WLS and "body positivity"

[theantichick 2,204]

I'm trying to figure out where I come down on the "body positivity" movement and the "health at every size" philosophy in relation to WLS. It's caused me to really think deeply about this, and I thought I'd throw my thoughts out and see how others view it.

For starters, I absolutely believe that people of all shapes and sizes deserve to be treated with respect and dignity. People should not be bullied for their shape or size. Physicians should not give different treatment plans for larger people than they do for thin people. The answer to strep throat is not "lose weight". I believe businesses should better accommodate people of all sizes with larger and more sturdy seating as well as better access for people who have mobility issues due to any cause. Airlines in particular. "Normal" people don't fit in those darned seats, for Pete's sake. I believe that people of all shapes and sizes should have access to good quality clothing at a reasonable price.

I also believe the diet industry is bogus. The medical field should start telling the truth about the success rates both short term and long term of the "diet and exercise" prescriptions. If the success rates for diet and exercise were given for a drug, it would be banned by the FDA for sale. We need to learn a LOT more about what drives obesity and quit experimenting without full disclosure on people who are obese, especially children. We need to learn more about the damage done to our bodies by dieting, which is likely to be worse than if we just stayed heavy and never dieted. What we do know is that weight is a complex issue that individuals have very little control over. It needs to stop being viewed as a moral issue, with heavier people seen as moral failures.

All of these things, I am in agreement with the HAES/body positivity movement. Then we get into the "health" discussion, and my stance starts diverging from theirs.

HAES claims that there is no direct causation between body fat and ill health and that the path to better health should not involve any level of focus on weight.

Well, not really. While there are some people who carry a lot of body fat and have no significant health concerns, there are also people who drink excessive amounts of alcohol and smoke daily who have no significant health concerns. No one would say that there is no causal relationship between alcohol and liver problems, or between cigarettes and lung issues just because not everyone who partakes is ill. The science is clear that excessive weight significantly increases the risk in a number of health areas. The body will compensate until it can't anymore, and then a cascade of health issues descends. I believe that to state otherwise is deceitful and damaging. And if your weight directly keeps you from being able to take care of yourself and move around, then there's no way you're "healthy", medically speaking.

That is not to say that healthcare should be denied to larger people. We still treat lung cancer, even if the patient smoked for 40 years and "brought it on themselves". But we also encourage intervention for the addiction and prescribe cessation programs. We don't have a lot of good options to offer people who struggle with weight issues, and we need to be more up-front about how well they work, but we shouldn't quit trying.

HAES/Body Positivity has and excellent observation about the health issues - it's no one's business. Unless I'm on your medical treatment team, it's not my business how much you weigh, and it's not my place to say you should lose weight. It's not my business what you do or don't eat. If I am on your treatment team, I should treat you with the utmost respect and not ignore symptoms and issues because you're larger. The whole argument about "my taxes pay for this treatment and y'all bring it on yourselves" is bogus. My taxes pay for sports injuries (caused by patient choice), car accidents (sometimes caused by patient choice), tobacco complications (caused by patient choice), and drug overdoses (caused by patient choice) and we don't see a large call for those people to go without treatment. Even if we were to start drawing lines, where exactly would they get drawn?

HAES also pushes for healthy lifestyle choices, just without a focus on weight. I'm down with that. People of every size can take steps to improve their health: make healthier food choices, exercise, reduce stress, get regular medical care. Some of these will even have more impact than the actual weight loss. Many of these will result in weight loss. People should not be discouraged from doing these things until after they lose weight. I can even (medically) support an attitude of, "I'm going to work on these other things, and I don't care about the scale while I do." (And once again, if I'm not on your medical team, it's none of my business.) HAES has the right idea about much of this.

And then I diverge again from HAES and the like when they say that being on Weight Watchers or having WLS or in any way deliberately focusing on modifying your size is AGAINST the body positivity movement. Everyone has different reasons for choosing these things, and not all of them have to do with hating your larger body. I loved myself at my highest weight and was generally okay with my body. I never looked in the mirror and hated myself. I have features I'm not crazy about, but it's at worst neutral, never a self-hatred. I didn't have VSG because I wanted to fit in a size 10 jean again (if I get there or even close it'll be a welcome side effect in my book). My decision was not swayed in the slightest by social pressures. I had VSG because I have physical health issues that are directly impacted by my weight and are reducing my mobility and taking my activity level down to practically nothing. I was lacking a quality of life and wanted to improve the things in my life that HAES talks about. Because of those health issues, I didn't feel like I had time to do it "the long way". I don't advocate WLS for everyone, and unless you ask me directly I'm not going to say whether or not I think it would be a good idea for you. But I'm not "body positive" because I "amputated a healthy organ" in order to change my size.

