Dear Medical Professionals

Well, yet again the amazing Marilyn Wann has inspired me.  She shared this article on her Facebook page and of course I popped over to read it.  It’s an excellent piece on the damage caused by fat stigma and the responsibility the medical profession has towards it’s patients.  I was reading the comments and I was just struck with the desire to tell my story as a fat T2 diabetic to members of the medical profession.  I started to type a comment to the article, and what happened is I found myself writing a letter to medical professionals in general.  I have submitted it as a comment on the site (it’s awaiting moderation over there), but I decided I wanted to copy it and share it with you here.

It is of course nothing we haven’t all been saying in the Fatosphere over and over again, and it’s nothing I personally haven’t said before (repeatedly!), but I believe that we really do need to be telling our stories over and over and over, we do need to be addressing all kinds of different audiences about our experiences and perspectives, if we’re ever going to get real change in our culture towards fat stigmatisation.

So, without rambling on any more, here is my letter to medical professionals (any that care to listen).

Dear Medical Professionals

My name is Kath and I am fat (by the pointless BMI standards, I am morbidly obese at around 300lbs, but I prefer the term fat) AND I have Type 2 diabetes.  I am the one so many in the medical profession use as a cautionary tale against what happens to “bad/lazy/greedy” people who don’t live a “healthy” lifestyle.  Until I found my current doctor, not one health care professional would believe that I was not a sedentary glutton, and as a consequence I developed an eating disorder from about 13 years of age until my early 30’s, and was suicidal during that time as well.  I was starving myself and abusing both prescription weight loss drugs and other substances to try to lose weight.  Medical professionals I went to praised me if I lost weight, but chastised and even bullied me if I gained.  I always gained eventually, always what I had lost, and always some more.  When I confessed disordered behaviour, several health care professionals actually sanctioned it, and encouraged me to continue, since it was “working” (albeit temporarily).   I was rarely asked as to what I was actually eating and what exercise I was doing, but if I was, it was met with disbelief.   After all, calories in, calories out right?  How can one be fat if they are consuming less than they are expending?

In my mid-30’s, I decided that if nobody would believe me, and I couldn’t be thin and therefore worthy of space in this world, I would end it all and relieve myself and the world of suffering.  Thanks to the love of a good friend, I didn’t succeed.  But it was at that moment I opted out.  Opted out of the constant barrage of hatred that is poured towards fat people.  Opted out of dieting and employing any other methods of attempting weight loss.  I didn’t know where I was going at first, I just knew I couldn’t live that way any more, and I wanted to live, but not like I was.

Eventually, I stumbled across the concept of Health at Every Size (HaES) and my world was changed.  First step, find a doctor who listened to me and treated me as a human being, not an amorphous blob of fat to be eradicated, cured, prevented.  Second step, find a decent psychologist to help me heal the trauma of the stigmatisation I lived all my life just for existing in a fat body.  Third step, learn to eat again.  And when I say learn to eat, that means both for nutrition of my body AND for the pleasure food can give.  It means listening to hunger and satiety cues.  It means feeding myself what I need, and what fits within the life I live.  I still struggle with some disordered thinking and behaviour, but I will keep working at it until I have it beaten.  I also reclaimed my right to appear in public as a fat person, which has enabled me to do things like swimming at the beach and riding my bicycle, despite the fact that I am still ridiculed and shamed for daring to be a fat person who is active in public.

It has been about 5 years since the moment I opted out, and in that time I was diagnosed with Type 2 diabetes.  I should have known, on my maternal side, my Grandmother is diabetic, on my paternal side, two aunts, an uncle and several of my older cousins (all T2).  I am built like my Grandma and my aunts, as are my female cousins, but the male relatives with diabetes are all tall and thin.  Nobody has ever shamed the men with T2 diabetes in my family, but all of we women have experienced shaming for it.

On diagnosis of T2 diabetes, I became even firmer in my resolve to practice HaES.  Since my diagnosis, my doctor and I have worked together and with HaES and appropriate medication, my blood sugar levels are in the normal range.  I am still fat, but all my vital measures are within the robustly healthy range.

I was far more a drain on society when I was trying to get thin than I am now that I live a HaES lifestyle.  I’ve gone from suicidal, frequently unemployed due to depression and the damage I did with my eating disorder, and constantly needing medical care.  Now I have a successful career in a field that I am passionate about and contributes to society.  I am a passionate campaigner for social justice and inclusion, and I contribute strongly to the public coffers via taxes, my private health care and the work I do in social justice and inclusion.

