Tuesday, June 21, 2011

It's Between My Doctor & Me. Butt Out.

A friend of mine recently complained online about the "fat ass" of the person seated next to him on an airplane. I'm sure he meant well; my friend was uncomfortable in his own seat because of the bulging figure of the man encroaching on his space. My friend was understandably frustrated at feeling he had to share his own seat, and he was apparently blaming the larger man for having a body too big for his seat. (That airlines have been squeezing more and more seats onto planes in order to save money can't have escaped my friend's notice, so I'm sure he was frustrated with the airline as well.) I doubt, though, that my friend stopped to consider the physical discomfort caused by being too big for one's own airplane seat. I've been informed by someone larger than I am that bruised hips and other discomforts are among the difficulties of being too big for one's chair; I've also heard tall people complain of health problems because they don't fit happily in airline seats.

While tall people can do nothing to change their size, it's true that, over time, with much exercise and strict diet (and sometimes expensive surgery) obese persons may be able to reduce their girth. Occasionally (but rarely), obese people are able even to lose scores of pounds and manage to keep it off for the rest of their lives. Major weight loss is the exception, not the rule.

More to the point, an apparent need to lose weight is a health issue, and health issues are private ones. To refer to a person with such a health problem using derogatory terms such as "fat ass" is basically to refer to someone's private health problem in an unfairly judgmental and personal way. It's similar to making rude comments about skin conditions or baldness -- only it's worse, because modern society unfairly assigns weight an almost moral quality.

I have heard many people in the United States complain about fat people. People say they don't want to see "fatties" in bikinis on the beach. Or they talk about all the fat people in the park or at the mall with some mixture of pity and derision. Almost all the people I've ever known to complain about other people's "weight problems" are people who have never been more than 20 or so pounds overweight. They likely cannot imagine what it is like to be fighting not for the same 5 or 15 pounds, but against forces of societal pressures, self-preservation and genetics that causes people to be severely overweight. Most of the time, fear of fat drives insults, which puts weightism in the same class as racism. Only in this case, people are not so much afraid of other fat people as they are afraid of becoming fat themselves. I hate to tell the weightists this, but overweight and obese people are not an "other". They are people, with strengths and faults and feelings and thoughts. They are us.

It's bad enough when someone makes insensitive comments about obesity. But often if the subject of eating or exercise comes up in discussing weight problems with others, everyone has an answer. Stop eating meat, some believe. Others believe more protein is the answer. Some swear by yoga, while others think running is the only way to a "slimmer" body. Join a gym, cut out carbs, eat five meals a day, try a cleansing enema - I have heard all of these "answers" and more. While I think a conversation like this is fine and probably harmless in private, one-on-one situations, it concerns me that so many people think they have an answer to a problem they've probably never had - namely, extreme weight gain.

If an overweight friend came to me for advice on losing weight (I'm an authority, of course, since I lost 20 pounds a couple years ago, right? even though I'm technically still overweight...), I would tell him what worked for me (lots of walking and a slight reduction in calories), remind him that the same solutions don't work for everyone, and then I would suggest he go see a doctor. A doctor can check for hormonal imbalances and drug side effects, and can consider whether a specific genetic predisposition means a higher weight is normal and healthy. A doctor can recommend physical therapists, personal trainers, nutritionists and others who have expertise on healthy, appropriate weight loss. Under some circumstances a doctor may even recommend further medical care.

Furthermore, I would only give this most minimal advice if I was asked. Why? Because I am not an expert. So many educated people I know these days seem to think they are experts on how a person should care for herself. They give advice constantly, unbidden. If I mention I'm feeling sad, my friends often don't sympathize (though often they do!); often they tell me all the things they think I should do to feel better. Maybe I'm just sad, and I don't feel the need for help! The same is true for being overweight. In some situations, being visibly overweight is a problem, while in others it might not be such a big deal. But that's between me and my doctor.

So the next time you think disapproving thoughts to yourself about another person's weight, whether that person is heavy or thin, really think about what you are saying. Are you expressing frustration at an unpleasant situation (as my friend on the plane)? Are you fearing lack of control over your own weight? Are you trying to play the medical expert when you are not one? Or are you just matching your expectations for others to society's ridiculous and unfair demands? Then remember that weight is a private health matter, and butt out.