Sunday, October 05, 2008

Fat Acceptance

I don't know too many women who are happy with their weight. It's a topic that comes up often in psychotherapy, and the degree of someone's distress seems to have little to do with the patient's actual weight: slim, fit women are often obsessed with wanting to be a few pounds lighter, and while heavier women also wish to be thinner, their distress isn't proportionally more-- so someone who is 50 pounds heavier than they'd like to be is not necessarily 10 times more distressed than someone who is 5 pounds heavier than they'd like to be. And outside of therapy, in the course of conversation with friends, oh, it seems if you stick people in a room for long enough, the subject of weight and diet becomes inevitable.

It seems we've all signed on to the idea that thinner is better and thinner is healthier. We take this as a given and somehow it's something we've bought into so strongly that we don't even question it. It's unhealthy and that's the refrain, but we also think fat people are fat because of laziness, lack of self-control, bad habits, and "how did she let herself get so fat?" In essence, it becomes okay to blame people for being heavier than we think they should be, and often they agree.

Okay so...and you knew I was going today's Sunday New York Times Magazine, Robin Marantz Henig writes in "Losing the Weight Stigma" :

Scientists who study obesity at the cellular level say genetics determines people’s natural weight range, right down to the type and amount of food they crave, how much they move and where they accumulate fat. Asking how someone got to be so fat is as meaningless as asking how he got to be so tall. “The severely obese have some underlying genetic or metabolic difference we’re not smart enough to identify yet,” says Dr. Rudolph Leibel of Columbia University Medical Center. “It’s the same way that a 7-foot-tall basketball player is genetically different from me, at 5-foot-8.”

Fat has been blamed for cardiac trouble, diabetes and some forms of cancer. But fat-acceptance activists argue that the epidemiological studies that link fatness to disease often fail to adjust for non-weight-related risk factors found more often in fat populations. Poverty, minority-group status, too much fast food, a sedentary lifestyle, lack of access to health insurance or to nonjudgmental medical care, the stress of self-loathing and being part of a stigmatized group — all are more common among fat people, and all are linked to poorer health outcomes at any weight. This makes it harder to say to what extent an association between obesity and disease is due to the fatness itself or to the risk factors that tend to go along with being fat.

It remains an open question, one deserving of further scientific scrutiny, whether the health risks seen in fat populations are caused by the fat itself or by something else. Only then can we really know how to effectively wage the war on obesity — or if such a war even needs to be waged.

Henig makes the point that there are many slim people with cardiac disease, diabetes, and cancer (illnesses associated with being overweight) and that half of overweight people-- and a third of obese individuals--- have normal blood pressure, cholesterol, and blood sugars.

The issue of "health" gives credence to the belief that it's best to be slim-- but regardless of the health issues, as long as thinness is equated with attractiveness, we might all still want to be a little thinner.


Awake and Dreaming said...

I have an awesome doctor. She hasn't bought into the whole fat is completely evil thing. She's much more concerned with my blood pressure, cholesterol, and pulse and stuff then the fact that I'm overweight.

I know though, that as an overweight woman, there is SO much stigma. And the thing is, I'm not immune to it. It's the little things, like seeing someone really over weight in McDonalds, or getting whipped cream at Starbucks, that sets off my biases. I don't like anyone to see me eat the "bad" foods, so they don't think the same about me. I realize my biases, I understand them, and I work to change them, but they're still there.

Joylene Green said...

We do have so many stereotypes about fat people... and the bias is perpetuated in the media. I'm glad to hear more folks talking about the issue. Great post.

Anonymous said...

Hm, I'm at the upper end of my normal weight and while I wouldn't go as far as happy, I'm certainly content or indifferent. My thinner sister kids me occasionally but I think it says more about her.

Screw the double standard for women, I'm not having it. I am not my appearance and especially not the clothes I wear. Let others have the men who only care about having pretty things to look at in their relationships, or who need some sort of trophy wife. It seems as insane to me as it always has.

I've only touched a "girl magazine" a handful of times in my life though...maybe that's why I'm not convinced I'm not allowed to be happy as is. They all seem to be about eyeliner and diets and how to be sexy and crimes against fashion. In otherwords, snore. Give me SciAm or Wired any day of the week.

