I’m thinking about fat stigma today, in part because I haven’t lost any weight yet. It’s not surprising, of course, since I’m on .25mg of Ozempic, and then I’ll go up to .5, and some people go up to 2mg. I’ve had some gastrointestinal pain, but I’ve had that for a year—during which time I tried a variety of proton pump inhibitors and finally had my gallbladder taken out—and it doesn’t seem to stop me eating sweets. I keep remembering that Ozempic studies showed that rats given access to chocolate, which they love, took a prudent bite and then went back to their healthy pellets. That’s the goal, I tell myself. A prudent bite, and then content with healthy food.
But I’m thinking about fat stigma and how deep it goes, both in our culture and in us as individuals, because I saw myself in the mirror on the way to the scale and I thought, “Disgusting.” I wondered how my husband can still find me attractive. I had one of my fear-fantasy moments in which he dies before me, and I thought, “Well, I’ll be alone until my death if that happens.” If anyone said those things about any other overweight person around me, I’d be furious. I would point out that what I personally find attractive is humor, intelligence, self-awareness, and kindness. I’d note that people spend innumerable hours of time and mental energy trying to be thin, hating themselves for how they look, developing eating disorders, and having numerous surgeries (at a high cost in terms of both pain and money) because of attitudes like the one I just inflicted on myself. Because fat stigma causes so. much. suffering.
Let me just tell you about a few instances of fat stigma that are part of my own personal experience.
First, as any overweight person could tell you, every doctor of every kind not only weighs you at every appointment, but talks about your weight. An assistant at a chiropractor’s office once weighed me, then said, “Where do you put it all?” I don’t know if that was supposed to be a compliment, implying that I didn’t look at fat as I was, or not. I’ve been weighed at neurologist offices, gynecologist offices, allergist offices. I’ve had nurses who literally didn’t believe me when I said I walk 45-60 minutes every day with my dogs at the off-leash dog park, because how could I still be so fat if I did that? And this is from medical professionals, when even a casual google search will get you articles from as far back as 2010 pointing out that fat stigma, both internal and external, can directly cause both poor mental and physical health.
As this article says, “Beyond its severe mental health consequences, obesity stigma is also detrimental to short- and long-term physical health. Counter to traditional public health beliefs that social pressure encourages people with obesity to lose weight, ironically, evidence suggests that obesity stigma actually increases the risk of obesity.”
I wish I could persuade many relatives and friends, particularly relatives and friends of people I love, to educate themselves on this science. But if even doctors don’t know or accept these findings, why would regular people, also steeped in the poison of fatphobia, change their behavior based on it? As I said, I turned this stigma on myself just recently, and I’ve spent years educating myself about these harms.
Aside from my own numerous experiences with doctors, family, and friends, and the experiences of people I care about too much to retell their stories in any kind of detail, let me share my sister’s worst experience of fat stigma.
In the spring of 2018, my sister had some strange symptoms: she kept throwing up, at least once a week, with no discernible cause, and she was losing weight without trying to. Yes, she was a person with obesity, so she didn’t mind the weight loss, but it was still strange. I convinced her to go to her doctor, but unfortunately, her normal primary care physician, a woman, was out on maternity leave. The clinic booked her with one of the other doctors, a man. When my sister told him about her symptoms, he said, “If you go on a keto diet, that will help all this.”
By the fall of 2018, she still had the throwing up and weight loss, and she was getting winded much more easily. When out of breath, she wheezed. She was still quite overweight, and at least one doctor implied that was the reason for her breathing problems, but finally she was referred to a pulmonologist, who saw that her lungs had nodules all over. She had never smoked, which may be why he assumed that this was an infection, and it took another four months for him to discover the truth: it was lung cancer that had already spread throughout both lungs. And the throwing up and other gastrointestinal issues, which had gotten worse all this time, were caused by a tumor attached to the outside of her small intestine. A WHOLE YEAR after she went to a fatphobic doctor, she discovered that she had cancer all along.
Would a more compassionate doctor have ordered the MRI that found the abdominal tumor after she first went in? Would she have gotten treatment for her cancer earlier, gained more time before she died, in late 2019? I don’t know. But the possibility torments me.
I feel like I shouldn’t have to say this, but overweight people and people with obesity are not lazy, stupid, or self-indulgent. We work hard (my sister was a hospital chaplain AND the co-founder of an equine therapy center), have advanced degrees (she had a masters in nursing and a master of divinity), and care about others (see: nurse, chaplain, therapist for disabled kids and troubled teens).
But I do have to say those things. I have to say them over and over to myself, and in this series of writings on weight, and to those rare friends and family members who will listen, and in my head when I can’t say them out loud lest I cause more trouble for the people I would like to defend. Instead, I remind myself that fat can be a health condition for some of us, and I am lucky enough to be able to try a medication that could help me. But if it doesn’t work, I’m still worthy of every good thing.
Heartfelt! Will your challenges allow you to do additional workouts on top of the long doggies walks, Katie? I find solace and joy in being, more or less “fat and fit” with lots of strength training-weekday class and with a personal trainer biweekly, weekly yoga, lots of walks (not as much as you though! Unless I’m dog sitting). Moving a good bit typically helps my sciatica and arthritis and it’s a joy to see endurance improve and routines get easier. Best wishes always!! Sara T.
Powerful and painful