Fat Stigma, Healthism and Eating Disorders

A little housekeeping first – the zine is still trucking along nicely, thank you to those of you who have already submitted contributions, (I’ll be in touch soon if I haven’t already) and to those of you thinking of submitting something, please do!  I particularly need artwork, even just small pieces to fill in around articles and break up the text.

Trigger warning on what follows: discussion of eating disorders, prejudice against fat eating disorder sufferers and rampant healthism.

Photo by Isaac Brown for Stocky Bodies.

Now, on to the actual topic of this post!  As you know, on Tuesday night I was proud to present at the UQ Women’s Collective Diversity Week event.  One of my fellow speakers was a representative from the Eating Disorders Association Inc (EDA) and she spoke on what eating disorders are, who is most likely to be affected by them, and what methods of treatments there are.  We had some robust discussion during the Q&A portion of the event in response to audience questions.  I only wish we could have answered more audience questions, but alas, we ran out of time.

Since then, I have had a LOT of thoughts swirling around my head around eating disorders and how they relate to fat people.  As you would have seen in my last post, I have been an eating disorder sufferer for most of my life, however I was in my 30’s before I was finally officially diagnosed with EDNOS (eating disorder not otherwise specified), which technically means an eating disorder that for some reason does not fit under Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder (which has only this week been classified officially as an eating disorder).  In personal terms, for me it means that I have an eating disorder… but I’m fat, so I am excluded from being diagnosed with anorexia or bulimia, despite meeting almost all of the other criteria.  Yes, just being fat disqualifies you from having anorexia or bulimia regardless of your meeting all or most of the other criteria.

So it’s probably no surprise to any of you that I have issues with how the health care industry, most eating disorder support organisations and the general community of eating disorder sufferers treat fat people.  Particularly as it is mostly assumed that fat = binge eating disorder, which is nothing short of bullshit.  Can I put that in any plainer terms for anyone?  BULLSHIT.  Fat people are assumed to just be overeaters or binge eaters by way of being fat.  It is often believed that it is impossible for a fat person to have a restrictive or purging eating disorder, or to be involved in disordered exercise behaviours.  Even as much research (and anecdotal evidence/lived experience) there is out there showing how many fat people have engaged in these forms of disordered eating/activity, the medical profession and most eating disorder organisations still do not recognise it in fat people, and instead suggest that “denial” is one of our symptoms of what must be binge eating disorder.

What regularly happens to fat people who present with all of the markers of restrictive/purging/exercise mania is that we are told to “keep up the good work” instead of having our illnesses recognised.  Behaviours which are widely recognised as destructive, disordered behaviour in thin people, are considered a “positive lifestyle change” in fat people and actively encouraged.  It certainly was for many, many years through my suffering.

And it seems that hasn’t changed much.

So fat people are being failed by most eating disorder support organisations, the medical/health care industry and the general eating disorder community still.

The first question to the panel on Tuesday night was asking how we respond to the “But what about your health?!” demands.  As the fattest person in the room, it meant a lot to me to make it clear that my health, and in fact anyone’s individual health, is nobody’s business but their own.  That it’s not a subject up for discussion unless the person themselves wish it to be so.  You know, the “If it’s not your body, it’s not your business.” mantra.

The representative from EDA then added that she saw the situation differently, and while she started positively with stating that the same health messages should be given to all people, regardless of their body shape or size (which I agree with), it soon devolved into a lot of deeply healthist and fat stigmatising rhetoric about bell curves of mortality rates in body sizes, BMI, “obesity epidemic” and “weight risk factors”.  I was at pains to point out that as someone at one end of that “bell curve”, most of this rhetoric is deeply problematic as it has a risk of demonising and othering those of us who fall at either end of that bell curve.  It also implies that we require intervention into our health, and ignores the fact that “risk” in no way equals “certainty”.  It perpetuates an assumption that people at the ends of the bell curve are by default defective, rather than just the natural extremes of a diverse spectrum of body types.  It also perpetuates the assumption that very fat people or very thin people by default are inevitably going to suffer health issues and/or shorter lifespans that they are only statistically “at risk” for.  This is not an accurate assumption nor is it a helpful one.

I was grateful that it was also raised by someone in the audience (kudos to Amy if you’re reading this) that BMI is both an inaccurate and ineffectual measure of anything (other than ratio of weight to height) and that it is deeply triggering to not just fat people but also to eating disorder sufferers in general (which was many of the audience – since it was an eating disorders event).  BMI is often the stick that people with poor self esteem and body image, and eating disorders beat themselves over the head with.