My point in telling my story here?  “The Obese” are not a disease to be eradicated, prevented, cured.  We are not some disgusting medical condition that is costing society millions.  We do not sit at home on the sofa eating cheeseburgers.  Nor are we stupid or liars.

We are people.  We are human beings with lives, loves, emotions, needs, aspirations and value in society like any other human being.  We deserve to be treated as such and allowed to advocate for ourselves.

Please remember that.

Thank you for your time in reading this.
Kath

On Making Diabetics the Demons

Well the Fatosphere has been alive this week with discussion on the rather awful piece by Jess Weiner in Glamour magazine where she claims that body acceptance (not quite sure why she chooses the word “body” when we all know she means the word “fat”) almost killed her.

I’m not really going to talk about why her article and attitudes towards FA, not when so many other people have done it already and probably better than I could.  Check out these pieces by Ragen of Dances with Fat, Golda at Body Love Wellness, Marianne at The Rotund and on the Health at Every Size blog.

What I want to talk about in this context is Ms Weiner’s demonisation of diabetes, especially as using it as a death threat.  In her article, she quotes her blood sugar levels pre-epiphany as 99 (and states that between 100 and 125 is pre-diabetic – which would make her 99 reading PRE-prediabetic – go figure!) and also quotes her doctor as saying:

“Jess,” she said, “your blood sugar numbers show me that you are almost in the prediabetic range. If you don’t lose some weight and watch your sugar intake, you will get diabetes.”

I have to say… this is a pretty bloody alarmist statement.  Yes, Ms Weiner’s blood sugar levels were on the high side… OF NORMAL.  We also don’t know if her doctor made a prognosis on anything more than Ms Weiner’s weight and current blood sugar levels.  There’s no mention of Ms Weiner’s pre-epiphany eating habits or activity levels, but from the article one can surmise that she has been living a fairly active lifestyle already, and it is known she has a history of eating disorders.  Is  none of that a contributor to someone’s health?

This is all a prime example of just how easily fat people are given the prognosis of future diabetes, even when their blood sugar levels are in the normal range or they are active and eat well.

But let’s just say that Ms Weiner was on her way to diabetes, perhaps because she has a family history of type 2 diabetes, or for some other reason.  The reason doesn’t matter.  Let’s just say that diabetes was a known likely issue for her.

Why is body acceptance a threat to her life?  Does body acceptance (let’s go back to calling it fat acceptance) encourage people to be sedentary in their lives?  No.  In fact quite the opposite, it urges people to live their lives to the full, to find activities and pursuits that they enjoy and make them feel good.  Does fat acceptance encourage people to eat extreme levels of food with the purpose of gaining weight so that everyone is fat like us?  Not at all, fat acceptance is all about loving the body you are in, and treating it well, while nourishing it with the food it needs.  Most fat acceptance activists do not believe in changing ones body to change ones life, which includes gaining weight as much as it does losing it.  Does fat acceptance discourage people from obtaining medical care from health professionals?  Absolutely not!  Again, quite the opposite.  It encourages people to demand respectful, dignified health care that listens to the patient and works with the patient to find the best methods to encourage wellbeing in the patient, no matter what the circumstances of the patients life.

Something wants me to say to Jess Weiner – Fat/Body Acceptance… You’re doin’ it wrong!

And finally, as a diabetic myself, I get so royally fucking fed up with type 2 diabetes being used as some kind of moral measure of the population.  The minute the word diabetes comes up in a conversation about bodies, people start gasping and clutching their pearls, and screaming “Won’t somebody think of the children!!??”  While there are lots of us out there in the world who actually have type 2 diabetes, who are fed up with being used as some kind of cautionary tale for “bad” people who “let themselves get fat/unhealthy”.

The reality is, diabetes exists.  It’s not fun, it is an illness that people suffer and if not managed, it can make your health decline rapidly and irreversibly.  However, diabetes is not a death sentence.  It’s not an indication that your life is over and that you have “failed”.  Like any other chronic illness, it requires managing and some changes to your life to mitigate any problems that may arise.  It is not an indicator of who is a lazy glutton (after all, lots of thin people and active people get Type 2 diabetes as well – I have several in my family alone) or who has “failed” to take care of their health.

Unlike Jess Weiner, I am not pre-pre-prediabetic, I actually HAVE been diagnosed with type 2 diabetes and I’m fat.  That doesn’t mean I don’t want to optimise my health as best I can within the circumstances of my life, nor does it mean that I have got myself this way by “loving my body”.  It also doesn’t mean that I deserve to be demonised as what happens to lazy gluttons who are “bad people”.

