Friday, August 17, 2012

Fat, health, and the right to get sick

I've heard some discussion, and would like to hear more, about the pressure on advocates of Health at Every Size (TM) advocates to maintain perfect health. I think HAES (TM) carries a greater burden of proof than other approaches to health. It is still controversial, and still has to battle the prolific (and abundantly funded) claims of anti-HAES institutions such as the weight loss industry. The unquestionsed assumption that weight is unhealthy seems to be the starting point for the vast majority of conversations about our bodies. We may find ourselves teaching a crash courses in HAES (TM) 101, before we can even begin to discuss our health in a meaningful way. And in that discussion, our own bodies may get used as evidence for proving the validity of HAES. It feels triumphant to say, "I'm 'morbidly obese' and my blood pressure, blood sugar, cholesterol, and overall health are just perfect, thank you very much." But then what happens when health challenges do occur? This can create a roller coaster of success and failure. (Not unlike the roller coaster some people experience when their goal is weight loss.) It's easy enough, perhaps, to continue arguing for HAES when we get diseases that have no particular correlation with size and weight. But what if there are increases in the metabolic indicators that the anti-HAES view attributes to obesity? What if we need medical care for diseases considered to be "preventable" through weight loss? I wonder how many formerly healthy fat people end up feeling guilty or inadequate when this happens. People of all sizes, when we get sick, have plenty to deal with: accessing medical care, living with diminished abilities, and coping with pain or discomfort. It doesn't seem fair for fat people to bear the additional burden of feeling like being sick is our own fault. I believe people of all sizes are entitled to make our own choices about how to take care of our bodies, put as much or as little effort as we like into the effort to prevent illness, and receive affordable, compassionate medical care whenever and for whatever reason we need it.

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