blueollie

Fat Phobia…

This post is inspired by this one; I know that things are seldom as simple as they seem.

This is a sensitive topic for me, given that I am now relatively slender (see any of my photos) but I haven’t always been (see my photo album)

My journey has been up and down:

1982:

1991:

2000: (bascially, me from 1996 to the present)

So, I’ve gotten to see life from various sizes. And yes, when I got my current job, I was over 300 pounds and approaching my top weight (320).

Thank goodness I was in mathematics, where one is mostly judged by what one produces (both in scholarship and in the classroom). But I still got to see what life was like as a fat person: the name calling (overtly, which happened from time to time, mostly from teens in passing cars), the being unable to fit in seats, the difficulty in finding clothes, and of course the “oh my god” looks.

There is a nice article about society and how fat people are treated in it here.

Some highlights:

Walk in Deidra Everett’s shoes a moment: You know that you dress nicely; that you are well-spoken; that you are clean and friendly and funny and smart. Yet when you go for a job interview, your potential employer’s eyes tend to sweep your person and fill with horror.

You can joke about it — ”the look” — but it has happened so many times that you have almost given up. The unemployment rate in Massachusetts is under 3 percent. Your office administration skills are in desperate demand. But you, as you are often reminded by stares and gibes from strangers, are fat. Fat.

”I’m an upbeat and confident person,” said Ms. Everett, 33 years old, 5-foot-10 and about 440 pounds. ”But you get kicked enough and even the strongest people say, ‘You know, I just don’t want to be kicked anymore. I’ll be strong in my own little world.’ ”

Deidra Everett’s personal trials fit into a picture that scholars and advocates have been building for years. Over all, their work increasingly suggests that weight may now draw more open and widespread discrimination than race or gender or age. And opposition to such discrimination is mounting.

There have been lawsuits, ”size acceptance” talks, and a current campaign by a fat woman for bigger seat belts in cars, as well as the recent pushes in San Francisco and elsewhere to pass ordinances banning discrimination based on a person’s size. [...]

”Fat hatred is being taught to our children,” said Miriam Berg, president of the Council on Size and Weight Discrimination, a national nonprofit group. ”I know from how children react to me: at age 1 1/2, babies love me and smile at me; you come to 2 1/2 and already they look at me with fear; it begins that young, unless they grow up in a household with people of different sizes.”

It could be said that fat hatred begins even before birth: According to a national survey, 16 percent of the general adult population would abort a child if they knew it would be untreatably obese, said Dorothy C. Wertz, an ethicist and sociologist at the University of Massachusetts Medical School who specializes in genetics and who performed the study. By comparison, she said, 17 percent would abort if the child would be mildly retarded.

By elementary school, another study showed, children use words like ”dirty,” ”lazy,” ”ugly,” ”stupid” and ”sloppy” to describe the silhouette of a fat child.

By adolescence, fat teenagers like Emily Zimmer, an eighth grader who lives near Seattle, may be used to the teasing, but moments of mortification still abound. Recently, Emily said, she went to a fair and found that the restraints on the roller coaster were designed for bodies smaller than hers, so she could not ride.

”It was just so embarrassing,” she said. ”I was with my brother, and he thought I was mad. And I said no, not mad; I was just dejected, depressed. What if somebody I knew had seen that happen?” [...]

But for all her brains, one thing still baffles her: ”I don’t understand what people are trying to do by making fun of fat people,” she said. ”It’s not going to make them thin; if anything, it’s going to make it worse.”

Yet the teenage compulsion to be cruel to fat peers appears powerful. Consider a volley of 1998 messages still posted on the USA-Talk chat Web site about a fat eighth grader in Willowick, Ohio:

”He is the most disgusting slob I know,” one posting reads. ”Maybe it’s the six chins, or thunder thighs. Any way you look at him, you have to be disgusted. A group of us are planning a little prank at the next pep-assembly. We’re going to jump on him, drag him into the locker room and strip him naked. We’ll then shove him out into the gym for all the school to see. Maybe then people will see what a disgusting person he is.”

