2008 was a great year for Fat Panic so it seems only fitting to honour a handful of people who did so much this year to ensure that people of all sizes, but especially the fatties, feel alienated from and profoundly ashamed of their bodies, confused about how best to manage their own health, responsible for the world's ills, and are ready for salvation in weight loss.
First, The 2008 Obesity Timebomb Shit List
Sir Liam Donaldson
The Chief Medical Officer for England would have passed me right by had it not been for his BBC Viewpoint piece today. Here he shows just how out of touch he is, and how little idea he has of the impact of his institutionally fatphobic policies on people in the UK. He seems genuinely surprised that fat people might experience stigma, or that he is responsible for fat kids getting bullied because of his work in forcing weight loss and surveillance on school children, and has an outrageous insensitivity about the language used to describe fat.
Fern Britton
The woman who used to be the face of size acceptance became a poster girl for gastric banding in 2008. Vilified by the press for lies attributing her weight loss to diet and exercise, she chose to present her surgery as a private and personal choice. This conveniently absolved Britton of any accountability she might have as a public person who has invested in something really risky. Remember the personal is political? Apparently not.
Kira Cochrane
The Guardian's feminist dieter is oh so reasonable, sympathetic and right-on, yet unexamined self-hatred oozes out of every depressing column she writes about her inevitably failing and humiliatingly unsustainable diet, as well as her tragic efforts at self-policing. Despite attempts at presenting a knowing distance, Cochrane is clearly invested in weight loss which she legitimates for her Guardian demographic. There is an amazing history of feminist engagement with fat and body stuff, look at The Fat Underground, for example; the column could be a powerful opportunity to explore a non-diet feminist approach to health and happiness, yet Cochrane refuses to get a life, remains mired in the misery, and wants us to read all about it. Blurp.
LighterLife
2008 offered up this dodgy weight loss company another inquest and the quiet collapse of a fake charity they funded as a marketing project, not to mention a hostile BBC investigative report that uncovered more hospitalisations. In any other business this would constitute A Bad Year, but the weight loss industry is different, LigherLife boss Bar Hewlett is unrepentant and the company made an alleged £18 million profit this year.
Tam Fry
More children-measuring! Genetic explanations for fat shouldn't stop people from trying to lose weight! Obesity is the greatest killer known to humankind! Exterminate the fatties! Exterminate! Sorry, I lost myself a bit there…
Lest that bunch leave you feeling as though you want to end it all, let's move on to the real movers and shakers of 2008, people and organisations who gave me hope and a load of big fat reasons to keep on keeping on.
The Hit List
Fat Studies UK
A gathering, an online forum and soon, a book. Fat Studies UK has been busy creating community in 2008 where previously there were just a bunch of scattered academics and activists. Applause is due for the intellectual vigour of the work being produced as well as its accessibility. FSUK has been so needed and is so welcome.
FemmeCast
Bringing together queer, fat, femme, DIY and technology in an unholy alliance, the FemmeCast is my favourite fat media fix. I don't always agree with everything, and my world is quite different to the world I listen to, but what I love about the podcast is how it provides a snapshot of queer fat femme culture in the US. You really get a strong sense of community from it, not only that, but a community that is questioning, reflective, politicised and as hot as hell. They are an example to us all.
Geleni Fontaine
Geleni presented a beautiful keynote at Nolose 2008 which incorporated powerful stories like the one about hir* Dad's job at the Sweet n Low factory in the 1960s. Ze* got the room yelling and punching, which was truly a sight to be seen, and managed to talk about intersectional identities in a way that really brought the subject alive. Read the keynote again. *Geleni uses gender-neutral pronouns, fact fans.
Linda Bacon
Health At Every Size got a fierce shot of mainstream attention with the publication of Linda's brilliant new book. Bring it on!
Fat Activist Network
Portland zinester Krissy Durden created a social networking site for fat activists this year and it's been wonderful to see faces appearing and connections forming as a result. Who knows what direction it might take? Whatever, it's given me a greater sense of being part of something, and it's instilled a lot of hope for change in what has generally been a tough year for fat folks.
17 December 2008
Obesity, search filters and fat panic
I was just mooching around The Guardian's search pages and filters just now and I noticed some stuff that I'm going to share here. It would be really interesting to compare these search results with those of different media outlets, maybe in different countries, from different political perspectives (The Guardian is a centre-left newspaper in the UK).I searched on "Obesity" to see where and when fat panic stories were published this year. Sure, the search may have picked up stories that aren't entirely hostile to fat people, but Obesity is a pretty loaded term, not really acceptable amongst fat activists, and is generally used to support the idea of fat being a problem that needs to be cured by weight loss.
So I searched on Obesity and then I started playing around with some of the search filters.
