Reality and PerceptionOften 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 reasonablesuspension 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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4 thoughts on “Inexplicably

  1. Hi Ragen! One of my mum’s carers is currently trying to work out why she feels so ill after eating various foods, and, because the normal NHS routes have so far got her nowhere, other than being told to cut out fat, she went to see a homeopath. She made the mistake of mentioning that she’d done so at the next appointment with her GP, and he will now no longer attempt to find out what her problem is. I think this is another example of the health care profession’s arrogance, as with people who just happen to be fat/overweight who might have an illness or injury that was never related to that in the first place. My friend Anne went to the doctor recently about her long-standing thyroid condition. She’s taken thyroxine for many years. She is always being told she’s overweight, whatever she goes to the doctor for, and was even told that was why she’d broken a bone in her foot last year! Not the fact that she’d tripped off the kerb of the pavement on her way to work. No! It was because she’s fat! There seem to be so few doctors who are prepared to stand up and say “Let’s look at this a bit more objectively. Is there another way? Are we actually right when we say X or Y?” You would think that that was the mark of a really good doctor, but the profession as a whole doesn’t appear to think so.

  2. Great article! Just noting an edit. Last paragraph, second line, first word. You’ll see it. 🙂

    Also, positive thoughts your way for the marathon! Go get ’em!! 😀

  3. I think that the fantasy of being thin (or staying thin, for most people) is so strong that even health professionals have fallen for it, and fallen hard. The idea that weight loss is healthy has so permeated society that even medical professionals, who are part of this same society, believe it, too, even if evidence totally deflates that fantasy. It’s that powerful, and I think it ties in to the idea that there is a single cause of all illnesses, and if there is a single cause, there is a single cure.

    Either that, or the “Even if it doesn’t work, try again anyway” comes from another idea in society that good things happen if you try something hard enough, and make enough attempts. And if something doesn’t work the eighteenth time, the nineteenth time’s the charm and if you give up, you deserve Bad Things Happening To You, because you’re A Quitter. Quitting, when it’s not something that’s actually detrimental to your health (like smoking or drinking to excess), is an admission of defeat, of weakness, of failure. I guess that’s where the phrase “letting [yourself] go” in reference to someone gaining X amount of pounds (where X means anything from “enough to go up a pants size” to “enough to become visibly larger than they were before) comes from, since someone’s hopped off the dieting merry-go-round, so they’ve given up on themselves, as if the one thing a person can do for themselves is work forever toward a goal that all but a few people ever reach, the goal of permanent thinness. In general, quitting has a bad reputation in this society, and in particular, when it comes to weight loss attempts, and it’s reflected in the way people talk about gaining weight as “letting [yourself] go” and losing weight as “getting [yourself] back”.

    Best of luck to you in the marathon!

  4. I think current medicine and doctors like to play Sherlock Holmes: they like to pretend they’re so smart that they can “deduce” our habits and lifestyles just by looking at us. But no one can actually do that.

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