I’ve talked before about the three things that I think are most important for public health:
- Fight for access
- Make your own choices
- Respect the choices of others
Today I want to expand on this a little bit:
Fight for Access
Lets look at four areas of access: food, movement, information, healthcare
When it comes to food I’m talking about people having access to the foods they would choose to eat (not the foods that anybody thinks they should eat). That means that they can both acquire and afford them. Just a thought – if we stopped giving 60 billion dollars to the diet industry (an industry that has to say “it doesn’t really work” every time they even suggest that their project works) we could build 60,000 million-dollar farms including land, buildings, seed, and tractors.
With movement I am talking about making sure that people have safe movement options that they enjoy. Safe includes physical safety and emotional safety. For example, fat people may want to work out in a pool but in this culture being fat in a swimsuit in public can be terrifying – that doesn’t qualify as safe. People who practice from a Health at Every Size perspective are not in a safe space if they are being pummeled with a “burn those calories, lose that weight, fear the muffin top” message while they are trying to enjoy moving their bodies, for me it also ruins my enjoyment of movement. Again, if we stopped giving 60 billion a year to the diet industry we could build 60,000 community centers for $500,000 each and use the other $500,000 to make them sliding scale so that everyone can afford them.
Access to information is tricky. I think that it would be awesome if there were trained researchers who were paid to simply put research in layman’s terms, including a discussion of the limitations of the research so that peole know what’s going on. I think it would be a good first start if our information about nutrition, fitness, and health wasn’t funded by and reported by people with strong financial investment in the outcome. I wish more researchers were like Linda Bacon and would look at the existing research through a more critical eye and question the status quo. I wish that people could take classes in “how to read a study” so that they could get studies and understand them.
Access to good evidence-based healthcare is perhaps the most difficult under the current culture. First, you have to be able to afford it – made more difficult if we, as fat people, can’t get insurance or can’t afford the insurance for which we qualify because our body size is held against us (can you imagine the outrage if tall people were charged more?) You also have to be able to get off work to go see a doctor, afford to take the time off work, and have transportation to get there. If you can overcome those challenges you have to find a healthcare provider who can actually offer good evidence based healthcare (rather than just diagnosing us as fat and prescribing weight loss). Then, if you want to take the medications the doctor recommends, you have to be able to afford the prescription medications that are priced to support the multi-billion dollar pharmaceutical industry’s need to maintain fiduciary responsibility to their shareholders. To be clear I think that people should have access to the healthcare that they choose and that includes doctors, acupuncturists, chiropractors etc.
Make Your Own Choices
Use whatever methods you prefer – do your own research, work with professionals, do whatever comes into your head. It’s your choice. It’s your body, you are 100% the boss of your underpants.
Respect Other People’s Choices
Regardless of how much we might disagree with their choices. We are 100% NOT the boss of other people’s underpants. People’s right to punch ends at the tip of someone else’s nose. If you find your nose unaffected that’s how you know it’s not your business. This is for everyone’s own good. One of deeply problematic arguments that I hear about this is “Other people’s behavior costs me tax dollars so this is about me”. Here’s the problem with that:
Personal responsibility does not mean that we are personally responsible for doing what other people think we should and it’s quite a slippery slope when we start to decide whose healthcare we should pay for. Should vegans only have to pay for the healthcare of other vegans? I don’t drink, smoke or do drugs – should I not have to pay for the healthcare costs of those who do? Can I say that I’m willing to pay for the healthcare of the victim of a drunk driving accident but not the drunk driver? What if I don’t want to pay for accidents of people who drive in the merge lane? As a professional competitive dancer I train strength, stamina, flexibility, and dance 15 hours per week, should I not have to pay the healthcare costs of thin people who are sedentary? What about people who choose stressful jobs and don’t get enough sleep? What about people who choose to mountain climb, BASE jump, bungee jump, luge, or not look both ways before they cross the street? What about people who speed, or choose cars that have less safety features, or choose to live in highly polluted areas? Who deserves healthcare? Every single person participates in behaviors that other people think that they shouldn’t. I believe in compassion and in giving people preventative healthcare when they are well, evidence-based healthcare when they’re sick, and the opportunity to believe that their bodies are worthy of care by creating a body-shame-free world. Then, as previously mentioned, respect their choices.
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Dances With Fat 
“can you imagine the outrage if tall people were charged more?”
That argument won’t hold water with some people because they’ll say, “Tall people don’t make themselves tall, but fat people make themselves fat!”, and good luck convincing them otherwise*.
People want to believe that diets work, because they want to believe that they have it within them to fit our very narrow standard of beauty if only they work hard enough. And when that doesn’t happen, they blame themselves. It’s like buying an eyeshadow advertised by, oh, say, Cindy Crawford and then blaming yourself rather than the false advertising when you put it on and don’t end up looking like she does.
*And you know what? Even if some people *do* make themselves fat, if they spend all day on the couch stuffing their faces with Twinkies and Coke, that’s *their business* and *not mine*. People can smoke, drink, or eat themselves to death, and it’s not my business nor is it my place to deny them health care just because they may not have made the best choices or the choices that I would have made for myself.
Reblogged this on Crafty Monkey Junky.
“I think that it would be awesome if there were trained researchers who were paid to simply put research in layman’s terms, including a discussion of the limitations of the research so that peole know what’s going on.” There are. They’re called “librarians”!
Unfortunately, funding for library services is under attack.
“I think that it would be awesome if there were trained researchers who were paid to simply put research in layman’s terms, including a discussion of the limitations of the research so that people know what’s going on.”
I found a great writer called Henci Goer who examined the obstetric research with a jaundiced eye and who specialized in translating it into lay terms so anyone could understand it. Changed my life, and I began doing the same thing for pregnancy in women of size, as well as general pregnancy-related topics. And it was my local medical librarians (in my small local community hospital) who helped me figure out how to do this. Go to them and they can help you get started.
Henci also recommends the book, “How To Read a Paper: The Basics of Evidence-Based Medicine” by Trisha Greenhalgh. You can find it on Amazon.com at the following link. It’s not cheap but you can buy a used copy for a reasonable price.
With public access to medline via PubMed (www.pubmed.gov) it’s not that hard to do your own research. Often local libraries have budgets to help you get free copies of the full texts of these studies (and we must fiercely protect their budgets for this important service!). Then it’s easier to look at the evidence with a more careful eye and see what it does—and doesn’t—have to say.
Linda Bacon, Paul Ernsberger, Paul Campos, Joanne Ikeda, Frances Berg and many others have been leaders in doing this kind of research translation of “obesity” research for lay people. There ARE resources out there for this, if you only know where to look.
Thanks, I hadn’t heard of Henci Goer or Trisha Greenhalgh. I’m aware (and greatly appreciate) that there are people who are doing this in the HAES community, I was thinking more a group of people who looked at all categories of research (perhaps doing a factcheck type service for stories that come out in the news and cite studies…)
~Ragen
Have you read “Fat Politics: The Real Story behind America’s Obesity Epidemic” by J. Eric Oliver? It was published in 2006. I read it a few years ago and thought it a good resource.
This is tangential, but since you brought up the message to “fear the muffin top”, I just want to put in a good word for muffin tops.
I think muffin tops are adorable, like push-up bras for your hips.
(Except where the waistband is hurting you, of course.)
There are common classes that teach people how to read a study: statistics, biology, and physics come to mind immediately. Every science class I’ve taken since middle school has warned against buying into pseudoscience or biased studies, right in the very first chapter. Statistics laid out the difference between correlation and causation in the first week of class. Unfortunately, people fear both math and science, therefore they trust other people to do their thinking for them when it comes to those subjects.