Publication year interested me. One of the reasons that there is just one meagre result for Obesity in 1998 could be because Guardian online was only just beginning at that point and there wasn't much content available. The growth in the number of Obesity results in ten years is really startling, however, almost doubling each year between 1999 and 2004, with a millennial plateau in the middle. Apparently we are in the grip of an Obesity EpidemicTM, although these results suggest that it is more of an epidemic of fat panic reporting.2004 was a significant year because it coincides with the World Health Organization's report, Obesity: preventing and managing the global epidemic, which is likely to have kicked-off this current wave of fat panic. The number of Guardian results for Obesity in 2004, their highest ever, seems to bear that out.
Publication months for 2008 confirm my suspicions about fat reporting peaking in January, the month of new year diet resolutions; and July, the beginning of the journalistic Silly Season, where any old crap gets published because everyone's on holiday, and also the season of beach body anxiety.
The section results for 2008 show how Obesity has infiltrated areas where you might be somewhat sceptical about there being a connection. Journalists, got a dreary story? Jazz it up by adding a pinch of fat panic! Hence the multitude of Sport and Environment stories, and entries in Money, Art and Design. Needless to say, there are no results for "fat liberation" or "size acceptance."
Finally, the juxtaposition of hard news and Sponsored Links seems particularly telling. It made me think about how weight loss industries, and private eating disorder clinics, are cashing-in on the back of fat panic in the media. This screengrab seems to illustrate this idea really well.
14 December 2008
Healthy Towns
I'm late to the discussion about the Change4Life Healthy Towns initiative, but I have a few comments.
Dudley, Halifax, Sheffield, Tower Hamlets, Thetford, Middlesborough, Manchester, Tewkesbury, Peterborough and Portsmouth have been given £30 million to promote cycling, walking, healthy eating and green spaces in a bid to curb obesity levels.
In theory I have no beef with the idea of more cycle facilities; cycling any distance in London for me means negotiating cruddy drivers and dual carriageways. I know two cyclists who have been killed on the roads in the past two years. Better signage for walking would be great too, I love London Underground's JourneyPlanner, which has opened up new routes and walking in the city for me. Access to good quality and affordable fresh food, who could argue with that? Likewise green spaces. Sounds great, right?
There are a couple of fundamental problems with Healthy Towns, however, which change things for me.
Firstly, the framing of these initiatives as part of a response to a global obesity epidemic perpetuates fat panic, positions "obesity" as a problem to be eliminated, promotes the idea that fat is costing the NHS a packet, and negates me and my kind.
Secondly, "health" is not really defined, apart from through obesity statistics. Health is multi-dimensional and extremely subjective, and the reductive tactic of allying it to bodyweight is, well, quite stupid. I suspect that Healthy Towns is a euphemism for "Towns Where We've Got Rid of The Fatties So they Can't Clog Up The NHS With Their Revolting Bodies And Cost Us a Fortune". Doesn't sound so friendly now.
Thirdly, 30 million does not buy a huge amount of infrastructure redesign amongst ten municipalities. I think it's likely that local authorities will try and do things on the cheap in a really muddled and ill-conceived way. I expect to see more instances where, for example, a local council does a deal with a dieting company, as has happened in East London, and where my council tax is funding Newham's association with Slimming World. Pardon my cynicism but is the commercial weight loss industry really the best advocate of my health? Nope.
Imagine a £3 million investment in Health At Every Size instead. Strategies to improve people's health that take a holistic view and which don't base health on an outmoded chart don't have to be expensive. If I was in charge of that money I'd spend it on:
Dudley, Halifax, Sheffield, Tower Hamlets, Thetford, Middlesborough, Manchester, Tewkesbury, Peterborough and Portsmouth have been given £30 million to promote cycling, walking, healthy eating and green spaces in a bid to curb obesity levels.
In theory I have no beef with the idea of more cycle facilities; cycling any distance in London for me means negotiating cruddy drivers and dual carriageways. I know two cyclists who have been killed on the roads in the past two years. Better signage for walking would be great too, I love London Underground's JourneyPlanner, which has opened up new routes and walking in the city for me. Access to good quality and affordable fresh food, who could argue with that? Likewise green spaces. Sounds great, right?
There are a couple of fundamental problems with Healthy Towns, however, which change things for me.
Firstly, the framing of these initiatives as part of a response to a global obesity epidemic perpetuates fat panic, positions "obesity" as a problem to be eliminated, promotes the idea that fat is costing the NHS a packet, and negates me and my kind.
Secondly, "health" is not really defined, apart from through obesity statistics. Health is multi-dimensional and extremely subjective, and the reductive tactic of allying it to bodyweight is, well, quite stupid. I suspect that Healthy Towns is a euphemism for "Towns Where We've Got Rid of The Fatties So they Can't Clog Up The NHS With Their Revolting Bodies And Cost Us a Fortune". Doesn't sound so friendly now.
