Dealing With The Vague Future Health Threat (VFHT) Form Of Fatphobia

Vague Future Health ThreatThe Vague Future Health Threat is something that I first wrote about almost a decade ago. But it’s still going on, and it came up in conversation today, so I’m writing about it again today!

This happens to me way too often:  I’m in a conversation with someone who thought it was appropriate to make random guesses about my health based only on my size.  I’ve quelled my rage, given them the benefit of the doubt, and asked permission to suggest another point of view – to which they’ve agreed. I’ve explained that there are other beliefs out there, I’ve explained about the science.  I’ve explained  Health at Every Size.  I’ve explained that there are plenty of people with the same food and lifestyle choices who have vastly different body sizes – both healthy and unhealthy.  I’ve explained that health is not entirely within our control, that it is neither an obligation nor a barometer of worthiness.  I say that I’m happy with the prioritization of my health and the path I’ve chosen to support my health.

Then it happens.  The VFHT:  The Vague Future Health Threat.

It sounds like this “Well, you may be healthy now, but it will catch up to you someday”.  They look triumphant because the VFHT, they believe, is indefensible.

Now instead of completely quelling my rage and giving them the benefit of the doubt, I’m just fighting the urge to set this person on fire. It’s not just the person I’m talking to –  it’s also that this is the 20 zillionth time I’ve heard this. I’m starting to wonder if I’ll be 102 years old and still pressured to diet so that it doesn’t “catch up to me”.

I find this to be paternalistic, ignorant, scientifically unsupported, and annoying for the following reasons:

1. Adding healthism to fatphobia does not improve the situation. Health issues should never be used to threaten, taunt, or insult someone.

2. I have a rule – if you’re going to act like you’re psychic, cough up some lottery number or leave me alone.

3.  Everyone is going to die. There is a 100% chance.  I just happen to live in a culture where it almost doesn’t matter how I die, they will try to blame it on my fat. A piano being carried through the air by a flock of flying alien flamingo piano thieves could be dropped on my head and the coroner’s report would mention my body size, calling me “morbidly” fat, and some researcher would come along, count my death as “death by fat” and charge all of my crush-injury medical expenses to my fatness and report about the high medical cost of fat people.

That doesn’t make it true.  This “it will catch up to you” claim is just not supported by the available science, and of all the people who’ve VFHT’d me in my life, NOT ONE has accepted my invitation to cite his/her research (including doctors).

4.  Speaking of the lottery. What if I changed the rules of the lottery so that if you lost, you had to pay the lottery money as a penalty?  Now not only is your chance of winning infinitesimally small,  but there is a near 100% chance that you’ll end up with LESS money than you had after you bought the ticket.  Would you play?

Now imagine that this isn’t your money we’re talking about – it’s your long term health.  There is not a single study that proves that any weight loss method is effective long term, but many studies indicate that weight cycling (yo-yo dieting) is less healthy than being obese.  Since diets have such an abysmal failure rate, with most people losing weight in the beginning and then gaining it all back within 2-5 years (and up to 2/3 of people gaining back more than they lost) if I go on just 2 diets where I lose weight and gain it back (and I have an extremely high chance of doing just that both times), then I’ve likely damaged my current health and endangered my future health by weight-cycling, all on a roll of the dice that was obviously a losing bet from the beginning.

The person VFHTing me is asking that I do something they can’t prove is possible, for a reason they can’t prove is valid, with a very high percentage that I’ll end up less healthy at the end.  Hard pass.

So what do you say to the VFHT?

Here are some possible responses broken down by category.

Quick and simple:

  • It’s not your place to make guesses about my future health.
  • My health is not your business.  (If, at this point, they bring up tax payer dollars or health care costs, I ask them for an itemized list of things for which their local, state, and federal taxes pay, or health problems that people develop for which causation cannot be proven;  broken down into categories of things they are happy to pay for, and things they don’t want to pay for. If they don’t happen to have that list on hand, I let them know that I’ll be happy to discuss it once they do.)

More detailed/scientific

  • I don’t know of a single statistically significant, properly controlled scientific study that supports that statement.  So, either cite your research or I’m going to assume that I know more about this than you do and you are just talking without actually knowing what you’re talking about.  (Or “talking out of your ass”, depending on my mood).
  • You have no way to know that.  Cite your research or I will assume that you are putting my health at risk by talking about things for which you have no actual knowledge or qualifications.  That is completely unacceptable to me.

The pointed response (feel free to mix and match questions/responses with boundary statements)

  • How dare you make assumptions about my health?  It’s not your place to discuss my health with me.
  • I find you completely unqualified to make that statement. Please keep your opinions about my health to yourself.
  • My health is not your business and you are not allowed to comment on it.
  • You will immediately stop making guesses and assumptions about my future health or this conversation is over.
  • I appreciate what I assume are good intentions, but I’m simply not interested in your opinions about my health.

