“Obesity-related” disease actually tracks your social status more than what size clothing you wear. In developed nations, data show, members of stigmatized groups, including those who are economically disadvantaged and people of color, are the most common victims of illnesses typically grouped under the “metabolic” umbrella. [...] With social status comes control over one’s circumstances – success at work, fostering loved ones’ well-being, being able to plan for the future, or even next week. The absence of those, no matter how punctilious our lifestyle habits, stresses our systems in disease-promoting ways. In contrast, being able to exert an influence over what matters to us is health-promoting.
It’s amazing what fat is used to justify. Besides the increased health risks associated with obesity, we’re told fat people harm national defense, make global warming worse, and decrease workplace productivity.* The “Oh, but we need to do something about obesity!!!” is trotted out to sell organic foods, free range foods, Whole Foods, books, TV shows, spas, beauty products, workout systems, clothing, fat camps, school-based “interventions”, workplace “wellness” programs, and so on.
Now, some physical fitness instructors in Denver are upset that private property owners and city parks don’t want to have their open space used rent-free for fitness classes. And what is one of the justifications?
[I]n a country battling obesity and high rates of heart disease and diabetes, they say, governments should be doing everything possible to get people up and moving.
Note this dispute isn’t about a specific “anti-obesity” program. This is about small businesses using public parks, or even privately owned areas open to the public, to offer private fitness classes.
Obesity isn’t the actual story. The story is a clash between those who enjoy taking or offering open-air classes and those who’d like to enjoy the park without them. It’s also about small businesses that want to offer classes without having to rent space and the need for the parks to be available to all.* The “but we need to fight obesity, heart disease & diabetes” is thrown in as an appeal to the public interest. Why? Because being fat is assumed to be bad, to be wrong, to be against the public interest.
This is probably not how the writer intended it. And yet.
*It’s assumed, of course, that all fat people get sick more often. That said, it’s interesting to note that office equipment that fits the worker can improve productivity.
**”People will still be able to get together to play Frisbee or soccer. But if money changes hands, said Jeff Green, a Denver Parks spokesman, ‘you need to have a permit.’”
- A fit fat person is usually healthier than a sedentary thin person.
- Obese people (BMI of 30 to 34.9) have no greater risk of early death than those of “normal” body size (BMI 18.5 to 24.9). Most people who fit the clinical definition of obese are in the smaller categories.
- “Normal-weight” people who think they’re fat have a lower quality of life. Why?
It distracts from the real issues:
- Weight discrimination in healthcare prevents proper diagnoses
- Health practitioners already are too likely to diagnose on body size instead of symptoms and facts
- Exercise improves health, but it often doesn’t cause weight loss. If your goal is weight loss, it’s easy to get discouraged and quit exercising.
- Fat bias prevents fat people from getting jobs, from getting raises, and from getting proper healthcare treatment. Society’s response? ”Prevent obesity!”
It’s a win for the weight cycling industry:
- Diet programs benefit from the (short-term, usually temporary) success of diets. Most people diet to lose weight and then regain. A significant subset then go on a new diet, regain, try another new diet, and so on. Someone may do Weight Watchers, then NutriSystem, then Jenny Craig, then Weight Watchers again. Who’s making money in this situation?
- When lost weight is regained, the dieter is blamed – not the diet.
- New York Times reporter Gina Kolata wrote in Ultimate Fitness: The Quest for Truth about Health and Exercise that news agencies receive hundreds of press releases a week from diet programs, authors, and researchers. Most have something to sell. Weight loss is a terrific product to sell, because it’s so often temporary.
- Ever notice how weight loss ads extolling how someone lost 40 or 50 or 60lbs will include a note “Results not typical”? There’s a reason for that.
Unfortunately, what’s good for the weight cycling industry isn’t necessarily good for patients:
- Contrary to popular belief, weight loss usually results in being less fat, not thinness.
- Being “less fat” doesn’t necessarily help.
- Dieting is a risk factor for eating disorders.
