Weight-Based Oppression Is Not a Public Health Intervention

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Activist Harry Minot let me know about a terrible program being promoted in the UK that they are calling a “whole systems approach to obesity.” The tagline is “making obesity everybody’s business.” Ugh.

I will not be linking to it but this certainly isn’t the only suggestion that governments should create programs that purport to create health by encouraging literally everyone to shame, stigmatize, harass and oppress fat people. The fact that anyone outside of a 4chan group full of unsettled fatphobes would suggest something like this shows how totally off the rails we are when it comes to fat people and health.

There are two major issues here – the most often discussed is whether or not appearance-based bigotry constitutes an appropriate, evidence-based health intervention. It does not – there is no research to suggest that convincing every person that a fat person comes in contact with to try to make that fat person hate the body they live in 100% of the time leads to people becoming healthier or thinner (which are, of course, two different things.) In fact, Peter Muennig from Columbia found in his research, just living in a society where one is stigmatized is correlated with many of the same health issues that are used to judge “unhealthiness.” So it’s not just that this approach lacks any kind of research basis, but that this approach is contraindicated by the research.

But in the grand scheme of what’s important, that’s not why this is so terrible. The reason that these “everybody get involved in fatphobia” programs are abhorrent is that they suggest that bullying based on healthism is something that is not just ok, but should receive government support. And that’s bullshit. Even if someone believes that they can tell by looking at someone that they are unhealthy (they can’t), and even if they believe that giving them unsolicited advice and treating them poorly will make them healthier (it won’t), it’s still an absolutely unacceptable thing to do.

First because health is not an obligation, a barometer of worthiness, entirely within our control, or guaranteed under any circumstances. Our health (and how it may or may not be tied to how we look) is not anybody else’s business unless we ask them to make it their business. I also want to point out, again, that these so-called interventions aren’t actually about health, they are about appearance. Nobody can tell how healthy someone is by what size they are as there are “healthy” and “unhealthy” people – by whatever definition – of every size (and even if they could, it still wouldn’t be any of their damn business.)

The other major problem is that it increases the weight-based oppression that already affects every area of the lives of fat people who are hired less and paid less than thin people, have extreme difficulty accessing actual evidence-based healthcare (in no small part because doctors are so busy engaging in fatphobia that they forget to give us actual, you know, healthcare,) and are regularly subjected to street harassment.

As I’ve said before, my fat body is not a representation of my failures, sins, or mistakes. My fat body is not an indication of my level of health or fitness, neither of which is anyone else’s business anyway. My fat body is not up for public discussion, debate or judgment. My fat body is not a signal that I need help or input to make decisions about my health or life.  My fat body is the constant companion that helps me do every single thing that I do every second of every day and it deserves respect and admiration.

I will wield my beautiful fat body like a weapon.  I will love it, I will care for it, I will show it in public, and I will viciously defend my body against anyone (including the UK government,) who seeks to classify it as anything but amazing.

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23 thoughts on “Weight-Based Oppression Is Not a Public Health Intervention

  1. I live in England, I love England, but it has to be the most fatphobic place I’ve ever lived, ( and I’ve lived in a few) we are constantly reminded about the so called “obesity crisis” in every media there is, a long time ago My son was weighed in school and a letter was sent home telling us that ” while not over limit at the moment he is well on the way” so what is the limit anyway and who sets it? I have bone problems and of course the treatment is” loose weight”( many thin people have the same problems me) and I have to have some bone scans, but my local hospital tells me I can’t have them there as they don’t have the facility’s for me, which cracks me up as while fat, I am not of a size that has ever caused me problems before, and even if it did they should acomadate that, so I have to travel a long way to get the scans, everything in the UK seems smaller than Australia and America from seats in buses, chairs to dress sizes, and we are made to feel we are a drain on society, so this story about the government making us feel even worse is no surprise.
    Thank god for this site and others like it. x

  2. We’ve already learned of the UK’s National Health Service denying elective surgeries to fat people. This new approach is utterly horrifying. And the message it sends to fat kids is especially frightening.

    1. As the trend is for Gov. to shift more of the care burden off itself and onto individuals who have the least resources already, of course the “your weight is everybody’s business” idea makes (paradoxical sense). While I’m blaming that person in the next seat who’s bigger than me for societal woes, I’m not thinking about tax breaks for the wealthy and how they deprive every citizen of the care we deserve. I’m also not thinking about how the same private companies that pitch shame also pitch indulgence in the next breath: they make money whether I’m purchasing “good” food or “bad” food. :/

  3. I looked it up and read their “Tackling Obesities: Future Choices” second edition program.

    I… can see why there’s no link to that. I need brain bleach.

