TW: Fatmisia/Fatphobia, ableism, diet culture, dieting, size mentions, eating disorders, weight loss drugs
In the United States of America (Land of the Free and Home of the Brave), you can legally be fired for being fat in 49 states. In this essay, fat is not used in a derogatory manner. Fat is just a descriptor, like thin or tall or short or white or black. Fat people all over the world are taking back the word fat from cruel people who use it to hurl pain at others. Michigan is the only state with laws prohibiting anti-fat discrimination. There are also six cities where discrimination against people based on their size is illegal: Binghamton, NY, Madison, WI, San Francisco, CA, Santa Cruz, CA, Urbana, IL, and Washington, DC. Approximately 42% of Americans are considered ob*se, meaning that almost half of our citizens can legally be discriminated against for their weight. Ob*sity or ob*se are harmful terms used to medicalize and stigmatize fat people. I will only use them in reference to studies on or research related to ob*sity. Each of us who lives in America has been steeped in an anti-fat stew for as long as we’ve been alive. Some people may think it’s right or fair that someone can be fired for being fat. It’s likely that some people believe (falsely) that fat people got that way because of their own behavior. Some people may believe that all people above a certain weight are unhealthy, or that body positivity is only good for people up to a certain size. As far as people’s “health concerns,” Lindo Bacon’s Health at Every Size cites a plethora of sources that show it is actually anti-fat bias that is correlated with illness, not fatness itself. So why are Americans so obsessed with being thin and why are Americans so terrible to fat people?
In Sonya Renee Taylor’s revelatory book, The Body Is Not an Apology, she explains that, “it is an act of terrorism against our bodies to perpetuate body shame and to support body-based oppression. I call this ‘body terrorism.’ Terrorism is defined as ‘the systematic use of terror especially as a means of coercion.’ It takes no more than a brief review of the historic and present-day examples of media manipulation and legislative oppression to acknowledge that we are indeed being coerced into body shame for both economic and political reasons.”
As Virgie Tovar explains in her book, You Have the Right to Remain Fat, Fatmisia affects everyone because people are either being oppressed because they are fat or they are afraid of becoming fat because they know how awfully fat people are treated. Fat people are treated differently because they don’t function within the norms of the default or ideal body according to society. We aren’t straight, white, thin, middle class men (or women). We are punished for being different, even though most people would never choose to be fat because they know about body-based oppression, even if they haven’t experienced it themselves. While there is a small minority of people who would choose to be fat, one study showed that 16% of women surveyed would give up a year of their life to be thin. In addition, 10% were willing to trade 2-5 years, 2% were willing to give up to ten years of their life away, and 1% said they would give 21 years or more. People are willing to die early to be thin, which is so sad but honestly kind of makes sense because of how terribly everyone knows fat people are treated.
I want to take a moment here to address something that many of you will think I am making up: thin privilege. Having thin privilege doesn’t mean no one has ever been mean to you because of your size or made unwanted comments about your weight, it just means that you aren’t systemically oppressed for being thin. You can shop at almost any store you want to for clothes. Airline seats are made with you in mind. Your doctor is more likely to believe you about symptoms and not attribute any ailment or illness to you needing to lose weight. You can’t legally be fired in 49 states because of your weight. Because of sizeism, smaller fat people hold some thin privilege as well. Fat people have identified a spectrum of fatness. People lower on that spectrum have still probably experienced oppression, but probably not as much of it as people higher on that spectrum. As a midfat, I’ve probably experienced more body-based oppression than a smallfat, but relatively a lot less oppression than someone who is an infinifat.
My brother called me chubby from as early as I can remember. Every time we would argue, and even when we weren’t arguing, he felt the need to call out my weight. I weighed about the same as other kids my age until I hit puberty. What my brother was saying wasn’t even true. I didn’t start wearing clothing in sizes that couldn’t be found at most straight-sized brick and mortar stores until I was in my mid-twenties, but it stung so deeply to know that someone I loved thought I was fat. Straight-sized people can find clothing in almost any clothing store that will fit them. At the time, I thought fat was the worst thing a person could be. Society, the media, and my relatives had made sure of that.
