What Fat People Have to Do

Public HealthAll kinds of things are being floated as things that fat people should have to do either by social pressure or government edict until we are thin (at which point we can ostensibly do whatever the hell we want as long as we don’t get fat again.)  I’ve seen it suggested that we should be forced to exercise, forced to undergo mandatory counseling, forced to have our food and exercise monitored by the government etc.  The media publishes studies with highly questionable research methods funded by corporations which directly benefit from their findings as proof that fat people can’t be trusted to make decisions for ourselves.  It is suggested that completely untested interventions should be made mandatory for all fat people.  That’s how fat people become often unwitting- sometimes obligatory – participants in experimental medicine, sometimes with some truly horrible results and almost always without success.

This is all done under the guise that”fat people need to be healthier for the greater good”.  But upon even a light inspection this falls apart.  First of all, fat is not a behavior or set of behaviors – it’s a body size.  Just like thin isn’t a set of behaviors – it is a body size.  Just like there are fat athletes there are thin couch potatoes.  You can’t look at someone and tell from their body size what their habits are. or how healthy they are.

Upon examination the choice to focus on fat people is, at best, the result of people being incredibly lazy and trying to find a group that is identifiable by sight to study blame things on.   At worst it is simply thinly veiled bigotry.  Anytime we take a group of people who we can identify by sight and then attempt to calculate their cost on society, then create an initiative to eradicate them we are going down a bad road.  Researchers take “everybody knows” size prejudice and solidify it using poor research techniques and confirmation bias.  As Lindo Bacon and Lucy Aphramor found when they reviewed the research around weight and health “Researchers have demonstrated ways in which bias and convention interfere with robust scientific reasoning such that obesity research seems to ‘enjoy special immunity from accepted standards in clinical practice and publishing ethics’”

Researchers base their work on “everybody knows” assumptions without even an attempt to provide proof of these assumptions.  Researchers claim to calculate how much fat people cost in extra fuel, when they don’t even have basic information like how many fat people own cars, and what kind.  The media continues to report that fat people are causing massive increases in healthcare costs when the evidence is clearly to the contrary.

Even if you believe that you can tell that fat people don’t prioritize our health just by looking at us, focusing on fat people is highly questionable when there are so many people who don’t prioritize their health who we celebrate.  We love Olympic athletes, but going 80 miles an hour down an ice track face first does not prioritize health.  We love pro football and basketball players but look what they do to their bodies.  We love our pop stars but the schedule that they keep to go on tour and all the publicity that they do to sell tickets does not prioritize health.

Not to mention that plenty of people don’t get the recommended amount of sleep, don’t look both ways before they cross the street, eat soup while driving, and any number of things that don’t prioritize health, and that for every fat person you can find a thin person with the exact same habits but a different body.  The research shows that healthy habits are the best chance for a healthy body, note that there isn’t a war on sedentary people or a war on people who don’t eat their vegetables – it becomes pretty clear pretty quickly that this isn’t about health, but about body size.

Hey, I’ve got an idea – how about if we don’t have wars on people at all.  How about if stop acting like it’s our job to tell people what they “have to do” for their health for the greater good, because that becomes a slippery slope pretty fast. Who gets to dictate what healthy habits fat people, or people in general, “have to” practice – the person who eats paleo?  The one who eats raw foods vegan? The person who believes that people shouldn’t be allowed to play sports because they cause unnecessary injuries?

This is exactly why public health should be about providing options, information and access and not about saying that all people who look a certain way should have to do this or that. Let’s remember that health is multi-dimensional and not entirely within our control, and that health and healthy habits are not an obligation nor a barometer for worthiness.   Let’s make sure everyone has access to the foods they want to eat, any movement options that they may choose, and affordable evidence-based healthcare.

Then let’s start to spread true information, like the fact that 30 minutes of moderate movement about 5 days a week provides tremendous health benefits to most people but will likely never lead to weight loss.  Of course nobody’s obligated to exercise but it would be nice to have true information about what “exercise” means so that we don’t get fooled by posters at the gym that suggest that we have to be miserable for hours every day to get any health benefit, when the truth is that three 1o minutes sessions a day of dancing around the living room in our underwear would get the job done.