It’s a complete “othering” of people who have a chronic illness and it’s disgusting that people do this.

To Ms Weiner and anyone else who wants to use diabetes to frighten people into dieting and following their “campaigns”, I send a hearty FUCK YOU!

On “Letting Yourself” Get Unhealthy

I read this post from Dr Samantha Thomas over at The Discourse and I must say, while I’m absolutely disgusted at the way Amanda Bell has been treated, sadly I am not actually surprised.  Because most of us who live in fat bodies know all too well that respectful, dignified health care is not something we can find easily, and that part of the reason so many of us find ourselves ill is because we avoid going anywhere near medical providers due to the amount of shame and bullying that is heaped on us when we do.

As I mentioned in my last post, I have recently been diagnosed with Type 2 diabetes, which is a chronic illness that comes with a whole host of it’s own shaming, which is compounded when it is suffered by someone who is fat.  I am lucky, I have a GP who is supportive, sympathetic and treats me with respect and dignity.  She also listens to me.  However I was in my 30’s before I found my beloved Doc Jo.  But I dread the thought of needing a specialist of any kind, because it is fresh in my mind the horror of having to deal with fat shaming and the general disrespect of fat-hostile medical professionals (and I use the term “professional” loosely).

But as I have read more and more on the topic of T2 diabetes, all I have found is further fat-shaming from both health care professionals and from every “expert” member of the media and the public who profess to have an opinion on a chronic illness that they neither suffer nor have studied.  The most common message is that T2 diabetics, or to be specific, fat T2 diabetics, have “brought it upon themselves” and are now “clogging up our health care system on something they did to themselves.”  Somehow thin T2 diabetics escape this criticism and are often heaped with sympathy and disbelief on how they should get a disease that the commenter believes is something that only “unhealthy fat people” get.

And just tonight, on Twitter I have had some two-bit television doctor from the UK dismissing me as “being silly” when I tried to speak to him about the disrespect and shaming that fat people suffer at the hands of medical professionals.  Clearly he fails to see that a patronising tone is not an adequate argument.

What I want to talk about today is the commonly held belief that fat people do not deserve respectful, caring medical attention and are unable to advocate for their own health.  Now, let’s pretend, for just a moment, that all the evidence we have found about there being no causal links between fatness and disease, only correlation, and we’ll pretend, just for a moment, that there are no healthy fat people, nor unhealthy thin people, and we’ll even pretend for a moment that 95% of diets and weight loss regimes do not fail over the long term.  So if we ignore all of that evidence, and pretend, just for a moment, that fat really is something that can be controlled and eradicated by diet and exercise.

Let’s just pretend for a minute (bear with me).

If that’s the case, wouldn’t that mean that EVERYBODY who engages in risky behaviour or does things that are detrimental to their own health should be shamed, bullied, intervened into and vilified for their behaviours?  Wouldn’t that mean that ANYONE who is not in 100% tip-top physical form through some kind of activity or behaviour that may possibly do damage to the human body should be held fully financially responsible (without any support from private or public health care) for their illnesses and injuries?

Let’s think about that.

Do you tan/sunbathe/expose ANY of your skin to the sun?  Well, that counts you out for respectful health care, because you’ve let yourself get skin cancer.  Do you drink alcohol?  No respectful health care for you, if you let yourself get cirrhosis, stomach ulcers or alcohol related illnesses.  How about anyone who plays sport?  If you let yourself get injured on the field/course/track/court – no respectful health care for you.  Have you ever had sexual intercourse in your life? Well if you get any of the long list of illnesses and diseases that can be contracted from just one sexual encounter, then it’s your fault, you are also exempt from respectful health care.  Do you drive a car?   If you have an accident, you let it happen, so off the list you go too.  Take public transport to commute to and from work?  Well, if the bus has an accident, or you get the flu from other people on your train – you let that happen by engaging in behaviour that has risks, so you’re off the list there.  Choose to get pregnant?  Well, all those things that can happen during pregnancy and childbirth – you let those happen by exposing yourself to that risk, so nope, no respectful health care for you either.

