Since MLK Day earlier this week, I’ve been moved to send emails to a bunch of friends about what we can do to address the horrible budget cuts in our state (Washington). So, that’s crowded out lots of other stuff, including some sleep, physical activity and fat-related thinking and blogging. But to me — this stuff is all related. Fat hate hits children, families, elders, women, people of color, poor people and people with disabilities in ways that intersect with and worsen problems that already make life harder than it has to be for people who fall in these groups (one or more of them).
But, as the amazing Fat Nutritionist puts it, I still seek a “unified theory” of fatness and my mind told me to get out of bed and write this post. Or it wouldn’t let me go back to sleep.
Which comes first, the fatness or the health?
When we see fatness, are we seeing a marker of poor health? Or are we seeing an outcome of poor health? Or in many cases, is it neither — a “ghost pattern” that we are trying to make fit? Not all people who are fat are in poor health. Not all people who are in poor health are fat. Some people who are in poor health who are fat would be in poor health regardless of weight, and some would be in worse health if they were to be less fat.
There’s a subset of people who are fat for whom health problems have been neglected. I don’t say this in a way to assign blame to the person themselves. But for whatever reason, there may be symptoms or processes that are happening that are not addressed, and lead to weight gain. For these people, being told “you just need to lose weight” or “eat less, move more” (ELMM) is malicious. It’s quite likely that the underlying cause of the weight gain requires attention. Giving attention to whatever is driving the weight gain is more important than losing weight or stopping the weight gain. In this subset of people, whether it’s pain or fatigue that is making exercise next to impossible, or stress, or insulin resistance, or an underactive thyroid, a compassionate and complete assessment is needed. Ideally, a HAES(SM) approach would be provided as part of the treatment without an emphasis on weight loss, but on addressing whatever is causing the symptom of weight gain to happen. Again, I’m not talking about all fat people, but those who have something going on that is causing weight gain that may be associated with another problem that can be treated.
Whose health is it, anyway?
In my opinion, health is idolized. One tenet of my religion is “you shall have no other gods before me” (I’m a Reconstructionist Jew). Health is being treated as a god (sometimes, I see this even more pronounced in the Jewish community than other communities). Such as, “if you believe in Health, you will be saved.”
Part and parcel of life is death. And illness. And disability. And being a host to other life forms. And, if we live long enough, there’s aging.
Take a tree, for example. Picture this tree early in its life. Depending on where it is planted, it may be larger or smaller, but there are in most cases some biological parameters for how large or small it will be. But it’s pretty much guaranteed to have to ward off parasites, internal and external. It may have its branches broken off in a storm. It may have a much larger tree grow nearby and block its sun. It may have suffered an injury early in its life that stunts its ability to grow to its full potential. It may have been born a little different from most of the same kinds of trees in a way that makes it larger, smaller, taller, shorter, better able or less able to ward off tree diseases. As it ages, it may become smaller, lose branches, become more vulnerable. It is no less a tree. While it is alive, it’s a living tree. When its no longer alive, its life still had worth.
We don’t owe it to anyone to be healthy, as I see it. Sure, being as free from pain and suffering as possible is an understandable thing to strive for, but none of us can guarantee it. Some of the things we do to ward off pain, suffering, disease — we may find out later cause the exact things we were trying to avoid (I think that’s the meaning of iatrogenic). Such as the knowledge we now have that dieting tends to cause weight gain (and loss of muscle tissue) in the long-term.
Being “healthy” does not make one person better than another. For me, being in good emotional health means I tend to make what I regard as better decisions, but if I’m going through a period of poor emotional health, that’s just how it goes. I’m not a worse person because of it.
How my thoughts about a woman I think is trans made me think about fatness differently
Yesterday, I was thinking about a woman I know who I think maybe has undergone a gender change. I wasn’t happy about the way I was thinking about her — wondering about her past. It occurred to me that maybe she wasn’t trans. Maybe she wasn’t ever a man. In fact, I started to think that she had always been a woman, regardless of what her appearance may have been. I realized my curiosity was understandable but not to be indulged. But thinking about her as “always having been a woman” was somehow transformational. It made me think about how people think about fatness. *
If I regard someone who is fat as “a potential thin person” — someone who is just waiting for their inner thin person to shed outer layers — I’m not seeing the person they have likely always been and will continue to be. Similarly, if someone sees me and thinks “wow, she could stand to lose some weight” — they won’t have seen that I have been both larger and smaller than I am today in my adult life, and realize that for me, where I am now is the healthiest equilibrium I can muster. Accepting (as in profound, quantum-level acceptance) that who I see before me is the person they have always been and will always be, is freeing. I can’t see into their past, or their future, and it’s beyond impolite for me to ask about it.
I had thoughts about “performing thinness” like “performing gender.” The woman I know who I thought might be trans isn’t performing femme any more or less than I am. A woman who acts as though she is always dieting isn’t “performing thinness” any more or less than someone who is “naturally thin” — when I see someone who is thin I don’t know that they are undereating any more than I can assume someone who is fat is overeating. When I dress in a way that calls attention to myself, that might not be the most slimming clothes but the ones that I like best, I’m “performing fatness” in a particular way.
What size am I, then?
One of the things that tends to keep me awake in the middle of the night is the concept of “healthy weight.” How do we know what our “ideal weight” is? I do, and I don’t, mean this in an individual sense. On a population sense, I think there are some basic parameters (with individual outliers) for sizes and weights that best support continued life, but the range that supports life is much smaller on the lighter end and much wider on the heavier end. Plus, we’ve never had this exact population before — for example, what happens when the genes of peasant Eastern European stock combines with the genes of Indigenous people from Mexico? What would that combination of genes that have survived thousands of years of cycles of famine and plenty produce in terms of size? And, as a population, we haven’t been exposed to this particular food environment ever before. So to say that there is a very narrow range of sizes or weights that are “healthy” or “normal” is ludicrous.
Are all fat people overeaters?
I like Dr. Arya Sharma (even though he’s not perfect from a fat-acceptance perspective, he is a “bariatric doctor” after all). I read something he wrote with an interested eye “binge eating disorder (BED) can be diagnosed in as many as in one in four patients presenting in bariatric centres for weight loss.” Gee, you would think that all people who are fat have binge eating disorder, based on media portrayals of us. Or that none of us have binge eating disorder, we all just need to move more (4 or more hours of intense activity a day perhaps) and eat less (than is needed to sustain life), depending on which program you are watching.
The idea of “overeating” assumes a “normal” eating and an “undereating.” What normal eating is currently defined as means that a person eats in a manner that allows them to attain and maintain a stable “healthy weight.” Now, I’m not so opposed to that definition, as long as “healthy weight” is self-defined. But even so, weight can and does fluctuate — a neat and life-preserving feature, really — so I don’t think good health requires that ones weight always stay within a very narrow range. I imagine that someone who lives and works on a farm may gain or lose no small amount of weight depending on the season, available food and what work needs to be done. Overalls tend to accommodate a wide range of weights and sizes.
So, can I go back to sleep now?
That depends. I probably didn’t muse enough, but I might give some more sleep a go.
Thanks for tuning in. Sorry for such a long series of thoughts.
*Feedback, especially if I’ve written about trans-gender in an othering way, is welcome. I’m embarrassingly cis-genered.