Let's get this out of the way first: I'm fat, I call myself fat, and I'm involved in Health at Every Size. You've probably heard this same intro from other people, including some of the wonderful writers on this site.
I also have a degree in nutrition, and I've worked in nutrition for almost ten years. I started in food service, moved over to endocrinology at one point, rotated through a bunch of different clinical areas, and then started doing nutrition education on eating competence. My official job title is "diet tech," which no one, except for dietitians and other diet techs, has ever heard of. Soon I will be a dietetic intern, and with any luck, next year I will become a registered dietitian.
Even though I call myself fat, my goal is not to make people fat, or insist that people remain fat against their will, or pretend that fat people should never be concerned about their health, that being fatter carries no health risks, or that fat people are already 100% healthy.
My goal is also not to make people feel bad for dieting or losing weight, or for being thin, or to set up certain people as more "real" than certain other people based on body size. Or to tell certain other people to eat a sandwich.
All that, frankly, is crap. I don't have time for it, and I bet you don't, either.
My actual goal is to break down a part of the social hierarchy that, in my experience, and according to research, does people harm. It's the part of the hierarchy that says, "Fatter people are worth less than thinner people because they are automatically unhealthy, ignorant about nutrition and exercise, have no self-discipline, and also happen to displease my very peculiar aesthetic tastes that I created from thin air and which appear, curiously, to be 100% unique to me as an individual."
That last part is sarcasm.
I do this, in part, by spreading the message that fat people have the right to eat food.
I know this is very controversial, since it seems to be an unspoken (sometimes spoken) assumption of our culture that fat people are camels, and should live off their stored fat until such time as they reach an aesthetically pleasing state of thinness and presumed ideal health. Camels notwithstanding, I believe fat people have the right to eat food.
Now, I want to reassure anyone who has suddenly become deeply concerned for my health: I do quite well with eating. I was counseled by a wonderful dietitian at one point who taught me how to eat, and I took the foundation she gave me and built some amazing skills on top of it. Like having regular mealtimes, respecting my hunger and fullness signals, eating many fruits and vegetables, and even getting regular exercise because it's fun and helps me have more energy. I do all four of the healthy habits on this graph.
And I teach the very same things to my own clients, fat or thin, as do several other people. This approach is not really new.
But, more importantly, if I didn't do all of those healthy things, would I have less of a right to eat food? No I would not. Eating is a survival need, and food is a basic human right. If I didn't do all those healthy things, would I be a bad fat person? No I would not. Eating and exercise, while they do impact your health, cannot fundamentally alter your human worth. There are no bad fatties. (Except for those who go around slaughtering innocents. I disagree strenuously with such activities. Shame on you.)
So, a few weeks ago on Twitter, @fatbodypolitics and @mazzie started the Twitter hashtag #notyourgoodfatty, in protest of the idea that fat people must prove their human worth through health or health behaviors. I sort of ran my mouth about it, and someone Storified the results.
In the course of that hashtag and the bizarre "debate" that it engendered, at least one person expressed the belief that only worthless people die. Even in the fairly hyperbolic context of Twitter arguments, I found this pretty revealing -- and pretty disturbing. I think this reveals something of the ideological framework our culture operates from -- that healthier people are worth more than less healthy people, and ergo, if your health declines to the point that you die, it is proof that you're worthless. ("F MINUS MINUS MINUS, WOULD NOT HUMAN AGAIN.")
When you consider the enormous impact that politics and social determinants have on health, it's also an expression of social Darwinism, the banner under which bigotry marches. As I said in my Twitter rant, people have expressed anger about my stance on health, as though I have the power to take their own health away by believing that health does not equal human worth. Since it is literally impossible for opinions to take away the health of someone who disagrees with them, I believe their anger is not actually about health at all.
We don't exercise and eat well purely for the sake of our health, despite what we may say to others, or even believe ourselves -- we also do it to signal status, and to attain things (like a body that fits normative ideals of beauty and strength and fitness) that add to our social capital. We do this with lots of things -- what car we buy, what clothing we wear, the books we read, the music we like, what neighborhood or city we live in, where we go to school, what our job title is... and what we choose to eat, and how we choose to move our bodies.
Research on weight stigma shows quite plainly that fitting normative standards of ideal weight confers certain social privileges -- you are more likely to have a higher income, to attain higher education, and to experience less social exclusion, if you are thinner. You will be less vulnerable to stigma and loss of status. So when people are angry at this issue, they are not actually angry about health -- they are angry about the loss of status they would sustain if we eliminated healthism.
Why is status so important? Frankly, I wish I knew. Humans are obsessed with it and will do the damnedest things to gain or protect it. My suspicion is that, because higher status provides better access to resources, it alleviates existential anxiety about mortality and death. "Being good gets you stuff... Good stuff gets you being," or something.
The problem is, after your most important needs are met, it doesn't actually work. No matter how many resources you have, you are still mortal. No matter how much status you have, there will always be someone who has more. But people sometimes squander their precious time alive, and their goodwill for the rest of humanity, in their attempt to scramble up that inscrutable ladder. And they hurt other people in the process.
This bothers me. I don't think health should be the marker of status, or the referendum on human worth, that it currently is. At the same time, I think everyone should have access to the conditions necessary for good health -- fair wages, good working conditions, education, housing, adequate food, appropriate health care, and social inclusion.
Health is a resource for living, a social good that should be accessible to us all -- not a status symbol available only to an elite few. I want there to be less inequality in the world, I want there to be less stigma, and I want people to do valuable things with their short time here on Earth.
You know, things other than shrieking at people on Twitter that they're GONNA DIIIIIIIIE. (Drop it, Axl. This isn't the jungle.)