Open letter to "fat" kids

Dear Beautiful Little Person,

I hear someone's been telling you you're fat. It might have been someone at school, or your brother or sister, or your parents. They've probably also been talking about how much exercise you do and what you eat. They've almost certainly been telling you what shouldn't be eating. Most of them are probably genuinely concerned about your health.

But here's the secret - it's your body. It's an amazing, strong and beautiful body. It can do all sorts of cool things. And because it's yours and yours alone, it's amazing and wonderful in its own unique ways. If you look after your body, get to know it really well, teach it new tricks and give it every opportunity to show off the tricks it knows, it will look after you. And it will look after you, and be able to learn new tricks, regardless of what shape it is, or what it is or isn't able to do compared to other people. This is what exercise is really about. Doing what you and your body love to do. Your body has different needs to everyone else's. It might need more rest than other people. It might prefer to go crazy for half an hour, or it might prefer a long walk. The new tricks you teach it might be cartwheels, or spins in your wheel chair, or playing handball. Get to know what you and your body love doing together, and do it as often as you can.

People also make a big fuss about food. There's a reason for that - it's important to be good at eating. But being good at eating isn't about what you shouldn't eat, it's about what your body needs. Just like exercise, different bodies need different food. It can be really hard to work out what your body needs, so a good place to start is to try to eat as many different kinds of food as you possibly can. That's hard when you're a kid - lots of kinds of food taste yuck when you're younger, and seem to taste better as you get older. While you're waiting for broccoli to start to taste good (and it really does!), keep trying different foods, and remember the ones you like. The more variety you eat, the happier your body will be.

As you grow up, try to pay attention to how foods make you feel. Which breakfasts make you feel good at school, and which ones leave you starving even before recess? Do some foods make you feel terrible a couple of hours later? (Drinking fizzy drinks gives me a headache about 2 hours after I drink them - I don't know why, but I mostly don't drink them anymore!) Eat the things that make you feel good, give you energy and have a huge variety of good stuff in them. Then you'll be good at eating, and you'll be looking after your body.

Your body is beautiful and wonderful and powerful exactly as it is. It doesn't matter what shape it is. It will change shape over and over again through out your life. That's not what matters. Look after it, don't compare it to other bodies and enjoy it.

Obligation and health

Lots of people have written good stuff in response to fat acceptance (or fat advocacy, or "for gods' sakes stop vilifying fat people" - whatever you want to call it) concern trolls - those people who respond with "But OMG you're GOING TO DIE". Fat Heffalump is the one that springs to mind right now, but you'll find it popping up all over FA stuff. I'm not going to repeat it, just pull out one aspect that runs through most of it - that you have no obligation to be healthy.

Concern trolls pull out "Your lifestyle isn't healthy" as though it's a lay down misere. Aside from the fact that it may not be true, even if it is, who says I have to be healthy? I may not even have a choice. For whatever reasons, living the troll's sanctioned "healthy lifestyle" may be entirely beyond my reach. Or living it might not, in fact, make me healthy. Or, I may have all the choice in the world, and decide that I value my current lifestyle more than health. Trolly McTrollpants has no right to decide that I should.

I've read this argument again and again, and I agree with it. But. You knew there was a "but" coming didn't you? There has always been something niggling in the back of my brain, a little "but" bouncing up and down behind the logic. When I finally paid it some attention, I realised it's not really so much a "but", rather it's more of an "also", or an "even so".

Before I even address the niggle, I need to point out I'm thinking in terms of "as healthy as one can be" not healthy by some arbitrary standard. I'm also including emotional and psychological health in this picture. Blood pressure is neither more important than, nor independent of, emotional and psychological well-being. Using a complete picture of health pretty much rules out fat shaming all by itself (nobody is healthy when they are made to hate their own body).

There are two aspects to this niggle, a personal and a public. The personal is straightforward - I think we do owe optimised health to those we care about. I don't think this negates the "no obligation to be healthy" as such, because I certainly owe nothing to Trolly, and because this is about balancing what you have, not meeting an arbitrary standard. My "optimised health" looks nothing like yours, and so making sweeping statements about how people should live isn't helpful. But I do think I owe my kids, my partner, and everyone I love the best health I can offer them, within the power that I have. That doesn't make ill-health a Bad Thing. It just means I should control what I can, and deal with what I can't.

