Facing Anti-Fatness




It's taken me more than 20 years to be able to identify as fat*. My size was a bit larger for my age as a really young kid, but beginning at age 7 or 8, my body was larger than what would have been considered “adorably chubby.” Since then, except for a few (very brief) periods of life, I’ve been fat. For most of my life, I thought that there was an amazing, self-confident, datable, happy, strong thin person just waiting to get out of this fat shell. And, why wouldn’t I? Fatness is supposed to be temporary, something that a magical combination of diet, exercise, willpower, knowledge, motivation, medication, and surgery will fix.


Identifying as a Fat Person


I navigated life, thinking daily about my need to lose weight, going on dozens of diets, joining gyms, reading books, trying medication, and even diving into weight loss research trying to find something that would work (as you can tell by the first part of this article, I never found it). My weight/size was a huge (pun intended) part of my life, both in terms of how much impact it had on my daily life and how much time, energy, and mental space I put into losing weight. Yet, it was never something that was part of my identity. In addition to being temporary (at least according to healthcare professionals, media, friends, family, books, media, etc.), being fat is widely considered something shameful, even repulsive (more on this great topic later).


It’s not that becoming a thin person is challenging or elusive - it’s downright nearly impossible.

Despite the fact that the global weight loss and diet industry is worth $263 billion, research confirms that long-term weight loss is almost impossible (seriously, that’s the name of an article summarizing research). At my size, the chances of me becoming not fat is 0.14%. Plus, repeated attempts to try to lose weight lead to a host of negative effects, such as weight gain, eating disorders, lowered metabolism, cardiovascular disease, stroke, diabetes and altered immune function (some of which are also considered consequences of being fat, isn’t that interesting?).



Accepting fatness as part of my identity and learning to live as a fat person (and a fat woman, which has its own set of challenges) means facing anti-fatness.

Dealing with Anti-Fat Bias & Fat Shaming


While prevalent, anti-fat bias in healthcare, employment, and education is well-documented and particularly harmful. Here’s a super quick (and oh so fun) rundown of research in these three areas:


Healthcare

Surveys have found that 24% of nurses said that fat patients repulsed them, 12% said they didn’t want to touch fat patients, and 31% said they preferred not to care for fat patients at all. Doctors are less motivated to help fat patients and are more likely to see fat patients as a waste of time. Fat patients are regularly denied fertility treatments like IVF and surgery for knee replacements, hernia repairs, and other conditions.


Employment

Fat people face discrimination in hiring, training, pay, promotions, and termination. When hiring managers and supervisors believe common stereotypes about fat people (such as that they are lazy, less intelligent, less agreeable, less capable, and less emotionally stable), fat candidates and professionals suffer. In employment, fat women, in particular, face more significant bias than fat men.


Education

It’s likely not a surprise to hear that fat students are bullied more than their peers. However, anti-fat bias also comes from teachers. Research studies found that K-12 teachers considered fat students a burden, had lower academic expectations for them, and rated them lower in abilities in reading and in math. Within higher education (the field I work in) fat students received fewer acceptances to graduate programs (it’s a good thing my grad school acceptance interviews were when I was at a lower weight). There are (at least) two cases of students being kicked out of college because of their weight.


Anti-fatness is perhaps the final area of identity shaming that’s still socially acceptable.

Take, for example, the Telegraph article whose author railed against a plus-sized mannequin wearing workout gear or Bill Maher making a case on his HBO show that fat shaming should be brought back (exactly where does he think fat shaming went?). Most fat people (myself included) have experienced unexpected anti-fat bullying from strangers in normal everyday settings, like a driver rolling down their window to yell weight-related insults, a shopper taking “unhealthy” food out of someone’s grocery cart, or a stranger giving unsolicited weight loss advice.


Discrimination against fat people is based on two largely unsubstantiated ideas: that weight is controllable (which means that people who are fat lack the intelligence and/or motivation to lose weight) and that fatness is unhealthy. Fat shaming has the pretense of motivating fat people to be healthy (through weight loss), even though studies repeatedly show that fat shaming can have a host of negative physical and psychological consequences, including (surprise!) weight gain.


Dealing with anti-fat bias and fat shaming isn’t just annoying and embarrassing; it’s dangerous.

Being fat isn’t killing fat people - anti-fat bias is what’s killing fat people. Literally.

In an analysis of data from two longitudinal studies of a total of 19,000 people, researchers found that people who reported experiencing weight discrimination had a 60% increased risk of dying, independent of BMI and other common physical and psychological risk factors.


Anti-fat bias is a social justice issue with far-reaching effects on as many as 2 billion adults worldwide. Many of the organizations (check out the National Association to Advance Fat Acceptance) and leaders in the field of weight stigma believe that it will take a combination of legislation and education to reduce anti-fat bias and allow fat people to lead healthier lives.


Here are a few things to think about - no matter what size body you're in:


Want to explore your own implicit bias around weight? Take Harvard's Weight Implicit Association Test.


How does knowing that research shows that sustained weight loss is nearly impossible impact the way you think about fatness?


If sustained weight loss is close to impossible and pursuing weight loss can lead to physical and psychological damage, then what does it look like for fat people to pursue health (if that's something they want)? I'm working on an article on how fat people can better navigate healthcare, using my own experiences, set to be published later this month, so stay tuned!


*About the word “fat” - I use that word to describe myself, while others prefer “plus sized,” “person of size,” or another term. I hope someday that the word “fat” will just be a descriptive adjective (like short, thin, or tall) that’s used in a neutral way. Academic studies often use the terms "obese" and "overweight," which can be offensive, since those terms pathologize fatness - I've replaced those terms with "fat."