The snarky responses (Not the best for starting conversations, but excellent for ending them!)

  • I had no idea you could predict the future!   Would you mind giving me tomorrow’s lottery numbers?
  • Actually the fat doesn’t have to catch up with me – I keep it right here.
  • I totally forgot that being thin would make me immortal – thank god you told me or I might have died someday.
  • I meant to tell you that I’m actually worried about you.  I read on a website that we are about to experience another ice age and without fat stores to keep you alive and warm, you’re absolutely going to freeze to death.  I know it sounds weird but it was on the internet so you know it must be true and I think you should immediately go and tell everyone.

Remember that in many cases you get to choose how people treat you.  If you decide that they don’t get to VFHT you, then you just need to put that plan into action, set boundaries and consequences and get after it.

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8 thoughts on “Dealing With The Vague Future Health Threat (VFHT) Form Of Fatphobia

  1. Every medical practitioner ever thinks or says this. What, more unprovable assumptions? No. but statistically speaking, and who really speaks IN statistics? For any conversation where someone is telling YOU about YOU, you need to remember it is mostly about THEM.
    Whatever it is you “can’t be doing, shouldn’t do, will have happen to you, not have happen to you”, there is a good chance it is something they spend a large amount of time worrying about.

    1. “For any conversation where someone is telling YOU about YOU, you need to remember it is mostly about THEM.”

      I find VFHT’s creepy for this very reason: they don’t feel so much like something the speaker thinks *will* happen to us as something the speaker thinks *should* happen to us as punishment for our being so uppity and disobedient. They portray poor health like it’s some kind of punishment you can “deserve” if you’re “bad” enough, like “You think you’re getting away with your evil fat ways now, but you can’t escape justice forever, you body criminal! You’ll never get away with this!”

      Like, geeze, why don’t you just shake your fist to top it off? And also that’s a super messed-up way to be thinking about either body size or health.

      1. Way.
        I had a nurse practitioner read my blood test results back like this… “Well, you don’t have diabetes,” in her uber crisp resentful termagant voice. This woman was DISAPOINTED I didn’t have a disease. She NEEDED me to be sick. To be punished for being “obese”. Maybe it is like that thing where it isn’t enough that a person do well themselves, but that another is seen to fail that gives them their sense of superior selfhood.

        Low BP, Low Chol, Low BS. Hanks ’em off every time.

        I imagine when I am dead, somewhere someone is gonna rejoice. See, I told you so.

  2. I remember when Aretha Franklin died, her size was brought up in almost every article about her.
    When David Bowie died, his size wasn’t mentioned once.
    Both of them died from cancer. Both of them were in the same age range.
    But wait–was David Bowie secretly fat or something? Isn’t it only supposed to be fat people who develop health problems? Now I’m confused!

  3. This isn’t a VFHT, but a ‘random giving of medical advice’ situation. I’ve had high cholesterol since my 20s. Probably genetic. I also have anxiety, but it wasn’t diagnosed back then.

    Back then, when I had a blood test and got the letter, there would be the standard advice of ‘eat less of this, eat more of that’ and it always upset because I was ALREADY doing that, dammit, and the numbers weren’t budging. I felt like a failure.

    It wasn’t until years later that it dawned on me that it was probably not directed specifically at me, but a standard thing that on all blood test results that have high cholesterol, like ‘have a nice day’ but with random advice.

    One of last year’s diabetes blood tests was high, and I immediately got a call (before I’d even left the parking lot) from a random physicians assistant trying to talk to me about upping my meds. I had to convince her that this was probably tied to the recent death and last illness of my father. Then I had to talk to three other people about it over the next few days. My dad had *just* died the previous week. I’d told my doctor when I saw her earlier that day, it should have been in my chart.. I was and am STILL angry they were more interested in how to change my blood sugar number than in treating me as a whole person.

    I guess I needed to vent. But the VFHT, and not treating the patient as a whole person, makes me so angry and causes a lot of unneeded stress.

  4. I’d like to add that BMI guidelines increase the “normal” range when people reach 65 years. This is because of evidence showing decreased mortality in older populations who are placed in the “overweight” and “obese” categories when compared to their counterparts who are placed in the “underweight” and “normal” categories. Tendency to live longer when heavier (in relation to height) doesn’t really jive with the VFHT argument.

    BMI is still a fundamentally flawed measure, and should not be used as an indicator for health. It is, however, one of many tools I’ve used in my work. I find the change in guidelines at 65 years thought provoking and wanted to share.

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