Often during talks when I show evidence that habits are a better indicator of future health than body size, I get challenged by someone who tells a story of how someone they knew lost weight and got healthier. I ask if the person changed their behaviors prior to the weight loss and the answer is always say yes. So why, I ask, do we credit the weight loss for the change in health rather than the behavior change. (And let’s remember that health is not entirely within our control, is not an obligation, and is not a barometer of worthiness.)
It seems to me that the health change and the weight change both follow the behavior change so I don’t understand why, inexplicably, we ignore the behavior changes and credit the weight loss with improving the health. In reality, I think that the research indicates that the weight loss is a possible, and likely temporary, side effect of the behavior change.
Often when I deal with a doctor who is prescribing “lose weight feel great” for whatever I’ve come in for (sprained wrist, strep throat, severed limb, whatever) and I start discussing the evidence – that there is not a single study that shows that more than a tiny fraction of people succeed at long term weight loss and that there is not a single study that shows that even the tiny minority who maintain the weight loss have health benefits, and that the majority of people who attempt weight loss end up heavier than when they started – the doctors wholeheartedly agree with me. Then insist that it’s still worth trying. Inexplicably, doctors are constantly prescribing an intervention that has almost no chance of working and, the vast majority of the time, ends in the exact opposite of the intended effect. They are saying that I’m unhealthy because I’m fat, and then prescribing an intervention that is most likely to end in me being fatter.
Inexplicably, when discussing fat people and how we might be made thin, doctors, the government, and anyone who is not fat can suspend all concepts of research and logic, declare themselves an expert, and implement ideas created by rectal pull with absolutely no evidence to suggest that the implementation will work, or even that it won’t harm us. Experiment on children, ignore mountains of evidence, ignore good research methods, make bigotry sound reasonable, suspension of disbelief nothing is too much then we’re talking about making fat people thin.
One thing that fat people can do is stand up and demand that we be treated better than this. Call it out when it’s happening. Refuse to be the unwilling subjects of experimental medicine. Quit being pawns in a game that makes diet companies rich beyond belief and fat people the victims of shame, stigma and oppression. Decide that if they want a war on obesity, we’ll give them one. Enough is enough.
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