Let’s quit assuming that we can look at someone’s size and know anything about them other than their size and our prejudices about their size.  Let’s stop trying to dictate what fat people “have to do” based on assumptions of what fat people do and don’t do as if that’s not just stereotyping and bigotry.  Let’s start giving everyone options, information, and access, and then respecting people’s individual decisions about prioritization and path for their health.  Voila – public health.

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17 thoughts on “What Fat People Have to Do

  1. This is about 99% of what is wrong with politics today, and not just fat politics. The “We MUST act!” approach drives me up the wall, because inevitably, when someone says that, (1.) “acting” is definitely unnecessary and probably a terrible idea, and (2.) the action suggested has nothing to do with improving anyone’s situation in any meaningful way — unless you count a politician’s chances for re-election.

    I know it’s the libertarian wackobird in me that gets so angry about it. And I know it won’t change. “Let’s mind our own damn business!” is never going to be a battle cry that will rile up a crowd.

    1. As a Libertarian, I seem to automatically reject anything that starts with “we must,” lol. Don’t tell me what I “must.” I’ll decide for myself if I “must.”

  2. I have definitely not prioritized my physical health for the past few days. Mr. Twistie is off and away for a while so I’ve spent the last few days sitting on the couch watching costume dramas based on classic English literature and grisly true crime documentaries until my eyes bubble, torturing my Simmies, and eating lots of Trader Joe’s Cheese Crunchies.

    Today I am definitely ready for a good, long walk and a fully considered meal. My body is starting to cry out for better treatment. But I needed the mental break first.

    My emotional health is also important, and my body isn’t going to completely fall apart if I take a couple days to be mopy about my beloved being away combined with doing the things that drive him up a tree when he’s here.

    I can still walk to the store without panting for breath. I can still lift my Le Creuset pots easily. I have not forgotten what a fresh salad looks like. I just needed to do what I needed to do… and so do we all.

      1. I’ve only got a couple pieces, but I have to say that in case of fire, they might be the one thing I save, even over my wedding photos. Hell, if something (Universe forbid!) were to happen to Mr. Twistie, I might just set up housekeeping with my Le Creuset saucepan with the lid that doubles as a very small skillet as my significant other.

    1. Of course when talking about physical health, we are still missing something if we do not consider mental health. We talk about these like they are two completely separate things, but that’s not how people actually work. Poor mental health can cause physical problems (and similarly, poor physical health can lead to poor mental health)- the two are related and interconnected.

      1. Yes, and the truth of the matter is… all the dieting in the world never made me physically healthier. But it definitely made me mentally UNhealthier. And trying to explain to people caught up in this “we must” crap that EVEN IF they are right, and my ohmygoddeathfat means I’ll live a shorter life? Well… I’d honestly rather live a shorter, happier life than a longer, miserably unhappy one. And that’s MY choice to make, not anyone else’s to make for me.

        Nothing I have ever done made me thinner for more than a brief time. I never got even remotely close to my “goal” weight. My biggest “weight loss success” was 60 pounds. I maintained it for a few months, and then the gaining began. Then I tried different diet plans. Then more gaining ensued. It took me a year to lose those 60 pounds and about 9 months to gain 75.

        Those fad diets were definitely NOT healthy (and the result was gaining a lot of weight very fast, which is probably not healthy, either), and frankly a lot of the “tricks” I used to lose the 60 pounds in the first place, though Weight Watchers leader sanctioned, were also not “healthy.” What is certain is that ALL of it was extremely bad for my mental health, and contributed to eating disorder behaviors I’d already been battling for over a decade.

        So if given a choice between fat and struggling (but not succeeding) to not be, and hating myself, or being fat, content and at peace emotionally? I’ll take the latter, thanks.

        1. I saw a column on XO Jane the other day about an 18 year old woman struggling with anorexia . . . that was officially diagnosed when she was eleven. Eleven years old and she’s starving herself to death. How ’bout that?