Thirdly, 30 million does not buy a huge amount of infrastructure redesign amongst ten municipalities. I think it's likely that local authorities will try and do things on the cheap in a really muddled and ill-conceived way. I expect to see more instances where, for example, a local council does a deal with a dieting company, as has happened in East London, and where my council tax is funding Newham's association with Slimming World. Pardon my cynicism but is the commercial weight loss industry really the best advocate of my health? Nope.
Imagine a £3 million investment in Health At Every Size instead. Strategies to improve people's health that take a holistic view and which don't base health on an outmoded chart don't have to be expensive. If I was in charge of that money I'd spend it on:
- Assertiveness skills classes so that fat people can learn to self-advocate for their health within a system that seems intent on denying us access to acceptable standards of care.
- Systems for training health professionals to deal with fat people sensitively and helpfully.
- Fat-friendly swims, fat-friendly social groups, fat-friendly yoga or trampolining lessons.
- I'd set up collections of fat liberation materials within local libraries and make them accessible online, and in ways that reach people who are not library or internet users.
- Oral history projects encouraging fat people to know about their community, their history, projects that enable people to feel empowered, less alone.
- Accessible equipment, big kayaks, scuba gear, stuff that would make activities fun for people, with subsidies for shops selling large-sized gear.
- Grants available for people exploring HAES through community projects, grants, research.
- Good quality, non-judgmental counselling services and supportive resources for people dealing with fatphobia, self-hatred, dieting fallout, etc
- A regular dance party.
Oh, the list goes on.
Finally, the whole shebang reminds me of Ruth Levitas' work on social exclusion. In 2004 she wrote about the ways that social exclusion is influenced by political ideology, she describes the ways that it was positioned under New Labour in the UK during the mid-1990s by charting a chronology and identifying themes within social exclusion. She argues that in the UK in the 1980s and early 1990s social exclusion was understood as multi-dimensional, connected to poverty and social inequality, and that its proponents sought to reduce inequalities through greater rights and a redistribution of resources, which she called RED. By the 90s this model was supplanted by two new approaches: Social Integrationist Discourse (SID) sought to integrate people into work as a means of addressing social exclusion, whilst Moral Underclass Discourse (MUD) characterised socially excluded people as morally distinct from the rest of society". Levitas is rightly critical of SID and MUD because they neglect how work is structured under capitalism (eg poor working conditions, McJobs), they stigmatise and shame people, and they support the idea that the state is essentially meritocratic. and that social inclusion can be achieved by hard work and opportunity.
I think this process is happening with Healthy Towns, and that Change4Life is on the same trajectory as welfare reforms of the recent past, a stick and carrot approach to social health, with the emphasis on the stick. Referring back to Levitas , these strategies are typically modelled on SID and MUD in that they propose a neoliberal agenda in which frighteningly deviant bodies are rehabilitated into the mainstream through the hard work of diet and exercise – never mind the evidence that diet and exercise are themselves problematic in relation to slimming down fat people.
Meanwhile, Tower Hamlets, one of the Healthy Towns, is a neighbouring borough to my own, and I'll be keeping an eye on developments there.
Finally, the whole shebang reminds me of Ruth Levitas' work on social exclusion. In 2004 she wrote about the ways that social exclusion is influenced by political ideology, she describes the ways that it was positioned under New Labour in the UK during the mid-1990s by charting a chronology and identifying themes within social exclusion. She argues that in the UK in the 1980s and early 1990s social exclusion was understood as multi-dimensional, connected to poverty and social inequality, and that its proponents sought to reduce inequalities through greater rights and a redistribution of resources, which she called RED. By the 90s this model was supplanted by two new approaches: Social Integrationist Discourse (SID) sought to integrate people into work as a means of addressing social exclusion, whilst Moral Underclass Discourse (MUD) characterised socially excluded people as morally distinct from the rest of society". Levitas is rightly critical of SID and MUD because they neglect how work is structured under capitalism (eg poor working conditions, McJobs), they stigmatise and shame people, and they support the idea that the state is essentially meritocratic. and that social inclusion can be achieved by hard work and opportunity.
I think this process is happening with Healthy Towns, and that Change4Life is on the same trajectory as welfare reforms of the recent past, a stick and carrot approach to social health, with the emphasis on the stick. Referring back to Levitas , these strategies are typically modelled on SID and MUD in that they propose a neoliberal agenda in which frighteningly deviant bodies are rehabilitated into the mainstream through the hard work of diet and exercise – never mind the evidence that diet and exercise are themselves problematic in relation to slimming down fat people.