- Waiting until you lose weight before healthcare practitioners take you seriously can have long-term repercussions. Including death.
In the coverage of this fat-hating, scientifically inaccurate, harmful mess, I’ve seen a lot of variations on calling out Miller for hitting out the send button impulsively or failing to properly censor himself. But the problem isn’t that Miller broadcast this bigotry in a public venue. The problem is that he holds this bigoted view at all.
Maybe Zimmerman should have saved the money donated to him for his defense to actually pay for his defense instead of using ~$213,000 of it to bail himself out of jail and live out of a hotel.
My existence challenges everything that you’ve been told to believe about me, which makes you uncomfortable. And instead of getting to know me, you cast hate and anger at me. Hoping that your negativity will tell me to quit, hoping that I will amount to the nothing you desperately want me to be, and hoping that your negativity will give you a voice for a moment.
Believe it or not, getting rid of contraception and abortion isn’t going to lead to improved women’s health.
As noted on Twitter, the article Tara Parker-Pope wrote for the New York Times about a study in Obesity looking at how fat patients aren’t always welcomed by doctors. Not news, though I suppose it’s good to have quantitative research supporting it.
Really, though, this is just the tip of the iceberg. Here’s some more.
For patient stories on health professionals, check out the crowdsourced http://fathealth.wordpress.com
- Yale Rudd Center Policy Brief on weight bias (PDF)
- Stigma of Obesity (PDF) by Rebecca M. Puhl and Chelsea A. Heuer, published in Obesity, in 2009.
- New Developments in the Law for Obesity Discrimination Protection (PDF) by Jennifer L. Pomeranz and Rebecca M. Puhl, published in Obesity, in 2013.
I understand if anyone doesn’t want to read this. But it says something about our society.
When typing “fit people are” into Google,* it helpfully tries to finish the thought for me, providing “more successful”, “happier”, “harder to kill”, and “smarter”. The search results are similar.
Typing in “thin people are” shows options like “better”, “beautiful”, and “more successful”. The top piece discusses the latest “moderately fat people live longer” study.**
Finally is the “fat people are” results: “gross”,” lazy”, and “stupid”.
Google doesn’t just index the web. It also aggregates what other sites are linking to and what people are searching for — and what they navigate to. The effort Google puts into making their search results find what people are looking for makes it also a somewhat accurate reflection of our society.
*Google does, over time, reflect what an individual has searched for in the past. As I frequently search for fat-positive items, these screenshots were generated using a browser I rarely use, where I wasn’t logged into Google. I’d also cleared the browser cache.
**If Google is using IP addresses to adjust results this may be due to my usual fat-positive bias. Might be helpful to know if anyone else sees this.
UPDATE: Several other folks get the same or similar results.
People do not die of “obesity.” Some fat people die from complications of what are commonly known as “obesity-related diseases,” like heart disease and diabetes, but those diseases have only been shown to be correlated with fat, not caused by fat. (Which is why thin people have them, too.) So it’s not even accurate to assert that obesity kills indirectly.
And speaking of correlation, an explanation of causation vs correlation at The New York Times makes use of a correlation between ads for junk food and fatness:
The problem is that their policy recommendations rest on a crucial but unjustified assumption: that any link between obesity and advertising occurs because more advertising causes higher rates of obesity. But the study at hand showed only an association: people living in areas with more food ads were more likely to be obese than people living in areas with fewer food ads. [...] In fact, it is easy to imagine how the causation could run the opposite way (something the article did not mention): If food vendors believe obese people are more likely than non-obese people to buy their products, they will place more ads in areas where obese people already live. [...]
This is not an arcane statistical point or a mere technical criticism of one academic article. Too often, relationships that are far from being understood are assumed to reflect a particular, strong causal connection, leading to no end of regulatory mistakes.
