Why You’ve Got to Stop the ‘Tough Love’ for Your Fat Friend’s Health

Originally published on Healthcare in America and republished here with the author’s permission.

I was in fourth grade, sitting in a doctor’s office, the first time my face flushed with shame. I was, I had just learned, overweight.

“It’s probably from eating all that pizza and ice cream. It tastes good, doesn’t it? But it makes your body big and fat.”

I was confused. Dinners at home were usually fish or chicken, rice, and steamed vegetables; breakfasts were cottage cheese and cantaloupe. After all, I was the child of a 1980s’ Weight Watchers mother.

“Just imagine that your body is made out of clay. If you can just stay the same weight, as you grow, you’ll stretch out. And once you grow up, you’ll be thin and beautiful. Won’t that be great?”

I felt my face sear with shame. My skin was neon, hot and bright, noisy and garish. I had learned so much in that one moment: You’re eating too much junk food. You’re not beautiful. You’re indulging too much. Your body is wrong. You must have done it.

Something was wrong with my body. I’d failed a test I didn’t even know I’d taken.

The coming years became an exercise in weathering the storm of conversations like these. Well-meaning, otherwise supportive people eagerly pointed out my perceived failings at every turn. Even when I wasn’t in the doctor’s office, everyone seemed to have recommendations, hypotheses, requirements, edicts.

Otherwise compassionate, thoughtful people abruptly shifted into harsh judgments and zero-tolerance attitudes, all bootstraps and personal responsibility. After all, I was responsible for my own body, and my body was an undeniable display of failure.

More and more foods, I was told, were off-limits. It wasn’t just that I shouldn’t eat them  –  they were sinful, bad, tempting. My agnostic family was suddenly awash in religious language, building a heaven and a hell with each meal, and it was clear that I was tempted by devil’s food, closest to hellfire. Get thee behind me, pizza!

Many of those foods  –  eggs, nuts, avocados  – would later fall back in the good graces of healthy eating, redeemed years later by a ruthless culture. At the time, they were collateral damage in a crusade to slash calories at all costs. Fiber, vitamins, minerals, fatty acids, protein — they were all sacrificed at the altar of calories in, calories out.

The focus was never on enjoying healthy foods, just on deprivation, will, and lack. It was an orthodoxy of hunger, a never-ending fast. It was self-flagellation, a forced performance to display my commitment to changing an unacceptable body.

Food became not just something to eat when hungry, it became emotionally and morally laden. A slice of cheddar cheese became a referendum on my character. A bite of ice cream was a “moment of weakness”; a scoop, cause for concern; two called for an intervention.

Because those foods were quarantined, any occasion to eat them became a rare opportunity to indulge, the way I was told I had always wanted to. Birthday parties at school called for two slices of cake; potato chips required three helpings. Every encounter with forbidden foods became a time to load up.

As I got older, this meant eating contraband in secret, hiding foods to eat when I was alone. Shame taught me to overeat, and to fetishize food. The more it was withheld, the more tempting it became.

My strength and activity deteriorated, too. I’d spent years on a competitive swim team, winning relay races and swimming the complicated butterfly stroke. I’d loved volleyball and softball.

As I got older, my body precluded me from the sports I loved the most  – not because it was incapable, but because it was unsightly. As a swimmer, I’d have to be seen in a swimsuit, exposing the body of which I’d learned to be so deeply ashamed. There were beach bodies in the world, and mine was not one of them.

Shame diseased all of my conversations, like blight spreading through a crop. I constantly inoculated those around me with an endless string of caveats and excuses for daring to be seen when I wasn’t yet thin. Still, I received unsolicited health suggestions, stern lectures, gym recommendations, names of surgeons  – an avalanche of advice I was already taking.

Talking about diet and exercise, my favorite vegetables and personal bests, were all shorthand to preempt the inevitable. I know I’m fat, but I’m spending every waking moment trying to change that. I hope you won’t write me off completely.

It took years to reprogram that thinking, to keep my head above water in a tumultuous sea of shame. I had been taught over and over and over again that my body was at best unexpected, at worst, worthy of public displays of disgust.

I was stuck in an untenable binary. In our cultural imagination, since I wasn’t already lithe and athletic, I must be sitting at home, eating junk food every day. And if I was doing that, I must be either ignorant of healthy behaviors, or arrogant, thinking myself above them.

Unless I visibly repented, my body stood as a record of the sins I’d committed. The orthodoxy of calories in, calories out dictated that one French fry off a friend’s plate, one publicly ordered ice cream cone, even a plate of pasta was cause for intervention or judgment.

In that way, just leaving the house as a fat person can feel like a risk. Every meal, every trip to the gym, every outfit chosen becomes an insurmountable task, a statement, an invitation or renunciation of the comments and judgments that will inevitably follow.

Anyone can be an expert on your body  – what it looks like, how it works, what it needs. Anyone but you.

