Fat and Feminist
Large Women's Health Experiences

by Monica Persson in 1996

I've been the chubby little girl, the plump teenager, the zaftig girlfriend and the queen-size wife, but I really like being a Fat Feminist best. Being a Fat Feminist means that I don't spend all my time counting calories, or hiding behind dark colored, vertical striped clothing. Being a Fat Feminist means I carry a chair to a classroom when the chairs provided are too small, instead of dropping the class.

Being a Fat Feminist means that I accept and love myself just the way I am. Don't get me wrong - I'm still fat in a society that isn't nearly large enough for me. People give me looks when I wear shorts or eat an ice cream cone in public. Well meaning family members tell me I have "such a pretty face..." and offer quick weight loss schemes found in tabloids. But perhaps most distressing has been my experiences with health care providers. For most of my life, doctors have prescribed everything from amphetamines to ultra-low calorie liquid diets, all in the name of health.

My evolution from chubby girl to Fat Feminist would not have been possible without other large women. Support groups, regional conferences, exercise classes and magazines have been created to empower people of size and I draw strength from them all.

Last July, I attended a Fat Women's Health workshop at the East Coast Fat Feminist Conference, and heard a lot of comments like this:

"The answer to nearly every health condition or concern is 'lose weight'."
"My doctor gave me a diet when I had come in for an earache -- nothing for the ear was prescribed."
"My new gynecologist is terrible; giving me an unwanted, endless lecture on the new diet drugs. This doctor was shocked that I requested a birth control method, not believing I could be sexually active."
"[My doctor] really acts surprised every time my blood pressure shows up normal, which is every time. And every session she says I should lose weight. She says it nicely, but still says it."

Listening to the conference participants, my frustration and anger at the medical profession grew. The experiences I had with doctors was not unique.

To Find Out More ...
A Survey of Medical Experiences of Large Women

My Fat Feminist coworker, Pam Saari, developed a survey to learn more about large women's health care experiences. Sixty-three of the of the women attending the West Coast Fat Feminist Conference in Nov. 1996 responded to the survey. We hope the results will be useful to other health care providers. An excerpt of the survey follows:

Medical Survey Highlights:

Have you ever been treated disrespectfully by your physician or their staff?"
Yes: 56% No: 44%

Would you characterize your physician as size friendly?
Yes: 54% No: 46%

"She accepts my feelings about size, but with visible reluctance. She does not push diets but does attribute many ailments to weight."

"Friendly, yes. But also extremely fat phobic."

"At age 25 and 170 pounds, after a clean bill of health, [my doctor said] 'You'll die if you don't lose weight'."

"Many, many times in the past I had many weight prejudiced experiences. During a recent hospital stay ... no scale that goes high enough to weigh me ... not a big enough blood pressure cuff ... not big enough gowns ... etc., etc., etc."

"I try to choose carefully - ask questions ahead or send letter ahead to express my views and how I would like to be treated (as a member of my health team)."

As size acceptance spreads, Pam and I hope that everybody will be treated with compassion, empathy and high quality care.


Size Prejudice Dramatically Impacts Women's Lives

In this country, we are preoccupied with weight. Every woman's magazine has articles on diets and fitness. Countless hours of TV advertising promise "quick and easy weight loss." Over the last 20 years, women have become heavier while the beauty ideal has become leaner. In the general mania for thinness, Americans have come to see themselves as unacceptable. In fact, 75% of U.S. women are dissatisfied with their appearance.

Because of the constant pressure to be thin, many people try sporadically or constantly to lose weight by reducing the calories they consume. While on a low-calorie diet, the human body reacts as if it were being starved and tries to preserve as much energy as possible by decreasing its rate of metabolism. Any food taken in is held on to frantically by a body that isn't sure when it will be fed next. This helps explains why over 90% of reducing diets fail to produce permanent weight loss.

Many fat adults have a lifelong history of dieting themselves into their current size. Over time, it becomes harder and harder, and finally impossible for some to lose weight at all. For those who cannot find self-acceptance, this can lead to drastic measures: gastric bypass, vertical banded gastroplasty, jaw wiring, life-threatening drugs. Most people do not know that far more women have died from weight loss surgery than from Toxic Shock Syndrome. And yet, these body mutilations are looked upon with favor from a society that doesn't tolerate human size diversity.