I missed the husband who loved me no matter what, not the new anti-fat crusader he had changed into. But he felt the same way: he’d fallen in love with a plump-but-not-fat woman who wanted to be thin, and now he had a fat wife who’d “given up on herself.” And Ihad given up: given up on dieting, given up on the idea that my body needed to be fixed.I already wished I hadn’t spent so many years beating myself up for being fat; I wasn’t going to stay in a marriage where my husband did it for me.
Tonight I overheard some thin 20somethings discussing fat people as a group (nothing said about the 40ish couple at a nearby table). The terms and statements made were rather derogatory. There was laughter. Then their discussion moved to other topics.
This wasn’t pleasant. I tweeted about it. I then focused on dinner with the man of the house.
In the microcosm of this hour and this room, their comments did not necessarily have to affect me. Their opinions did not cause me to lose my job or my home. And their finding fat people unsexy doesn’t undo what we did this morning. ;)
At the same time, however, the anti-fat views expressed by a group at a bar encourages and reinforces anti-fat views at the societal level. Society’s view that anyone can lose weight, and that fat people are stupid or in denial or lazy to not be thin, makes it less likely that I will be hired than a thin person with my qualifications. Or that I’ll be paid as well as a thin person. It’s also part of why medical professionals view fat people as non-compliant and deficient, since we are “willfully” avoiding thinness. Etcetera.
Does it matter to me what a random stranger thinks of fat people? Individually, maybe not. But society’s view of fat people matters a great deal.
1) I am sooo looking forward to tomorrow morning, when Mark Reads will post the second-to-last chapter of Deadline. Mark Reads reviews books a chapter at a time, progressing through books every other weekday, and it’s been building to this OMG HUGE second-to-last chapter for weeks. (Need I say “spoilers”?) Some of the books he’s done this with in the past are the Harry Potter books, The Hobbit, The Lord of the Rings, and The Hunger Games. Deadline is the middle book of the Newsflesh trilogy & Mark’s reading the whole thing, starting with the first chapter of Feed here.
2) I got myself a Fitbit Zip to help me be more consistently active — I use it as a pedometer that does built-in recordkeeping, so I can get a sense of how active I am in general, not just a single day. Since I got it I’ve found myself at work focusing deeply for one to two hours and then getting up to walk and get water or coffee or tea or something. I’d quit feeling guilty about it because I found that a brief break to walk and stretch lets me focus better afterward. This article helps me rationalize it more ;)
3) A year ago today I signed my father’s hospice paperwork as his medical power of attorney. The anniversary was a bit freaky this week. At the moment I’m at peace with it all, but I know my reactions will likely continue to change.
4) I’ve been posting on fat discrimination at http://fatdiscrimination.tumblr.com. It’s not a subject I want to dive into a lot, so posts are somewhat sporadic.
“You have such a pretty face. You should lose weight.”
“A pretty face and fine clothes do not make character”
“Who cares about pretty? I’m going for noticeable.”
— Veronica Roth
“It has been said that a pretty face is a passport. But it’s not, it’s a visa, and it runs out fast.”"
— Julie Burchill
“After all those years as a woman hearing ‘not thin enough, not pretty enough, not smart enough, not this enough, not that enough,’ almost overnight I woke up one morning and thought, ‘I’m enough.’”
— Anna Quindlen
“It suddenly struck me that that tiny pea, pretty and blue, was the Earth. I put up my thumb and shut one eye, and my thumb blotted out the planet Earth. I didn’t feel like a giant. I felt very, very small. ”
— Neil Armstrong
[Discussion of bullying and weight punishments; feel free to skip.]
Parents and other adults who are “only trying to help” may do harm rather than good, as a recent study from the journal Pediatrics makes clear.
It is a good discussion and I’m glad to see it. At the same time, it can be upsetting to see things you’ve lived with discussed dispassionately. Dr Rebecca Puhl, from the fat-phobic Rudd Center, appears, as does Ellyn Satter.
