Tuesday, August 16, 2016

Shrill and Other Weighty Issues

“It is only with the heart that one can see rightly; what is essential is invisible to the eye.”  
Antoine de Saint Exupéry



A few weeks ago I read a wonderful book by Lindy West, Shrill, Notes from a Loud Woman. For me, the best books are the ones that you are still thinking about long after you finish reading them. This is one of those books. It’s honest, sometimes heart wrenching, and often hilarious. I’m not usually a fan of memoirs, but this one is so much more than just her life story. It’s about a woman who at one point wanted to hide, but found her voice and learned to not be afraid to use it. There are so many superb reasons to read Shrill, but the sections that have remained with me are the ones dealing with being a fat woman in American society. It has caused me to evaluate my own struggle with my weight, and the consequences of that struggle.

From the book:

You have to participate, with a smile, in your own disintegration. You have to swallow, every day, that you are a secondary being whose worth is measured by an arbitrary, impossible standard, administered by men.

I understand those words. I live with them every day. I am a fat woman in a world that devalues any female that is larger than a size 10. I’m a size 18 currently but the number has fluctuated wildly over the past 20 years. I still struggle everyday to come to terms with my body, my relationship with food, exercise, and myself.

Lindy West isn’t the only one bringing this issue into the media spotlight. Another brilliant piece on being fat in America comes from Ira Glass and This American Life. It features Lindy West, Roxanne Gay and a brave young woman named Elna. Her story is powerful, one that you won’t forget. Everyone, including men, should listen to that podcast. You can find it here:

http://www.thisamericanlife.org/radio-archives/episode/589/tell-me-im-fat.

I want to be able to acknowledge that the shape of my body is not a reflection of who I am, but the question I keep coming back to is this: How can I ask others to accept and appreciate me for who I am if I can’t do it myself?

Lindy West has accomplished that. I am sure she has moments and days that are still difficult, that’s life as a human being, but I admire her strength and courage to choose to be happy, even though it may have been painful getting to that point. This is not a self-help book in any form, but it’s hard not to see Ms. West as a role model. Accepting our bodies, and rejecting the body-shaming trend, is not just a problem for fat women.

Despite all of this, I have to admit that I am ensnared by the societal pressure that I need to be thin and that there is something wrong with me as a human being because I am not. I will never be thin, but I could be thinner. And that’s the trap. How slim is slim enough? How many calories should I not consume and how many miles a week should I run? I was bulimic for years and the sad reality -as I see it anyways- is that an individual with an eating disorder is more acceptable to people than a person who is fat.

I realize that being fat can and does cause health issues for some, but not all, people. The illnesses the medical community has linked to being fat are staggering. The top seven according to WebMD are; heart disease and stroke,  high blood pressure, diabetes, some cancers, gallbladder disease, osteoarthritis, gout, and breathing issues such as sleep apnea and asthma. However, more recent research has revealed that a sedentary lifestyle may play a bigger role in these conditions than previously thought.

The weight loss industry is a multibillion dollar machine that is a clear indication of how many individuals are affected by this issue. No one has the answers or the miracle cure. The drug companies would love to find the drug that magically melts fat. The book publishers are all looking for the author who can write the next fad diet book to sell millions of copies. Weight Watchers, Nutrisystem, Jenny Craig and dozens of others are raking in tons of cash from individuals who are desperate to lose weight. They too believe the propaganda that the meaning of happy is thin.

The truth is that it’s just not as simple as diet and exercise. The truth is that it’s a complicated issue with components of poverty, a ridiculous healthcare system, emotional health, genetics and conflicting scientific research.

The emotional health aspect of obesity is just as vital as physical health in this equation. On its website the Harvard T. Chan School of Public Heath writes:
New evidence confirms that the relationship between obesity and depression may be a two-way street: A meta-analysis of 15 long-term studies that followed 58,000 participants for up to 28 years found that people who were obese at the start of the study had a 55 percent higher risk of developing depression by the end of the follow-up period, and people who had depression at the start of the study had a 58 percent higher risk of becoming obese. (1)

Of course fat people have higher rates of depression! Anyone that is systematically abused and humiliated on regular basis is going to suffer with some level of despair. The “war on obesity” can often be nothing more than moral licensing to abuse fat people.

