I just completed an interview with Ash, host of The Fat Lip podcast. We talked about how I came to this work and to The Fat Lady Sings. Ash tells me she will edit our talk today and you should be able to listen sometime tomorrow afternoon. So check it out if you want to hear me.
There is resistance in some corners of the fat acceptance community to considering any emotional factors involved in becoming and in being fat. As a Jungian, I pretty much do not think in terms of "mental illness" because I am more interested in what symptoms and problems mean than I am in diagnostic issues. But somewhere along the line, people began to conflate background emotional issues with mental illness. This is understandable as medicalization of all kinds of problems in living has pushed ordinary ups and downs in life into classification as a mental illness and this creates resistance to looking at them.
In my book I explore how fat became the target in the so-called “War on Obesity” and I write:
Pressure for this classification likely came from pharmaceutical companies and bariatric surgeons and other groups with an economic interest in gaining support for coverage of this “disease” by health insurance. One obesity researcher said in an interview with Rebecca Weinstein:
… there are several important implications of this decision. Classifying obesity as a disease, or a health condition that may be, at least in part, due to circumstances beyond an individual’s control, will open up the discussion to address it seriously and to persistently pursue all potential treatment options. It will help to overcome that barrier of blame and shame that currently occurs in the medical examination room. It will also force health insurance companies to consider covering its treatment. Additionally, treating it in a formal and standardized way will help evaluate and improve current standards of care. Lastly, classifying obesity as a disease will eventually create a medical support system for the treatment of obesity, which will, importantly, educate the public and put an end to the quackery that preys on obese individuals who are trying to lose weight every day. (Weinstein, Fat Kids: Truth and Consequences, 2014, pp. 104-105)
Her comment sounds reasonable until one considers that it classifies anyone above a certain BMI as diseased regardless of his or actual state of health. And it carries the assumption that being fat is something that should be treated, i.e. changed. Under this way of viewing obesity, treating fat can readily take priority over diagnosing and treating medical conditions that may or may not be related at all to weight. (The Fat Lady Sing, P. 15)
The battle to keep obesity out of classification as a disease was lost. But efforts to classify fat as a mental illness have not succeeded -- yet. There is no DSM V diagnosis for obesity. It is argued by some that being fat constitutes an eating disorder, based on the assumption, unquestioned and unchallenged, that fat people are compulsive eaters and in general eat differently from slender people. So some code it as Eating disorder not otherwise specified (EDNOS). There are fat people who are bulimic, anorexic, who eat compulsively. Just as there are slender people with the same issues. Weight alone is insufficient for diagnosis. I also do not believe that to be fat is to have an eating disorder.
This morning I read Ragen Chastain’s latest post, They Want Fat People to Swallow Balloons Now about yet another invasive, potentially lethal weight loss device called Obera. As Ragen explains, Obera is a silicon balloon inserted into the stomach and left in place for 6 months and is promoted as non-surgical, non-invasive (though how having to be sedated in order to have the balloon inserted qualifies as non-invasive beats me), non-permanent, and no incisions. The “non-permanent” part is correct because as with any such effort the weight loss is not permanent.
If you go to their site, way down at the bottom in tiny print is the following.
Important ORBERA® Intragastric Balloon System Safety Information:
- The ORBERA® Intragastric Balloon System is a weight loss aid for adults suffering from obesity, with a body mass index (BMI) ≥30 and ≤40 kg/m2, who have tried other weight loss programs, such as following supervised diet, exercise, and behavior modification programs, but who were unable to lose weight and keep it off.
- To receive ORBERA® you must be willing to also follow a 12-month program, beginning with the placement of ORBERA® and continuing for 6 months after, that includes a healthy diet and exercise plan. If the diet and exercise program is not followed, you will not experience significant weight loss results; in fact, you may not experience any weight loss.
- Losing weight and keeping it off is not easy, so you will be supervised throughout this program by a team of physicians, physiologists, and nutritionists. This team will help you make and maintain major changes in your eating and exercise habits.
