Body size, health and fatphobia
Using science to justify discrimination
With the health-care reform debate gearing up in the states, there has been a great deal of controversy over the current system of health insurance. Last month, a four-month old baby in Denver was refused health insurance because he was considered too fat. Despite being breast-fed and healthy in all respects, Rocky Mountain Health Plans deemed the boy, who is in the 99th percentile for height and weight, too great a risk to insure. According to current U.S. health insurance system, companies can refuse to insure individuals with a pre-existing condition — including obesity. Babies above the 95th percentile and adults with a body mass index (BMI) over 30 are almost always denied health insurance.
Here is where the line between what is acceptable and what is outright discrimination gets fuzzy. Up until a few years ago, refusing a pudgy baby health insurance might have seemed outrageous. But the “obesity epidemic” has many people convinced that our weight is our problem. A large percentage of Canadians take as fact that weight is wholly determined by what we eat and how much exercise we get.
Too bad it’s not nearly that simple.
One problem with the obesity epidemic is that many people fail to question how obesity is measured. Yes, an increasing proportion of the population is now “obese,” but by what standards? The standard measure of obesity is the BMI, which is calculated using a person’s height and weight. Nothing else is measured — not your muscle mass, not your cholesterol, not even your age. For anyone who is above or below average height, or who has an above or below average muscle mass, the BMI is utterly useless. According to the BMI, Lebron James is overweight and Dwayne “The Rock” Johnson is morbidly obese. How can anyone put their faith in a scale that would classify Dwayne Johnson as morbidly obese?
Putting aside the inaccuracy in the measurement of obesity, there is still a real problem with indiscriminately labelling every fat person as unhealthy. Several alternate theories to the obesity epidemic have come out, including the notion that we are simply a fatter generation. The increase in obesity-related death could simply be a result of humans living longer. Instead of dying from pneumonia and scarlet fever, we are living long enough to die of heart disease. The health risks associated with being overweight and obese have also been exaggerated. A 2008 study found that about half of overweight individuals are metabolically healthy. Moreover, a study in September found that exercise can significantly diminish the risks associated with obesity, irrespective of weight loss. This means that even if obesity is linked to health risks, many of these risks can be overcome through regular exercise.
So, why are people so quick to hop on the “fat is bad” bandwagon? Why is the obesity epidemic such big news? Maybe they’ve provided a convincing argument, or maybe we just wanted some excuse for the negative associations we have with fat.
Fatphobia is one of the last remaining socially acceptable forms of prejudice. In fact, fatphobia is so ingrained in society that even young children characterize their plump classmates as lazy and mean. Studies have shown that fat people are less likely to be admitted to elite colleges and to less likely to be hired. One U.S. study found that for every pound they are “overweight,” professionals sacrifice US$1,000 in salary. A survey asked 47 previously fat men and women if they would rather be blind or gain back their lost weight; 89 per cent of the respondents said they would rather be blind. At least when you are blind, people want to help you.
Weight-based discrimination has gotten so bad that fat people must now fear for their safety. Last week a woman in the UK was attacked and beaten because of her size. Her assailant called the woman a “big fat pig” before kicking her in the face and torso.
The notion that anyone can be thin makes fatphobia even more pervasive. Not only are you prey to your obsessive mothers and the media’s obsession with all things thin, now the obesity epidemic has given any jerk the right to criticize the way you look. Even doctors are jumping on the fatphobic bandwagon. Many doctors refuse to treat obese patients, and prescribe “losing weight” as a solution to anything from knee pain to headaches. Despite a wealth of evidence to the contrary, even doctors believe obesity is a lifestyle choice rather than a genetic disposition.
Fat people are not a drain on the health care system, nor are they necessarily lazy, mean or selfish. A fat person is not a source for ridicule and judgement. They are not a forecast of what you could become if you eat that last piece of cake. Fat people are just like everyone else. Some are healthy; some are not. You do not have the right to pass judgement on someone based on the way they look, and you know it.
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Discussion
This almost brought me to tears. Thank you so much. This is what I want people to know. As a fat woman... I don't hate, envy, or look down upon thin women. I just ask for that same respect and the same rights and opertunities as anyone else.
Peace, love, and big smiles. -Lexie Di
Hey Shawna - great article. Very well written. Thanks for bringing this issue to the public eye.
Obesity is not caused by eating to excess or by insufficient exercise. There has never been a scrap of reproducible scientific research or evidence to support the theory that excess calorie intake causes obesity, nor that calorie deficit reduces obesity. The theory and the advice it spawns should be abandoned forthwith. They cause great harm and suffering. When people whose blood vessels are weaker than the norm eat salt, the result is weight gain and obesity (because of excess sodium and water held in the blood vessels). This condition is sometimes called sodium retention.