    I’d just note their opinion on evidence-based medical care on pages 13 and 61. It is not unfair to sum it up as “Evidence? Who has time for that? People are being fat at me right now and the government needs to Do Something! Who *cares* if what they do works?”

    Also note that underneath their cute euphemisms, the “interventions” they’re suggesting are tantamount to fining employers for hiring fat people, fining fat people for existing, breaking up families if one or more members is fat, pumping fat people full of untested diet pills, actually spying on fat people, and actually starving fat people. It’s like… throwing punitive and pharmaceutical spaghetti at the wall to see if a stay noodle will fly like a spear and strike the Fatmonster’s heart.

    1. Thank you for reading that, so I don’t have to. I just don’t have the spoons right now (and haven’t for a couple of months, probably won’t for a few more).

      Also, I love your metaphor. Don’t let anyone complain at you that it is mixed or otherwise “imperfect.” It is glorious.

  4. I find it interesting how these people use percentages instead of actual numbers. Even if it is true that 90% of people with type 2 diabetes are obese, only 20% of obese people have type 2 diabetes (in the US any ways). So that means on 2 out of 10 obese people will have diabetes, so why the fear mongering?

    1. Who was it who said that famous quote? “There are three types of liars: liars, damn liars, and statisticians.”

      I once saw an actual claim that “1 out of 10 patients suffering adverse events, including death, is not statistically significant.” In other words, “We don’t care if it kills you. Buy our drug!” They used some really convoluted math, and even the statisticians in my department were boggled, both at the math and at the audacity of the claim. “Not statistically significant.” My @$$!

      1. It just amazes me how these so called “scientists” calculate things in reverse. They start with the illness in question and then look at the number of obese people who fall into that group; as opposed to the other route which is look at obese people and determine how many actually have said disease. The fact that even if only obese people got diabetes or heart disease, it would only be at most 25% of obese people who would have them and yet if underweight makes up at the most 20% of people with heart disease or diabetes they would all have it. Maybe WHO and the CDC should be more concerned with all the people suffering anorexia, eating disorders, or any other wasting disease, because those people are probably at greater risk.

          1. I know they are human, but I just wish that they would look at things from all angles and not just the one that benefits their view. Personally I believe science should be unbiased.

  5. Turned out I miss calculated the percentage of obese people who have heart disease, the corrected percentage is less than 1%. WTF?

  6. I live in UK; another favourite over here is that fat people have lower intelligence, and come from lower status areas and lower status jobs. They aren’t intelligent and educated enough to understand about how to eat what the morons saying this crap define as a healthy “diet”. I am lucky in that my GP is fairly fat friendly – he is a rugby player and thus understands that BMI is a crap measure of anything. I go to the gym daily, and he knows that and is doesn’t go on about my weight. Plus my diabetic control is really good, with helps.

  7. Just realized that I calculated deaths from heart disease. Actual number is closer to the earlier one, being 2%. Still WTF

    1. Just like the “fat people live 5% shorter lives than thin people,” (and I don’t even know where they get that crap “statistic” from) turns into, “If you are fat at 20, you will be dead by 30, and not live to see your kids pass kindergarten.”

      1. Similar to the claim that obese pets live 10 months less or what ever the claim is. First off not all pets are the same, a great dane doesn’t live as long as a chihuahua. Plus, I work with rats and mice, and the obese ones seem to live just as long if not longer than their thin counterparts. Obese mice who have seizures are more like to survive, recover faster, and the seizure doesn’t last as long. Also my sister’s dog was more playful and happier when she was fat and now she acts weird and just lays around, won’t even play with her toys.

          1. Some of her behaviors are different then when we got her. The thing that really got me is that the vet was basing her weight off of her Chihuahua side, even though she is part lab. she is in the middle, so her weight would be in the middle too. She is still alive, just acts weird and lazy, wouldn’t call it a decline but she certainly was more active and less annoying when she was fat. I just wish doctors/vets would stop trying to predict how long some one has to live based on their weight.

    1. And the really scary thing is that they even admit that, mentioning several times in their program pdf they aren’t following the scientific method or doing any research and subsequently expect their “well-intentioned interventions” to fail – but that they have to skip the usual steps and get their “programs” running right away so they can… again, it is NOT unfair to characterize the document this way… put the machinery to get rid of fat people in place before the bleeding hearts who don’t like “tough choices” can figure out what they’re doing and make it illegal.

      So they don’t just recognize their programs are unscientific, they also recognize they’re unethical.

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