The public is much messier. I proceed here with caution, but I don't think I can ignore it as an issue. In a country like Australia where health care is largely publicly funded, my decision not to be healthy has impacts beyond my immediate circle. Of course, if I choose to be fatally unhealthy in a swift fashion, it doesn't cost the country much (see personal obligations), but it is possible that lower grade unhealthy living costs the country money (although I'm not sure it's entirely clear whether health costs are going up because of healthy or unhealthy lifestyles - living longer can also cost more in the long run, and I've never really seen convincing arguments on either side). Assuming it does cost, what exactly does that mean for personal obligation to health?

I'll consider first the individual obligation (under the assumption that it does cost money). I'm struggling a bit with this, so I'm more than open to feed back and outright disagreement - I think it counts as one aspect of my membership in society. One thing I can do to contribute to society is to optimise my health. This does not include health issues over which I have no control, that is contribution neutral. On the other hand, there are many other ways in which I can contribute to society, and I think choosing to be something of a burden on society healthwise can be compensated for by my many other contributions. I have been a burden on society in myriad ways all my life, starting with my childhood and education and carrying on through my use of roads and other public facilities. I give back to compensate for that. This is true for everyone, and no-one gets to look from afar and judge a person's overall contributions.

That's the theoretical. From a practical perspective, we have no problems at all accepting and even celebrating other people damaging their health - elite athletes, mountaineers and other extreme adventurers, for example. It is outright hypocrisy to condemn people for, for example, sedentary related ill-health while celebrating sport related ill-health. I think all people have the same, vague and flexible obligation to be as healthy as they can, and all people have the same right to prioritise that obligation as they wish against other obligations and contributions.

When talking about costs to the public, the government's role obviously also needs to be considered. Still under the assumption that less-than-optimised health costs money, the government has an obligation to encourage people to optimise their health, as responsible custodians of the public purse. Note that their obligation is limited to encouragement, not requirement. People within a society make a million decisions every day that affect the people around them. On the whole we need to minimise the number of things which are enforced by law, and encourage voluntary, cooperative behaviour. So I support government initiatives that encourage health. Things which inform, things which make healthy options (food, activity, medication etc) more accessible, things which discourage behaviour that impacts negatively on other people's health (for example unhealthy work places, polluting industries and so on).

I do not support things which shame anyone for their health, whether they have control over that health or not. For starters, it's self-defeating. Shaming people damages their emotional and psychological health, and makes them less likely to participate - either in healthy activities or in alternative ways to contribute. Shaming makes them less healthy and less likely to contribute. It's also putting a moral rub on something that in fact only has a financial motive. The government has an obligation to be a good steward of our cash, it does not have the right to add moral overtones to that stewardship.

In the end, I have no strict obligation to be healthy, but I count optimising my health among the worthy goals that I can consider and that the government can encourage. There may be other worthy goals that I may choose to pursue instead, and that doesn't make me a bad person.

Fat and health

I'm still thinking about fat. The intense responses to the idea of fat acceptance are often justified in terms of health. The more I think about this, the more, intertwined reasons there are for calling bullshit on it.

Firstly, there's the science. All the research on obesity. Lots and lots of it is sponsored by the diet industry. Oddly, this doesn't seem to bother the medicos citing it. Also, more transparently, the premise of obesity research is to treat obese people as a uniform group of people. To look at obese people and compare them with not obese people. In many respects, health outcomes are worse for obese people. However, as well all know, correlation is not causation. Just as the strong correlation between the population of storks and number of babies born in Hamburg fails as evidence against babies being born via their mamas' vaginas, this correlation on its own doesn't mean obesity is the root cause of all evils.

