We have a right to live as we are

As I mentioned I have started to regularly read the blog Shakesville, written primarily by Melissa McEwen. She describes herself as a "progressive feminist" discussing many of the same things I discuss from my viewpoint as a gay man. She wants her blog to be a safe space, not a public square. So she welcomes disagreement, but not name-calling and other forms of oppression.

A post from a couple days ago is part of her series on "Fatsronauts 101" in which she discusses assumptions and stereotypes about fat people used to dehumanize and marginalize. That got my attention since I've been discussing diet issues for quite a while now and one of the primary purposes of this blog is to call attention to the assumptions and stereotypes about sexual minorites used to dehumanize and marginalize. I need to explore what she says. I'll refer to this as post #1.

The big statement to investigate: There is a false equivalence between "fat" and "unhealthy." I followed the link to a post McEwen wrote a couple years ago specifically discussing this false link. I'll call this post #2. She starts her rebuttal with:

There are fat people who do not have health problems, fat-related or otherwise. There are fat people who do have health problems that are unrelated to their fat. There are fat people who have health problems that are associated with, and in some cases the direct result of, their fat. And there are fat people who are fat as a result of disability, disease, injury, trauma, or some other divergence from "ideal health."
…
You don't need to take my word for it. There are studies you can find that say the same. And the ones that don't, well, I would caution you to look at the source of their funding, because it's usually someone with a vested interest in the notion that fat axiomatically correlates with a lack of health, e.g. the Diet Industry.

Oh, yes, I've been through the Diet Industry. It didn't go well. That's why I'm working through my current nutritionist. And this nutritionist has also talked about the Processed Food Industry and the Agribusiness Industry, the source of all the unhealthy food lacking in nutrition that Americans are eating.

But is McEwen's statement true? She links to two more blogs. The first is Health at Every Size where I found a reply to the top reason to shed the pounds – obesity causes diabetes. In a post by David Spero, RN, he talks about this connection:

Poverty and Blackness are both strongly linked with “obesity” and diabetes, my professional specialty. According to the Centers for Disease Control, non-Hispanic Blacks have a 90% higher diabetes rate than Whites.
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Being poor, traumatized, and discriminated against are stressful. Worrying about money and your kids’ safety and their future, and/or fearing for your life on a regular basis will make you insulin resistant and worsen your asthma. Stress raises blood pressure to prepare bodies to fight or run away from danger, and the body perceives all of these oppressive life conditions to be dangerous.

Stress makes you gain weight through the effect of stress hormones, and chronic stress makes you sick. It’s not the gained weight that makes you sick, it’s the chronic stress and unhealthy environments that cause both changes.

Another misuse of correlation taken to mean causation.

The second blog McEwen links to is Junkfood Science, which says it is a critical look at studies and news on food, weight, health, and healthcare, especially where myths and fraud might be involved. The blog hasn't been updated since 2009, though it will still be useful. It has a sidebar listing series of posts about anti-quackery, healthcare and policy, food safety and nutrition, bariatric surgery, obesity paradox, and body weight issues. I'll be exploring this one for a while.

I clicked on the first article in the obesity paradox series, titled Say it Isn't So and written by the blog owner Sandy Szwarc, an RN. In 2005 the senior research scientists of the National Center for Health Statistics, part of the CDC came out with an expose on the "grossly exaggerated and fabricated scare campaign" of the Diet Industry. This study showed the science behind the industry "had been derived from poor data and had flagrant methodological flaw. How bad was it? It didn't even account for aging, the single biggest risk factor for death, in its computer model!"

It took only hours for the Diet Industry to swing into action to discredit the report. This team included the American Cancer Society, American Heart Association, and the CDC itself. Their spin relied on most media people not reading the original report and trusting the AHA and CDC. "With that inconvenience – the truth – dealt with, the war on obesity proceeded without skipping a beat." The post concludes with this:

The whole “obesity” thing has been an easy sell because our culture has come to believe so strongly that thin is better and fat is bad, and so loves to hate fat people, that the idea of questioning it is inconceivable.

I clicked on a couple of the obesity paradox posts (there are 17 paradoxes and several supporting posts). The first one cited studies that show there is no relationship between fatness and the artery build-up that causes heart attacks. And when heart attacks happen the obese are more likely to survive. I'll call this post #3.

The second obesity paradox article I read says there is there is an inverse correlation between body mass index (BMI) and incidence of stroke and stroke survivability. That means those who are underweight (the "waif" look prized in the fashion industry) have more strokes and worse stroke outcomes than those who are overweight. The post notes that both heart disease and stroke have been declining over the last 50 years as the rate of obesity has been rising.

When I first went to my current nutritionist it was because previous diets had failed. I was quite surprised that she seemed to be so uninterested in weight – she didn't even weigh me during the first few visits. My sessions with her focused on the health of my body and healthy eating (as I've described before her definition of healthy eating is quite different from what the Diet Industry says it should be). Is my body holding onto toxins or viruses? Are there organs not working as they should? Are there nutrition components I'm lacking? Weight seemed like an afterthought. At the time that was disconcerting because my traditional medical provider has a weight limit – be under a certain BMI or go on a diet program or pay higher copays. I have another weight check by the end of March (I'd skip traditional medicine entirely except my nutritionist doesn't set bones). Though today's reading I now understand more of why she isn't so concerned about weight.

While weight may not by itself be unhealthy it is likely for many of us what we eat is making us unhealthy and making us obese. These last 50 years of rising obesity match the rise of the Processed Food Industry.

The end of post #3 mentions a medical student struggling to understand the paradox. The student suggests the improved outcome must be because obese people received better care.

To answer that I go back to post #2. Yes, fat kills. More accurately, discrimination against fat people kills. And the worst discriminators are medical professionals. Emergency crews who laugh at obese people. Doctors who tell patients that weight reductions will fix problems because the doctor refuses to look beyond the fat. An underlying condition causing the fat is not treated. Medical equipment that can't accommodate the obese. Drug trials that don't include the obese so the obese are given the wrong dosage. Patients are so viciously fat-shamed by medical professionals that they don't ask for medical care soon enough. All these kill.

Back to post #1. In addition to discrimination killing the obese, discrimination discourages large people from living. Society is telling us to lose weight before we pursue our dreams.

A commenter wrote that she used to be a fan of the TV show Biggest Loser. Then she realized the tone of the show. No matter your station in life, no matter your accomplishments, the most important accomplishment is to lose weight. Only then will your real life start.

McEwen summarizes:

I can't. I can't put myself out there. I can't wear a sleeveless shirt. I can't wear tight jeans. I can't cut my hair short. I can't try to be beautiful. I can't go on a beach holiday. I can't wear a bathing suit in public. I can't show my legs. I can't go to the gym. I can't have my picture taken. I can't go to a club to dance. I can't join the Peace Corps. I can't fall in love. I can't let myself be loved. I can't be happy. I can't live.

Not until I'm not fat anymore. And then I'll deserve it. All of it. Then I'll have permission from the galactic granter of access to life to do all the things I want to do.

That is bullshit.

It is dehumanizing bullshit. It is internalized eliminationist bullshit. It is harmful, hateful, despicable bullshit that exhorts us to remove ourselves from life as much as we can, so as not to sully it up with our imperfect aesthetics.

We have a right to live as we are and to do that right now.