100 lbs) I’ve been an athlete and dancer all my life, except during pregnancies. I’ve seen numerous doctors for recurrent angina and terrible chest pains, to the point that every inhalation felt like a dagger in my chest. Each time I was told “Well, you’re in excellent shape, so it’s probably just dehydration. Drink more water.” Then my GP suggested I should be evaluated for an eating disorder — because the only thin people with heart problems are anorexic or bulimic. Which is it — am I too thin to be well, or too thin to be ill? I’m still trying to get a diagnosis, hopefully before my baby (#2) is born. I just wish my size was less of an issue to physicians than my complaints.

    1. I am so sorry that this is happening to you. The idea of making weight such a big part of diagnostics is relatively new and I can’t for the life of me figure out who it’s actually helping. I hope that you find some help and congratulations on your current and on-the-way babies!


    2. This is entirely random – but I’ve been diagnosed with costochondritis before. I’m very thin and was having terrible heart pains – as to which I couldn’t walk down the road without my chest being in agony and not being able to breathe. Its a fairly obscure thing and took a specialist doctor to diagnose for me…. ask a doctor about it, there’s a chance!

  16. I’m sorry that people are moronic toward you and others who are fat – it’s one thing to disagree, but are you so stupid that you cannot defend your own opinion, and need to resort to violence?

    I just want you to know that you ARE making a difference. I’ve been reading this blog for a few months now. I was skeptical at first – I’ve struggled with bulimia since puberty, and my fixation with thinness lead to a really unhealthy, ignorant attitude toward fat people. Reading what you have to say has really altered my way of thinking, though. Today in class someone insinuated that because a woman was overweight, she clearly wasn’t doing her job (as a social worker – you know, because we don’t spend half our time sitting doing paperwork) otherwise she would not be fat. My hand shot straight up, and I reamed him. Are we really going to assume that a person’s weight can tell you how good they are at their job? Our country has turned fat people into the scapegoats of society, and it’s not okay. Being thin, I’m never on the recieving side of that hate, and I never would have seen how ugly it is, if it weren’t for you.

    1. Hi Danielle,

      I can’t tell you how happy your comment made me. It gives me so much hope to know that there are people out there like you who are willing to open their minds to new ideas and have the courage to stand up and be allies. Also, just for the record I am in awe of your ability to be a social worker – it’s such hard work and it’s so important. So thank you so much for being awesome in a whole bunch of different ways.


  17. Thank God I found your blog! I love it! You speak the truth and it’s a truth that many people need to hear. I adore you and thank you for what you write. 🙂

  18. As someone who can eat and eat and eat and stay thin, I have to disagree with the first point. I’ve been denied insurance, cornered and asked about my ‘problem’, singled out, sent away etc- solely because people though I was anorexic because I was thin.
    Society judges you no matter what your size, its not always easier for skinny people than it is for larger people.

    1. I totally agree. I DO have anorexia, but I’ve been denied a lot of medical treatment due to being ‘too thin’. I am sick of being told that everything that is wrong with me is due to my ED, even when it has nothing to do with it.
      And the discrimination can be just as bad.
      People need to stop judging, full stop.

  19. YES!!!!

    Nobody believes that I eat twice what my husband does. He clearly must be a pig because he’s obese and I’m thin. The looks on the faces of servers at restaurants when we order and then when I really eat all that stuff, is both priceless and enraging.

    I don’t even bother trying to explain that while he has MS (not caused by fat), I’m the one with high blood pressure, high cholesterol and and joint problems. Nobody ever lectures me for the way I eat, even when they know what my blood pressure and cholesterol are. But nobody hesitates to lecture my husband on eating fucking salad. (The dressing you see, it is bad.)

    When I go to the doctor with fallen arches, I get all sorts of solutions, like shoe inserts and pain relief, my husband gets a lecture about his weight.

    Seriously, it’s unreal. Stupidly unreal.

  20. Thank You! People keep telling me I am overweight, when I eat half as much as they do! Some people don’t understand that we are all different and need to accept each other as we are! It took a long time, but I am happy where I am at!

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