In addition to being called chubby, my family members, friends, and even strangers have been alarmed by the fact that I don’t eat vegetables. People love to point out that if I ate more vegetables and less junk, I would lose weight. Everyone is always telling me I am, “just too picky.” It is incredibly shaming and my paternal grandmother continues to ask questions like, “when are you going to grow up and eat your vegetables?” When the DSM-V (The Diagnostic and Statistics Manual for Psychology) came out, there was a term for people who avoided certain complete categories of food- Avoidant Restrictive Food Intake Disorder. ARFID. It wasn’t that I was “just too picky,” I’d had an undiagnosed eating disorder for all of my life. I remember one time in middle school when I decided that I wanted to be a vegetarian for moral reasons. Since I didn’t actually eat vegetables, at the end of the second or third day of barely eating anything, I fainted.
I can remember my mom starting Weight Watchers when I was about ten. Since she was dieting and she prepared our meals, the whole family was dieting. I remember eating homemade Weight Watchers ice cream sandwiches- one chocolate graham cracker broken in half with fat free whipped topping frozen in the middle. They tasted pretty good and I assumed that if the adults in my life were dieting, it must be the right thing to do.
My brother eventually stopped calling me chubby about 16 years too late when I was in high school after I had a meltdown about it. My heart was breaking because I thought that if my brother thought I was fat, it must be true. If I was fat, that meant I had failed as a person. It meant I was lazy and gluttonous and wasn’t trying hard enough. Not trying hard enough is not something people could typically accuse me of, as I tend to be an overachiever in all things. I was especially an overachiever at dieting as a teenager. My doctor and any number of media sources made it seem simple. If I consumed less calories than I was burning, I would lose weight. This was kind of a game to me. I tried to subsist on as few calories and burn as many calories as I could. It never worked and I always ended up compensating for the missing calories by binging later.
Freshmen and sophomore year of college, I learned that I have a hair-trigger gag reflex and could throw up any time I wanted to. This, coupled with my deep hatred of myself, led to about a year and a half of bulimia, during which time I was the skinniest I’ve ever been. People treated me as though I had achieved something marvelous and spectacular. Everyone told me how great I looked. It was wonderful and awful. I came across some photos from that time recently and even now, with all of the knowledge I have about diet culture and Fatmisia, my first thought was, “wow. I wish I could look like that now.” I stopped making myself vomit sometime during sophomore year when I got into a relationship with a guy I really liked. It was too complicated making sure I had a tooth brush and mouthwash with me after every snack or meal. I gained the weight back, but I was still what anyone would consider straight-sized and could still purchase clothing at stores that didn’t sell plus sized clothing. That boyfriend eventually told me I had gained too much weight and was no longer attractive. When I told him that I had lost it all by making myself throw up, he said it would be ok with him if I started doing that again. I didn’t resume my bulimia, but I did stay with him and feel like shit about myself for at least another year after that. At the time, I thought, “even the person I love, who is supposed to love me, is telling me I’m not good enough because of my size. That must mean I’m truly worthless.”
My brother and that boyfriend are not the reason I’m fat now and they surely aren’t the only people in my world who have ever commented on my weight, but that judgment from my brother about my weight as a child and pre-teen and the revelation from my then boyfriend when I was not fat still sit with me. It breaks my heart to know how steeped in diet culture I was and how much anti-fat bias I held. It isn’t that I don’t hold any of that bias now, but I’m much more aware of it and try to challenge it every time it pops into my head.
While I was in graduate school, I decided to go to The Bariatric Clinic in my area. They happily prescribed a diet and phentermine, a weight loss drug that I had heard about from my cousin. Phentermine is an appetite suppressant that is also known to cause rapid or irregular heartbeat, delirium, panic, psychosis, and heart failure. I signed a waiver. I didn’t care if it killed me, I, like so many others, just wanted to be thin. I was on phentermine for a few months and lost the weight I wanted to. I don’t remember why I stopped taking phentermine, but I’m glad that it hasn’t had any apparent long-term effects on my health.
I tried to get back on it after returning home from the Peace Corps in spite of my being straight-sized at the time. The doctors refused. Not because of my weight, my BMI even then categorized me as ob*se in spite of me being able to wear straight-sized clothing, but because I had been diagnosed with Bipolar Disorder during my time in the Peace Corps, and a medication that can cause psychosis isn’t ideal for a patient that already experiences psychosis.