Like so many things in our current society, the opposing sides would have you think that it's a binary situation - on or off, good or bad, this or that. I have never embraced a black and white binary way of thinking and am not about to start now. I want to support the HAES movement, but it seems like I'm not welcome and some of the concepts they propose as near-gospel I find to be scientifically questionable. Maybe I'm trying to justify my position against what I want to believe and it just doesn't fit, I don't know. What do you think?

[heidikat72 935]

You've explained it perfectly and I am in 100% agreement!

[LipstickLady 25,682]

I agree with a lot of what you are saying, but not all. Yes, everyone deseerves dignity and respect. No one should be bullied for their shape or size or (even their level of assholiness).

I DO think that physician have to vary their plan based on someone's weight in many, not all, cases. And I am not a doctor, just a layperson's thoughts. Strength and dosage of antibiotics, medication's impact on blood pressure or insulin levels, amount of pain relief needed due to issues not directly related to the illness being treated, length or time treatment is needed because the body is not at prime level of health, etc. I think EVERY BODY is due more diligent care based on their personal medical history, but I believe weight plays a large part in effectiveness of the treatment.

Airplane seats are small and they do suck. So are roller coaster seats, bus seats, theater seats, restaurant booths... Hell! The chairs at WWs meetings are generally too close together. But can you imagine the outcry if we had an "obese" section? I was obese but I never would have used it. Who pays for the larger accommodations and the more limited patronage (bigger seats = smaller admissions = smaller profits). I also wonder about weight distribution and engineering. Should all super obese people sit closer to the front? Dead center? Near the rear? Is this also going to cause an outcry despite the obvious need for public safety?

And clothing... I used to feel the same way until I did some research on why fat women's clothes are so expensive and so ... UGH. I can't find the article but I will keep looking for it. It talked about how forms and patterns are pretty standard and ladies' sizes simply mean adding an inch (or whatever), where plus sizes need to be more specially measured and cut.

It also talked about the average size of a bolt of fabric and how patterns need to be laid out. An average size might be able to be laid out two or three times across the average width of (again, out of my butt) let's say 64" but a plus size may only be able to be laid out once, wasting a lot of fabric.

Also, plus sizes require different fabrics because the weight of the extra fabric may pull and lay differently based on the materials. For instance, a really large, soft t shirt is going to lay differently in a 3x than it is in a medium simply because of the drag of the fabric.

Another interesting point was the actual inventory expense. There are so many women who measure medium, large, XL, but not many who measure XSL, 3x, 4x, etc. These clothes often go on clearance and cost a retailer money because they are such "oddball" sizes. Ask your teeny friends, they will tell you it's just as hard to find a 00 or XXS as it is a 4XL. And no, you can't eat them as a snack just because it's not fair.

Another mention was the cost of shipping. Ten 4XL garments are going to weigh as much as 15 or 17 medium garments. (Again, out of my butt.) Who is eating this cost?

Again, I agree with a lot of your points, but I also believe that when I was morbidly obese, it was up to ME to pay the price for my health issues. My FIL has 6 kinds of cancer right now. Believe me, he is paying the costs of that and it's not his fault at all.

Hide

For starters, I absolutely believe that people of all shapes and sizes deserve to be treated with respect and dignity.

People should not be bullied for their shape or size.

Physicians should not give different treatment plans for larger people than they do for thin people. The answer to strep throat is not "lose weight".

I believe businesses should better accommodate people of all sizes with larger and more sturdy seating as well as better access for people who have mobility issues due to any cause. Airlines in particular. "Normal" people don't fit in those darned seats, for Pete's sake.

I believe that people of all shapes and sizes should have access to good quality clothing at a reasonable price.