Other writers eventually censured the person who posted the message, but first, there was support like this: ”Oh, and you failed to mention the fact that his gold chain around his neck is buried under a mound of fat.”

A National Education Association position paper says that ”for fat students, the school experience is one of ongoing prejudice, unnoticed discrimination, and almost constant harassment.”

”From nursery school through college,” the paper continued, ”fat students experience ostracism, discouragement and sometimes violence.” [...]

The job market presents other challenges. Studies have found that fat white women tend to earn significantly less than their thinner counterparts. One study found that highly obese women earn 24 percent less while the moderately obese earn about 6 percent less. Another survey found that among 81 employers, about 16 percent considered obesity ”an absolute bar to employment” and 44 percent considered it conditional medical grounds for passing over an applicant.

Dr. Roehling’s review of 29 such studies found evidence for discrimination at every stage of the work process: hiring, placement, promotion, discipline and wages.

”I talk to managers here in Michigan, and they tell me flat out they wouldn’t hire people because they’re fat,” he said.

The elements of such discrimination may be complex. Dr. Roehling said that employers described several concerns, from worries about the costs of their health insurance premiums to worries that their customers will respond negatively to a fat employee.

The interplay of cause and effect can also be complex: is a woman fat because she is poor, for example, or poor because she is fat? In general, it does seem that obesity causes poverty and other disadvantages rather than the disadvantages that cause obesity, said Esther Rothblum, a psychology professor at the University of Vermont who has done extensive research on the stigma associated with weight.

The evidence, she said, shows clearly that being fat makes people ”downwardly mobile,” because of obstacles they face to education, work and marriage. (Studies indicate that being fat does not seem to hinder developing friendships and good relations with colleagues, she noted.) [...]

San Francisco, which passed its ordinance in May, did so at the instigation of some members of what Larry Brinkin, the member of the city’s Human Rights Commission staff who handled the issue, calls the ”fat liberation movement.” Its advocates had been pressing for years for such a law, he said, but really gained traction after an incident in which a local health club put up a billboard depicting a space alien and declaring, ”When they come, they’ll eat the fat ones first.”

Though the sign was clearly meant to be comical, advocates picketed the health club, giving momentum to the push for a law. City hearings at which dozens of fat people testified to the discrimination they had encountered, and the failure of all their attempts to lose weight, added impetus, as well.

Some in San Francisco disapproved, saying that the law was frivolous and that fat people could solve their problems simply by losing weight. The San Francisco Chronicle editorialized against the law, saying that fat people would be healthier if they lost weight, and that ”it is true that genetics can be a factor in obesity, but that is not always the case.”

The law passed the city’s Board of Supervisors unanimously, however, and now, Mr. Brinkin said, the commission is working on implementing it, wrestling with such issues as whether theaters should be asked to have a row of free-standing seats without arms that can accommodate large people. [...]

”The hardest thing to live with as a fat person is that you can’t get health insurance,” said Ms. Berg of the Council on Size and Weight Discrimination. ”When people call me up and say, ‘My H.M.O. kicked me out; what should I do?’ I have nothing to tell them. Nothing.”

A person’s weight does influence many health insurers, and a significantly overweight applicant can be turned down, said Janet Trautwein, director of federal policy for the National Association of Health Underwriters. ”It’s not an appearance thing,” she said. ”It’s just strictly a health status factor, and it’s used in combination with other factors like, ‘Do you smoke, have high blood pressure, high cholesterol or diabetes?’ ” [...]

I can see many sides: should businesses be required to spend lots of money to accomidate some overweight people? If so, how much? How overweight? 300 pounds? 400 pounds? 800 pounds?

On the other hand, weight doesn’t have much to do with, say, how well one thinks. I’d never dream of letting a person’s size could my judgement of, say, how good a scientist is.

My personal emotions
Still, I find myself a bit repulsed around the still fat, especially if they are overeating in front of me. The reminders of my past life are still there.

In fact, I am often more bothered than the “never were fat and never are going to be fat” people in my life; I see many of these because I run, walk and swim.