We could go on like this for ever.  Because every single action we do in our lives, can and does have health risks.  Not to mention that we humans do a lot of very stupid things to ourselves and end up sick or injured because of it.  We drive big metal and glass vehicles at high speeds, we perch atop small things with wheels on them and hurtle along roads, down hills and around car-parks in the name of fun or transport.  We hurl balls, sticks, spears, discs and other projectiles at each other in the name of sport.  We jump out of planes, strap huge cans of air to our backs and dive to the bottom of the ocean with big creatures that have teeth that and see us as food, we go places where there are things that can bite, sting, spear and poison us.  We have sex with all kinds of people and things, we use mind-altering substances and we engage in all kinds of purely cosmetic procedures that can go wrong.  In the name of entertainment, pleasure or convenience, we do hundreds of things that are not entirely necessary, and carry risks to our health.

Such is life.  Simply being conceived, gestated and born is the riskiest thing any human being can do – all the stuff afterwards is just the icing on the risk cake.

So why is it that fatness is singled out?  Why is it that there is this general perception that fat people aren’t capable of making informed, conscious choices about our own lives and the risks associated?  Why is it believed that we need to be shamed for our own good?

Because it’s not about health.  It has never been about health.  It is about appearance and moral superiority.  A fat person offends the eye of a fat hater (and fat hatred is encouraged in our society), so they need to be shamed and bullied until they are either thin, or hidden away where the fat hater cannot see them.  Or better still, eradicated.  And our culture encourages people to feel moral superiority over others, so as we are encouraged to hate fat, who better to claim moral superiority over to make ourselves feel better than the fatties?

Yet so many people still can’t understand why fat people avoid going to the doctor…

The One In Which I Come Out as a Diabetic

Well, last week I was diagnosed with Type 2 diabetes.

Cue the trolls:

• But you brought this on yourself!
• Serves you right, you should have just put down the cheeseburger!
• I told you it would happen eventually.
• Don’t you care about your health?
• If you’d just lost weight, you wouldn’t have got diabetes.
• Well, you’ll just have to lose weight now, won’t you?
• You’re driving our taxes/health-care costs up!!
• You’ll probably die now, thanks to your obesity.
• You’re a walking heart-attack/stroke, it’s just a matter of time.
• Turns out being fat DOES mean you’ll get diabetes after all huh?  Told you so.  Maybe you’ll see sense and give up this fat acceptance rot now.
• Get off the sofa fatty, no wonder you got diabetes, all you do is just sit.

I could go on, but we’ve heard them all before.  I just wanted to sprinkle a few out there to save the trolls some breath.

Thing is, I’m not at all unwell, nor was I when it was discovered during a routine annual blood work up (the kind every one of you should get annually, whether you’re fat, thin or in between).  I have no symptoms, and every other blood test came back embarrasingly healthy.

I’ll talk more about my thoughts, feelings and the stuff around my diagnosis later (especially about my anger in taking Metformin to prevent diabetes for YEARS but developing diabetes anyway), but I just wanted to announce to the world that I am now officially… wait for it…

 

A BAD FATTY WITH TEH DIABEETUS!

 

Guess what?  That doesn’t mean I’m lazy, that I eat too much, that I should have lost weight and I wouldn’t have got diabetes (tell that to my 81 year old Grandma and various other relatives on both sides of my family who sent that gene my way – who are a liberal mix of fat, thin and in between) or that I’m going to die.  What it does mean is that my doctor and I are working together to optimise my health and mitigate any future issues.  We are not approaching with dieting, and we are looking for a Health at Every Size (HAES) plan.

I do have to eat more.  Yes, this fatty has been instructed to eat more because I am not eating enough.  I need to add more Low GI foods to my daily intake.  The worst thing?  I cannot find Low GI information that isn’t loaded with fat shaming and weight loss crap.  It’s of no use to me if it’s shaming me for my body, only if it’s informing me on the best foods to add to my daily intake.  It’s frustrating and confusing because there is so much conflicting information and I see so much fat loathing and scare-mongering that I just opt out of viewing it all together.

There is a Facebook community for Diet Free Talk for Diabetes/Insulin Issues in infancy (email me if you want to be included – it is a closed, private group to keep the fat hating trolls out and preserve a safe space for us to talk) and I hope to come up with some more resources I can share with you all in time.

But most of all, today’s message is this:

A person’s health, and their body, is their own, and nobody has the right to judge, bully, troll, lecture, vilify, disrespect or discriminate against anyone for their health or their body shape or size.  Even if their weight DID contribute to an illness, it’s nobody’s business but THEIRS.

So unless you have something constructive and supportive to add to the topic of diabetes and fatness, you are not welcome here.