[LipstickLady 25,682]

In general, I believe with the overall thought process of HAES, but not their reverse discrimination. Fat people feeling bullied or hated by HAES because they choose to lose weight, diet, exercise, have surgery...

Some people use their HAES standpoint as a weapon, just as some people use their religion as a weapon. (WBC, anyone?) I think most extremists suck and people should just let people do their own thing unless it's taking away from your rights to be happy as well.

I'm one of those dang liberals, though.

[theantichick 2,204]

I DO think that physician have to vary their plan based on someone's weight in many, not all, cases. And I am not a doctor, just a layperson's thoughts. Strength and dosage of antibiotics, medication's impact on blood pressure or insulin levels, amount of pain relief needed due to issues not directly related to the illness being treated, length or time treatment is needed because the body is not at prime level of health, etc. I think EVERY BODY is due more diligent care based on their personal medical history, but I believe weight plays a large part in effectiveness of the treatment.

I'm mainly referring to the phenomenon where doctors give completely different treatment plans for the same malady, with the heavy person being told to lose weight. There are stories out there about a woman who went to her doctor and her strep screen was positive. Instead of prescribing an antibiotic, he told her she needed to lose weight. Weight has nothing to do with ear infections or strep throat, and shouldn't affect the treatment. But for some doctors, no matter what the complaint, if the patient is large, that's all they can focus on. Even when it comes to things like knee injuries - one lady tore an ACL while exercising you know, doing what all "good fatties" do, and there's only one treatment for a completely torn ACL and that's surgery. Doctor said the only thing she could do was lose weight. Another lady was having severe pain with her periods. Doc said lose weight. Turns out she had ovarian cancer, and i she hadn't changed doctors after that, she'd be dead. Those are the things that have to stop in the medical community. I don't expect my doc to quit including weight management in the treatment plan, but I do expect her to give me real, science based, evidence based treatment plans. Diets don't meet the standard for evidence based. If a cancer treatment only worked 5% of the time, and made 50% of the people worse, it would never get approved for use. But diets are still being prescribed, and they are awful medicine.

In general, I believe with the overall thought process of HAES, but not their reverse discrimination. Fat people feeling bullied or hated by HAES because they choose to lose weight, diet, exercise, have surgery...

Some people use their HAES standpoint as a weapon, just as some people use their religion as a weapon. (WBC, anyone?) I think most extremists suck and people should just let people do their own thing unless it's taking away from your rights to be happy as well.

I'm one of those dang liberals, though.

I'm one of those liberals too, go figure. LOL

[Chicken Lady 102]

I was a very healthy fat person. Lab work is always great. No known comorbidities or long term illnesses. I was active and strong. I don't needs any new joints or sleep apnea machines to sleep.

I chose WLS so I could continue to be healthy. I know what would likely be in my future if I didn't drop the weight.

That being said- I have learned through this journey that you cannot judge a person by looking at them. Now when I see a large person, I wonder if they are happy at their weight, aren't ready to start their journey or are they happy cause they lost 100# and are finally feeling great... People deserve respect at all sizes & health. (And great clothes at reasonable prices that fit well!)

Sent from my iPhone using the BariatricPal App

[Inner Surfer Girl 12,015]

I agree with a lot of what you are saying, but not all. Yes, everyone deseerves dignity and respect. No one should be bullied for their shape or size or (even their level of assholiness).

I DO think that physician have to vary their plan based on someone's weight in many, not all, cases. And I am not a doctor, just a layperson's thoughts. Strength and dosage of antibiotics, medication's impact on blood pressure or insulin levels, amount of pain relief needed due to issues not directly related to the illness being treated, length or time treatment is needed because the body is not at prime level of health, etc. I think EVERY BODY is due more diligent care based on their personal medical history, but I believe weight plays a large part in effectiveness of the treatment.

Airplane seats are small and they do suck. So are roller coaster seats, bus seats, theater seats, restaurant booths... Hell! The chairs at WWs meetings are generally too close together. But can you imagine the outcry if we had an "obese" section? I was obese but I never would have used it. Who pays for the larger accommodations and the more limited patronage (bigger seats = smaller admissions = smaller profits). I also wonder about weight distribution and engineering. Should all super obese people sit closer to the front? Dead center? Near the rear? Is this also going to cause an outcry despite the obvious need for public safety?

