Living While Fat - An American Crime

I am fat. I have been fat since I was 10. And while it was never a conscious decision about how to live, after years of personal struggle and self-realization I decided long ago to not let it get in the way of living fully. Which, by the way I do, probably way more than most skinny people.

Now I know that there are lots of people out there who are uncomfortable with the idea that someone as large as I can be professionally and personally successful, but I live to break the barriers of small-minded expectations. And although you may see me as fat on the outside, on the inside I have never been fat in the negative vitriolic way that we large people are expected to hate ourselves.

Which is why I’m still adjusting to the recent epiphany that fat people, like me, have become the latest government-sanctioned target for ridicule and bigotry in America.

It’s not like we haven’t been down the road of stigma and discrimination on a whole host of other issues in our ugly past before. Once upon a time Blacks were only 3/5ths the value of a White man and it was socially acceptable, and even fashionable, to call people Spicks, Fags, Kikes, Niggers, etc. It isn’t like fat kids have not been the joke of the playground since time immemorial, and it isn’t like adults supervising those playgrounds have not turned a blind eye to those particular rants – even in these days where there is sensitivity about bullying.

Is it not bad enough that people spit the word “fat” out as a curse word or derogatory marker? In this case, the word “fat” somehow emphasizes the terribleness of some other bad trait (e.g. “she is a fat slut” when really that slutty girl is not fat at all but a fat slut is worse than a regular old slut).

From my perch here in Tanzania it seems that what has changed is that fat is now an acceptable stigma for ADULTS and our very own GOVERNMENT to wield in America. And once again I am left wondering why it somehow makes us feel better about ourselves to put other people down for the things we fear the most. Like somehow the very presence of a fat person highlights all the insecurities we have about our own bodies – or something bigger - like the national debt.

And to make it worse, it is my own people – fellow public health professionals – that are leading the completely misguided assault on fat people. It seems that now that we’ve largely won the war on cigarettes the public health mafia needs a new place to turn their attentions.

Don’t get me wrong, it is not misguided to educate people about healthier behaviors and pitch to them the reasons why they should change, and to give them step-by-step guidance for how to make those changes. And it is not wrong to worry about the burden of obesity’s (as well as a whole long list of unhealthy behaviors) effect on our society. But in their overzealousness, my public health sisters and brothers are attacking the people who are fat rather than coming up with creative ways to deal with the undesirable behaviors or seeking to understand the true reasons why most seriously overweight people are overweight - which in my somewhat experienced opinion is really due to a complex mix of psychological and metabolic factors rather than simply too much McDonalds or Kentucky Fried Chicken.

Which leads me to why it is that I am up at nearly 2 AM on a Sunday night/Monday morning, writing about fat stigma, with my blood boiling and my face turning purple with rage. Well… it is the fault of the BBC. At 11 PM I listened to an interview with the head of student health from Lincoln University in Philadelphia describe why it is that the university plans to prevent almost 80 students with BMIs of over 30 from graduating unless they take a special fitness and health education class for obese students only. And to make it worse, arguing with an editor from the student newspaper who categorized the classes as offensive and inconsequential to the degree programs that students have completed, the BBC commentator countered that the university should even reconsider investing in fat students at all since probably not long after they graduate they will just get sick and be a burden to society, and therefore a wasted education.

WTF?

When did it become fashionable again to deny a person an education because of their outside casing? Are students who smoke, drink, take drugs, have a family history of cancer, or have unprotected sex being subjected to special classes? Are they being told that because they may eventually be a burden to society they, too, should be divested of the degrees which they have spent four years earning?

I hope those students sue the ass off that school. I will be the first in line to contribute to the legal fund.

And this leads me to ask, whatever happened to loving the sinner but hating the sin?

The truth is that when stigma increases, the ability and willingness of people to seek help for that stigmatized issue decreases. I see it all the time in my work where people living with HIV in communities where stigma is high end up denying themselves access to treatments and support that might help them live longer and put others at less risk because the social risks of seeking help are too high. Where stigma decreases, communities are better able to cope. It is in communities where the partnership between people with the disease and their friends and neighbors without the disease work together that we have seen the best successes in curbing the spread of HIV.

It is frankly the same with fat people. The more the society around us seeks to stigmatize us, the less likely we are to feel comfortable interacting with the rest of the world, taking that exercise walk around the block, or seeking the medical assistance we need to stay as healthy as possible. Think about how unpleasant it can be to visit a new medical provider when you aren’t overweight. Then imagine what it must be like for someone who is significantly overweight to get weighed (and inevitably judged) by a stranger, be given a medical gown that doesn’t fit, meet with a new doctor who is more likely to lecture than counsel, and share your body – which you are not very comfortable in – with that lecturing stranger. It can be agonizing, demoralizing and stigma enhancing.

Here in Tanzania I have become sick of opening up my MSN every morning to read another article about the fat tax on fattening foods, airlines denying seats to fat people with the happy approval of the rest of the country, or health insurance companies using fat as a preexisting condition to deny coverage to people who are even barely overweight. I don’t care if skinny Americans, are slightly put out by the very presence of fat people. For me their discomfort isn’t all that different than how some people 60 years ago didn’t want to have to ride the bus with Colored folks. Tough shit. The world is diverse, and not everyone can or should look like Heidi Klum.

Fat is a human rights issue. Stigmatizing me and my kind will not make America skinnier. It will just make us unhappier, more divided, and angrier. And by the way, none of these conditions are particularly conducive to weight loss.

**** Edited to remove a snarky comment about people doing coke to stay thin. I was trying to be ironic, but I think it just got in the way of my message.