Things Obesity Isn’t

You Cannot Be SeriousWhether it’s in internet articles, comments on internet articles, or e-mails that I get, I see “obesity”/being fat used in comparisons that don’t actually make any sense.   Let’s clear up some of this confusion.

Obesity is not heroin addiction. 

Almost every day I get a couple of people, who think they are geniuses, who leave comments asking if I’m going to start a heroin acceptance movement since it’s the same as size acceptance. These are not comparable because heroin use is a single, specific behavior – everyone heroin addict does heroin.  “Obesity” is the end result of a math equation (weight in pounds time 703 divided by height in inches squared is greater than or equal to 30, a group that includes actors, professional athletes, and me.)  Obese/fat people cannot be identified by a single or even a group of common activities that are different from people who fall into different weight categories. Whatever your beliefs about heroin addiction and “obesity”, this comparison does not make any damn sense.

Obesity is not an eating disorder, nor is it the opposite of anorexia. 

An eating disorder is an illness with mental and physical components, and though sometimes it can affect body size, body size is not a definitive diagnosis of an eating disorder. People with active eating disorders participate in disordered behaviors around eating.  Eating disorders are serious, dangerous, and can be fatal.  Using anorexia and obesity as opposite sides of the same coin is a completely faulty comparison that ends up hurting fat people by suggesting that their body size is a definitive diagnosis of the need for a medial intervention, and for people with anorexia who have enough difficulty getting access to treatment without having a potentially fatal mental illness treated as the same thing as having a fat body.

The idea that someone can’t get “that fat” (for varying, subjective and completely random definitions of “that fat”) without having an eating disorder is a myth. Many fat people have very healthy relationships with food, and there are some fat people with eating disorders. It should be noted that while some fat people have Binge Eating Disorder, there are also fat people with anorexia and bulimia and other restrictive EDs and often family, friends, even doctors make the dangerous mistake of encouraging disordered eating behavior/full blown eating disorders in a fat person that they would correctly diagnose as dangerous in a thin person

Obesity is not a cost that can be calculated

Obesity is a body size, there are healthy and unhealthy fat people just like there are healthy and unhealthy thin people.  The current state of oppression, stigma and shame around obesity means that any calculation of the cost of obesity is impossible to separate from the cost of that oppression, stigma and shame.

Obesity is correlated to a number of diseases so it is considered a “risk factor” although the term is used loosely since there is no proof of causality of risk, it’s as if they found out that short people get a certain disease more often but they have no idea why so they say that shortness is a “risk factor”.  So naming “obesity” as a risk factor does not prove that it causes the health issue, nor does it prove that making someone thinner would change the risk factor (certain types of male baldness correlate very highly with an increased risk factor for heart attacks, but getting bald men to grow hair does not lower that risk.) Correlation does not imply causation. The calculations that are commonly used to show the “cost of obesity” are often based on the assumption that every “obese” person will get every disease for which they have a risk factor, and/or that every health issue they get is caused by their fat.   It’s just crap research that would get a college freshman failed in Research Methods 101.

Besides which, attempting to take a group of people who share a single physical characteristic and make an attempt to calculate their “cost to society” in order to promote the eradication of that population because the world would be cheaper if they didn’t exist is clearly dangerous and wrong.

Obesity is not a Metaphor

Using a fat person to represent greed, over-consumption, a negative view of capitalism etc. is stereotyping and bigotry, pure and simple.  It’s wrong on every level.  We are not yours for the metaphoring.

While we’re at it, let’s talk about Size Acceptance.

Size Acceptance is not the opposite of “Thinspiration”.

Thinspiration exists to reinforce a stereotype of beauty, and in many cases is used to reinforce disordered eating/eating disorders.

Size Acceptance is a civil rights concept that reminds us that everyone has the right to life, liberty and the pursuit of happiness in the body they have now, and that other people’s bodies are not our business.  It is not about telling people who size body they should have, nor is it about the mythical, ridiculous notions of “promoting obesity” or “my tax dollars“.

Obesity is not your business, unless we are talking about your obesity, in which case it’s nobody else’s business unless you want to make it their business.  Other than that nobody has any business making comments, assumptions, metaphors, cost calculations or comparisons about someone else’s body.

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9 thoughts on “Things Obesity Isn’t

  1. Trigger Warning: ED stuff.

    I will never forget the first story I ever read over at First Do No Harm. It was from a woman who had bulimia. When she got to the point where she was vomiting blood, she headed for the ER to get help. What help was she given? A packet of information about the local Weight Watchers group!