Unfortunately, I have found healthist rhetoric like this is alarmingly common from eating disorder support organisations, and while they may be well intentioned, are causing the exclusion of many people based on body shape and size, as well as level of health.  The reality is, many eating disorder sufferers have other health issues or may be people with disabilities as well as those caused by or part of their eating disorders, and these already vulnerable people are often made to feel that they do not deserve compassionate treatment and support because they’re hearing the message that health is the most important factor in treatment and support.

We need to keep repeating the message that not only is health completely and utterly arbitrary, but it is not a moral obligation either.  Moralising health is a deeply ableist attitude.  We need to keep fighting for our personal agency in health care as well.  Yes, occasionally there are people who are genuinely unable to advocate for themselves, these are in the vast minority and most importantly, that cannot be determined by either their weight or their actual physical health.  I believe the ONLY way to assess the inability to self advocate is through thorough and compassionate psychological assessment.

As long as we as a culture continue to define wellbeing and human worth by weight and/or arbitrary health measures, we are engaging in both ableism and fat stigma, neither of which actually help people build better wellbeing.  And it’s not just fat people/people with disabilities who are affected by this.   The fear of fat and stigmatising, ableist messages about health trigger damaging behaviours in people of all sizes and levels of physical health/ability.  As long as people are afraid of being fat or place moral obligation on health, they will be engaging in damaging and indeed unhealthy behaviours to avoid being fat or unhealthy.  It is a vicious cycle of direct cause and effect that we have to break for any progress to be made, and that needs to start with the very organisations who are in place to help break disordered behaviours.

What we need an entire cultural change around health and weight and I believe that eating disorder support organisations and groups need to be at the front of this cultural change, not being dragged along by those of us on the margins.  They have a responsibility to make effort to include and support those of us who are most vulnerable to stigma and bigotry, not marginalise us further.

Falsely Filling in the Story

Firstly I want to share the amazing work of Rachele aka The Nearsighted Owl with you.  Rachele has been doing a series of “shame loss” artworks, which I think are absolutely brilliant.  You can check them out on her blog, or you can find them on her Tumblr.  I want you to go and look at them on her sites, so I’m only going to share the one with you all now, because I want to talk about it.  It is this take on the crappy Special K ad:

Image courtesy of Rachele of The Nearsighted Owl

Isn’t it fabulous?  I am loving that Rachele is creating lots of intersectional images of fat folk – people of colour, people with disibility, across gender and of varying shapes and sizes.  Some of them are naked, some are clothed, the variety so far has been great and I look forward to the others she comes up with – I really do hope she comes up with more!

The reason I’m singling out this piece is because of the horrific healthism and ableism that has come out of people responding to the artwork.  Most predominantly, that this fat woman “did it to herself” because she must have diabetes and has had a leg amputated because of it.  I know, can you believe just how fucked in the head the thinking is around the image of a fat woman with a prosthetic leg that they’ve invented a whole fucking scenario for her… from a drawing!

Let’s ignore the logic of the whole thing that she’s clearly a young woman and people who suffer amputation due to diabetes are almost always elderly and it takes many years of suffering from vascular issues before things get as drastic as amputation.  Not to mention that it’s a drawing, not a fucking photograph of an actual person.  Logic clearly doesn’t come into play with these people.

Let’s focus on the bullshit attitude that somehow because she is a fat woman she “did it to herself”.

Let’s imagine that the image is exactly the same, only she is thin. What scenario do you think these people would dream up for her prosthetic leg then?

Car accident?  Well let’s ask if the car accident was her fault?  Did she “do it to herself” then?

How about through some kind of extreme sport/thrill accident?  An accident base- jumping?  Mountain climbing?  Snowboarding?  Surfing in shark infested waters?  Would that come under “did it to herself”?

How about some of the cancers that are caused by lifestyle?  Did she sunbathe?  Smoke cigarettes?  Live somewhere near radioactive material?  Does that come under “did it to herself”?