From Shrill again:

They’d whipped up a host of reasons why it was right and good to hate fat people; our repulsive, unsexy bodies, of course (the classic!), but also our drain on the healthcare system, our hogging of plane armrests, our impact on “the children,” our pathetic inability and/or monstrous refusal to swap austerity for gluttony (like thin people, who, as you know, are moderate and virtuous in all ways). Oh and our “health.” Because they care. They abuse us for our own good.
Fat people receive poor and inadequate healthcare because too many physicians tend to write off all symptoms as obesity related. They are treating the number not the patient. I have cancelled my annual physical 3 times the past few months because I am afraid of getting on the scale and listening to another lecture about my weight. Like it’s a surprise to me I’m fat. As if everyone who is fat decided they would like to be that way instead of thin. “I would be thin but I enjoy all the rude comments I get everyday like ‘wide load coming through’ as I step on to a subway car, but thanks anyway.”

Diabetes is closely linked with obesity and a common weapon in the “fat is bad” arsenal. At the Global Changing Diabetes Leadership Forum in New York, in March 2007, Malcolm Gladwell stated:
I would think that the biggest indication would be that health would replace race and gender as drivers of discrimination... If in this country, for example, we didn’t change our healthcare system. It would become so prohibitively expensive for businesses to have people with this disease on their payroll that they would start to take active steps to avoid hiring people at this risk in the first place.
He is talking about diabetes but the disease has become synonymous with obesity. Discrimination against fat people would lead to hiring choices based on BMI instead of qualifications. Higher unemployment rates would increase poverty levels for the overweight. Lack of income would translate into unhealthy food choices because “bad” food is much cheaper than “good” food, compounded by the lack of supermarkets and fresh produce in poor neighborhoods.

Malcolm Gladwell also wrote a piece for The New Yorker in 1998 about weight (this debate has been going on a long time) entitled “The Pima Paradox.” The full article is here on his website: http://gladwell.com/the-pima-paradox/. Despite the fact that it is now 18 years old it still raises some valid points and proves that not much has changed in the landscape of American fat and what to do about it. The section on diet books alone makes this an essay worth reading.

Gladwell -an obsessive compulsive runner who probably weighs 155 pounds- doesn’t endorse obesity, or make excuses for those who are overweight, but he acknowledges that losing weight is not as simple as some people may claim or expect. And while a lot of his reporting isn’t good news for those looking to drop pounds, it is a balanced view of the problems associated with losing –or not losing- weight.
As the world grows fatter, and as one best-selling diet scheme after another inevitably fails, the idea that being slender is an attainable–or even an advisable–condition is slowly receding. Last month, when The New England Journal of Medicine published a study suggesting that the mortality costs of obesity had been overstated, the news was greeted with resounding relief, as if we were all somehow off the hook, as if the issue with obesity were only mortality and not the thousand ways in which being fat undermines our quality of life...
What Gladwell missed -maybe he can revisit this essay in the next season of his podcast Revisionist History- was the emotional toll of carrying around all that extra weight. Fat people are more than mortality rates on a page. There are legitimate physical, mental, genetic and environmental complications in the effort to shed pounds. Those shouldn’t be discounted when you look at a fat person. We are not looking for excuses, but we shouldn’t owe anyone justifications. I should be able to shop in a supermarket without people studying, and judging, the items in my cart. We are looking for kindness, compassion and the awareness that we are human beings. It’s a basic right and one that no one on this planet should be denied.

I try to remember that I am more than the number on a scale, or that a dress size determines my self-worth. It’s hard sometimes to focus on the positives. I’m kind, smart, funny, talented, loyal and strong. Boston strong. It’s hard to take me down to the point that I don’t get up again, but my weight is a weapon that does just that. It hurts. There are things that I want that are denied to me for no other reason other than I am fat. And that sucks.

1. Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies.Arch Gen Psychiatry. 2010; 67:2209.