Meanwhile, Tower Hamlets, one of the Healthy Towns, is a neighbouring borough to my own, and I'll be keeping an eye on developments there.
13 December 2008
LighterLife
Let’s take a moment to mourn Jacqueline Henson, whose inquest this week revealed that she had died after drinking a huge amount of water as she tried to follow the LighterLife diet. Heartbreaking evidence concerning the circumstances of her death were provided by her husband Brian, who said that the diet had been going brilliantly, "she loved it because she was losing weight. She was over the moon." On the night she died, Jacqueline’s 18 year-old daughter Chantelle found her unconscious.
This is not the first time that LighterLife have been implicated in a death. Matilda Callaghan died of a heart attack after living on LighterLife’s very low calorie diet for six months. One death might be described as a tragic accident, but two is plain careless.
In both cases LighterLife denied any liability. Regarding Ms Henson a spokeswoman claimed that the company states clearly how and when water should be drunk. As for Ms Callaghan, LighterLife boss Bar Hewlett told the inquest that "Miss Callaghan had been obese since the age of 12 and could have died at any time." She made a longer refutation in an open letter after the case was heard. Apologies for the vile blog I have linked to.
Despite their claims of innocence, there is a growing body of evidence against LighterLife, as reported by the BBC and the devil’s Daily Mail; Jacqueline Henson’s sister has also hit out at the company. And then there’s TOAST, secretly funded by LighterLife as a supposedly independent anti-obesity charity, and promoting their programmes, whilst also in receipt of government cash.
In any other sector, except perhaps the arms trade, it would be astounding that a company with this kind of record would have any credibility left. Weight Loss businesses are a law unto themselves, however, and LighterLife continues to enjoy good business. As well as sponsoring 2007’s Guild of Health Writers Awards, they also benefit from the UK’s lack of regulation in the counselling and psychotherapy industry. LighterLife recruits counsellors through the British Association of Counselling and Psychotherapy’s magazine, Therapy, which is available to the organisation’s members. LighterLife’s counsellors are trained and accredited with the BACP, who are playing an instrumental role in the development of an official UK register of therapists which is likely to be introduced within the next few years. Accreditation and BACP membership means inclusion on that register. Nobody seems to think that this is a problem, even though it is questionable, given the evidence cited above, whether LighterLife adheres to the BACP’s ethical framework.
One would think that companies that push very low calorie diets would be unsustainable because the products and practises they promote are doomed to failure and are really risky. Yet I’m stunned to see that Optifast is still a viable brand, as is Slimfast, and LighterLife also keeps popping right back up, despite the various PR disasters. How long can they go on? How many more deaths will there be?
This is not the first time that LighterLife have been implicated in a death. Matilda Callaghan died of a heart attack after living on LighterLife’s very low calorie diet for six months. One death might be described as a tragic accident, but two is plain careless.
In both cases LighterLife denied any liability. Regarding Ms Henson a spokeswoman claimed that the company states clearly how and when water should be drunk. As for Ms Callaghan, LighterLife boss Bar Hewlett told the inquest that "Miss Callaghan had been obese since the age of 12 and could have died at any time." She made a longer refutation in an open letter after the case was heard. Apologies for the vile blog I have linked to.
Despite their claims of innocence, there is a growing body of evidence against LighterLife, as reported by the BBC and the devil’s Daily Mail; Jacqueline Henson’s sister has also hit out at the company. And then there’s TOAST, secretly funded by LighterLife as a supposedly independent anti-obesity charity, and promoting their programmes, whilst also in receipt of government cash.
In any other sector, except perhaps the arms trade, it would be astounding that a company with this kind of record would have any credibility left. Weight Loss businesses are a law unto themselves, however, and LighterLife continues to enjoy good business. As well as sponsoring 2007’s Guild of Health Writers Awards, they also benefit from the UK’s lack of regulation in the counselling and psychotherapy industry. LighterLife recruits counsellors through the British Association of Counselling and Psychotherapy’s magazine, Therapy, which is available to the organisation’s members. LighterLife’s counsellors are trained and accredited with the BACP, who are playing an instrumental role in the development of an official UK register of therapists which is likely to be introduced within the next few years. Accreditation and BACP membership means inclusion on that register. Nobody seems to think that this is a problem, even though it is questionable, given the evidence cited above, whether LighterLife adheres to the BACP’s ethical framework.
One would think that companies that push very low calorie diets would be unsustainable because the products and practises they promote are doomed to failure and are really risky. Yet I’m stunned to see that Optifast is still a viable brand, as is Slimfast, and LighterLife also keeps popping right back up, despite the various PR disasters. How long can they go on? How many more deaths will there be?