Sure, a friend told me: hey, it isn’t contagious (the propensity to overeat), and, if it were, you already have it. ;)

Yes, some might object that I am conflating overeating with obesity, and while some folks might have downright reptilian metabolisms, if you eat more than your body requires, you get fat. If you don’t, you won’t; it is just that a few folks don’t require much food at all.

And of course, the prognosis for losing weight and keeping it off is very grim:

The authors analyzed 46 trials that included 6,386 people who were participating in dietary counseling-based weight loss programs and 5,467 people not involved in formal weight loss programs. Programs with more frequent meetings and greater calorie restrictions tended to produce greater weight losses over time.

Approximately half the weight loss remained at three years, but almost none of the weight loss remained at five years. Obesity-related problems are among the most serious health problems facing U.S. adults. Nearly two-thirds of U.S. adults are overweight (BMI over 25), and approximately half of overweight adults are obese (BMI over 30). Overweight and obesity are known risk factors for diabetes, coronary heart disease, high blood pressure, stroke, hypertension, degenerative joint disease of the knees and hips, and some forms of cancer, among other conditions.

And the number of weight loss operations are growing rapidly.

Now about the original post that inspired this one: it is a fact that excessive fat complicates things; it adds risk factors and, as the post shows, can hide other possibly non-related symptoms, sometimes to fatal effect.

And people can be well meaning (people’s health usually improves if they lose weight in a healthy way, even a moderate amount of weight) but still make things worse anyway.

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July 13, 2007 - Posted by | politics/social

14 Comments »

  1. Thanks for your post. It is always interesting to read others’ perspectives on the weight issue. As someone who has lost 105 lbs and kept it off for almost a year (so far!), I have a lot of emotions about the whole thing. I remember how it was to be fat – how people look at you, and how icky you feel all the time. I remember the self-loathing, the shame, and burying the pain of it with still more food. However, I also know the other side now – the marvelous feeling of taking the bull by the horns and working incredibly hard to change my lifestyle. I now know the freedom of shopping for clothes in normal stores, looking great in a little black dress, and racewalking a 5K under 30 minutes. If I could go back in time and talk to myself on February 4, 2004 (the day before I joined Weight Watchers), I would tell myself not to be so scared. I’d say, “You are about to embark upon the best and most fulfilling journey of your life – enjoy the adventure!”. And today, I am loving it!!!

    Comment by Tammy | July 14, 2007 | Reply

  2. This is thoughtful, but I’m confused by the ending.

    it is a fact that excessive fat complicates things; it adds risk factors and, as the post shows, can hide other possibly non-related symptoms, sometimes to fatal effect.

    I think you may have misunderstood the post. Thorn’s mother did not die because her fat hid her other symptoms; she died because her fat made her doctor refuse to acknowledge her symptoms. She died because her doctor declined to treat her the way he would have treated a thinner patient, and because his dismissal (and the kind of behavior you describe above) instilled such shame that she was embarrassed to ask for him or anyone to look after her health. She didn’t die because her fat made her unhealthy. She died because her fat made it impossible for her to get adequate health treatment.

    Incidentally, fat is correlated with other risk factors, but causation has never been determined. More likely there are a few things going on: first, the kinds of behaviors that often cause fat can also cause risk factors, including overeating and inactivity (hardly the sole province of the fat) but also probably including dieting and disordered eating. Second, and this is significant here, fat people’s health is negatively affected because they’re afraid to go to the doctor or because doctors refuse them adequate treatment.

    Comment by Jess | July 14, 2007 | Reply

  3. A couple of comments: excessive fat indeed can cause symptoms and conditions that other things might cause (e. g., shortness of breath).

    As far as correlation: one could argue that, say, smoking is correlated with heart disease and lung cancer (and non smokers sometimes get these conditions).

    And, studies have shown that many of those correlated health problems improve with a sustained weight loss.

    Comment by blueollie | July 14, 2007 | Reply

  4. “Sustained weight loss”? Like, beyond the five years that most people take to put it back on?

