Everybody has seen the recent tabloid ploy to polarise Britain – yep, we’re back to vilifying fat people again. Essentially the story informed readers that GPs are being actively encouraged to shame fat patients, who are the current focus of the moral panic surrounding the ever-elusive “drain on the NHS”, by putting them on diets regardless of the reason they sought medical help.
There are two camps here. On one hand, there are those who think fat people should absolutely feel ashamed of themselves. After all, it isn’t the millions of pounds wasted on unnecessary prescriptions every year which damages the NHS, nor the GP appointments which follow every tickle of the chest and cost the NHS £43 a visit, but somehow it is in the inherent nature of body fat itself to fundamentally destroy the British health system. It is the opinion of many (and technically I can’t disregard it as invalid and the opinion of idiots in the interest of fairness, but, y’know…) that there is no better place to shame a fat person than in a GP’s office. However, that throws up a few issues which are really problematic to me.
The first obvious problem is the fact that this whole system is based on shame. It immediately creates a social hierarchy at which fat people form the bottom tier: you have ownership over that person, and are therefore able to decide that they deserve shame and actually force them into a diet. If you were genuinely interested in health (which, I’m sorry, you’re not – the media makes billions tricking people into believing that “them vs us” is a justifiable position for you to be in, and unfortunately you’ve just fallen for it) you would use language that puts you on an equal footing to your fat friend. You would help. You would support. You would not raise yourself above that person and condemn them to such a negative experience.
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Secondly, it goes beyond patronising to assume that a fat person is not aware of their own size – and actually, that ties in very closely with shame. I know very well how much space I am taking up, and trust me when I tell you that strangers do their best to make it clear that they know, too. Thin privilege is not seeing fear flash through a stranger’s eyes when you smile in that “sorry, there are no seats left” way and shuffle over to sit next to them on the bus. So believe me, my mass is no secret to anybody, and certainly not me. It can take years of committed immersion in the body positive community for some women to feel happy, or even proud, of their own bodies because our social spaces are geared towards shaming the other – a medical professional simply telling me “you are overweight” is irrelevant, patronising and unnecessary.
My next issue is that in the maximum of five minutes you are sitting opposite a GP, it is impossible for him or her to get a grasp of your social experiences and triggers. If total body positivity is achieved on a scale of 1 to 10 (I am pretty sure nobody is a full 10) and you’re hovering at a 4, it may be that a shameful experience can cause you to have a real set back. Alternatively, you could be somebody who is really struggling to feel positive about yourself and taking part in quite dangerous eating patterns. Christ, the article itself gives you details on the 5:2 diet, which is the epitome of binge-restrict and painfully unhealthy. Eating disorders are already drowning in shame, and shameful words from somebody you are supposed to trust (such as a medical professional) can make things so much worse – and even undo some important recovery you may have made. Many of us in the body positive community have fallen victim to the repeated “diet – binge – hate yourself – repeat” cycle and are specifically triggered by numbers and weight loss goals. Bringing these up with no prior warning is going to hurt your patient’s mental and physical health, as they spiral into that same obsessive cycle of self-loathing. Or worse, they might take the advice given in this article and engage in a truly damaging diet which appears to place fatphobia over health. But anything to make money, right?
Danger to health
Do you realise how many times I have avoided going to the doctor because I have not wanted to get a lecture about my weight? And I’m talking about things that are not related to my weight in any way. When I last went for a smear test, my nurse told me she was unable to carry out the smear test without me first standing on the scales and having a discussion about my exercise and eating habits. I even got the whispered “you’re quite overweight” as if it’s a closely guarded secret. Let me tell you, you can be a solid 9 on the body positivity scale and you are never going to be able to avoid that sting. At the end of the smear test (it was my first one), I asked her why my weight had been relevant to the procedure. “Oh, it hadn’t been, but I could hardly let you walk out of here without me weighing you when you’re that big, so I just had to tell you that it was necessary” – yes, I was lied to, and I stupidly believed her, hopped onto those scales and cried about myself for two days after. And now, as important as I know smear tests are, I am already dreading my next one. If my anxiety is stronger than my logic at the time of my next one, it is very likely that I won’t go. If there are any abnormalities, I may never find out until they develop into a problem. Can you see from this one example why shame in what is supposed to be a safe space is so troubling and dangerous? My aversion to doctors may even mean that I’m costing the NHS less than I would have done if I was thin and actually took my real medical problems to the GP instead of suffering in silence and fear. But maybe that is the entire point.
You cannot tell
My final point should literally just be called “having common sense”. You cannot tell how healthy somebody is just by looking at them. Interestingly, when somebody gets seriously ill, the first thing they do is lose a large amount of weight – are those people then more healthy? Also, to give you another personal example, I am the fattest staff member here at She Might Be. I am also on my feet all day every day, working as a retail supervisor. I receive daily surprised comments about my stamina, strength and energy levels. I often help middle-aged men carry things to their cars because they’re too heavy, and I have heard “wow, well done!” on many an occasion when I can lift and carry things that others can’t. You absolutely do not know my eating habits by looking at me. You do not know if I have any diseases, any disorders, any ailments. You do not know if I am active. You do not know a thing about a person’s health by looking at them and actually, we all have a right to exist exactly as we are without being made to feel ashamed of ourselves.
If you want to know why the NHS is suffering, look to the people who claim free prescriptions for things they could buy over the counter. Look at the length of time people are waiting at walk-in centres for issues that could be dealt with at home. I’m not going to make this a political issue, but perhaps before deciding that only one section of society should face the blame for a struggling healthcare system, dig deeper than what tabloids are telling you. Do not let cultural fatphobia rob you of your logic and reason and if you are one of us – a fat person who is horrified and terrified – please remember that you are not the problem and you never were.
Oh, and in the interest of fairness, the same publication brought out a report a year ago outlining the biggest drains on the NHS, and fat people aren’t even mentioned.