- ORBERA® is placed for no more than six months. Any time that the balloon is in the stomach for longer than six months puts you at risk for complications, such as bowel obstruction, which can be fatal.
- Some patients are ineligible to receive ORBERA®. Your doctor will ask you about your medical history and will also perform a physical examination to determine your eligibility for the device. Additionally, at the time of placement, the doctor may identify internal factors, such as stomach irritation or ulcers, which may prevent you from receiving ORBERA®.
- You must not receive ORBERA® if you are pregnant, a woman planning to become pregnant within six months’ time, or breast-feeding.
- Complications that may result from the use of ORBERA® include the risks associated with any endoscopic procedure and those associated with the medications and methods used in this procedure, as well as your ability to tolerate a foreign object placed in your stomach. Possible complications include: partial or complete blockage of the bowel by the balloon, insufficient or no weight loss, adverse health consequences resulting from weight loss, stomach discomfort, continuing nausea and vomiting, abdominal or back pain, acid reflux, influence on digestion of food, blockage of food entering the stomach, bacterial growth in the fluid filling the balloon which can lead to infection, injury to the lining of the digestive tract, stomach or esophagus, and balloon deflation.
And if at the very bottom of that page you follow their link to full safety information, you find this - a lengthy PDF meant for physicians detailing the procedure and adverse events and complications. Do take a look.
So what we have here is another device, like the AspireAssist, which is basically a device which works by inducing bulimia without the messiness of vomiting. And though less drastic than the various and sundry bariatric surgery procedures, nevertheless physically assaults the fat person’s body, causes pain and other unpleasant side effects and which can kill the patient, all in the name of eliminating fat. Procrustes’ dream!
One of the major issues I look at in The Fat Lady Sings is the issue of anti-fat bias in the psychotherapy consulting room.I write:
In a room with a slender therapist and a fat patient, it is the patient who has a weight problem. That therapist, bene tting from thin privilege may well assume that the way she eats, what she eats and how she exercises are what make her different from her patient, what make her thin and her patient fat. She may believe that because she carefully monitors what she eats and faith- fully exercises, that she has control over her body, control that the fat woman could have if only she tried harder and did as she does. There is nothing in the media or even the professional literature to contradict her assumptions.
There is actually very little in the way of guidelines for therapist in how to work with fat patients or even how to make their offices welcoming.I have been able to locate three sets of guidelines for therapists when dealing with patients with size issues -- one published in the American Psychological Association's Monitor, one by NAAFA, and the last by Marion Woodman. So let's look at the first two.
First, from the APA Monitor, a brief set of guidelines for therapists interested in being "size friendly" -- it's a short piece and seems to have been little noticed, though it was published in January 2004. Here are the guidelines:
* Don't make assumptions about overweight clients, such as about whether they have an eating disorder or are working toward acceptance of their weight.
* Display size-friendly artwork or magazines in your office or lounge.
* Have seating in your office that can accommodate larger people. An example is armless chairs.
* Raise your colleagues' and students' awareness by addressing these issues in formal and informal ways, such as during clinical supervision or in workshops.
I started this blog when I began to gather material for and write my book. I have bounced back and forth between keeping it separate and itself and just merging it into my more general blog, Jung-At-Heart. Here we are in another bounce and a name change.
Having published my book, The Fat Lady Sings, I hope that this space can serve as one where we can explore together issues I write about in the book and pretty much anything related to anti-fat bias, fat acceptance, being fat.
Today when I thought to look into changing the name of the blog from The Fat Chronicles, which I still like, to The Fat Lady Sings, I was beside myself with disbelief and delight when I thought I found the domain name thfefatladysings was available. So I quickly purchased it and asked my web host to change the name. The this morning I discovered that actually the name I thought I had found available hadn’t been and it was through the grace of a typo that I found what I did. My hope, for now, is that people will come here through links in my email sig file, on Jung At Heart, and on social media. So please know that thanks to my typo, the domain name for this site is actually thfefatladysings.com. 😞
This morning NPR posted author interviews with Mona Awad and Sarai Walker, both authors of novels about being fat. The piece is lovely. Both books are terrific — I recommend them heartily. Do read the interviews.
