All kinds of things are being floated as things that fat people should have to do either by social pressure or government edict until we are thin (at which point we can ostensibly do whatever the hell we want as long as we don’t get fat.) I’ve seen it suggested that we should be forced to exercise, forced to undergo mandatory counseling, forced to have our food and exercise monitored by the government etc. The media publishes studies with highly questionable research methods funded by corporations which directly benefit from their findings as proof that fat people can’t be trusted to make decisions for ourselves. It is suggested that completely untested interventions should be made mandatory for all fat people. That’s how fat people become unwitting- sometimes obligatory – participants in experimental medicine, sometimes with some truly horrible results and almost always without success.

This is all done under the guise that”fat people need to be healthier for the greater good”. But upon even a light inspection this falls apart. First of all, fat is not a behavior or set of behaviors – it’s a body size. Just like thin isn’t a set of behaviors – it is a body size. Just like there are fat athletes there are thin couch potatoes. You can’t look at someone and tell from their body size what their habits are. or how healthy they are.

Upon examination the choice to focus on fat people is, at best, the result of people being incredibly lazy and trying to find a group that is identifiable by sight to blame for things study. At worst it is simply thinly veiled bigotry. Anytime we take a group of people who we can identify by sight and then attempt to calculate their cost on society, then create an initiative to eradicate them we are going down a bad road. Researchers take “everybody knows” size prejudice and solidify it using poor research techniques and confirmation bias. As Linda Bacon and Lucy Aphramor found when they reviewed the research around weight and health “Researchers have demonstrated ways in which bias and convention interfere with robust scientific reasoning such that obesity research seems to ‘enjoy special immunity from accepted standards in clinical practice and publishing ethics'”

Researchers base their work on “everybody knows” assumptions without even an attempt to provide proof of these assumptions. Researchers claim to calculate how much fat people cost in extra fuel, when they don’t even have basic information like how many fat people own cars, and what kind. The media continues to report that fat people are causing massive increases in healthcare costs when the evidence is clearly to the contrary.

Even if you believe that you can tell that fat people don’t prioritize our health just by looking at us, focusing on fat people is highly questionable when there are so many people who don’t prioritize their health who we celebrate. We love Olympic athletes, but going 80 miles an hour down an ice track face first does not prioritize health. We love pro football and basketball players but look what they do to their bodies. We love our pop stars but the schedule that they keep to go on tour and all the publicity that they do to sell tickets does not prioritize health. Not to mention that plenty of people don’t get the recommended amount of sleep, don’t look both ways before they cross the street, eat soup while driving, and any number of things that don’t prioritize health, and that for every fat person you can find a thin person with the exact same habits but a different body. The research shows that healthy habits are the best chance for a healthy body, instead of talking about what fat people “have to do” and having a war on us, why isn’t there a war on sedentary people or a war on people who don’t eat their vegetables, or a war on elite athletes?

Or, hey, here’s an idea – how about if we don’t have wars on people at all. How about if stop acting like it’s our job to tell people what they “have to do” for their health for the greater good, because that becomes a slippery slope pretty fast. Who gets to dictate what healthy habits fat people, or people in general, “have to” practice – the person who eats paleo? The one who eats raw foods vegan?

This is exactly why public health should be about providing options, information and access and not about saying that all people who look a certain way should have to do this or that. Let’s remember that health is multi-dimensional and not entirely within our control, and agree that health and healthy habits are not an obligation nor a barometer for worthiness. Let’s make sure everyone has access to the foods they want to eat, any movement options that they may choose, and affordable evidence-based healthcare. Then let’s start to spread true information, like the fact that 30 minutes of moderate movement about 5 days a week provides tremendous health benefits to most people but will likely never lead to weight loss. Of course nobody’s obligated to exercise but it would be nice to have true information about what “exercise” means so that we don’t get fooled by posters at the gym that suggest that we have to be miserable for hours every day to get any health benefit, when the truth is that three 1o minutes sessions a day of dancing around the living room in our underwear would get the job done. Let’s quit assuming that we can look at someone’s size and know anything about them other than their size and our prejudices about their size. Let’s stop trying to dictate what fat people “have to do” based on assumptions of what fat people do and don’t do as if that’s not just stereotyping and bigotry. Let’s start giving everyone options, information, and access, and then respecting people’s individual decisions about prioritization and path for their health. Voila – public health.

Cool news (well, at least cool to me):

My book (Fat: The Owner’s Manual) now has its own website! If you’ve read the book and would like to submit a review that would be awesome, just e-mail it to me at ragen at danceswithfat dot org! I would also love to do a page with pictures of people reading the book so if you want to submit a picture just shoot it to the e-mail above and I’ll get it posted.

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