I could go on.  But what I’m really getting at is that if this was a picture of a thin woman with a prosthetic leg, there would be no question of “she did it to herself” and the image would not be met with the disgust and dreamed-up diabetes amputation scenario that came with it as it is above.  There still would have no doubt been ableism, but the “fat chick did it to herself” people would have asked how a thin woman came to have a prosthetic leg, or assumed it was congenital, or some “tragic” circumstance

Only fat people get accused of “doing it to themselves” when it comes to disability or illness.  Fat people are never allowed to have tragic circumstances, accidents, congenital illnesses or any other reason for their disabilities, no, it’s assumed that we must be unhealthy and have “done it to ourselves”.  Even with NO information other than the person in the picture is fat and has a prosthetic leg, fat haters invent their own story for the person laying the “blame” on them.  As Amanda at Fat Body Politics says on her post Speaking Hypothetically:

Attacking a drawing, that doesn’t depict a real person, gives people who are blinded by their own prejudice an ability to try and remove their own responsibility that is connected to the harm their words cause. The issue really isn’t that they are reading a drawing of a person that was meant to be positive, but that they are trying to negate the reality that their words have been said about real people, with real bodies that live in reality. Their lives and body should never be used as a hypothetical situation.

But what REALLY pisses me is that regardless of body shape or size, what if it was a picture of someone who had an amputation because of diabetes? (Since thin people get diabetes too – ie, my paternal uncles)  It is disgustingly healthist and ableist to suggest that they “deserve” to be treated poorly.  Every single human being, regardless of level of health, physical ability, size or general quality of life, deserves to live their lives in peace and dignity, without being vilified and bullied because of their bodies.

I don’t care if someone is the fattest person on the planet and they cut their own leg off for kicks, they still deserve to live their lives in peace and dignity, and to see themselves represented and accommodated in society – fat, with a disability and any other identifying features – as valid human beings.

Genuine Concern vs Concern Trolling

Quick housekeeping – I’ve started a Tumblr for all of the troll comments I get here on Fat Heffalump.  Behold – Trollapalooza.  Be warned though, you may find it triggering, as there is an awful lot of fat hatred, threats of violence, healthist bullshit and general nastiness that comes my way.

Now, on to today’s post!

I think it’s time to talk about concern.  I’ve noticed a phenomenon, one where people don’t seem to recognise what is legitimate concern for someone’s wellbeing, and what is concern trolling for the sake of sticking your nose up in someone’s business, or using it as an excuse to shame them or make oneself feel superior.

So let’s talk about it, and learn to recognise what is genuine concern, and what is concern trolling.

Genuine concern is ok.  In fact, it’s part of what bonds us as social beings.  When someone we care about, a family member or friend, or even a colleague, is not their usual selves, when something just doesn’t seem right, or when we actually know they are unwell, and we are worried about them, we are genuinely concerned about them.  That friend who seems to have lost their energy, the colleague who has gone from calm and productive to stressed and struggling, the family member who just isn’t their usual self.  Or someone you know who is actually suffering illness (because they’ve told you they are).  It’s perfectly acceptable to ask after their wellbeing.  Things like:

• Are you ok?
• You don’t seem like your usual self, is everything alright?
• Can I help with anything?
• If you want to talk, you know I’m available for you ok?
• How are you coping with [insert illness or injury they have told you about here]?

Do know, that you shouldn’t do it because you’re curious, but because you genuinely want to help.  And also know, that if someone says they’re fine, the answer is not to nag them about it, but to say “Please know that I’m here to listen/help if you need it ok?”  Sure, sometimes “I’m fine.” is a way to fob you off when someone doesn’t want to bother you, or because they’re ashamed/embarrassed about needing help, but sometimes it’s also just “I’m fine.”

However, it is not ok to suggest someone has an illness, or that they might get an illness due to their behaviour or body.  It’s not ok to say to that friend eating a donut “Be careful, you’ll get diabetes.” or any other illness or injury.  Even if you know someone has an illness or injury, unless they have spoken directly about it in your presence, it’s not ok to question them on it.  For example, I can’t tell you the number of people who have actually asked me what my blood sugar readings are like since they found out I am diabetic.  NONE OF YOUR FUCKIN’ BUSINESS PAL!

