Sometimes, I feel like I live in two worlds at the same time.
One of these worlds is the cozy space of the Fatosphere, where it’s okay to be whatever size I am. I’m not blamed for the health problems I have, and if I’m feeling down no one is going to tell me that losing weight would help with that.
The other world I live in is the medical/governmental/public health world, the one I occupy for work, but even if I didn’t, I would still spend some time in out of intellectual curiosity, and a desire to understand what I’m up against.
The bridge I have between these two worlds comes in the form of my public health education perspective, and a social justice set of tools (hammer, bell, song, to name a few), plus a feminist studies lens I picked up as an undergrad.
I’ve been thinking lately about the idea of “framing.” That word has multiple meanings and connotations, and I want to explore some of them. One of the meanings is the idea of being wrongly pinned as the perpetrator. In that way, fat people are “framed” for a plethora of problems plaguing society. And the “real culprits” go unnamed and unblamed.
Another meaning of framing is the concept that what we see is determined by which parts of the picture we are shown, and the frame itself influences how we see the picture. A plain or even unattractive picture in a gilt frame might come across as more appealing than a gorgeous picture in an unattractive frame. This is the “framing” I want to explore for a bit, and I will need to stop at some point and get on with my day, that includes a variety of activities including a rally to stand in solidarity with Wisconsin’s public workers.
The health problems facing people are real. Diabetes is truly increasing (type 1 & type 2). Our medical systems are ill equipped to manage health issues that fat people have, regardless of the origins of those health issues. Some people want to lose weight for what they and their health care providers perceive as health reasons, and there aren’t proven, safe long-term ways to manage weight. that are available on anything other than an extremely local and expensive basis. People who have undergone weight-loss surgery require lifelong monitoring and if they are not “succeeding,” they are more likely to be lost to follow-up, and when they show up in an emergency situation, the resources to help them are insufficient. Our environments do not support our health — especially in predominantly low-income areas — it can be hard to get food that sustains health, have the time or resources to prepare foods at home, and finding safe, enjoyable forms of physical activity can be difficult, too. The health problems that get pinned on “obesity” have as their root causes, in my opinion, social injustice. Societal neglect, and a tolerance for the accumulation of wealth while those at the lower end of the economic ladder are ignored and told they should be happy with whatever they have. It’s a recipe for poor health, and obesity isn’t a cause of poor health, as much as it is a co-morbidity of the risk factor of being exposed to social inequality.
I’m going to stop there for now. That’s what I want to think about next — how to frame the picture in a way that highlights the myriad ways that social inequality (for racial, economic, gender, or other reasons — including fat hatred) leads to poor health.
The relationship between obesity and health is not something I’m interested in ignoring. But it’s a false scent trail — leading away from the real culprits.
I’m off to mother, to show up for justice, to spread love and peace, and butter* on a piece of handmade chappati that is waiting for me in the kitchen.
* Not really butter. Earth Balance margarine. It’s the glue that holds my family together.
Quantum Acceptance 
Hi !
Could you clarify what you mean by ” extremely local and expensive” ways to manage weight? Are you talking about plastic surgery ?or i am missing something …?
i am a recovering bulimic and a big part of my recovery is accepting that there is no sane method for me to manipulate my weight.It would really help me not obsess about your comment if I had a better idea of what exactly you were talking about.
Thanks
Ps: Also Earth Balance rocks 😀
Sorry — that wasn’t clear. What I meant to say is that for some people, they have access to a provider who can help them maintain their weight over the long-term. That’s probably the 5% that everyone talks about.
There is no sane method that I’m aware of that works for the vast majority of people with regard to weight. There are some things that work for a small number of people a small percentage of the time.
I will think about “reframing” what I wrote — I wrote it in a big hurry — because the last thing on earth I would want to do would be to lend credence to the idea that there is a sane method of weight manipulation out there and it’s just a matter of people not accessing it.
Thank you for your comment and for the chance to rephrase something that was poorly written.
Are you familiar with this?: http://www.unnaturalcauses.org/
PBS in the U.S. did a documentary series in 2008 that had a deep impact on my thinking as a nursing student. I already had a solid background in social theories, and was struggling mightily to tolerate the heavy influences of distorted, uncritical perspectives being dished out in the majority of my RN/BSN courses. The blaming of patients by providers is one area where I focus my worry now in terms of an “epidemic”; the understaffing in medical facilities is approaching criminal levels–but of course these problems almost always get blamed on “bad” individuals–while the larger picture remains unseen. The larger picture being: the system increasingly constructs more and more barriers that prevent compassionate interactions and quality care. Human beings are being treated like machines or parts on an assembly line.
I don’t know how to find my place in this mess. Participating as an RN, in this system (in most places where I could work as entry level), will force me to be complicit, to collude with the ongoing insanity because, in a strange sense, I now know too much, see too much, cannot pretend I do not see what I see, and cannot pretend I do not know what I know. I don’t have the internal defenses to ignore the horrible inequities and inhumane treatments. I don’t know how it would be possible to “do no harm”–nevermind be of help–in the current system.
Yes, I’m familiar with the Unnatural Causes series.
I really appreciate the comments you’ve written, here and elsewhere.
I too feel like I’m participating in the system (as an MPH) — but by being there, I can point out where the inconsistencies are, and at least, when I interact with people, bring compassion rather than judgment in my language and interaction.
Keep commenting — your thoughts are so valuable! And the world is lucky to have an RN like you. You aren’t the only one — I know of many others, at least where I live, who share your perspective.
DebraSY pointed me here. I tend to get real wordy when attempting to identify causal links (and mis-links) related to scapegoating, and real culprits – Big Ag and their lobbies, the FDA and USDA and their selective enforcement and lack thereof – going unpunished for the havoc they wreak.
Thanks for providing an entry where I can direct people and say “This. This is exactly what I’ve been trying to tell you about”.