Keep banging your head against the wall
Sarcasm is not my favourite type of retort but I will make an exception with the weekend’s spate of reports that obesity interventions for children are not making any difference to their weights with the only response worth making: O RLY? You mean that monitoring and surveillance make no difference? Hectoring and shaming have no magical weight loss properties? That massively-funded Chicken-Licken-style fat panic has failed to make an impact on fat kids?
Amazingly, this is not being taken as evidence that the people behind the interventions have got it wrong, or that a more evidence-based, compassionate approach to children, health and bodies based within specific social contexts, using Health At Every Size, might be a more fruitful way forwards. Oh no.
Tam Fry has other ideas, not surprising for a man who likes to measure his grandchildren, and he’s probably bending some gullible politician’s ear to get them introduced right now as I type, perhaps weight loss surgery for chubby tots? Joy.
Amazingly, this is not being taken as evidence that the people behind the interventions have got it wrong, or that a more evidence-based, compassionate approach to children, health and bodies based within specific social contexts, using Health At Every Size, might be a more fruitful way forwards. Oh no.
Tam Fry has other ideas, not surprising for a man who likes to measure his grandchildren, and he’s probably bending some gullible politician’s ear to get them introduced right now as I type, perhaps weight loss surgery for chubby tots? Joy.
06 December 2008
Simon is "Overweight"
I'm sorry about the length of this entry. I don't know how to do LiveJournal-style cuts here, can someone help me out with some easy code?
My boyfriend Simon Murphy went to the doctor's this week to get a possible ear infection checked out. Whilst he was there, the doctor told him that he is "overweight". I was very surprised by this announcement because I don't relate to Simon as fat or "overweight' at all. Simon agreed to talk about the experience in an interview. You can listen to a recording, and/or read the transcript below.
I think doctor/patient interactions around weight are really critical in creating a problem of weight where none previously existed, and I'm shocked at how perfunctorily the doctor goes about this, how vague he is regarding the nature of the "problem," or its "remedy," because of the unspoken, common-sense assumption that "everybody knows" what overweight is about. I think Simon is in an unusual position because of the discussions that he and I share about fat, and because of his shared experiences with me and my fat activism. But I think that these kinds of interactions can make people feel really awful and anxious.
There's a further set of problems that Simon talks about in the way that an appointment for an ear inspection was turned by the doctor into an interrogation. Not only that but the information was recorded wrongly via parameters that do not reflect the reality of Simon's personal experience. The doctor maintained a bizarre professional hierarchy that was disempowering in every way. In addition, there was no explanation as to what the data gathered was for, how it would be used, or whether or not Simon had a choice in providing it.
I've also had interactions with this particular doctor, and they are generally quite dismal, whereas others at the practice are better at dealing with their clients. This was such a minor interaction, yet says so much about how fat/obesity is kind of invented, or at least problematised, in the surgery between doctor and patient, and how it is recorded.
Simon is overweight (.mp3, 5.1mb)
4.20pm Saturday 6 December 2008
Home, London E15
Charlotte: Ok, I'm just going to put this here.
Simon: Ok.
You don't have to speak too loudly, it'll pick it up. So, um, can you tell me who you are?
I'm Simon Murphy!
Yes.
I'm 43 and I live in East London.
And you're my boyfriend.
Yes.
And I'm your girlfriend.
Yes.
And I'd like you to tell me what happened last week when you went to the doctor's to find out about an ear infection.
Ok. I wasn't feeling very well so I went to the doctor's, and he looked in my mouth and asked me to say "Aah," and he looked in my ear.
Yep.
And then he started to ask me questions about different diseases and whatnot in my family. He was filling out a questionnaire on the computer and so he took my height and then weighed me and told me that I was overweight.
Alright, so how did he find out that you were overweight?
I could see that on his computer he had a little ready reckoner of height versus weight and he said that for my height, which is 1.72 metres, or 5'8" high, I should be 68.4kg and my actual weight is more like 75kg.
Ok. So do you think it was a BMI chart that he had on his computer, or some other sort of thing?
It didn't seem as sophisticated as that.
Right.
So it was just height and weight.
So how did he tell you?
He just said, well, he said: "Oh," he didn't say it in a surprised way, he just said: "Oh, you're overweight and you'll have to" – what did he say – "You'll have to keep an eye on that," he said, or: "You'll have to do something about that."
You'll have to do something about that? Did he say what you might have to do?
No, he didn't say anything.
And "keeping an eye" I wonder what do you think he meant by that?
I don't know. I didn't really take it seriously. He asked me about, he asked me three times during the course of when I was there whether or not I smoked.
Yeah.
When he was going through he asked me if I smoked, how much did I drink each week, and how much exercise did I get and I said that I didn't really get any exercise, particularly.