“There still remains the widespread perception that a little stigma can be a good thing, that it might motivate weight loss,” said Dr. Puhl, a clinical psychologist. (Medical doctors, too, fall prey to this misconception.) But research done at the Rudd Center and elsewhere has shown that even well-intentioned commentary from parents and other adults can trigger disordered eating, use of laxatives and other dangerous weight-control practices, and depression.
Hells yes, y’all, parents can bully their fat children. Or maybe you don’t want to call it “bullying.” Maybe you want to call it teasing, belittling, or harassing. Oh, here’s one: providing incentive. Maybe buying your kids clothes that “will fit when you lose weight” instead of now, or pointing out that the fat kid gets different (less) food than the rest of the family, is just something that “has to be done” too. No, it’s not. It is abusive. And you should not be surprised if the kids you reject for being fat reject you in turn.
Kudos to Harriet for broaching a topic that many parents like to pretend doesn’t exist. Also for common sense suggestions, including
¶ Don’t blame your child for his weight. [...]
¶ Don’t engage in “fat talk,” complaining about weight and appearance, whether it’s your own, your child’s or a celebrity’s. [....]
¶ Don’t promise your child that if only he lost weight, he wouldn’t be bullied or teased. [...]
¶ Don’t treat your child as if he has — or is — a problem that needs remedying. “This will make him feel flawed and inferior,” says Ellyn Satter, a dietitian and therapist in Madison, Wis., and author of “Your Child’s Weight: Helping Without Harming.” Instead, she suggests, focus on a child’s other good qualities, and encourage traits like common sense, character and problem-solving skills.
I would strongly recommend NOT reading the comments in the Times.
Marilyn Wann takes on weight bias in healthcare in “Big deal: You can be fat and fit” on CNN.COM:
…People are telling their stories of weight bias in medical care on websites like First, Do No Harm, This Is Thin Privilege and Obesity Surgery Gone Wrong. The National Association to Advance Fat Acceptance has been speaking out on behalf of fat people’s civil rights since its founding in 1969.
Health professionals of good conscience are joining this effort in increasing numbers. They’ve developed an approach called Health At Every Size that is proving to be better for people’s health than weight-loss attempts. The Health At Every Size professional organization,Association of Size Diversity and Health, this week launched the project Resolved, a response to New Year’s weight-loss resolutions. It invites people to share stories about weight discrimination in health care and opinions about what needs to change.
Weight bias has been documented among doctors, nurses, fitness instructors and other professionals on whom a fat person might need to rely for help. Last year, researchers who themselves are part of an anti-”obesity” institution (Yale’s Rudd Institute) surveyed medical professionals who specialize in caring for fat people and found that they had high levels of weight bias, viewing us as “lazy, stupid, and worthless.”
Paul Campos uses the latest “obesity paradox” study with “Our Absurd Fear of Fat” in The New York Times to argue that policing fat is worthless:
The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals. If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.
Now, if we were to employ the logic of our public health authorities, who treat any correlation between weight and increased mortality risk as a good reason to encourage people to try to modify their weight, we ought to be telling the 75 million American adults currently occupying the government’s “healthy weight” category to put on some pounds, so they can move into the lower risk, higher-weight categories.
In reality, of course, it would be nonsensical to tell so-called normal-weight people to try to become heavier to lower their mortality risk. [...T]iny variations in relative risk in observational studies provide no scientific basis for concluding either that those variations are causally related to the variable in question or that this risk would change if the variable were altered.
Both articles are well worth reading, but I would skip the comments on those sites. If you must discuss with someone, chat about it here ;)
Hello and welcome! I’m back at work with my new cartoon-a-day calendar (New Yorker cartoons) and new wall calendar (Pacific Northwest landscapes). I even cut off some of the photos from last year’s wall calendar to decorate my cube. Ready to work! (Yes, I know it’s Wednesday, but today feels like Monday to me. Yay four-day weekends! )
I adjusted the layout, let me know if you can’t find things. Also, let me know if you have additional topics or questions you’d like me to write about.