    “Excessive fat” doesn’t cause shortness of breath; being out of shape causes shortness of breath. Newsflash: thin people can also be out of shape. (Unless you mean “excessive” like 500 extra pounds? You should certainly know better than to think that this level of fat correlates with clinically-defined obesity.)

    As far as correlation: one could argue that, say, smoking is correlated with heart disease and lung cancer (and non smokers sometimes get these conditions).

    Difference: causation has been convincingly proven here. I highly recommend reading Sandy Szwarc’s Junkfood Science for analyses of studies on fat. There are some great books, too, but for some reason nobody ever wants to read them.

    But you know what? You didn’t address what I actually said, which is that in the post you linked to, a real person is writing about how her mother died NOT because of fat, NOT because of “symptoms and conditions that other things might cause,” but because of a doctor’s bigotry. Whether or not adipose tissue can cause shortness of breath (of course it can, because people who get liposuction are instantly in great shape, right?) is totally not of issue. My assertion was that you missed the point, and I think you missed the point of my comment too. You can believe whatever gets you through the day about whether fat is bad for your health, but can you seriously read a post like that and ignore the fact that fat-hating doctors can be more deadly than fat could ever be?

    Comment by Jess | July 14, 2007 | Reply

  5. I am currently fighting to keep diabetes at bay because I have been moderately obese for a big part of my life. My doctor does get onto me for being ‘fat’ although he doesn’t come right out and call me fat. I walk almost every day and eat pretty healthy foods. I still snack too often but I use the excuse that my snacks are health like walnuts, etc. Now risking the wrath of the above poster I guess what I’m trying to say is that I’m responsible for my life and speaking up for myself and for the shape I’m in. Thankfully I have a loving family that doesn’t roll their eyes at me but is there for me and encourages and nourishes me in all things that matter. WE all know that smoking, drinking, driving too fast, and yes being overweight is not good for us but we do it anyway. We live with the consequences of our actions or inactions.

    Comment by Rose | July 14, 2007 | Reply

  6. About health risks:

    http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm

    These risks were determined by rigorous scientific studies.

    Of course, in every discipline there are those who refuse to accept what the vast majority of the scientific community accepts (creationists, etc.).

    As far as the doctor: yes, he didn’t communicate well; had he told me that when I was morbidly obese, I surely would have gone for treatment had I, say, twisted my ankle, gotten a severe cough, got the symptoms of a heart attack, etc., even had I not lost the weight.

    I think that I know what the doctor meant to say (as would most people who had either military type experience, or team sports experience), but there are those who will take what he said literally, and evidently this doctor didn’t understand that.

    Unfortunately, poor communication skills can be fatal in the medical profession.

    Comment by blueollie | July 14, 2007 | Reply

  7. I found your blog from another walking blog – maybe Marshall’s blog (he’s another ultrawalker)? I also have seen your name on Dave’s Clinic Alumni Yahoo group. I went to his clinic here in Salt Lake in April this year, and it was fabulous.

    Love the pic from your last 5K where you are passing the jogger. Gotta love passing runners – it’s pretty entertaining to hear their comments sometimes!

    Anyway, nice to “meet” another walker, and best wishes for happy training!

    Comment by Tammy | July 14, 2007 | Reply

  8. By the way, I have to agree with you about health risks of being morbidly obese. It is definitely well-documented in the literature, even if people don’t want to see it that way. It’s really sad when people refuse to see where the evidence is pointing, especially when it is to their detriment. (As a fellow scientist (I’m a molecular biologist), I feel your pain).

    Doctors who do not address a patient’s weight issues SENSITIVELY and in the proper manner are doing them a disservice. To ignore a patient’s morbid obesity would be like ignoring heart disease or diabetes. When I was fat, I didn’t like hearing from the doctor that I needed to change, but honestly, I needed to hear it. As long as doctors tell patients in a sensitive manner and offer the whatever assistance and advice they can give, they are doing their job. No, there is not an easy cure for obesity. It is hard to change one’s lifestyle, but it is possible, with help.

    Ollie – to what do you attribute your weight loss success?

