As I was scrolling through my Facebook feed two articles came across in a row. The first was about how a University health sciences lecturer in Barbados made a public address at the Ministry of Health’s town hall meeting where the topic was the future of health care financing, and suggested that fat people should be subjected to a special tax.
Taxing people based on their perceived “healthcare costs” is a terrible idea. It’s a terrible idea even if the numbers are on your side (which, when it comes to fat people, they are not.) It’s also the slipperiest of slopes (or it would be if this were about anything other than sizeism.) Are we going to tax sedentary thin people? How about people who don’t get the recommended servings of vegetables. How about people who participate in sports who will have injuries now, and possibly later in life that are quite expensive? How about people who don’t look both ways before they cross the street? And if that seems ridiculous then maybe it’s time to face the fact that this has nothing to do with health and is actually about a fatphobic society trying to punish fat people?
There’s always some proud fatphobe trying to add to the institutionalized oppression that fat people face, like trying to tax us for existing. What made this interesting was the next article on my Facebook feed. It was about a study that showed, like every long-term weight loss study shows, that dieting tends to lead to weight gain – that the odds of becoming fat almost double if you diet once and nearly triple if you diet twice.
Studies that look at dieters long-term show that the vast majority of people gain their weight back and a majority gain back more than they lost. So, even for those who think that being fat is bad, recommending attempts at weight loss is the absolute worst advice they could give.
Something that would be funny if it weren’t headdesk level ridiculous is the study’s conclusion:
Dieting to lose weight can contribute to the risk of future obesity and weight gain. Losing weight requires a commitment to change one’s lifestyle and a sustained effort to maintain a healthy diet and engage in physical activity.
The first sentence is based on their actual research. Their second sentence is absolutely made up – 100% rectal pull. They have literally NOTHING to back it up, there is no research anywhere of any method of “maintaining a healthy diet and engaging in physical activity” in which people lost weight long term. The research that does exist comes to the same conclusion that they came to in their research – intentional weight loss simply doesn’t work.
This is the state of diet research, basically these researchers’ concluded: Dieting leads to weight gain. In order to lose weight you have to engage in a game of semantics in which you call dieting something else.” This is sadly typical of the embarrassing state of research when it comes to weight loss and health, as Lindo Bacon and Lucy Aphramor have explained.
So, let’s take stock of the situation here: There is not a single study of any intentional weight loss method where more than a tiny fraction of people are able to lose weight long-term. And even among the tiny fraction who maintain weight loss, most don’t lose enough weight to change classes – so those who started classes as “obese” were still “obese” after the weight loss, and those classed as “overweight” were still “overweight” after the weight loss. And remember that the majority of people actually gain weight long term.
So if the fat tax people get their way, they will tax people for their weight in pounds times 703 divided by their height in inches squared (aka – their BMI.) We know from the research that any attempt that fat people make to try to be not fat (so that they don’t have to pay the fat tax) will likely end up in them being fatter (and perhaps subject to even more tax?) Think it seems far-fetched? It’s already happening in corporate wellness programs in which people are penalized for being fat and have to pay thousands more for their insurance premiums until they lose weight, including having their companies enroll them in diet programs with proven track records of creating weight gain.
This is a vicious cycle of oppression and it has to stop. This is why our public health conversation should focusing on providing access to information, and options for health, and removing barriers to health (like lack of access, oppression and marginalization, doctor bias etc.) Public health should be about making information and options available to the public, not about making fat people’s bodies the public’s business. And if we need the revenue that badly, maybe we can create a bigot tax so that making other people’s lives miserable becomes a little more expensive.
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