Then scroll down to the comments. I know, I know — the comments section to newspaper and other articles puts the worst impulses of people on full display. But in this case, it is important to read them. For those of you who are not fat, take a look at what people say — and frankly many are willing to say these things to us directly — try to put yourself in the place of a fat person hearing and seeing and knowing that these judgements are out there. Look at yourself — how many of the negative sentiments do you hold? Is your concern about the health of fat people really just a way to disguise your disgust about fat? Your own ambivalence about your body? Your fears that without tight control you would become one of the despised?
Then let me know what you feel.
Several years ago, Lane Bryant made a beautiful lingerie commercial featuring a plus-size model. It was rejected by ABC television as inappropriate, though Victoria’s Secret ads, showing far more skin, were deemed acceptable to be shown throughout the day. There was a flurry of discussion, the ad remained off the air.
Now, six years later, Lane Bryant — which is should be noted has only in the last decade or so featured plus size models despite specializing in clothing for women in that size range — again offers a commercial showing large bodies. Models. A woman holding and breastfeeding her baby. Fleshy bodies of women who are not hiding their bodies but inhabiting them.
Dove has run ads showing women of varying size in their recent commercials. Victoria’s Secret models are all but nude. But show a women whose body shows a roll of fat and suddenly it is not acceptable, or as NBC and ABC say does not comply with broadcast indecency guidelines. Thin bodies are fine. Fat bodies are not.
Whatever you think of Sports Illustrated’s swim suit issue — and believe me, I have a lot of thoughts about it — it is remarkable that they include Ashley Graham, a plus size model, as one of their cover models. Usually the so-called “plus-size” models we see are nowhere near what the average woman who buys her clothes in plus sizes looks like. Plus size in the world of models is a woman size 8 and above. That’s right — size 8! When asked by Ellen DeGeneres what plus size is, Graham replied, "“Plus size starts at a size 8 and it goes up to a size 16/18. So the majority of this room is considered plus size”. When the average American woman wears a size 14 or above, that range does not begin to look like the average Lane Bryant or Making It Big customer.
Of course in the climate we live in, no good deed like including a woman who looks far more like women we see every day can go unpunished.Up pops Cheryl Tiegs to let us know that showing a woman like Graham in a positive light glamorizes fat and supports being unhealthy. She knows this because she believes what Dr. Amos Oz says — he who says every fat patient he has suffers from heart disease, as if it should be otherwise for a cardiologist. There is always someone to tell us we are unhealthy, that we should not be encouraged to be as we are, that we must do anything and everything to conform to the standard they believe to be healthy, regardless of our actual health.
I hadn't intended for there to be so long between posts. You know how it is, time slips by and -- well, here we are.
I have been thinking a lot about how best to respond to the kinds of "helpful" opinions and advice people seem to feel free to give to those of us who are fat. You may remember that this summer I encountered such a person in an unexpected place and that I dealt with it then by writing an open letter. I talked with the experience my own analyst who suggested that expressing my anger more directly to her was something for me to consider. And that sounded like a good idea. So I worked on writing a letter to the woman who had started it all. It took several drafts to clearly and simply state my feelings without resorting to explanations or justifications. But finally I got there and I sent the letter. I didn't expect anything back because honestly the letter didn't invite further contact and I am not naive enough to think that she would have an AHA! moment and see the error of her ways.
Well she did reply. And in her reply did not respond at all to what I said about the feelings her intrusion into my life and her unsolicited advice about my body aroused in me. No, she reiterated her beliefs and held to her position.
