This is less a book review and more of a (rare) blog post.
Some years ago, in the early 2000s, I had an epiphany. After countless attempts to starve myself thin, after countless doctor’s appointments where I was prescribed weight loss for everything from sinus infections to migraines to broken fingers, after countless unsolicited comments about my body from strangers and loved ones, after countless microaggressions and acts of hostility regarding my size, I had an epiphany.
I am fat. And that’s okay.
My epiphany came at a good time. I’d been starving myself and doing everything “they” say to do, and yet my weight wasn’t budging. The internet was booming, and there were neighborhoods of people dedicated to fat acceptance and fat liberation. They were part of or learned from groups like NOLOSE, ASDAH, and from fat elders. People just like me, who realized they were fat no matter how they tortured or stressed their bodies, their bodies were wise, their bodies knew best, and their bodies adapted. They stayed fat. Some got fatter. We all knew that our dignity and humanity should not be dependent on our ability to conform to a more socially acceptable size and shape.
By the late 2000s, fat acceptance had started being co-opted by “body positivity.” Body positivity was for thin, white, abled, cis-gendered women. Body positivity excluded the fattest among us. Body positivity was framed with “it’s not about being thin, it’s about being healthy.”
At a time when I was at my sickest, sick enough to be forced to quit a career I’d just begun, sick enough to spend more days in bed than out of it, sick enough to be congratulated on my illness-induced weight loss (while being simultaneously berated for continuing to be fat), I felt wholly excluded from this unrecognizable version of body acceptance. I wasn’t healthy or thin.
Today, fatness is demonized more than ever. While people are becoming more aware of other prejudices and slowly making efforts to mitigate them, anti-fat bias is on the rise. Let me reiterate: While small improvements in implicit biases like racism, sexism, and homophobia have been recorded, and while ableism and ageism have remained about the same, there has been a 40% increase in anti-fat bias.
Being fat has become a symbol of failure. Fat people embody sloth and gluttony and greed. We are drains on society. We are inconveniences. We are ugly.
Having visible adipose tissue now has a diagnostic code, because it’s existence now a disease, even in the absence of other markers of health. It’s on my every medical chart note, regardless of the reason for the visit that day. A group of professionals with a long history of being easily swayed by the shiny gifts and baubles from the pharmaceutical industry decided to pathologize an entire class of people (the majority of people alive right now) simply for how they look, regardless of actual measurable scientific markers of health. These professionals are using an utterly racist metric, which has no basis in fact or health, to dictate who is worthy of evidence-based healthcare. Regardless of the ample scientific evidence that it’s possible to be fat and healthy or thin and unhealthy, the American Medical Association has simply chosen to deny reality.
Relatedly, a study of autopsies of very fat people discovered that they had undiagnosed medical conditions, indicative of significant misdiagnoses and/or lack of access to adequate medical care.
This is the natural result of decades of fatphobia. Decades of healthcare workers being incapable of seeing past body size or shape. Decades of friends and neighbors being taught and believing that it is better to be dead than fat. People are willing to trade years off their life for the chance to be thin.
What We Don’t Talk About When We Talk About Fat is about all of these things, and so much more. It’s about the personal experiences of actual fat people. About how we are hated because of what we look like. About the magnitude of the oppression ingrained in ourselves, in our loved ones, in our culture.