As for resolutions, well, there’s resolve and then there’s Resolve the carpet cleaner, (Two Lumps). There’s also ASDAH’s Resolved: Addressing Weight Bias in Health Care Project, collecting health care stories in video or written form. Please see their site to see what they are asking for and the submission methods.
In the meantime, some things to read / discuss if you wish – warning for fat hate:
People are living longer! I thought this would be a good thing. Oops! As Fatties United discusses, some people aren’t happy with this.
Since so many fat people have had the audacity to keep on living instead of dropping dead on schedule, Dr. Mokdad is predicting that all these fat folks will be old sick fat folks and require lots and lots of medical treatment.
Charlotte Cooper writes about The UK Royal College of Physicians and their concerned about obesity! Oh dear.
Reading the report is like a journey into Opposite Land. The work is well-meaning, but it exists with a framework that is profoundly problematic. For example, it is hard to disagree that current service delivery for fat people is really poor, particularly for those who undergo weight loss surgery, and that there needs to be proper auditing, quality control and monitoring of all obesity treatments.
But the report, as is typical in a medicalised discourse of fat, is entrenched in a view that regards weight loss as the universal solution to the problem of fat people and health. The authors throw about “severe complex obesity,” a term they’re obviously pretty proud of, coming soon to a healthcare provider near you, and bound to further medicalise and stigmatise fat people. They make the crucial mistake of failing to question the effectiveness of weight loss at all, so it’s not weight loss surgery that ruins fat people’s health, it’s the fact that the care pathways surrounding the surgery need tweaking. This ties them up in all kinds of knots, looking for answers in the wrong places, for example suggesting that the UK needs a Michelle Obama figure to galvanise the population against obesity, even though her crusade in the US has been disastrous in re-stigmatising fat kids, and even though we’ve already seen Jamie Oliver screw things up over here.
Anyway, let’s be careful out there. Now, I’m going for a walk.
This showed up as one of the search terms used to get to my blog:
what is a job for a morbidly obese woman?
So, what sort of job is good for a morbidly obese woman? How about one that she has the skills for? One that she enjoys doing?
But what about in everyday life?
Fat women are doctors. Clerks. Nurses. Programmers. Saleswomen. Lawyers. Engineers. Housewives. Writers. Bosses. Janitors. Baristas. Fat women are everywhere. And we may not look as fat as you think we do.
So are fat men.
Even so, fat people, especially fat women, are less likely to be hired (there are fewer fat actors for a reason). Fat people are also often paid less and harassed more than similar-qualified people who are thin. As noted in an article in the California Law Review,
“highly obese” women earn 24% less than thin women while the so-called moderately obese earn 6% less. A Harvard Public Health Study found that fat women have household incomes $6,710 lower than thin women. Fat women also have a 10% higher rate of poverty.
I didn’t know all this when I was in college. I knew that I didn’t fit the late-80s “Dress for Success” look, and that being fat didn’t help, but I didn’t realize that weight discrimination was being studied. I knew I wouldn’t look like the stereotypical Seattle programmer , but I majored in computer science anyway. I’m likely to be paid less than others in my field, but at least it’s a field with above-median pay to start with.
Are there jobs that fat people can’t do? Probably not jobs where being small is part of the job, such as being a jockey. Weight Watchers refuses to hire people for certain jobs that don’t maintain their WW-determined “Goal Weight”. There are also jobs that fat people may not WANT to do — I’m afraid that individuals do tend to be individual about their wants, needs, and skills.
What do you think? Stupid question?
[Discussion of fat hate & discrimination]
OK, I wanted to give people the benefit of the doubt.
When Lesley Kinzel wrote about the Kickstarter campaign to raise money for a to stand up for “thin and athletic women” who are oppressed by society’s expectations, I wondered if:
- The author of the Kickstarter campaign thought that using hyperbole about “a society that protects fat culture” would be eye-catching, and,
- If the author of the Kickstarter campaign had conflated society’s dislike of visible muscles on women as “pro-fat”.