I'm completely down with diet and lifestyle being correlated with good health - in fact I also believe that it is partially causative. (Many people know perfectly well that their ill-health has nothing whatever to do with diet and lifestyle, so it can't be more than a partial causation.) Also, because weight loss is sold as the goal for everything, and the marker of health, there is a correlation between obesity and poor diet and lifestyle. The direction of causation is not so clear though. Once you are fat, if eating healthy and exercising sensibly don't produce weight loss, why would you bother? It's clearly not working anyway, since weight is health. I can't help wondering if body fat was ignored completely by everyone, how much healthier many fat people would be. Still, here I am focussing on fat people. Just like the research. No-one seems to round up all the people with similar diet and lifestyle, irrespective of weight, and look at health outcomes. Plenty of not fat people have crappy lifestyles and crappy health outcomes, but no-one glares at them when they eat in public. So I call bullshit on fat = unhealthy.

Also, the only lifestyle that's really been looked at independent of the starting weight of the people is the Dieting lifestyle. (I use big D "Diet" to refer to weight loss regimes, rather than the stuff you eat.) That's been shown to be really bad for you - with increased risk of stroke and heart disease. It's really bad for you, because it produces yo-yo weight gain and loss, and that's definitely worse than constantly being fat or thin. So I call bullshit on being told to go on a Diet for health reasons.

Moving on to practical matters. The public shaming of fat people causes bad health. It stops fat people going to the doctor, because they know they're just going to be told that whatever is wrong with them is because they are fat. They are far less likely to have preventative health checks, because they know the doctor is going to tell them they're fat (in case they'd managed to forget this fact for a millisecond). It means that doctors treat people with less respect, and with less actual medicine, as it happens. 95% of people can't lose weight and keep it off, so doctors prescribing that as a cure-all is simply bad practice. So I call bullshit on the idea that making people feel bad about being fat will lead them to be healthier.

From the practical to the moral. Who said healthy was the be all and end all to all arguments anyway? Everyone has the right to decide what priority they want to assign to what degree of health. Apparently one is a hard working moral citizen if one gets a stress induced illness (even if the source of stress is a result of choosing high income over low stress occupations) but totally devoid of morals if one chooses to focus on other aspects of lifestyle at the expense of one's health. Sports people are allowed to destroy their joints requiring surgery and more, and are hailed as heroes. I call bullshit on lack of health being viewed as a moral failing.

Finally, I've heard more than one person point out that the upside of cancer (or other life threatening illnesses) is weight loss. I can't think of better evidence that the claim that fat hatred is all about health is utter, utter bullshit.

And when I say "fat people" as though they are other, it's because I'm an in-betweeny. I'm well and truly obese by medical definitions, but I can still sometimes buy clothes in mainstream shops. So some of the fat hatred (and all the body shame) come my way, but I realise I don't cop it as bad as lots of other people.

Also, if you want to change your diet (with a little "d") to improve your health or make other lifestyle changes because they make you feel better, that's cool. If you lose weight as a result, that's also cool. If you don't lose weight as a result, that's exactly as good as if you do. For a fabulous piece on how talking about Diets affects other people, have a read of this Spilt Milk article.

The "wrong" shape

Last Friday night, the lovely Dr Samantha Thomas invited me (and many others, including Mim) to the Bodies Abound event in Newtown. There was some visual art, and 8 spoken presentations which varied from folks reading aloud to performance. (Or something like that, not that reading aloud isn't some kind of performance...)

It was a really fabulous night that really celebrated every body shape and shared the pain of being the "wrong" shape. There were fat people, skinny people and trans people. Sadly I can't share the things that were presented that night as I don't think there are any online versions of any of it.

Instead, I've got a small selection of links to people talking about various aspects have the "wrong" shape. I hope you can find some time to read them and they make you feel better about your body, no matter what shape it is.

Lots of the people at Bodies Abound were from the Fat Studies Conference that (the also very lovely) Dr Sam Murray organised at Macquarie Uni.

Fat Heffalump presented this amazing piece. It made me cry.

Nicholosophy speaks on how it's different when you're a bloke. It's different, but that doesn't make it fun.

Definatalie has a different story again. Another perspective, which surprised and interested me.

Fat is obviously not the only way to be "wrong" shaped, you can also have the "wrong" physical gender. This is a wonderful piece from the conservative father of a transgender child.

There are some summaries of the Fat Studies Conference out there too.

Obesity Timebomb

Definatalie

I'll add any others I come across. Please, go, read, feel better. :)

Update 21/9/10 And here is another one:
Sam Murray's piece from Bodies Abound. I laughed, and it was supportive.