Intense collective emotion is the hallmark of an activated cultural complex at the core of which is an archetypal pattern. Cultural complexes structure emotional experience and operate in the personal and collective psyche in much the same way as individual complexes, although their content might be quite different. Like individual complexes, cultural complexes tend to be repetitive, autonomous, resist consciousness, and collect experience that confirms their historical point of view. And, as already mentioned, cultural complexes tend to be bipolar, so that when they are activated, the group ego or the individual ego of a group member becomes identified with one part of the unconscious cultural complex, while the other part is projected out onto the suitable hook of another group or one of its members. Individuals and groups in the grips of a particular cultural complex automatically take on a shared body language and postures or express their distress in similar somatic complaints. Finally, like personal complexes, cultural complexes can provide those caught in their potent web of stories and emotions a simplistic certainty about the group's place in the world in the face of otherwise conflicting and ambiguous uncertainties. To summarize, cultural complexes are based on repetitive, historical group experiences which have taken root in the cultural unconscious of the group. At any ripe time, these slumbering cultural complexes can be activated in the cultural unconscious and take hold of the collective psyche of the group and the individual/ collective psyche of individual members of the group. The inner sociology of the cultural complexes can seize the imagination, the behavior and the emotions of the collective psyche and unleash tremendously irrational forces in the name of their "logic."
Samuel L. Kimbles; Thomas Singer (2007-03-20). The Cultural Complex (pp. 6-7). Taylor & Francis. Kindle Edition.
For the non-Jungians reading this, a "complex" is an unconscious, core pattern of emotions, memories, perceptions, and wishes organized around a common theme. For me, this notion of a cultural complex helps me to understand where the energy for the so-called "war on obesity" is coming from. Notice how the themes are repeated again and again along with images that are intended to support the the [dominant] group's place in the world in the face of otherwise conflicting and ambiguous uncertainties. The images of headless fatties, the constant drumbeat about the dangers of fat, the assumptions that fat is due to a failure of will and self-control all act to keep fat as Other.
This sign is not far from my house. To me what it says is a logical outcome of the distorted ideas about health that abound today and which I wrote about recently. Puritanism is alive and well.
Only during the last few decades has the legacy of Puritanism (operating in close partnership with the interests of capitalism) deftly lifted desire and gratification out of the equation, and replaced the notion that humans might like eating with the suggestion that we eat principally out of compulsion, illness, self-destructiveness, the desire for self-obliteration, to avoid intimacy and social contact, and so forth. As our cultural concerns have shifted from a focus on religion, God, and the afterlife to an obsession with health and (by extension) the fantasy of endless youth and eternal life, the glutton need no longer fear a punitive afterlife but, rather, death itself-a premature death caused by immoderation, excess, and slovenly self-indulgence.
Francine Prose. Gluttony (The Seven Deadly Sins) (Kindle Locations 101-105). Kindle Edition.
When next you eat today, choose something that tastes delicious. Delight in it.
I have recently re-read an important book, Against Health: How Health Became the New Morality. In their book, the authors, Jonathan Metzl and Anna Kirkland argue that what is considered healthy is becoming more and more narrowly defined and carries a moral tone.
How often have you heard things from your doctor like, "We'd like to see you at a healthy weight." and only if you think about it do you see that the term actually has very little bearing on health, especially if at the time it is said you are not ill. Or "healthy foods" -- does that mean it is not poisonous? Or what if I am allergic to a so-called "healthy food"? Is it healthy for me?
Think about it, what does "healthy" mean?
In an essay entitled "To Overhaul the System, ‘Health’ Needs Redefining", H. Gilbert Welch says
"In the past, people sought health care because they were sick. Now the medical-industrial complex seeks patients. It encourages those with minor symptoms to be evaluated and urges those who feel well to get “checked” — just to make sure nothing is wrong.
So, if health is the absence of abnormality, the only way to know you are healthy is to become a customer.
But healthy people aren’t great customers; they’re like the people who pay off their entire credit card balance each month. The money is in those in whom an abnormality can be found.
The medical-industrial complex has made that relatively easy to do.
It develops diagnostic technologies able to find smaller and smaller abnormalities. So more and more of us are found to have damaged cartilage in our knees, bulging discs in our backs, and narrowed blood vessels throughout our bodies. And far too many are also found to have “spots” or “shadows” that are seldom significant but are said to be “worrisome.” So more and more of us have knee surgery, back surgery, angioplasty and more diagnostic investigation."