The photo of the author on Kickstarter definitely shows visible abs definition, and yes, “feminine” usually correlates to “few or no visible muscles”. Some women do fear gaining visible muscle and avoid weightlifting as a result. Women bodybuilders are sometimes viewed as “masculine” or “freaky”.
From the Kickstarter description of the project:
Collection of images of women standing up against a society that protects fat culture while bastardizing thin and athletic women.
There are millions of women out there and im sure you know at least one looking for a voice , not from tvs and magazines, not from victorias secret.. but from the ground level , to speak up and tell them that its okay to want to be in better shape.
But.. if it just makes it into the hands of ONE little girl who feels like she has to be overweight to fit in with the current 70% of the overweight population of America, and it gives her the strength to know that being healthy isnt a bad thing.
Then this whole project is worth all the time and effort i can possibly afford to put into it.
…. ah no.
Obese individuals are highly stigmatized and face multiple forms of prejudice and discrimination because of their weight (1,2). The prevalence of weight discrimination in the United States has increased by 66% over the past decade (3), and is comparable to rates of racial discrimination, especially among women (4). Weight bias translates into inequities in employment settings, health-care facilities, and educational institutions, often due to widespread negative stereotypes that overweight and obese persons are lazy, unmotivated, lacking in self-discipline, less competent, noncompliant, and sloppy (2,5,6,7). These stereotypes are prevalent and are rarely challenged in Western society, leaving overweight and obese persons vulnerable to social injustice, unfair treatment, and impaired quality of life as a result of substantial disadvantages and stigma.
— Rebecca M. Puhl and Chelsea A. Heuer writing in “The Stigma of Obesity: A Review and Update” published in Obesity.
Look, I get that nobody’s life is perfect. There’s a reason the Romneys believed their college years were a “struggle”. There’s a problem with how our society regards bodies, especially women’s bodies, as open to public discussion. But I have trouble believing that a thin, fit woman is going to be less likely to be hired than a fat woman with the same qualifications. I have trouble believing that a fit, thin woman is going to be told to gain weight to when she goes to the doctor’s. And I certainly don’t buy this belief that women need to be told it’s okay to want to get into better shape when every women’s magazine assumes getting into better shape is every woman’s dream.
It will probably come as a surprise to most readers to learn that this hypothesis remains almost completely unconfirmed by the medical literature – in part because we simply don’t know how to produce significant long-term weight loss in a statistically significant group of people, so the hypothesis has been impossible to test.
The study, called Look AHEAD, has been covered elsewhere. Participants lost 5% of their body weight and maintained that loss for over 11 years. Yes, the researchers considered a “significant” weight loss to be a 5% loss from baseline. Not “reducing BMI to “normal”". Losing 5%. If losing 5% of your weight would put you in the “normal” BMI bracket, it’s likely you’re there already.
And the study found that maintaining that “long-term, significant” weight loss didn’t improve health outcomes.
If reminding folks that fat people are people first — that they are individuals and not some monolithic amoeba of disease rolling itself over the planet, and that their bodies are not shameful, not ugly, not embarrassing, not immoral, but as worthy of acceptance as every other body is — if THIS is the same as glorifying obesity, then bring on the glory. I will carry the banner. I won’t be sorry, not for my part in changing our culture around bodies in general and not for my own body that I live in, right now — I won’t be sorry, and I won’t apologize. Neither should you.
Free speech means that yes, you get to say anything you want (with some legal limits regarding libel and slander laws, advocating harm of another person or threatening someone with death or bodily harm, blackmail, all that), but free speech also means that other people get to say what they want, too, whether you like it or not.
Free speech does not mean the freedom to not be called an asshole.
Free speech also does not mean you get off scott-free for saying legally actionable things about or to other people.
Threatening people is not protected under free speech. Just in case you were getting any ideas.
I felt that people would look at me and assume I was diseased, and shudder and move away. And even though I was doing something ostensibly good for my health, this understanding and awareness that people find me gross did not make it easier or more rewarding to care for my health.