After I developed Bipolar Disorder, a variety of different psychiatrists tried a variety of different pharmacological treatments for me. On one combination of medications, I gained about 40% more of my body weight in two to three months. When I finally got around to getting a dietician this year, she was appalled. If a drug is known to cause weight gain and that weight gain occurs as more than a specific percentage of your body weight over a specific period of time, the drug is supposed to be stopped before you gain more weight. My doctor at the time either didn’t know that or didn’t care. It resulted in me seeing a photograph of myself in a tank top and shorts and deciding that I didn’t deserve to live.
I tried joining a gym. I tried dieting. Nothing would take away the pounds that the medicine had made me gain. To me, being fat was such an awful thing that I deserved to die just for living in a fat body. As a result of seeing that photo, I became suicidal. That depressive episode turned into a mixed episode that eventually landed me in the hospital, but there was little that could be done about my fatness since I’d already gained the weight and nothing had seemed to bring it back down. I even started taking Vyvanse, a drug prescribed for moderate to severe binge eating disorder, to try to lose the weight or to at least stop gaining. It didn’t make me lose any weight really and I was left in a body that I absolutely hated. I’ve told you all of this so that you have some small understanding of what my experience with diet culture and eating disorders has been like.
What I really want to talk about is what it’s like to be a fat person with an eating disorder. Behaviors that are frowned upon for thin people with eating disorders are encouraged for fat people with eating disorders. If someone weighs over a certain weight, counting calories and restricting and over-exercising may be seen as desirable by health care professionals. For people under a certain weight, that type of behavior will land you on an inpatient unit for eating disorder treatment. In addition to dealing with my own internalized Fatmisia, I experienced very blatant Fatmisia while in treatment for my eating disorder.
From September to December of 2020, I was in treatment at a PHP and IOP for my Bipolar Disorder, PTSD, and eating disorders (ARFID and Other Specified Feeding or Eating Disorder). My OSFED was, at the time, presenting as me skipping a lot of meals and restricting the meals I did eat to less than what I would normally eat. I had read You Have the Right to Remain Fat by Virgie Tovar a couple of years prior and had recently read Health At Every Size (HAES) by Lindo Bacon. I knew that yo-yo dieting and restricting were terrible for my body, but I couldn’t seem to make myself eat three meals and two snacks a day as recommended by the dietician I was seeing as part of treatment.
That dietician, who I adore, decided that for group one day, we would talk about Health at Every Size and the voluminous research referenced in it that proves that diets don’t work and being fat isn’t a personal failure. She told me ahead of time that we would be doing the group as she knew that I really valued HAES as a resource and way of understanding the world. I was so excited for my friends in treatment to share in what I already knew- that being fat isn’t a personal choice or failure and that diets fail over 90% of the time. What I mean by that is that research has shown that of those who diet and lose a substantial amount of weight, 90-92% will gain all of the weight back within 2-5 years. Many of them will gain back more weight than they originally lost. In addition, up to 70% of a person’s weight is actually genetic, so being fat has little to do with behavior and isn’t quite as simple as the “calories in- calories out” approach that we’ve been taught our whole lives. I thought this information would be revelatory to my fellow eating disorder friends. What I didn’t expect was someone I really liked and respected declaring that everyone over a certain size is unhealthy and, “I get body positivity up to a certain point, but come on.” I called this out as fatphobia, having not yet learned the word Fatmisia, by saying in my group end check out that “fatphobia is real and pervasive” and was devastated when the response was, “well, I guess I’m just a fatphobic asshole.” The person who said this is a person who holds a lot of thin privilege but who is oppressed in a lot of other ways. They had always seemed really progressive, so I was shocked. I was one of only two fat people in the room and the other fat person appeared to be asleep.
For the life of me, I couldn’t let this experience go. I spent weeks’ worth of therapy sessions and dietician sessions talking over and over again about how I just didn’t understand how someone who was so progressive in so many respects could still be hung up in Fatmisia. My therapist suggested that me, my therapist, my dietician, and the person who had made the fatphobic comments should have a session together where I, the fat person, was to do the emotional labor required to educate the thin fatphobic person on how and why what they had said was harmful. If it had been any other type of discrimination, the facility would have taken it more seriously, but they didn’t. Instead, they did the equivalent of asking a Black, Brown, or Asian person to explain to a white person how and why racist remarks were harmful. I was angry and I explained to my therapist that this would be asking me for a lot of emotional labor that I didn’t want to do and that it wasn’t my responsibility to do. That therapist told me that if the Black Lives Matter movement was less angry and was mourning in the streets, they would get a lot farther. I informed her that it isn’t Black people’s responsibility to make the movement more palatable for white people, just as it isn’t my job as a fat person to explain why fatphobia is harmful to a thin person steeped in their own Fatmisia.