    This is the biggest danger of the ‘obesity is the opposite of a restrictive ED’ meme. Behaviors that would be seen as dangerous and concerning in a thin person are seen as the minimum a fat person ‘owes’ the world for being fat.

  2. Oh, and by the way, people addicted to heroin and people with eating disorders also deserve respect, dignity, and basic human rights.

  3. Some of you may remember the story but at the beginning of the year on the advise of my cardiologist (whom I love, he treated me every single time I needed without shaming me, without recommending I change a thing, just great care) I went to see a new psychiatrist after my first big anxiety attack of the year. One thing that is great about living in San Diego is we have some of the best doctors on the planet (doctors like nice weather too apparently) and as I was researching this new psychiatrist, he had well over 100 publishing credits to his name and was widely recognized as being the absolute best psychiatrist in the world at treating the mental health problems that come with being a heart patient and how to deal with the medications and drugs that need to be taken simultaneously, etc… Trust me, after 5 heart attacks and 11 stents, there are a myriad of mental issues from anxiety, depression and fear knowing that your heart could turn on you at any second.

    I was excited to say the least to see such a great doctor. Surprisingly, he had a tiny office overlooking the water with a very sweet nurse and secretary. It was calming, welcoming, small scale with none of the hustle and bustle I was used to with medical offices. And I have to say that as far as manners go, this psychiatrist was so polite with a very calming and even “charming” voice.

    All this was great until he said and this is best I can remember it “I can tell right away that a lot of the problems you deal with are because you have Binge Eating Disorder, probably a food addiction…” and I tried my best to tune him out as he went on saying food addicts show the same compulsions as smokers and alcoholics, there’s a high correlation between food addiction and personality disorder, anxiety and depression. The good that its very treatable, we live in a world were food is more available to us than our bodies and psyches are adapted to handle and ON AND FUCKING ON. god I just wanted him to shut up so bad.

    Of course I told him it was ridiculous that I overate, that I enjoyed food, yes, but that I never overate. So his assignment to me was to keep a food log. This idiot wanted me to keep a pen and paper food log! I thought about it, then instantly made the decision that what I ate was none of his business so I lied to him and said i would keep a food log. The next week I saw him he was disappointed but in his calm voice just asked me to try again, that he really thought he was on to something with the BED/FA diagnosis then we talked about my medications.

    I have not had a chance to see him again and have moved on to the inpatient psychiatrist where I’m living now who thank god has made zero mention of food addiction or BED again and just focuses on my medications.

    1. This makes me sad that a doctor would make you feel so bad that you had to eventually give up and lie. I know what that’s like. I’ve started re-educating my doctor, and we’ve had several tense discussions. I used to lie to him, too. And tell him I would do food journals, give up certain foods, and talk to nutritionists, (why they always assume fat people need nutritionists; I’ve seen several nutritionists who recommended very disordered eating habits). It take so much time to argue with him, yet he’s one of the few doctors I’ve ever had to really listens, so I don’t want him to fire me as a patient. I’m hoping that the message continues to grow in him without my participation so eventually he will not mention weight loss at all.

      1. I came in wanting an x-ray on my knees to see what damages had been done from a bus crash from 1997, and several dozen falls down the stairs (and up them). He never showed me the x-rays, but recommended me to a nutritionist who also prescribed anorexia as a cure-all that would repair the nerve damage in my legs, and make me smokin’ hot. I had already been anorexic my whole life and explained that to the nutritionist, but she didn’t know how to deal with that, so kept giving out these pamphlets on how to cut out butter, use margarine, skim milk is good for you, meat is eeeeevvvvvuuuulllll, etc. And they give you a food log journal to keep that I found out is based on anorexic websites!!!

    2. Congratulations for having the guts to refuse and find a new doctor. I think I might have gotten myself something of a reputation with one of my doctors last week when I refused to follow the usual pattern of treatment. It’s become fairly routine — I tell them the same problem is happening, they call me in for an ultrasound that costs me an ungodly amount of money, they tell me I have the same problem I’ve had for 25 years and go home and wait it out. Last week I told them that since my meds weren’t working and they wouldn’t change them, I’d just skip the expensive and time-consuming part and move right on to waiting it out. The nurse seemed really annoyed, but I’m exhausted of repeating the same behavior and not getting anywhere.

  4. Hey, Ragen, the link in the cost paragraph (the cost of that oppression, stigma and shame) returns a page with this error: Sorry, no posts matched your criteria.

    Just thought I would let you know.

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