Breaking Down Fat Stigma: Self Advocacy

Published January 6, 2012 by Fat Heffalump

Following on from my last post about concern trolling, I think it’s time for us to talk about self advocacy with our bodies, our health and our lives.

Let’s start defining self advocacy.  This excellent definition comes from EDAC but you can find lots of similar versions on many social justice sites.  I like the simple language of this particular definition:

Self-advocacy is the ability to speak-up for yourself and the things that are important to you. Self-advocacy means you are able to ask for what you need and want and tell people about your thoughts and feelings. Self-advocacy means you know your rights and responsibilities, you speak-up for your rights, and you are able to make choices and decisions that affect your life. The goal of self-advocacy is for YOU to decide what you want then develop and carry out a plan to help you get it. It does not mean you can’t get help if you need or want it, it just means that you are making the choices and you have to be responsible for the choices you make.

Rembember, that as adults, our bodies, health and lives belong to us.  They do not belong to anyone else – not your family, not your employer, not your doctor.  Your body is yours to decide what to do with, what you feed them, how you move them and how you care for them.  You decide who you allow to touch them and engage in sexual activity with.  YOU are the boss of your body.

Fat people continually find themselves having our self advocacy removed from us.  We are constantly told that we don’t know our own bodies, aren’t competent to make decisions about our health and wellbeing, are “out of control” and we have our realities questioned repeatedly.  We are regularly accused of lying about what we eat and how active we are, or at least being in denial.  Our right to speak for ourselves and make decisions about our own lives is removed from us when people engage in this kind of behaviour.

When it comes to health care, it’s a bloody minefield to get decent, respectful, helpful medical care as a fat person.  We are judged incompetent to self advocate on sight of our fat bodies, are patronised, disrespected and discriminated against by the very medical professionals who we pay, either through our own payments, our private health insurance or our tax dollars, to care for us.  So often, lazy medical professionals look at us and prescribe weight loss for everything from a sore throat through to cancer.

Just to give you a prime example, some years ago (before I found my awesome Doc Jo), I hit my knee on a fence while riding my bicycle and bruised under the kneecap quite severely.  It was taking ages to heal so I went to the doctor, and even though I explained to her that it was sore because I whacked it on a metal fence while riding a bicycle, her response was “You need to do some exercise and lose some weight.”  I repeated that I actually got the injury WHILE exercising, to which she repeated “You need to do some exercise and lose some weight.”  She must have said that to me four or five times, no matter how I tried to phrase that I had got the injury while cycling.   She wasn’t listening to me at all, and it was like the only thing she could hear or see from me was “Fat!  Fat!  Fat!  Fat!  Fat!  Fat!”

It’s tough going to a doctor or any other health professional knowing that you’re likely to be shamed or ignored.  Not to mention many people don’t have the option to go to another health care provider if they don’t get treated with respect from the one they are allocated.  Thing is, we have to keep reminding ourselves that we are the owners and decision makers for our bodies and that we are the ones who actually pay for the services – again, be it through direct payment, private health insurance or our taxes contributing to public health insurance.  You are well within your rights to stop a health care provider and say, firmly and clearly “I will not consider obesity a suitable diagnosis nor weight loss a suitable treatment method, I am here to be treated for my illness/injury, not my body size.”

The good news is, you’re not alone.  We have a strong community of fabulous fat positive people who know exactly what we are going through, as they have experienced it themselves.  We have a network of Health at Every Size professionals who can give us advice and remind us of our core believes in those vulnerable times.  We also have resources from within our community, from fab fatties who have put together letters to health care practitioners, lists of fat positive health professionals and social media communities based around health and wellbeing for fat positive people.  Just off the top of my head, ones I have used are:

These are just a few that I personally have found really helpful and wonderful, please feel free to add any others in the comments.