Tell me what it said about the choices on his computer screen.
On the choices, I didn't see what the other ones were but I see he chose "avoids exercise" for me in the exercise question rather than "no exercise."
Because "avoids exercise" has a value judgement attached to it. But you don't…
I don't avoid exercise, I just don't really get exercise. I walk around every day and whatever.
But for you there's no value judgement about whether you get exercise or not.
If I wanted to do exercise, I mean, I might not have time to do exercise, so it's not like I'm avoiding it, I'm just not doing it.
Right, and he asked you if you went to the gym as well.
Yeah, he said, well, he said, in the exercise, in the question he said: do you do any sports? Do you go to the gym? Like: no, no. And that's like "avoids exercise" because I don't do those things.
Wow, that seems so bound up in values and assumptions, those questions. I was going to ask about, so did he define what he means by overweight?
No, only that for my height I should be a certain weight and I was more than that.
And have you ever been overweight at the doctor's before?
I'm sure I have, but I haven't been told what I should be, what I should weigh before.
So this was the first time it this was set up as a problem, what you weigh?
Yeah.
And how was it for you, hearing that?
I just thought it was stupid.
In what way was it stupid?
Well, I'm in my mid-40s so there would be an expectation, probably culturally, that I'd gain weight at this point in my life. And I don't think it’s a problem. And my weight has fluctuated quite a lot over my life, but I still have the same size trousers. Whatever, I don't know.
Yes, I was really really surprised when you came back and you told me this story because you are so, well, we joke about you being averagely medium-sized, and you really really are! It seems bizarre to me that your size would be a problem all of a sudden.
Well, I also thought…
I say problem in inverted commas because I don't think it's a problem.
No, but one thing it made me think of is that he has to provide statistics now to the local authority or whatever and so now, in his patients in Stratford, I've been added to the percentage of people who are overweight, so there can be a report done to say how many people in Newham or in London are overweight.
Yes, and maybe an intervention to stop us being overweight, or whatever that means. I was, your story was making me think about the way they gather statistics, the way the NHS does, and what they do with them, and whether we have a choice or not in whether those statistics about us are gathered, and I don't know if we do or not.
Well, I was going through the questionnaire, and it was like: is there a history of cancer or a history of diabetes and whatever, and it was just going through that, and how tall are you and how much do you weigh?
And all this when you'd just gone to get your ear checked out as well. You know, that happened to me when I went to get my ear checked out, at the same place a few months ago. It's like, what is going on? You go to get your ear checked out and all of a sudden you have to give them all this information? You don't know where its going, and also there's a judgement.
Hmm.
What else would you like to say about the experience?
Well, I didn't feel that he was listening to me, you know, he was just putting it all in, and he could have been putting it in wrongly anyway because he put in a couple of things wrong. He put in, well just for the, talking about a stroke, he asked me if there was a history of strokes in my family and I said that my grandmother had had a stroke and then he asked me if it was the maternal or paternal grandmother and he put in the wrong one, so I had to tell him that it was wrong. And when he went through he hadn't, for my ethnicity he didn't ask me, he just put White-British so that I had to say that if I was going to be, for ethnicity it should be White-Irish, so he changed that. And so any of the other things I'd said, I wasn't really looking at what he was putting in. But he tried to position me where I couldn't see what he was putting in, but because of the sun coming into the room in a particular way, I sat in a position that was comfortable for me to not to have the light in my eyes, which meant that I was in a position to see what he was typing in, otherwise I wouldn't have seen.
So it sounds like he's trying to maintain his professional distance yet putting information in that's completely wrong, or not how you would describe it.
Or just putting it in automatically without thinking about it.
Yes. And the parameters don't reflect your true feelings anyway, like "avoids exercise."
So when you told Kay and me about being overweight, I don't know, I suppose I felt like: "I wonder if you know how it feels now?" because I suppose there's always been this distance between us. I mean, you've always been very empathic about what it's like for me when I go to the doctor, but I suppose that in a way my heart sank that you would have to go through this crap now that you get at the doctor's, but also I felt quite excited that you would also see it and that there'd be another perspective on it.
Well if I go to the doctor's again next year and I've got the flu or something and he goes: "Well Simon, I can see that you're still x kilograms overweight," I'll tell him that it's not a problem and that I was there to get some antibiotics.
Yes, I suppose that in a way…
But that if that happens, if it did happen every time I went there then I would, I'd get that sort of experience, but at the moment it's just this stupid thing that happened.
Yes, I was interrupting you then to say that I suppose because you're sort of new to it, you've got years of not having had to deal with it, and also more strength [to resist hectoring about body weight from doctors], whereas maybe me or Kay would be more ground down by it.