I’m still shocked by that therapist’s response. I’m still shocked that the facility didn’t step in and do anything. I’m still shocked that the only repercussion was that the group collaboratively came up with new group norms (including anti-discrimination language) that would be overturned immediately as soon as my dietician left for private practice. The new group norms that the facility director came up with included rules about being authentic and not thinking too much about the effect of your words before you speak. Someone had used discriminatory language about people like me. I told my therapist, the dietician, and my case manager. As far as I know, there were never any consequences for the person who made the comments. They eventually, weeks later, reached out to me via text to apologize. I explained that I valued our friendship and that I was open to having a conversation about it, but I still needed some more time as I was still angry and hurt. Their response was kind and understanding and was much more in line with the person I thought they were than their fatphobic comments. We never ended up having that in-depth conversation, but I passed along some resources from the Fat Liberation Movement for them to read as well as a copy of You Have the Right to Remain Fat by Virgie Tovar. I have given out probably four or five copies of that book since I read it a couple of years ago.
I wasn’t ready to have a conversation with that person at the time, but if I was brave enough to reach out to them now, I would tell them this, “What you said was damaging and harmful. Even though I’m not in the weight category you were speaking of, you were speaking of people like me and about a weight I could reach at some point in my life. You reinforced the belief society has already beaten into my head that I’m not good enough and I never will be because I will never be thin again. You reinforced so many hurtful messages I have received throughout my life. You are someone I really respect, like, and trust, so it hurt worse coming from you than it would have coming from someone else. You reinforced the idea that there’s no way for me to ever be “healthy” because I am fat. You reinforced the idea that health is something everyone should be able to achieve, even though there’s a significant portion of the population for who that goal isn’t attainable due to chronic illness regardless of size. I thought you were progressive, and if your feminism doesn’t include fat people and disabled people, it isn’t intersectional and you need to take a good hard look at it.”
I think there are more things I would want to say, but even months later, I am still so upset thinking about the interaction that I can’t make the words come to me and can’t make them make sense. I’m used to messages like this from my family members. I’m used to messages like this from society. I’m not as used to messages like this from friends. People think they can say stuff like this around me because I’m not that fat. This week, I publicly made a commitment to call out fatphobia and Fatmisia when I see them. I posted on my Facebook and my Instagram. On Facebook, I said, “I’m done keeping quiet on other people’s fatphobic posts. I wouldn’t scroll quietly by if it was racism or ableism or homophobia and I’m not going to for Fatphobia/fatmisia anymore either. If you post something insulting or untruthful or insinuating something insulting or untruthful about fat people, expect some facts to pop up from me in your comment section. Immigrants can be deported from New Zealand for having a BMI over 35 and you can be fired in 48 states for being fat, but I’m sure some of you still think the fatphobia is all in my head. Here’s my recommended reading list for those of you who need convincing:
The Body is Not an Apology by Sonya Renee Taylor
What We Don’t Talk About When We Talk About Fat by Aubrey Gordon
Health at Every Size by Lindo Bacon
You Have the Right to Remain Fat by Virgie Tovar.”