Treating obesity with current medical technology has a 10% success rate at best. The World Health Organization and the US Department of Health agreed in 1992 that dieting and weight loss surgery can be dangerous to human health. To add insult to injury, the medical profession blames fat adults when their ill advised recommendations don't work. All people desire high quality, compassionate medical care. Fat women especially want health care providers to look beyond weight and see the patient.

In 1992, a panel of the U.S. National Institute of Health (NIH) concluded that diets do not work and may be harmful to one's health. It is also important to realize that some negative health consequences attributed to obesity may in fact be the result of intense and repeated weight loss episodes. Heart disease and premature death were 25 to 100 percent more likely with high weight variability (many weight changes or large changes) over the general population.

Devastating Impact on Girls

Perhaps most at risk are children. Young girls are more afraid of becoming fat than they are of nuclear war, cancer, or of losing their parents. Ninety percent of high school girls diet regularly, even though only between 10% and 15% are over the weight recommended by the standard height-weight charts. Dieting has been associated with an 8-fold increase in the probability of developing an eating disorder.

In addition to being a training ground for eating disorders and metabolic damage, dieting distracts women from their focus. In a study at Case Western Reserve University in Ohio, one group of students was allowed to snack from plates of cookies before attempting to solve a puzzle; another group was asked not to eat the cookies; a third worked in a cookieless room. None of them knew the puzzle was insolvable. Students who had to restrain themselves gave up after half as many tries as the other two groups.

Weight prejudice is a true form of bigotry in every sense of the word. Like sexism, it elevates the status of one group of people at the expense of another. Women, more often than men, are the victims of size discrimination in employment, education, and adoption. Fat women also suffer more social discrimination based on size. Thus, Americans spend $40-billion on weight loss programs and products each year. Consequently, we try to achieve an unrealistic body size by dieting, surgery or drugs. Therefore, we unconsciously use our focus and drive in creating "willpower" that contradicts our bodies' best interests.

But there are other options. The entire concept of an "ideal" weight for any woman or group of women should be abandoned. Humans come in all sizes. Learning to love and accept yourself just as you are will give you self-confidence, better health and a sense of well-being that will last a lifetime. When we reclaim the right to eat, focus on our lives and stop giving our money to the diet industry, anything is possible.

Size Esteem Resources:

Books and Videos:

Big Fat Lies by Glenn A. Gaesser, PhD.
Body Trust (Video) by Dayle Hayes RD
Great Shape: The First Fitness Guide for Large Women
        by Pat Lyons and Debby Burgard
The Invisible Woman: Confronting Weight Prejudice in America
        by W. Charisse Goodman
Making Peace with Food by Susan Kano
Nothing to Lose by Cheri Erdmann
Self Wise (Catalog of Resources) by Judy Sullivan
When Women Stop Hating Their Bodies by Jane Hirschmann and Carol Munter

Bigotry In Every Sense of the Word

"...Weight prejudice is a true form of bigotry in every sense of the word. Like racism, it is based on visible cues; i.e. that fat person is discriminated against primarily because of the way she looks. Like anti-Semitism, it defines an entire group of people numbering in the millions within a narrow range of negative characteristics and behaviors. Like sexism, it elevates the status of one group of people at the expense of another. And like homophobia, it serves as a vehicle of projection for the bigot's own anxieties, frustrations, and resentments, in effect using the hated outsider as a repository for the bigot's emotional debris and refuse..." [excerpt from W. Charisse Goodman, author of The Invisible Woman]

Sizism and Sexism - Women, more often than men, are the victims of size discrimination in employment, education, and adoption. Fat women also suffer more social discrimination based on size.

Sizism and Racism - The media has adopted "ideal" body proportions based upon white people. Tables of "ideal" weights based upon heights are based upon white people. People of color have a genetically distinct body type that was not taken into consideration in formulation of "ideal" proportions.

Sizism and Ageism - Older people, who are often discriminated against   in areas such as employment, tend to gain weight as they age (a physiological phenomena). Employers with stringent weight restrictions often do not allow for increased weight with age and suspend or fire older persons who don't meet weight requirements.

Celebrate Size Diversity

May 6 is International No Diet Day. Each year the festivities grow as people around the world gather to affirm that weight loss dieting is harmful to both body and spirit. In the US, we are preoccupied with weight. Every woman's magazine has articles on diets. In the mania for thinness, many women and girls believe they are overweight when they are not.

