What We Don't Talk About When We Talk About Fat

by Aubrey Gordon

I believe that I deserve to be loved in my body, not in spite of it. My body is not an inconvenience, a shameful fact, or an unfortunate truth. Desiring my body is not a pathological act. And I’m not alone. Despite the never-ending headwinds, fat people around the world find and forge the relationships they want. There is no road map, so we become cartographers, charting some new land for ourselves. We live extraordinary lives, beloved by our families, partners, communities. Fat people fall wildly in love. Fat people get married. Fat people have phenomenal sex. Fat people are impossibly happy. Those fat people live in defiance of the expectations set forth for them. Their fat lives are glorious and beautiful things, vibrant and beyond the reach of what the rest of us have been trained to imagine. Let’s imagine more.

Hiles’s experience illuminates the ways in which many healthcare providers rely on understanding their patients through what health policy and women’s studies scholar Anna Kirkland calls “actuarial personhood,” in which groups of people—such as fat people—are defined solely or primarily by the risk they are seen to pose.

Research has also linked internalized weight bias to prediabetes and “a conglomerate of cardiovascular disease risk factors that strongly increases the risk for diabetes, heart disease, and stroke.”

That is, what we think of as health risks associated with being fat may in fact be health risks of experiencing discrimination and internalizing stigma.

“It sounds like your health matters a lot to you,” he offered, his eyes meeting mine. And suddenly, I wept. Mine was a wailing and irrepressible grief, called up only by this simple act of recognition. All the years of effort, all the machinations to avoid humiliation and erasure, and someone had finally noticed. Later that day, I realized that despite years of trying, no one had ever told me that I cared about my health. And I did. I do. “I’m sorry,” I told him. “I don’t know why I’m crying.” But we both knew. The dam had burst. In the coming days, I waited for test results, nervous as anyone would be. But my heart beat steadied. The blood calmed in my veins. The waters found their cadence, flowing easy and fast over the wreckage of the dam. I didn’t know what came next, but I knew that at least I’d be heard.

I didn’t know what came next, but I knew that at least I’d be heard.

Ends each chpter with an example or a thoughtful invitation toward seeing fat people differently.

END THE LEGAL, WIDESPREAD PRACTICE OF WEIGHT DISCRIMINATION

Offers a list of things we can do

As it stands, hospitals are not required to have equipment on hand that accommodates fatter people, from exam tables to MRI machines. Doctors are free to set weight limits on the patients they’re willing to see, and some do.

The FDA doesn’t require testing of drugs on fatter people, which means that crucial drugs like emergency contraception have significantly reduced effectiveness on people who weigh more than 165 pounds.