Fat People and Faulty Assumptions

facepalmThe war on obesity is built on a bunch of faulty assumptions:

The assumption that fat people who are able to suppress their weight will have the same health outcomes of people who have never been fat.  That has never been proven (partially because weight loss almost never works long term, so there haven’t been enough fat people who have maintained weight loss to even test the hypothesis).

The assumption that anyone who tries hard enough can lose weight.  There is not a single study where more than a very small fraction of people are able to maintain weight loss for 5 years.  There is absolutely no reason for us to believe that long-term weight loss is possible for the vast majority of people.

The assumption that all thin people are healthy and part of the “solution”, and all fat people are unhealthy and part of the “problem”.  There are plenty of thin people who have the kind of lifestyle that is stereotypically assumed of fat people, and there are plenty of fat people who eat and exercise in a way that is stereotypically assumed of thin people. But that’s not the worst thing here, the worst thing is the idea that it’s ok to wage war on people because they are, or are perceived to be, unhealthy – that’s messed up. In truth, there are healthy and unhealthy people of every size, and everyone has the right to eat as they choose, move as they choose (or not), and everyone has the right to exist in their body regardless of size or health, without anyone waging war on them – whether they eat “unhealthy foods,” or risking their health with things like mountain climbing, or playing professional sports, or not getting “enough” sleep.

Then there’s the assumption that waging a war of constant shame and stigma on people will make those people healthier, and that having a war waged against them that creates a world where they are encouraged to internalize shame, stigma, bullying, and blame themselves for their oppression will have no negative health ramifications on a population.  This is obviously ridiculous. People don’t take care of things that they hate and that includes their bodies.  There is, unsurprisingly, no evidence to suggest that people are are the subjects constant stigma, shame, and public humiliation become thinner or healthier as a result. There is research that constant shame and stigma are correlated with many of the same diseases to which obesity is correlated, and that women who are concerned about their weight have more mental and physical illness than women who are fine with their size, regardless of their weight.

The problem with the war on obesity is that there is a war on obesity.  It’s a war built on baseless assumptions, fought with faulty ammunition, and constructed so that the only “winners” are those who profit from it, and where fat people end up as casualties.

Meanwhile there are people without access to the foods they would choose to eat, without safe movement options they would like to try, and without access to evidence-based healthcare.  But the government would rather spend it’s time fighting the ridiculous war on fat people.  What a tremendous misapplication of time, energy and money.

So we will fight this war, we will win, and then we will do our damndest to make sure that kind of unconscionable abuse of power, people and waste of resources never happens again.

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11 thoughts on “Fat People and Faulty Assumptions

  1. This always makes me think of Tatum in Scream: “There’s only so many times you can hear that Richard Gere/gerbil story before you have to believe it.” The most depressing thing about these assumptions is that most of them fall apart with a little basic research and observation. So why have they stuck around *so freaking long* past their sell-by date? Ubiquity. How can something this *everywhere* be wrong?

  2. Ragen, this is perfect. Thank you.

    I remember another thing about health that everyone “knew” and that was ubiquitous — that ulcers were caused by stress, that “Type A personalities” were giving themselves ulcers and needed to learn to slow down, that the more your ulcer bled and the more pain you were in, the more you were to blame for your own “driven” personality that was “causing” your ulcer.

    Except … No, wrong. Most ulcers are caused by H. pylori bacteria. They’re the result of an infection. Type A Personality has nothing to do with it, and all the chilling out and slowing down in the world won’t prevent an ulcer in the first place or make it go away once you’ve got it.

    And yet for decades, the Shame-And-Blame targeted at people with ulcers was just taken for granted. Everyone just KNEW that stress caused ulcers. And Everyone was wrong.

    1. Ugh, and the ulcer thing makes me think of all the blame on couples not being able to conceive being put on “stress.” “Well, just RELAX and I’m sure you’ll get pregnant.”

      1. So, low sperm count, scarring along the tubes, mother’s body rejecting the baby as a foreign object, and all that… No one ever heard of these things, I suppose?

        Some people, no matter how relaxed they are, simply WILL NOT conceive a child. Sterility is a real thing. And it’s neither shameful, nor their fault.

        I think “everyone” reads too many novels, where health issues are too often used for dramatic effect, without any proper knowledge behind it.

        1. It seems that every disease, before somebody gets the brilliant idea to actually research it, initially gets blamed on the infected’s “immoral” behavior. I think it’s a variant of the Just World Fallacy and fear on the part of the accuser – if circumstances beyond your control (ie, germs, toxins, DNA) have made you sick, then I could get sick, too. But if you’re sick because you’re a bad person does bad things, then I, a good person, shall be well forevermore!

    2. I have a family history of sinus headache and/or migraine on my mother’s side. My mother got told that it was all in her head. Because silly ladies and their silly aches and pains, amirite? Nothing that goes on in a woman’s head could possibly be worthy of medical attention. (GRRRR.)

      Now I tell a doctor that I have inherited the family hammer to the head and I get a sheaf of research about potential triggers and prevention methods.

      1. You know another physical disease once widely stigmatized as a type of ‘hysteria?’ Asthma. And it’s also a great example of how something “totally obvious!” can be wrong as hell. The *reason* so many people thought asthmatics were merely panicking and imagining that they couldn’t breathe came down to over-the-counter saline inhalers working almost as well in a pinch as the fancy prescriptions. See?! Placebo effect! Fake medicine only works on a fake illness! Put on your big boy pants and stop sucking your salt-water baby bottle, wheezy!

        …except, it turns out, asthma is 100% a real lung disease, caused by inflammation in the throat making the muscles in the asthmatic’s chest to tighten like steel wire when exposed to certain triggers. The saline “placebo” so many people decided was “proof” asthma was a myth worked because *the /high-pressure spray/ pushed the muscles back open.* It was the force of the mist, not the contents, easing the symptoms (though obviously, it works better if you’re using medicine that also treats the inflammation). Obvious failed.

  3. Doctors refuse to accept the fact that all the methods they have for losing weight whether diets, drugs or bariatric surgery have major flaws and do not work if at all for a long time.Nevertheless, when a fat patient walks in with a medical problem, they immediately suggest losing weight as a solution and going on a diet.Even though the usual failure leads to loss of self esteem and in many cases to eating disorders and depression.The few who do keep the weight off spend enormous amounts of precious time trying to maintain there low weight. The key question is how do we effectively get most doctors to stop pushing diets for every problem that a fat patient has and instead treat the persons problems more realisticly.

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