Anonymous said...

I'm at least 20lbs underweight and i'm "Fatter" now, than i was 15lbs ago!!! There is always a fine line between "dieting" and "eating disorder mentality". It seems to be the same thought process... "I'm not good enough as I am, what can I fix?"

Searching for happiness like that is a little like being delayed at an airport. You are promised this amazing new happy life in The Land of Thin, but the plane never actually leaves.
Lola x

Anonymous said...

There have been some articles about TOFI's (Thin Outside Fat Inside) that basically talks about how overall body fat is not indicative of fat in arteries, around organs. Check out:

Still, as a society, America is getting heavier. This is pretty undisputable, especially if you look at kids. This wouldn't be possible if weight is entirely genetic. So while you can't look at any one person and draw a conclusion, I think it would be putting your head in the sand to really not think choices make a difference.

shraddha said...

i am fat and distressed about it!:):)


Anonymous said... am the fattest I have ever been. I think normal for my height in 120. I am ~200. My doctor told me that 150 would be a healthy weight for me. Yeah, and I got that advise when I was only 175 lbs.

I just keep eating and eating when I am stressed out. I am like one of those people who when they have a bag of chips or something, they will notice an hour later that the bag was gone and barely remember eating them. That is me when I am stressed out.

When I am not stressed out, I still have issues...but they are now much worse with the psy meds. It sucks, I hate my appearance. Even my face is fat.

Novalis said...

There is of course the rarely taken Falstaffian path of defiant, willing obesity. It is scandalous for any doctor to say, but does health have to be the highest value in life? If obesity is partially a mental disorder (as some have very questionably proposed), then arguably the problem is not the weight, but the dysphoria that may go with it (and the society that helps to generate such dysphoria). Falstaff can thumb his nose at endocrinologists, psychiatrists, etc.--he is who he is, deal with it.

Anonymous said...

Perhaps the negative thoughts of obesity are the reasons for being obese. Perhaps its a safety of some kind. Just another form of keeping distance from others?

If there wasn't such a stigma about weight then maybe there wouldn't be such a focus on weight and the reasons why.

An attempt at addressing the symptom is sometimes all we have to go by - maybe it's better than nothing. But what if interfering (with good intentions of course) is not the best prescription?

I don't know... roses

Anonymous said...

When I am extremely busy like now...leave to teach at 6:30am and get home 4:30pm and twice a week take teaching credential classes from 4:30-8pm so home at 9pm followed by 3-4 hours of preparing lesson plan, correcting papers for another 1-2 hours, I tend to gain weight. Why? 1. No time to cook so I eat things that they sell where I teach and where I go to school that I would not if I were cooking. 2. No exercise on the long days and I used to walk 2 hours a day. 3. The hunger that's necessary to keep me at a thinner weight is too much of a stressor to handle when I ALREADY have a lot of stress on me.

Meanwhile I can't STAND being overweight perhaps because it's judged so poorly in our society and I internalize that view.

My theory on the obesity epidemic is that it's been caused in part by the bovine growth hormones in milk and meat. The use of hormones started when I was a child in the 1950's and I was forced to drink 3 full glasses of milk daily. I'd bet they did not know the "right" amount of hormone to use at that time and probably had time periods of excessive hormones in the milk. Since humans metabolize bovine growth hormone much the way cows do, is it any wonder that a drug that makes cows lactate earlier and be bigger, heftier, fatter wouldn't do the same to humans? Why has nobody studied this effect?

I have to acknowledge fast food, packaged foods, and less work and less walking into the equation.

Dragonfly said...
This comment has been removed by the author.
Dragonfly said...

It is an interesting issue. I am reminded of Susie Orbach's book "Fat is a Feminist Issue".
Great post!

Anonymous said...

EEK, I would rather be fat and happy than thin and miserable. I keep sending you email and you don't get them or something. Go sox. abf

Lisa Sargese said...

All my life my ailments were dismissed as "co-morbidities" of my size. Thank god I'm not alone in this. Thanks for exposing the discrimination and for this blog!!

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