However we of course don’t just deal with health care professionals removing our self advocacy about our bodies, but lots of other people in our lives do it too.  From friends, family and colleagues through to complete strangers, both on the street and on the internet.  Many people LOVE to tell fat people we don’t know how to look after our own bodies, and to predict our imminent deaths.   I think Amanda aka Fat Waitress from Love Your Body Detroit hit the nail on the head when she said:

I’m convinced those who think fat people are going to die and need to tell us repeatedly really fear death. By pointing at the fatty in the corner it makes them feel that their death is somehow farther off than ours.

Ding! Ding! Ding!  First prize to Amanda for summing it up perfectly.  Thing is, it’s a lie.  We all die someday, and that will be when our time comes.  Thin people die young, fat people die old.  And shaming someone about their perceived health isn’t going to change that one iota.

I also think they do it to feel superior to someone.  So long as they’ve got someone to look down on, they can cope with their own fears, low self esteem and general self loathing.

So I’ll leave you with this.  I want you to always remember that YOU own your body.  You are in charge of what you do with your health, your life, your body.  Every one of us will suffer illness and injury in our lives, fat, thin or somewhere in between, because human bodies are both vulnerable and complex.  But how you deal with those illnesses and injuries is your business.  How you decide to treat your body along the path of your life, and through good times and bad is your choice, not anyone else’s.

Anyone who tries to take that self advocacy away from you is undermining your competency.  Don’t let them take that away from you, no matter what size you are or what status your health is in.

19 comments on “Breaking Down Fat Stigma: Self Advocacy

  • A few years ago, I went to the doctor because, amongst other issues, I gained 40 pounds in a month without changing my eating or exercise habits, and hadn’t had my period in two years. The doctor told me it was normal – fat women don’t get periods, and all I needed to do was diet. I was devastated and ashamed. It wasn’t until over a year later, when I saw an ad for plus-sized pantyliners, that I realized fat women do menstruate, and maybe something else was going on. I went to a different doctor shortly thereafter, and was diagnosed with an endocrine issue that had caused all the problems I was experiencing. Unfortunately, I don’t have insurance and can’t afford to treat it. But I felt so much better knowing I had a genuine health issue that led to weight gain and wasn’t CAUSED by weight gain. That experience made me very wary of doctors, and really opened my eyes to the fact that I need to speak up if something supposedly blamed on my weight sounds weird.

    • 40 pounds in a month is NORMAL??!? What an incompetent ass. But I’ve a feeling that if you inexplicably LOST 40 pounds in a month, the same sorry excuse for an MD would probably congratulate you and tell you to keep up the good work.

    • Ugh, it makes me so angry to hear stories like this – even though I’ve had similar ones myself.

      I can promise you, and anyone reading, that fat women DO get periods, I’m over 300lbs and diabetic and I still get mine.

      I hope you can find a health care solution sometime soon prettylarge, I can’t imagine being without health care.

    • The shitty GP I used to go to made a big deal about fat women having irregular/no periods. Seriously?!

      Women of ALL sizes can have regular or irregular ones. I hadn’t gotten mine for 1.5 years due to a combination of birth control screwing up my entire system and extreme work-related stress. Once I was off BCPs, it took a few months but now I get em like clockwork.

      Any chance this stupid doctor was a man? My GP was; I honestly think over half of them are still in the Stone Age as far as periods are concerned.

      But yes, 40 pounds in a month is NOT normal. I agree with Mulberry that if it was a suspect weight *loss* of 40 pounds they’d be cheering you on….and how messed up is it that doctors have probably mis-diagnosed patients by automatically treating unintentional weight loss as a good thing instead of indicative of a problem?

      • It’s funny, one of the most common reasons women don’t menstruate is because they suffer PCOS. Yet one of the symptoms of PCOS is fatness. How many fat women are going undiagnosed as being PCOS sufferers because doctors leap to blame the fat, and not look for any underlying issues.