Yes, because you've had it every other time or every time you've gone, for x years. And you used to avoid going to the doctor for that reason didn't you?
Yeah, yeah.
I used to avoid going to the doctor's because they're a crap doctor's.
Yep.
Over the road. Yeah.
So I told some of my friends online, my fat friends, about it, and someone suggested that there should be some kind of welcoming ritual for new fatties. And someone suggested that you should wear a pig mask, or that there should be a special ring that you wear now, or there should be at least balloons or cake now, to welcome you to the world of the fatties. What do you think?
That would be good, or I thought I could wear a badge.
What would your badge say?
Well, it could be: Overweight? You decide.
Or how about: Overweight!
Or: Overweight? Overweight!
Ok, I'm going to turn this off now.
Ok.
My boyfriend Simon Murphy went to the doctor's this week to get a possible ear infection checked out. Whilst he was there, the doctor told him that he is "overweight". I was very surprised by this announcement because I don't relate to Simon as fat or "overweight' at all. Simon agreed to talk about the experience in an interview. You can listen to a recording, and/or read the transcript below.
I think doctor/patient interactions around weight are really critical in creating a problem of weight where none previously existed, and I'm shocked at how perfunctorily the doctor goes about this, how vague he is regarding the nature of the "problem," or its "remedy," because of the unspoken, common-sense assumption that "everybody knows" what overweight is about. I think Simon is in an unusual position because of the discussions that he and I share about fat, and because of his shared experiences with me and my fat activism. But I think that these kinds of interactions can make people feel really awful and anxious.
There's a further set of problems that Simon talks about in the way that an appointment for an ear inspection was turned by the doctor into an interrogation. Not only that but the information was recorded wrongly via parameters that do not reflect the reality of Simon's personal experience. The doctor maintained a bizarre professional hierarchy that was disempowering in every way. In addition, there was no explanation as to what the data gathered was for, how it would be used, or whether or not Simon had a choice in providing it.
I've also had interactions with this particular doctor, and they are generally quite dismal, whereas others at the practice are better at dealing with their clients. This was such a minor interaction, yet says so much about how fat/obesity is kind of invented, or at least problematised, in the surgery between doctor and patient, and how it is recorded.
Simon is overweight (.mp3, 5.1mb)
4.20pm Saturday 6 December 2008
Home, London E15
Charlotte: Ok, I'm just going to put this here.
Simon: Ok.
You don't have to speak too loudly, it'll pick it up. So, um, can you tell me who you are?
I'm Simon Murphy!
Yes.
I'm 43 and I live in East London.
And you're my boyfriend.
Yes.
And I'm your girlfriend.
Yes.
And I'd like you to tell me what happened last week when you went to the doctor's to find out about an ear infection.
Ok. I wasn't feeling very well so I went to the doctor's, and he looked in my mouth and asked me to say "Aah," and he looked in my ear.
Yep.
And then he started to ask me questions about different diseases and whatnot in my family. He was filling out a questionnaire on the computer and so he took my height and then weighed me and told me that I was overweight.
Alright, so how did he find out that you were overweight?
I could see that on his computer he had a little ready reckoner of height versus weight and he said that for my height, which is 1.72 metres, or 5'8" high, I should be 68.4kg and my actual weight is more like 75kg.
Ok. So do you think it was a BMI chart that he had on his computer, or some other sort of thing?
It didn't seem as sophisticated as that.
Right.
So it was just height and weight.
So how did he tell you?
He just said, well, he said: "Oh," he didn't say it in a surprised way, he just said: "Oh, you're overweight and you'll have to" – what did he say – "You'll have to keep an eye on that," he said, or: "You'll have to do something about that."
You'll have to do something about that? Did he say what you might have to do?
No, he didn't say anything.
And "keeping an eye" I wonder what do you think he meant by that?
I don't know. I didn't really take it seriously. He asked me about, he asked me three times during the course of when I was there whether or not I smoked.
Yeah.
When he was going through he asked me if I smoked, how much did I drink each week, and how much exercise did I get and I said that I didn't really get any exercise, particularly.
Tell me what it said about the choices on his computer screen.
On the choices, I didn't see what the other ones were but I see he chose "avoids exercise" for me in the exercise question rather than "no exercise."
Because "avoids exercise" has a value judgement attached to it. But you don't…
I don't avoid exercise, I just don't really get exercise. I walk around every day and whatever.
But for you there's no value judgement about whether you get exercise or not.
If I wanted to do exercise, I mean, I might not have time to do exercise, so it's not like I'm avoiding it, I'm just not doing it.
Right, and he asked you if you went to the gym as well.
Yeah, he said, well, he said, in the exercise, in the question he said: do you do any sports? Do you go to the gym? Like: no, no. And that's like "avoids exercise" because I don't do those things.