Now, on to what constitutes concern trolling – a little 101 on how to prove yourself nothing but a trolling douchebag who doesn’t give a shit about anyone’s health but wants to shame people for their weight:

• Stating that someone being fat is unhealthy – and then suggesting they kill themselves to save us all money.
• Stating that someone being fat is unhealthy – and then bitching about how much it costs the taxpayer money.
• Stating that someone being fat is unhealthy – and then diagnosing by looking at them (or a photograph of them) that they are going to explode from hernias, high blood pressure, heart attacks, arthritis and any other number of illnesses often correlated (but never causally linked to) fat.
• Shaming someone for suffering any injury or illness by pointing out that they “caused” it because they are fat.
• Stating “I’m concerned about your health!” without knowing ANYTHING about that person other than they have a fat body.
• Attributing laziness or gluttony to someone just because they have a fat body.
• Accusing someone of being irresponsible about their health because they have a fat body.
• Demanding people prove their health, or give you information about their health and wellbeing.
• Claiming people are “in denial” about their health, or their future health.
• Insisting that you know about their health better than they do.

If you do any of the things that I’ve just listed above, you are nothing more than a bully and a troll.  There, I’m saying it out loud and clear.  I’ll say it again:

If you engage in any of the behaviours in the list above, you are a bully and a troll and you need to stop that shit right now.

I know I sound like a broken record, but I have to keep saying it over and over and over again – If it’s not your body, it’s not your business.

It’s not a difficult concept.

Next time you feel like commenting on or judging someone’s health or wellbeing, ask yourself “Is it my body?”  If the answer is no, then shut the fuck up and mind your own business.

Fatties – the next time someone tries to concern troll you, just ask them – “Is it your body?” Again, if the answer is no, tell them to shut the fuck up and mind their own business.

You don’t have to be nice, be polite, be pleasing, to anyone who concern trolls you.  You don’t have to tolerate their behaviour.  You don’t have to “respect their opinion”.  You don’t have to “not rock the boat”, or “don’t take it seriously”.  If someone is up in your business telling you what to do with your body and your health, rock the damn boat all you like, and take it as seriously as you feel you need to.  It’s YOUR body, YOUR health and YOUR life.  You get to choose what you do with it, and who you allow to have any interaction with it.

Take no fucking prisoners!

BADD 2011 – Fat and Disablism

This is my first every foray into BADD, or Blogging Against Disablism Day.  I heard about it on Twitter a couple of weeks ago and thought it would be an excellent way for me to bring the topic of disablism to my blog, to begin a discussion over here.  I firmly believe that as a social justice movement, Fat Acceptance has a responsibility to address disablism within our sphere, which then I would hope, leads to further discussion about culture-wide disablism.

Please let me state very clearly that I very much consider myself a person of privilege in this area, and feel that I am constantly in a state of learning about the issues that surround disability discrimination, disablism or ableism.  I hope that in talking about this here, an opening up the discussion, I too can learn from those who live the experience.  I particularly look forward to reading as much as I can from the many other posts for BADD, and I urge you to read as many as you can too.

What I particularly wanted to talk about tonight is disablism in context of fatness, and how people with disabilities are often ignored or excluded by Fat Acceptance.  I think all too often we spend so much time trying to bust open the stereotypes of fat people being mobility impaired, suffering chronic illness and other health issues, that we completely ignore the experience of fat people who DO live with disabilities and illness.

As Brian over at Red No. 3 says, Fat Acceptance is for ALL Fat People, or at least it should be.  That includes those who happen to be within the range of the stereotypes placed upon fat people.  As far as I’m concerned, the fact that those who loathe and fear fat use people with disabilities or illness to heap their scorn upon all fat people is doubly insulting to those who live those experiences.  Not only are they reviled for their fatness, but they are then used yet again as cautionary tales, threats and ridicule for all other fat people as well.  If anything, we need to be standing up against that bullshit even more now than ever.

One of the things that I believe Fat Acceptance absolutely has to be about is the basic, fundamental human right of all people to live their lives with dignity and respect and without fear of being vilified for simply being who they are.  That’s why I believe that Fat Acceptance needs to benefit ALL fat people and that we have a responsibility to acknowledge those who regularly have their experiences erased because society has deemed that they embody what happens to fat people who don’t “take care of themselves”.

I think we need to call that shit out for what it actually is, which is double prejudice.  Instead of just defending our own health and ability, I think we need to call out the disablism as well.  When we get those threats of “Yeah well you’re gonna get diabetes/heart disease/end up with damaged knees/hips!” and so on from fat haters, we need to point out the sheer douchiness of using disability and illness as some kind of punishment for fatness, when people of all body shapes and sizes actually live with disability and illness, and should never be treated like they must have done something to “earn” it.

Besides, even if someone’s fatness somehow does contribute to illness or disability, this should never strip them of their right to live their lives with dignity and respect.