    2. Hi Twistie, I like all your excellent comments 🙂 You said you play the Sims, are you on the Sims 4? 😀 I am – I create beautiful fat Sims with a mod so you have to enable custom content in the gallery to see them 🙂 I give them kind, positive stories and families. I speak out against mean comments and posts. I makeover those Sims in “beauty challenges” without making them thin as most entries do, and explain why they are beautiful just the way they are 🙂 When another player’s fat Sims are ridiculed in the comment bar, I write that he/she is beautiful and compliment their hair or outfit 😀 It’s the least I can do to make the cyberspace world a little more size positive 😀 Let me know if you’d like to exchange Sims 4 usernames 🙂

  3. I have seen a nurse practitioner to assess whether I have ADD. Can you tell me why it was necessary for him to weigh me after one of my appointments? He apologized and mumbled something about not meaning to pick on me. I’m so curious as to why I had to be weighed and, even more, why I agreed to be weighed when it was hardly the issue.

    1. If I had to hazard a guess, it may be related to the possibility of prescribing you medication for your ADD. If your doc/np is doing their job properly, they’ll be addressing the fact that some medications need the dose adjusted according to the patient’s weight. Most dosing instructions are titrated to “average” or “ideal” (I despise that) weight. I don’t know if that’s relevant to ADD meds in particular — it definitely matters with things like anesthesia.

      Now, if he just did it because there was a blank on a form he needed to fill, that’s another story entirely.

  4. Your first paragraph reminds me of the McCarthy days when communists were rooted out. For that though, communists look no different than everyone else, so they had to spy on you, monitor your every move to make sure you didn’t go to a communist meeting, didn’t have a neighbour who was one, didn’t attend college where there was someone, etc. It was a “costly” endeavour both in wasting resources for a fake witch-hunt, and viewing everyone as a potential enemy, and I think that is why searching after fat people is easier than looking for a communist: we are visible and no hunting is necessary. We’re just there and they can see us without trying.

  5. Kind of interesting seeing this here today, after I just posted a blog entry yesterday about the whole “obligation to be healthy” thing, and how it doesn’t really work 🙂
    A few of the problems with the idea that people are somehow required to always take the healthy option to any situation are that sometimes one thing can be healthy from one but unhealthy from another. I used the example of moderate drinking- has been shown to have certain health benefits, but I know a lot of folks with a family history of alcoholism who think, for themselves, it’s not worth it for their health to drink at all for fear they could develop the same unhealthy addiction. So we have health reasons to drink some, and health reasons to abstain- what should each individuals choose? And of course the real answer to that is whichever we prefer and whatever we prioritize. And with limited time and resources, often we have certain things that are healthy that compete for those time and resources. An example I used was working out (healthy) or getting enough sleep (also healthy), if you have only enough time for one of these, which do you choose? Different people will choose different, individuals will choose differently on different days, and either choice is fine. Either way you are prioritizing one aspect of health over another- and we all have to do that at times. It’s ridiculous to think that the person who is constantly sleep deprived because they prioritize their workouts over sleep is morally superior for that health decision than the person who prioritizes adequate sleep, when both physical activity and adequate sleep are healthy behaviors. There is also the fact that everyone makes unhealthy choices from time to time because we have other wants or desires that we prioritize over what we could be doing for health at that time. And that is fine, that is normal, that is human! Everything about our lives does not, and should not, revolve around “health”. And real healthy lifestyles can cope just fine with sometimes making an unhealthy choice. A person who typically gets enough sleep can handle making a choice to stay up too late and not get much sleep one night. The health benefits of eating fruits and vegetables do not suddenly disappear when you decide to also eat some candy. Et cetera, et cetera.

  6. Ragen, the link in the first paragraph to experimental medicine doesn’t work… just an FYI. Great post again, though. And something I know I need to be reminded of from time to time, because when so many voices are shouting what I should do, it’s sometimes harder to hear the answer of my own inner voice that tells them to stfu. 😀

  7. Ragen, I especially enjoyed the maybe/maybe not intentional pun of “… thinly veiled bigotry.” I wrote a book, “Change How You See, Not How You Look: Power Tools for Celebrating Your Body,” in 2004, and am doing a complete update/rewrite called “Sacred Self-Acceptance,” which should be out within a year. I want to thank you for this wonderful work and assure you that it will be duly noted (and celebrated) in my book. Love your point of view, love your writing style. Keep up the good work.

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