Wow, that seems so bound up in values and assumptions, those questions. I was going to ask about, so did he define what he means by overweight?
No, only that for my height I should be a certain weight and I was more than that.
And have you ever been overweight at the doctor's before?
I'm sure I have, but I haven't been told what I should be, what I should weigh before.
So this was the first time it this was set up as a problem, what you weigh?
Yeah.
And how was it for you, hearing that?
I just thought it was stupid.
In what way was it stupid?
Well, I'm in my mid-40s so there would be an expectation, probably culturally, that I'd gain weight at this point in my life. And I don't think it’s a problem. And my weight has fluctuated quite a lot over my life, but I still have the same size trousers. Whatever, I don't know.
Yes, I was really really surprised when you came back and you told me this story because you are so, well, we joke about you being averagely medium-sized, and you really really are! It seems bizarre to me that your size would be a problem all of a sudden.
Well, I also thought…
I say problem in inverted commas because I don't think it's a problem.
No, but one thing it made me think of is that he has to provide statistics now to the local authority or whatever and so now, in his patients in Stratford, I've been added to the percentage of people who are overweight, so there can be a report done to say how many people in Newham or in London are overweight.
Yes, and maybe an intervention to stop us being overweight, or whatever that means. I was, your story was making me think about the way they gather statistics, the way the NHS does, and what they do with them, and whether we have a choice or not in whether those statistics about us are gathered, and I don't know if we do or not.
Well, I was going through the questionnaire, and it was like: is there a history of cancer or a history of diabetes and whatever, and it was just going through that, and how tall are you and how much do you weigh?
And all this when you'd just gone to get your ear checked out as well. You know, that happened to me when I went to get my ear checked out, at the same place a few months ago. It's like, what is going on? You go to get your ear checked out and all of a sudden you have to give them all this information? You don't know where its going, and also there's a judgement.
Hmm.
What else would you like to say about the experience?
Well, I didn't feel that he was listening to me, you know, he was just putting it all in, and he could have been putting it in wrongly anyway because he put in a couple of things wrong. He put in, well just for the, talking about a stroke, he asked me if there was a history of strokes in my family and I said that my grandmother had had a stroke and then he asked me if it was the maternal or paternal grandmother and he put in the wrong one, so I had to tell him that it was wrong. And when he went through he hadn't, for my ethnicity he didn't ask me, he just put White-British so that I had to say that if I was going to be, for ethnicity it should be White-Irish, so he changed that. And so any of the other things I'd said, I wasn't really looking at what he was putting in. But he tried to position me where I couldn't see what he was putting in, but because of the sun coming into the room in a particular way, I sat in a position that was comfortable for me to not to have the light in my eyes, which meant that I was in a position to see what he was typing in, otherwise I wouldn't have seen.
So it sounds like he's trying to maintain his professional distance yet putting information in that's completely wrong, or not how you would describe it.
Or just putting it in automatically without thinking about it.
Yes. And the parameters don't reflect your true feelings anyway, like "avoids exercise."
So when you told Kay and me about being overweight, I don't know, I suppose I felt like: "I wonder if you know how it feels now?" because I suppose there's always been this distance between us. I mean, you've always been very empathic about what it's like for me when I go to the doctor, but I suppose that in a way my heart sank that you would have to go through this crap now that you get at the doctor's, but also I felt quite excited that you would also see it and that there'd be another perspective on it.
Well if I go to the doctor's again next year and I've got the flu or something and he goes: "Well Simon, I can see that you're still x kilograms overweight," I'll tell him that it's not a problem and that I was there to get some antibiotics.
Yes, I suppose that in a way…
But that if that happens, if it did happen every time I went there then I would, I'd get that sort of experience, but at the moment it's just this stupid thing that happened.
Yes, I was interrupting you then to say that I suppose because you're sort of new to it, you've got years of not having had to deal with it, and also more strength [to resist hectoring about body weight from doctors], whereas maybe me or Kay would be more ground down by it.
Yes, because you've had it every other time or every time you've gone, for x years. And you used to avoid going to the doctor for that reason didn't you?
Yeah, yeah.
I used to avoid going to the doctor's because they're a crap doctor's.
Yep.
Over the road. Yeah.
So I told some of my friends online, my fat friends, about it, and someone suggested that there should be some kind of welcoming ritual for new fatties. And someone suggested that you should wear a pig mask, or that there should be a special ring that you wear now, or there should be at least balloons or cake now, to welcome you to the world of the fatties. What do you think?
That would be good, or I thought I could wear a badge.
What would your badge say?
Well, it could be: Overweight? You decide.
Or how about: Overweight!
Or: Overweight? Overweight!
Ok, I'm going to turn this off now.
Ok.
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