        • It took till I was in my 30s to get a firm PCOS diagnosis. I even went to a gyno who told me I was fat because I ate poorly and didn’t exercise and that PCOS didn’t have any interaction with obesity-I was just lazy.
          We had fertility issues-her only solution to my lack of ovulation due to PCOS was to have lapband surgery, starve myself till I weighed 65kg (losing more than 1/2 my bodyweight to do so) and then have ivf. I wonder how many people take poor advice like that instead of finally caling bullsh!t like I did.

      • Isn’t it ironic how doctors are so quick to call fat patients lazy,

        but they’re being totally lazy themselves by just jumping to conclusions about weight and not actually ASKING about patients’ issues?

  • “So long as they can feel superior…” Talk about hitting the nail on the head, my dear!
    The urge to feel superior to another is, at least in my opinion, the root of all forms of bias: racial, religious and of course anti-size. People fear what they don’t understand and the knee-jerk (emphasis on the “jerk”) reaction is to say, “I’m so much better than that!”

    Your observations are spot-on. Please keep them coming!

  • I’ve long been working on the theory that a heck of a lot of the crap in our lives, from fatphobia to cosmetics to healthfood fads to crappy sex ed, all comes down to a massive societal fear of dying, and the idea that if we just do the right things and ignore the fact our bodies are biological meat tubes then somehow we’ll become immortal or something.

  • To go along with the fabulous woman who owns my dance studio, I got super lucky when I went to the chiropractic student clinic. I have an old hip injury that I tried to get treated when it was new, but the chriopractor that I was seeing (and still owe several hundred dollars to, sigh) worked on just about everything EXCEPT that injury. Sigh. Finally learned about the student clinic, got myself an appointment there (since I have no insurance and not much money), and got lucky – the student I see is helping me a ton, and she’s a love, and she has never ONCE even REMOTELY suggested that my injury must be due to my weight. This could partly be because she’s digging into my muscles with her hands and feeling just how much muscle I have under the fat, but even before she touched me the first time, she never went there. And when I make my own inevitable comments about my weight (I’m *trying* to get better about that…), she still never goes there. They’re so hard to find, and it’s such a blessing when you get a good one…

  • “Many people LOVE to tell fat people we don’t know how to look after our own bodies, and to predict our imminent deaths.”

    Isn’t it hilarious how they talk to us as if they’re fucking Gods on Mount Olympus or something?

    Newsflash people, EVERYONE is going to die one day!

    Even if someone doesn’t take care of their body well…well, it’s that person’s concern, not some random stranger’s who thinks they are morally superior. I was at a small dinner party last week and an acquaintance of my best friend was whining about this girl she knows who says she is a vegetarian but gets sick all the time “because she just eats only pizza and cookies, how can you get any nutrition out of that? Just because you go running often doesn’t mean you can eat whatever you want!”

    Please darlin, go whine about something that actually concerns your own body, not someone else’s. And really, this person can eat whatever she wants; whether she goes running or not, because her body is her OWN. No one has a fucking duty to be healthy or to attach some moral bullshit to food, whether someone eats certain foods out of choice or circumstances.

    Akin to the BS that doctor gave you about the cycling injury, I had my own share of problems with finding a good podiatrist for my feet problems– and had left them untreated and get worse over the years because I was just so scared of having to waste time and money on doctors who’d tell me nothing but to lose weight despite being in fucking PAIN. I now have a great podiatrist who has never brought up my weight ONCE, except when he was talking about my condition and said it sometimes arises from weight fluctuation but people of all sizes and athletic conditions get it. I chalk it up to this wonderful community for giving me the strength to advocate for myself and not get browbeat by these doctors who didn’t do shit to help me with my problems; and I only wish I’d found these resources sooner so I’d be in less pain by now.