If we imagine that health means the absence of illness, that is not much help either, because illness is a slipperier concept than most of us think.
appealing to health allows for a set of moral assumptions that are allowed to fly stealthily under the radar. And the definition of our own health depends in part on our value judgments about others. We see them—the smokers, the overeaters, the activists, and the bottle-feeders—and realize our own health in the process.
Metzl, Jonathan (2010-11-23). Against Health (p. 2). NYU Press reference. Kindle Edition.
Anyone indulging in behaviors that are not socially sanctioned come to be viewed as ill. Look at the number of things now called "addictions", so much so that addiction in the original sense becomes almost trivialized.
A few weeks ago when I met with that new therapist for us to become acquainted with one another, she saw my assertion that being fat does not equate to being unhealthy as indicative of my pathology. When she said, "But Cheryl, you don't see the whole picture", she was saying to me that I was denying my own "illness".
Last week Slate ran an article that at first glance appears to be a step in the right direction -- Fat People Don't Need To Be Punished. The author makes all the right noises about the failure of diets and punitive measures. Any of us can agree with this. But then there is this:
The brutal reality is that the reason a lot of adults are fat is that they were fat as children. Research shows that obese children are at least twice as likely to be fat adults as non-obese children. Children aren't generally recognized in our culture as fully capable decision-makers. It's widely acknowledged that the responsibility for keeping children from getting obese lies not with the children, but with the parents.
I have been thinking about this and the whole idea of prevention.
The action of stopping something from happening or arising. *
Now think about it -- does not prevention require that we know the cause in the first place? We know that the polio virus causes polio and developed a vaccine which then conveys immunity, or prevents the development of the disease. Knowing the cause, we could find the means for preventing it. Or knowing that being thrown from the car is a cause of automobile accident deaths, we devise means to keep that from happening, thereby preventing some of those deaths.
So how are parents to prevent their children from becoming obese? Weight is heritable to the same degree as height -- that is 70-80% of the variance is accounted for by genetics, which leaves a pretty small window for this prevention to occur. And try setting up a Google News alert for "obesity research" and every day you will find new reports of putative causes -- everything from premature birth to thinking you are fat have been cited as causative factors in obesity in just the last week.
One of the consequences of the over-hyped "obesity crisis" is that perspective gets lost. One would think that one of the goals of "health care" is guarding the health of patients yet that goal seems to fly out the window all too often when it comes to dealing with fat people.
Consider this: last week the FDA approved a second weight loss drug. It is not unreasonable to assume that given that physicians are supposed now to urge weight loss on fat patients, prescriptions for these drugs will rapidly take them up the scale of the widely prescribed. Even knowing what happened the Phen-Fen, this is likely to happen. How well informed will prescribers be about the cautions around this latest drug? How many of them will stop to consider whether the small weight loss is worth the risk?
The Consumer Reports Health blog has this to say about this drug:
According to the evidence submitted to the FDA, Qsymia appears to help people drop a few pounds. In studies, obese and overweight people who took Qsymia for one year lost 3.5 to 9.3 more pounds than those who took a placebo. But that small benefit is probably not worth the risks of birth defects, heart attacks, and strokes. In fact, two years ago the FDA rejected the drug, then called Qnexa, due to these concerns, and it is not clear why the FDA reversed course this time, since those side effects are still an issue.
The drug also carries a warning that it can increase heart rate and should not be used by people who have heart disease or have suffered a stroke. Due to the heart concern, Vivus, the manufacturer of Qsymia, is required to conduct a study to determine whether the drug poses a risk of major cardiovascular problems, including heart attack and stroke. Also too, pregnant women should not take Qsymia because it increases the risk of their children being born with a cleft lip or palate.
Mindful of the risks -- though one wonders in the face of them why the FDA approved this drug -- the FDA has set up some restrictions on it, at least initially.
Qsymia will only be available through specially certified pharmacies under a Risk Evaluation and Mitigation Strategy, or REMS, which is intended to inform doctors and patients about the possibility of birth defects.