    Comment by Tammy | July 14, 2007 | Reply

  9. Tammy, e-mail me backchannel if you want to know everything that I am doing. What I can say in public is that I belong to a support group, and that I treat my tendency to overeat in the way that many sober alcholohics treat their alcoholism.

    By the way, one of my favorite blogs is Professor Moran’s blog:

    http://sandwalk.blogspot.com

    He is a biochemist though. ;-)

    Comment by blueollie | July 14, 2007 | Reply

  10. It is cruel of you to blame Thorn’s mother for her own demise and excuse her doctor no matter how they behave. That’s the funny thing about being fat, the way that other people are allowed to be human and you are not. You are told that you are defective, physically morally and psychologically, but somehow are expected to be superior to your superiors at the same time, does that rationale sound a all familiar to you blueollie?

    Comment by wriggles | July 14, 2007 | Reply

  11. Wriggles:

    It is cruel of you to blame Thorn’s mother for her own demise and excuse her doctor no matter how they behave.

    NO!!!!!

    First of all, I am very sorry that Thorn’s mother died.

    But the reality is that, if one wants to be completely objective about things, several things contributed to her early death, which include her obesity and the doctor not communicating properly with her.

    This sad situation isn’t as simple as “it is X’s fault alone”.

    That doctor would have worked for me, but didn’t work for her, and the results were tragic.

    Here is an analogy: about 1-2 years ago, a friend’s son died in a car accident.

    Factor 1: he had a blowout and the tire was indeed defective.

    Factor 2: the kid was driving drunk (right at the legal limit) at the time.

    Moral: sometimes, it is plain wrong to say either: X was “completely to blame” or that X “was a completely blameless victim” .

    Anyway, back to my experience: so long as I continued to play the old “poor old me” game, my situation didn’t improve.

    Self pity and playing the “poor old victim” didn’t work for me (and yes, I tried it)

    Did it make those who made fun of me for my weight right? Of course not; they were boorish to act the way that they did.

    In short, I am not blaming anybody nor am I condemning the original article. In fact, I hope that this article reminds me to react to the still obese with the correct type of compassion and understanding.

    Comment by blueollie | July 14, 2007 | Reply

  12. There is no excuse — none — for a doctor telling a patient, “Don’t come back until you lose 50 pounds.” You go on and on about “the health risks associated with obesity,” and yet you can’t see that this is very much one of them?

    I doubt that what happened to Thorn’s mother was a fluke. All the time I see fat people going to doctors and being told that if they’d lose weight all their health problems would go away, even if they came in for a sinus infection. Many fat people, even if they have insurance, don’t go to doctors for that very reason, either because the doctor has flat-out refused to treat them unless they get and stay thin, or because they simply don’t want the abuse. This causes all kinds of problems — whether “associated with” their weight or not — to fester and get much, much worse.

    And just because you got and stayed thin without too much trouble — i.e. you still have a life and your health — does not mean most fat people can do likewise and that those who don’t are just lazy, self-destructive, etc. You got lucky. It’s like telling people that if they get a college degree and are willing to work 70 hours a week, they can get the keys to the executive suite by age 28. A few people will. Most will not.

    Comment by Meowser | July 14, 2007 | Reply

  13. Meowser: I disagree with your saying “no excuse”; that type of talking to indeed works for some people (example: me).

    Note: I am not saying anything about my weight loss or maintaining it (yes, I work at it constantly).

    I can say that going on and on about “poor me” and “oh, the world is just so unfair” did me no good at all. Perhaps that works for some? I wouldn’t know.

    I am not saying that I shouldn’t speak up about fat prejudice; I should!
    I am not saying that this episode shouldn’t be used to educate the medical community about appropriate ways to deal with the public; it should.

    Comment by blueollie | July 14, 2007 | Reply

  14. [...] Fat Phobia Overweight and obesity are known risk factors for diabetes, coronary heart disease, high blood pressure, stroke, hypertension, degenerative joint disease of the knees and hips, and some forms of cancer, among other conditions. … [...]

    Pingback by Healthy Speak » Blog Archive » United health group - Lifestyle News from Your Best Life | July 15, 2007 | Reply


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