Overweight people who reduce their salt/sodium intake lose some water from the body and therefore lose weight and lower their blood pressure. Eating more fruit and vegetables results in greater and faster loss of weight and further lowering of blood pressure because the potassium in the fruit and vegetables helps to displace sodium from the body.
Dieting is harmful and unnecessary. Obesity is not caused by overeating; it is caused by fluid retention in people who are sensitive to salt. Reducing calorie intake and going hungry will not reduce obesity. Giving up dieting and concentrating instead on avoiding salt and salty food will reduce obesity.
A major cause of salt sensitivity is a side-effect of sodium and water retention from prescribed medications, including certain steroids, HRT, tricyclic anti-depressants, anti-psychotics, anti-epilepsy drugs and some other drugs. The ever-increasing prescribing of powerful pharmaceuticals by doctors who are often ill-informed about their side-effects (by a drug industry not well-known for being open about problems with their products) needs to be curbed by law.
Similarly the food industry should be legally obliged to reduce the amount of added salt it ladles into its products, not by some far-off future date, but PDQ!
80% of the salt we eat comes from processed foods. And it is not just the obviously salty ones, such as crisps and bacon, that cause the trouble. Bread and most breakfast cereals contain surprisingly high amounts of salt. Food that would otherwise be considered "healthy", because it is low in fat and sugar, will actually be unhealthy if it is high in salt. A bowl of cornflakes and two slices of toast with low fat spread is an unhealthy high salt breakfast, a "slimming" soup and cottage cheese salad with low fat mayonnaise and a piece of wholemeal bread is an unhealthy high salt lunch, and a calorie-counted ready meal is often an unhealthy high salt evening meal. The three meals together provide an unhealthily high salt total.
Low-fat foods promoted as 'slimming' foods will not help you lose weight if they are high in salt, which many of them are.
The recommended maximum daily intake of salt for adults is 6g. - This is too high for people who are very obese or are taking any of the drugs which cause sodium retention. People who are very overweight or are pregnant and/or who also have any of the other health problems associated with salt sensitivity or sodium retention would experience great benefit from lowering their salt intake much more than this.
The recommended maximum daily intake of salt for children is 3g. - This is too high for very small children and far too high if a child is taking a prescribed medication that causes sodium retention. It is best for children to eat as little salt and salty food as is reasonably possible. Salt is much more harmful for children than it is for adults.
If you are overweight, remember: there are no calories in salt - but if you cut down on salt and salty food you will easily lose weight.
Lose weight by eating less salt! - Go on! - Try it! - You will feel so much better!
Kudos to you Shawna. I am so impressed that SOMEONE is saying this in the media, and not just a card carrying member of the fatosphere.
As a card carrying member of the fatosphere myself, I have been active in campaigning for respect, dignity and equality for all regardless of body shape and size for some time now. But it is difficult to change people's perceptions without support from the media and vocal spokespeople from the medical field.
I'm a long way from Manitoba (in Brisbane, Australia) but I am thrilled to have come across this piece.
Not to mention all the active harm done by the medical profession by blaming everything on weight rather than looking for a cause - my cancer went undiagnosed for 18 months because extreme weight gain and fatigue were obviously from being fat and lazy, not from a thyroid tumour. I'm not the only one in that situation, either. Thanks for speaking up about this irrational hatred.
I'm surprised that you think fatphobia is one of the last acceptable prejudices, though, just after the state of Maine voted to deny equal rights to gay people. Fatphobia affects me more day to day, homophobia and sexism (to which fatphobia is closely tied) affect the shape of my whole life; I'm sure others find the same with racism.
Margaret:
I don't know about this salt thing. It can't be true for everyone who is fat.
People NEED salt to survive. When sweating alot or being sick and losing fluids, people drink lightly salted water. To ask someone to cut out salt is dangerous without that person going to their doctor first.
I do not reccomend anyone try this before first seeing their doctor.
Though, I agree with you that water retention may be the cause to SOME weight gain, I don't believe it's all of it for everyone.
In the end, it just seems like more weight loss advice. Another diet that potentially will not work and more self hate if/when it fails.
I think the best thing to do is go by Health At Every Size (HAES) which focuses on healthy eating, enjoyable exerscise and self-love to live well. Cutting out salt without medical advice and as a weight-loss technique does not seem smart to me...
Thank you, Shawna. Sincerely.
fabulous article Shawna! As the mother of an 8 year old who has been at or above the 95% percentile since infancy, I really appreciate you pointing out the insanity of labeling these children as obese or unhealthy. My breast milk was fantastically nutritious and perhaps set the stage, along with genetics (which is 60-80% of the equation), for my daughter to be significantly taller and heavier than her peers. Smarter too as a matter of fact ;-) Fat oppression should be a crime especially when it is used to harm and discriminate against children. Thank you!