"The very idea that a post marketing risk evaluation strategy was a condition required by the FDA for approval of this combination drug product seems like putting the cart ahead of the horse," says Marvin Lipman, M.D., chief medical adviser for Consumer Reports. "Such a study may very well result in preventable mortality and morbidity, a high price to pay in exchange for a few pounds of flesh."
And just in case you thought birth defects were the only concern, it also increases "the risk of glaucoma, kidney stones, mood problems such as anxiety and depression, and suicidal behavior or thinking about suicide". Nice, eh? Think that is a good trade off to achieve a weight loss of 3.5-9 pounds?
If it isn't already bad enough that bariatric surgery is being promoted for treating Type II diabetes, even for people who would not be considered fat, now this is posed as a real question : Would You Undergo Brain Surgery to Prevent Obesity?
Umm, no, no I would not. The procedure is in the very earliest experimental stages with mice, so we can hope this is a question that will not be seriously proposed for quite some time, if ever. But in addition, it is based on the premise that it is binge eating that is the BIG problem.
"Doing brain surgery for obesity treatment is a controversial idea... However, binge eating is a common feature of obese patients that frequently is associated with suboptimal treatment outcomes."
PULEEZE! We all know how well brain surgery worked as a treatment for mental illness, right?
Regan Chastain has a terrific post today that goes to the consequences of this War on Obesity that is now targeting folks like me. Regan is always worth reading so if you don't follow her, you should start now.
After citing an horrific example of fat bullying, Regan writes:
However well-intentioned people may be, this War tells people that they should look at fat people as the enemy. First the government suggests that we have a war on people based on how they look and that, as a country, our goal should be to eradicate these people whether they like it or not. “Researchers” then take the assumption that fat people are bad and run off with a basket of confirmation bias to figure out how to prove it – what can we be blamed for? How can they make us look expensive? HBO creates a documentary explaining how expensive obese people are based on the researchers biased conclusions. Public and private interests are encouraged spread the stereotype that fat people are gluttons who take more than our share. Everyone including and especially healthcare professionals (and celebrity barely-doctors) spreads the idea (which is refuted by all the evidence that exists) that everyone can be thin and those who aren’t thin just aren’t trying because we’re too busy being gluttonous, drains on society.
I sometimes get a sick feeling inside when I allow myself to really feel all the bias and blame directed at those of us who are fat. We know that stress is a major factor in those illnesses now attributed to weight yet this War only serves to increase the stress we experience.
I was thinking about this yesterday after reading and seeing the wonderful response of the Michigan lawmaker who, after being banned from speaking in the Michigan House, took to the capitol steps along with Eve Ensler and other women legislators to perform the Vagina Monolgues. What a great response! And I wonder if maybe we need to have The Fat Monologues to begin to show what we experience.
Near the end of her excellent book, Taking Up Space, Pattie Thomas has a wonderful long rant about being fat. In all of our desire to embrace body acceptance and to fight the good fight against bias, sometimes I think the legitimate anger and pain gets lost in the shuffle. She concludes the rant with this:
A fat woman happy with her body is a dangerous thing in the current culture. I know that writing this book will most likely bring me more grief. Being satisfied with a fat body flies in the face of several powerful interests that benefit from the belief that fat is bad. I am in the awkward position of hoping that this book is read by a lot of people and wishing that I won’t have to deal with any more negative consequences of being fat and smart in this society. There is a part of me that would just love to go live in Alaska or the Yukon with my husband and a bunch of dogs and sheep and stay as far away from people and North American culture as I can. I have to admit that I may yet do that if the dominant paradigm about my body doesn’t change soon. It is tiresome to live with the stress of this stigma. I often need to escape in some way to keep up my strength and perseverance. But escaping is difficult in a world in which we are constantly bombarded with messages about fatness, dieting and bodies.
Thomas, Pattie; Wilkerson, Carl (2012-01-06). Taking Up Space (Kindle Locations 4972-4980). Pearlsong Press. Kindle Edition.
It is tiresome to live with fat stigma. I get weary at the thought of going this fall to a new doctor and once again having to defend my right not to diet, not to be weighed, my right to be treated as a person.