So, you’re faced with a charged choice: Do you chase the perfection that won’t come? Or do you give up altogether? After all, there is no room for better, no room for nuance, no room for you. There is no in between. Walk the high wire of weight loss, making sure every calorie is accounted for, or freefall to the concrete below.

I spent years, decades, hating my body. It was a loathsome and inconvenient fact that I willed myself to ignore. I avoided pictures of myself, shied away from mirrors, wore clothing as unremarkable as possible. I eschewed makeup, wore ill-fitting clothing in drab colors, spoke quietly, stayed in. I willed my broad, soft body to become invisible. Stubbornly, hatefully, mournfully, it would not.

I withdrew, depressed and anxious. Anywhere I went was a place I could be seen. And anywhere I could be seen invited more of the same exhausting, exasperating conversations. My body brought me nothing but heartache, guilt and hurt.

My health suffered, because I couldn’t fathom taking care of a body that had been so thoroughly punishing.

When my frustration became too much to bear, I’d brave a gym, only to be met with a “good for you!” while other patrons looked on with disgust or pity. Or I’d go to a support group for dieters, where the air was saturated with shame and deprivation, a heady reminder the very problem that had gotten me there.

Doctors’ offices were just as bad as an adult as they had been as a child. I visited urgent care for an ear infection. After receiving the prescribed drops and antibiotics, I asked the doctor about after care.

He sighed, looking sternly at me. “You should lose weight,” he responded. “Immediately.”

Fat hadn’t caused an ear infection, but it was always an urgent failure. The noblesse oblige of thin people obligated them to remind and educate me.

This was true of every visit to the doctor’s office. No matter my symptoms, no matter the needs I stated, everything was attributed to being fat. Even when I lost weight, my health failed. Blood work showed that I had become anemic, dangerously short on iron, and low on essential vitamins.

Despite being a middle class, college educated woman, I was undernourished. Because the focus of weight loss is never nutrition  – just burning off as much fat as possible, as quickly as possible. Anything that didn’t do that was an abject failure.

We talk about fatness constantly: Caloric foods are “sinful,” “tempting,” “bad,” or “cheating.” Thin bodies are “emaciated,” fat bodies are “dangerous.” Clothing is routinely evaluated by whether the wearer is young enough, thin enough, feminine/masculine enough to “pull it off.” No action is free of judgment, no body escapes evaluation, no outfit is beyond critique.

When some bodies are held up as examples of what not to look like and who not to be, all of us suffer. It creates a culture of judgment and rejection, which leads to a world of hurt and shame. When there’s a single standard of what a good, moral person’s body can look like, all of us are trapped.

Our cultural conversation about fatness is devoid of the voices and experiences of fat people, unless we repent or seek redemption. And when only one voice speaks, a conversation isn’t a conversation, it’s a lecture  –  all punishment, no support.

Every aspect of fat hate feeds into this machine. So, for that matter, does exclusion of bodies with disabilities, bodies of color, trans bodies, old bodies, and more.

From overt harassment like shouting names at fat people walking down the street, to seemingly benign diet recommendations, or dwelling publicly on the parts of our bodies we hate  –  it all teaches us that our bodies are wrong, that they’re shameful reflections of the worst of our character. It’s a system that rejects all of us at one time or another.

And it leads to worse health. When I feel disconnected from my body, I don’t take care of it. When I embrace my body, when I appreciate what it does for me, I do. Learning not to hate our bodies isn’t a matter of feeling good or appeasing the self-esteem of fat people, it’s a matter of our physical health and emotional survival.

Health is a holistic thing. It speaks to our practices, our mentality, our family systems, our income.

Health is impacted by what food we have access to, and why. It is impacted by our mental health, which can often be hampered by shaming. Health is impacted by our income, the care we have access to, the treatments we can afford. And health is impacted by our race – whether providers understand our cultures, our needs, our language.

Health is multifaceted, and it exists in the irreducible complexity of our lives and identities.

At its core, weight loss is aesthetic. My weight doesn’t tell you what I eat, how much I exercise, how strong I am. It doesn’t tell you what my T-cell count is, or my bone density, or how healthy I feel. It doesn’t tell you if I’m thinner than I was before, or fatter.

It doesn’t tell you how I feel about myself, or what I’ve learned, or how I’ve changed. Judging someone by the size of their body is strictly visual, and it flattens a whole, beautiful, complex body and an unknown, extraordinary person.

There is more than enough at work to reduce us, to make us feel hurt and hardened. Instead, let us do the hard, vulnerable work of unburdening one another, and release our cumbersome shame. Let us abandon the manifest destiny of weight loss, abandon the quest to conquer bodies and the people in them.

Let us soften. Love is tough enough without tough love.

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Your Fat Friend. Politicized fatty. Email, Twitter, Facebook.