Fat-shaming: you can’t tell if I’m healthy just by looking at me

photoFat people face discrimination in many ways and many settings. It often feels like the last form of sanctioned discrimination – people are comfortable publicly shaming, criticizing, putting down and harrassing fat people in a way they never would when it comes to race, disability or sexual orientation. Part of the problem is that naysayers claim they’re doing it for our “own good”. Fat bodies have become pathologized and synonymous with lazy, gluttonous and unhealthy. Why someone would want to bully someone else into “good health” is beyond me. Plus, stigmatization of obese people actually threatens health and creates health disparities. The thing is, you simply can’t tell someone’s health status just by looking at them. A thin person could chain smoke and eat junk food all day. A fat person could run marathons and be a vegan. And yes, a thin person could be healthy and a fat person unhealthy. Health assumptions, fat shaming and stigma becomes especially problematic in the medical establishment. In a study of 620 primary care physicians, more than 50% of them perceived obese patients as unattractive, ugly and non-compliant and up to a third found them to be weak-willed, sloppy and lazy. Most fat people could tell you of times when a physician prescribed weight-loss as the answer to symptoms and conditions that were not weight-related, while ignoring the actual cause of the problem.

When I was living in the UK  I went in for a routine appointment to renew my birth control prescription with a doctor I had never met before. Dismissing me as I asked for the prescription renewal, she looked me over and declared that I was too fat. She recommended that I take pills that would block by body’s absorption of fat. I asked her what the side effects of these pills were – she said she wasn’t sure. Wonderful response from a doctor recommending you put drugs into your body.  A quick google search reveals that fat blocking drugs result  in a whopping 5-7 extra pounds lost a year and that they cause anal leakage (fun!), abdominal pain and headaches. At no point did this doctor ask me what my eating habits were or what my exercise regime was. If she did, she would have found out that I was a vegetarian eating mostly a whole foods diet full of veggies and fruits, was going to the gym 3-4 times a week and was walking to and from work every day. Imagine that! She also didn’t take my blood pressure, or do any other tests to determine that I was, in fact, “unhealthy”.  It was bad medicine. Luckily, I didn’t let her intimidate or silence me and I walked out of there with a firm no to her unwanted and unwarranted weight-loss advice. It upset me to think what would happen if a younger or more impressionable fat woman was in my seat. Would she have just said yes to the recommendation of weight loss drugs? Would she have felt ashamed of her body and wanted to avoid going to the doctor? If she stopped going would she get the birth control she needed or help for other health issues or concerns she may have? Would she have internalized that advice to mean that thinness was always better, even if achieving it meant doing things that damaged her health? Being treated with dignity by healthcare practitioners should be the norm, regardless of body size.

There is no proven way to make fat people thin. If there were, the US diet industry  wouldn’t earn an annual revenue of 20 billion dollars. Weight watchers long term success rate – the number of people who reach and maintain their goal weight –  wouldn’t be less than 1%. Yet most doctors don’t tell patients that the vast majority of people who lose weight end up gaining it all back, plus more within 5 years. Or that studies show little support for the idea that diets lead to sustained weight loss or even health benefits. This isn’t an issue of widespread, collective lack of will power. Diets don’t work. Weight loss pills don’t work. Fat shaming doesn’t work.

I practice a Health at Every Size approach to my health. I believe that the best way to stay healthy is to put my energy into healthy habits for their own intrinsic value, not out of an effort to be thinner. I have wasted too much of my life going down that miserable path. I ride my bike to work, do yoga, walk every day and eat wholesome food because it makes me feel good, because I like being active and because it helps keeps me healthy. Ultimately, my health is no one’s business but my own, so other people’s opinion is irrelevant. It is not for us to pass judgement on anyone’s health. It’s frustrating to even have to write posts such as this – defending myself and other fat people for just wanting to live our lives free of shame, discrimination and oppression.

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