  • As a 58 plus year fat woman, I can say that the two major health problems that I have experienced were not caused by my “weight”- they were caused by genetics and sun exposure. Being the recipient of a rare gene causing a horrible skin disorder (chronic with acute debilitating flare-ups needing expensive medical treatments) from my father’s gene pool was something that my two siblings and I would have gladly avoided if it had been possible. Being a water-baby and swim fanatic through my twenties (getting excessive amounts of sun, along with lots of exercise) have created a history of melanoma fortunately both caught very early after expensive surgeries. I have one other possible genetic possibility for medical problems in the future (macular degeneration), which is also not at all influenced by my obesity!

  • You know, I have often wondered about the very thing which Amanda says in your quote.

    I remember a rather fiery debate about the ‘obesity epidemic’ over at metafilter (not sure if you are familiar with the community?) in which many ex-fat and non-fat folks kept on throwing the same argument/warnings around – imminent death, diabetes, the usual concern trolly stuff – and I tried to imagine why they are so fiercely INVESTED in monitoring someone else’s health. I came to a variety of potential conclusions, although none of them really made a great deal of sense to me. I feel, personally, that somehow our culture at some point collectively (perhaps as a result some other, repressed beastie) decided that fat makes a terrific scapegoat. It is something ‘visible’, tangible, easy to prod, poke and measure, and it is obvious enough for people to point at and make moralising judgements about – whilst keeping us numb to what I consider to be more pressing, less visible issues (poverty – invisible to the select few, wars born of greed – now there’s your mighty tax dollars!, deeper and more insidious issues of sexual politics and the whole dirty fallout of capitalism).

    Perhaps it lessens their own moral burden to claim a vicarious interest in yours? (yours meaning the collective fat person, etc).

    Perhaps it is a sort of transference: if we all point at fatty, no one will look at my own failings!

    Perhaps, as a species, we are simply slow to evolve, trapped on the proverbial treadmill of fear and judgement, of desperately seeking ways in which to offload our moral panic onto someone else’s shoulders.

    So they sever the heads off of fat folks, to lessen their guilt a little. Our culture is so disturbingly obsessed with body image/size that it has begun to look something like a new religion, and there will always be the fanatics, extremists, that age old excuse of ‘we are doing it because we care about you’.

    Morality & bodyweight ought never to have joined hands.

    *forgive my off kilter ramble*

    • I think you’re totally onto something, Lapin– I honestly think that someone who is truly happy with their life and choices isn’t going to give a shit what someone else does. It could very well explain why they go after fat people (we’re such easy targets) to make up for their own failings, be they moral, health-wise, or who knows what else.

      It’s just easier for a lame person like that to focus on someone else’s life to attempt making up for what they can’t do in their own.

      PLEASE, imagine if half the effort random strangers put into telling fat people to OMG PUT DOWN THE DONUT went to something like fighting for education, job creation, and good healthcare!

    • I think you’re on to something there Lapin.

      I actually asked on Tumblr yesterday something along the lines of with all the crap in the world, rape, murder, corporate greed, bullying, government corruption, child poverty, crappy education standards, famine and such, why are people wasting their hatred and anger on fatness??

      I just don’t get it!

      • Perhaps if society (or big brother or whoever!) trains us to blame ourselves for indulgence, we will possibly turn a blind eye to disaster, poverty and greater injustices – I have actually pondered whether it is a some sort of mass distraction, for if we are constantly self focused and reeling with guilt for self induced behaviours (smoking, eating, etc) then we are less focused upon issues outside of ourselves. Self blame and guilt create numbness, shame and fear, leaving us little energy to expend upon issues in the world at large.

        And i am possibly beginning to sound like a mini -Mulder 😉

  • I avoid going to see MD doctors if possible because of many, many bad experiences with them (Yes, I have had bronchitis diagnosed as a result of being fat by someone with an MD). I go to Physician’s Assistants, or Nurse Practitioners instead, because in my experience they are more empathetic, and are more focused on treating the problem I have come in with. My current primary physician is the name of a doctor in a group practice that I see a Physician’s Assistant in.

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