And clothing... I used to feel the same way until I did some research on why fat women's clothes are so expensive and so ... UGH. I can't find the article but I will keep looking for it. It talked about how forms and patterns are pretty standard and ladies' sizes simply mean adding an inch (or whatever), where plus sizes need to be more specially measured and cut.

It also talked about the average size of a bolt of fabric and how patterns need to be laid out. An average size might be able to be laid out two or three times across the average width of (again, out of my butt) let's say 64" but a plus size may only be able to be laid out once, wasting a lot of fabric.

Also, plus sizes require different fabrics because the weight of the extra fabric may pull and lay differently based on the materials. For instance, a really large, soft t shirt is going to lay differently in a 3x than it is in a medium simply because of the drag of the fabric.

Another interesting point was the actual inventory expense. There are so many women who measure medium, large, XL, but not many who measure XSL, 3x, 4x, etc. These clothes often go on clearance and cost a retailer money because they are such "oddball" sizes. Ask your teeny friends, they will tell you it's just as hard to find a 00 or XXS as it is a 4XL. And no, you can't eat them as a snack just because it's not fair.

Another mention was the cost of shipping. Ten 4XL garments are going to weigh as much as 15 or 17 medium garments. (Again, out of my butt.) Who is eating this cost?

Again, I agree with a lot of your points, but I also believe that when I was morbidly obese, it was up to ME to pay the price for my health issues. My FIL has 6 kinds of cancer right now. Believe me, he is paying the costs of that and it's not his fault at all.

Hide

For starters, I absolutely believe that people of all shapes and sizes deserve to be treated with respect and dignity.

People should not be bullied for their shape or size.

Physicians should not give different treatment plans for larger people than they do for thin people. The answer to strep throat is not "lose weight".

I believe businesses should better accommodate people of all sizes with larger and more sturdy seating as well as better access for people who have mobility issues due to any cause. Airlines in particular. "Normal" people don't fit in those darned seats, for Pete's sake.

I believe that people of all shapes and sizes should have access to good quality clothing at a reasonable price.

Everything you talk about when it comes to clothes is because we have such a reliance on industrial production of clothing. Especially an industrial standard that was in many ways developed in the 18th and 19th centuries. Why is a bolt of cloth the size it is? I bet it had something to do with the average size of human beings in England during the industrial revolution.

What was "standard" is no longer standard. There is a diversity in body sizes and shapes that do not fit in a "standard", small range of industrial sizing.

We still want to standardize human bodies to fit our machines since it is "easier" and "cheaper" for those who control the world's wealth/capital.

I know I am rambling but it struck a cord.

There is a new book out about the dangers of big data that I want to read. I heard the author interviewed yesterday but can't remember the name. Math is in the title.

One of the arguments about big data is when we base our models on shaky underlying assumptions be tend to perpetrate biases.

[LipstickLady 25,682]

Everything you talk about when it comes to clothes is because we have such a reliance on industrial production of clothing. Especially an industrial standard that was in many ways developed in the 18th and 19th centuries. Why is a bolt of cloth the size it is? I bet it had something to do with the average size of human beings in England during the industrial revolution.

What was "standard" is no longer standard. There is a diversity in body sizes and shapes that do not fit in a "standard", small range of industrial sizing.

We still want to standardize human bodies to fit our machines since it is "easier" and "cheaper" for those who control the world's wealth/capital.

I know I am rambling but it struck a cord.

There is a new book out about the dangers of big data that I want to read. I heard the author interviewed yesterday but can't remember the name. Math is in the title.

One of the arguments about big data is when we base our models on shaky underlying assumptions be tend to perpetrate biases.

I can't disagree with you, but until a manufacturer comes along and changes the bolt sizes and the machine sizes and the form sizes and all the rest, stores like Old Navy and NY and CO and Loft are NOT going to eat the extra costs. It's a vicious cycle.

Stores like Torrid and Lane Bryant absorb some of the costs, especially in the clearance sections, but the costs are absolutely reflective in the original prices charged.

I don't like it, but as an owner of a retail business, I understand it. I've got to feed my family. I wish I could afford to eat more expenses than I do for my clients, but I just can't.

It sucks.