Because of the constant pressure to be thin, many people tray sporadically or constantly to lose weight by reducing calories. When you go on a low-calorie diet, your body reacts as if it is starving, and tries to preserve as much energy as possible by decreasing its rate of metabolism.

The entire concept of an "ideal" body size or weight should be abandoned. Instead, we should focus on getting variety and nutrition from food, plus exercise. We need to create new patterns to deal with food and activity if old patterns are not keeping us healthy.

Fat women can feel well and strong without being exploited by the multi-million dollar weight industries. Our money is better spent on healthful foods and activities that are not harmful to our bodies and psyches.

Ten Reasons to Give Up Dieting

    1. Diets don't work. Even if you lose weight, you will probably gain it all back, and you might gain back more than you lost.
    2. Diets are expensive. If you didn't buy special diet products, you could save enough to get new clothes which would improve your outlook right now.
    3. Diets are boring. People on diets talk and think about food and practically nothing else. There's a lot more to life.
    4. Diets don't necessarily improve your health. Like the weight loss, health improvement is temporary. Dieting can actually cause health problems.
    5. Diets don't make you beautiful. Very few people will ever look like models. Glamour is a look, not a size. You don't have to be thin to be attractive.
    6. Diets are not sexy. If you want to be more attractive, take care of your body and your appearance. Feeling healthy makes you look your best.
    7. Diets can turn into eating disorders. The obsession to be thin can lead to anorexia, bulimia, bingeing, and compulsive exercising.
    8. Diets can make you afraid of food. Food nourishes us and gives us pleasure. Dieting can make food seem like your enemy, and can deprive you of all the positive things about food.
    9. Diets and rob you of energy. If you want to lead a full and active life, you need good nutrition and enough food to meet your body's needs.
    10. Learning to love and accept yourself just as you are will give you self-confidence, better health, and a sense of well-being that will last a lifetime.

Excerpts from the National Women's Health Network Sep/Oct 1998 newsletter:

On June 17, 1998, the National Institutes of Health (a federally funded agency) issued new weight guidelines and overnight, 29 million more Americans -- 55% of the population -- went into the category of overweight.

"While every patient could be encouraged to eat lots of fruits and vegetables and try to be more active to improve health, singling large people out for this advice to "prevent obesity" and focuses the attention of both patient and health care provider on weight, not health. It also presumes that thinner people exercise, eat well and are healthy, which is hardly universally true."

"Lowering weight guidelines exposes 29 million additional Americans to weight discrimination, including the denial of health insurance."

The current medical model relies on drugs for treatment of anything and everything, but weight loss medications are among the most dangerous drugs around. "Given the staggering profit potential embedded in this medical model -- and since people must stay on drugs forever or regain weight when they go off -- the drug companies are now in a diet drug development frenzy."

An article in the New England Journal of Medicine states, "Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition."

10 Steps for Loving Your Body Just As It Is:

1. Be around people who accept themselves as they are. Join a support group, or start one if necessary-talk and listen to others who are on the same path.

2. Read books, pamphlets, and articles on self-acceptance; look at art; and watch films and videos with strong, beautiful characters of different sizes and shapes.

3. Buy full-length mirrors and appreciate yourself from all directions. Look at yourself standing, sitting, from the back, naked, clothed, every way.

4. Buy and wear great clothes you like and feel good in. Get rid of uncomfortable and ill-fitting clothing, and anything you've been saving "until it fits."

5. Take pictures of yourself. Let others take pictures of you. Don't avoid being in group pictures-in fact, insist on standing in the front row.

6. Stop being so hard on yourself.

7. Start acting as if you love and have always loved your body.

8. Learn to recognize size discrimination, diet obsession, fatphobia, and body hatred in the world around you -- in advertising, in television and movies, in public accommodations, on the street, and among your family and friends.

9. Start the process of "coming out" as a self-accepting person by telling your family, friends, coworkers, etc. of your decision:
    * to stop obsession about your weight and appearance
    * to give up dieting and the goal of losing weight, and
    * to accept yourself and your looks as you are

10. Become an advocate for the rights of people of any size, shape, color, ability, or physical appearance. Interrupt sizism, racism, looksism, ableism, sexism, and other prejudicial attitudes wherever you encounter them.

more info:

One Size Does Not Fit All

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