I met Saturday with my new writing group. The other two women in it are younger than I am and most decidedly not fat. I had shared the introduction to my own work in progress in which I write about my experience of being fat -- you can read some of it here. One of them looked at me and asked me if I didn't think that all women experience what I wrote about. Yes, I said to her, we all wrestle with the problems of constant being evaluated based on our appearance, but being fat is an order of magnitude more difficult, is to be subjected to another huge layer of stigma and disapproval.
I came home and read Pattie's rant again and felt better -- because she knows what it is like, because I wasn't as alone. And isn't that one of the big problems we face in trying to make things change? We tend to deal with fat and our feelings in isolation from each other. Yes, we can forge connections online. But how many of us have one or more friends we can sit down with and talk about all of this with? Where are our consciousness raising groups?
My former mother-in-law died yesterday. She was 90 and widowed just 6 weeks ago. Hers was a long life lived quite well She and I were not fond of one another. We thought the one thing we shared was love for her son and our children. But there is something else we shared -- a long history of being at odds with our bodies.
She was tiny -- barely 5 feet tall and her weight hovered around 100 pounds. But she was always anxious about food and eating and her body. I used to joke that she would have a psychotic episode if her weight went above 105 pounds but in hindsight I can see and feel how much that was not a joke. She was afraid to have ice cream in the house for fear she would eat it all. She never let herself really enjoy a meal in a restaurant -- her fears led her to always order dry broiled fish, salad with no dressing and vegetables with no sauce or butter. Food was her enemy and she dared no allow herself to enjoy it much for fear it would overwhelm her. Her appearance was everything to her. She could not even come down to breakfast without her full makeup and complement of jewelry on. She would not go out of the house in anything other than high heels. This necessitated surgery on her feet more than once because she would not give up the heels.
I have been thinking for a while now about fat acceptance and what it accomplishes. It is no small feat for a woman, fat or not, to make peace with her body and accept it no matter her size or weight. For a fat woman, peace often, perhaps usually comes only after years of struggle and failed diets and internalized shame and feelings of self-loathing. There is no denying that accomplishing this, that coming to accept and hopefully cherish one's body is not only desirable but far more healthy than living with the daily stress that self-loathing and the other accompaniments of hating one's body create. I support and embrace this goal wholeheartedly, having worked hard to get to that point myself.
But, it seems to me to be at best an uphill battle if I look outside myself and my very small circle. I am open about having long ago stepped off the diet train and about my embrace of HAES and of fat acceptance. I can say that I have made small differences in the people close to me because as I have changed in relationship with my body and with fat and body acceptance, those closest to me have also. But no matter what I do, no matter how open I am, have to face the reality that I and people like me make up the tiniest part of my culture. And I cannot see right now how to make significant impact on those whose attitudes need to be changed -- doctors and other health care providers, insurance companies, media outlets, airlines, stores and on and on. Because the bias is massive and pervasive and supported day in and day out with a constant drumbeat about how bad fat is and how much a drain on resources fat people are.
Policymic, which says of itself that it is a site for "next generation news and politics" has run two articles in the last week that are actually take a critical look at the effects of bias against fat. The first one, "Can Fat People Be Healthy?" concludes:
whatever view you take of the relationship between obesity, genetics, and our environment, it's abundantly clear that weight gain is far more complex an issue than we often assume. By itself, extra body fat isn't necessarily unhealthy and getting rid of it isn't just a matter of self control. These are important points to keep in mind as we learn more about weight regulation and try to keep ourselves healthy as a matter of policy.
Good statement. And then come the comments, which are less vitriolic than usually follow anything even remotely supporting body acceptance or HAES, but still we have the whole obesity as a choice thing. And this from the very first comment:
Obesity is not just an irrational lifestyle choice
Oh my god -- someone forgot to give me the memo on my weight being a lifestyle choice. Because who in their right mind would want to pass up the opportunity to be the target of vicious verbal attacks, bias even among health care providers, having to pay more for all kinds of things from clothing to health insurance, just to cite a few of the many "benefits" of this "lifestyle". Oyyyyyy!