On Instagram, I posted an excerpt from Sonya Renee Taylor’s The Body is not an Apology. It said, “fatphobia remains one of the most underdiscussed and unacknowledged forms of body terrorism. The allure of thin privilege is frighteningly persuasive; from easy shopping to better job and romantic opportunities, society promotes and rewards thinness and punishes fat. The pernicious lie of fatness as an individual failure of self-control, lack of discipline, evidence of gluttony and laziness all wrapped in a scientifically unsound narrative of health often leads even the most vocal intersectional social justice activists to promote weight loss and advance fatphobic body terrorism. Stomping out fatphobia will mean challenging our friends, families’, and coworkers’ indoctrination by questioning stereotypes, sharing what we are learning about fatphobia, and asking others to learn with us.” My comment below said, “Fatphobia/fatmisia is EVERYWHERE and is widely accepted by most people because they think fat people got that way through their own laziness and bad eating. I’m here to tell you that 70% of weight is related to GENETICS and NOT behavior or food choices. About 90% of people who diet and lose weight gain it all back (and often plus some more!) within 2-5 years. I’m asking you to think about this critically instead of just absorbing what society and medical professionals have told you. @lindobacon wrote Health at Every Size and it is a phenomenal book about what diet culture and fatphobia/fatmisia are doing to people. The excerpts above come from @sonyareneetaylor ‘s The Body Is Not an Apology and this book is a revelation. It talks about all the ways body terrorism affects everyone. It talks about the intersections of fatphobia/fatmisia and class, race, physical ability, mental health, etc etc. it’s only about 130 pages long, can be purchased on Amazon for about $17, and is guaranteed to change the way you look at the world. If you say you are concerned about fat people because of our “health”, read Health At Every Size and stop your concern trolling. Health is not a realistic thing for many chronically ill people to achieve, regardless of their body size. There are many many fat healthy people and many many thin unhealthy people and vice versa. It’s ableist to assume that everyone can and should be healthy because health is unachievable for so so many. Medical professionals contribute to this by refusing to see fat people’s health problems as anything but a symptom of their weight. People have DIED from undiagnosed cancer that their doctor just said was weight related pain. If you care about equity or justice at all, you must try to disrupt and dismantle fatphobia/fatmisia. If you call yourself a feminist, but aren’t doing this work, your feminism is hollow and incomplete.”
I’m sure that I’ll make many more posts and write many more essays about this as it’s a topic near and dear to my heart because it affects me every single day. For now, I’ll just leave you with the reminder that all bodies are good bodies. All human beings are inherently worthy of dignity and respect, regardless of what kind of body they live in.
Glossary of helpful terms
ARFID- Avoidant Restrictive Food Intake Disorder. ARFID is an eating disorder characterized by highly selective eating habits, disturbed feeding patterns or both.
Fat- In this essay, fat is not used in a derogatory manner. Fat is just a descriptor, like thin or tall or short or white or black. Fat people all over the world are taking back the word fat from cruel people who use it to hurl pain at others. I will describe myself as fat because I am fat. If that makes you uncomfortable, I encourage you to seek out resources on Fat Liberation and Fatmisia.
Fatmisia- from Simmons University, “Fatmisia (also called Fatphobia or Sizeism) is prejudice plus power; anyone of any weight or body type can have/exhibit size-based prejudice, but in North America and across the globe, thin people have the institutional power, therefore Fatmisia is a systematized discrimination or antagonism directed against fat bodies/people based on the belief that thinness is superior.”
Fatphobia- the fear and/or hatred of fat bodies
IOP- Intensive Outpatient Program. This is a level of care that is technically outpatient, but for people who struggle and need the structure of a 3-5 day a week program. The one I was in most recently was from 8AM- 1:30PM five days a week, then I dropped down to 8AM-1:30PM three days a week before discharge.
Ob*se- this is a harmful term used to medicalize and stigmatize fat people. I will only use it in reference to studies on or research related to ob*sity.
Other specified feeding or eating disorder (OSFED)- a DSM-5 category that, along with unspecified feeding or eating disorder (UFED), replaces the category formerly called eating disorder not otherwise specified (EDNOS) in the DSM-IV-TR. According to Wikipedia, “It captures feeding disorders and eating disorders of clinical severity that do not meet diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), pica, or rumination disorder.”
PHP- Partial Hospitalization Program. This is a level of care between inpatient and outpatient for people with mental health, substance abuse, or eating disorder struggles. They usually consist of several hours of group therapy plus individual therapy. The one I was in most recently was from 8AM-3:30PM five days a week and I also got to meet with a dietician once a week.
Straight Sized- straight-sized people can find clothing in almost any clothing store that will fit them. They do not have to shop in the plus size section of stores. This is generally considered to be a size 16 and below, though some clothing brands do stop production at a size 12. The national average size for women in America according to research published in the International Journal of Fashion Design, Technology, and Education, is, “a Misses size 16-18, which corresponds to a Women’s Plus size 20w.
Definitions about levels of fat vary, but here is a helpful chart based on definitions from thefatlip.com:
Health At Every Size by Lindo Bacon
The Body Is Not An Apology by Sonya Renee Taylor
You Have the Right to Remain Fat by Virgie Tovar
What We Don’t Talk About When We Talk About Fat by Aubrey Gordon
The Fat Studies Reader edited by Esther Rothblum and Sondra Solovay
My Fat Studies Amazon Wish List with books recommended by people in the Fat Studies Community