Fat Luck? The Obese Have Very Little Of It

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Interesting essay this week in The New York Times about how and when the seriously overweight feel others’ contempt:

As a woman whose height and weight put me in the obese category on the body-mass-index chart, I cringed when Michelle Obama recently spoke of putting her daughters on a diet. While I’m sure the first lady’s intentions are good, I’m also sure that her comments about childhood obesity will add yet another layer to the stigma of being overweight in America.

Last August, Dr. Delos M. Cosgrove, a cardiac surgeon and chief executive of the prestigious Cleveland Clinic, told a columnist for The New York Times that if he could get away with it legally, he would refuse to hire anyone who is obese. He probably could get away with it, actually, because no federal legislation protects the civil rights of fat workers, and only one state, Michigan, bans discrimination on the basis of weight.

Dr. Cosgrove may be unusually blunt, but he is far from alone. Public attitudes about fat have never been more judgmental; stigmatizing fat people has become not just acceptable but, in some circles, de rigueur. I’ve sat in meetings with colleagues who wouldn’t dream of disparaging anyone’s color, sex, economic status or general attractiveness, yet feel free to comment witheringly on a person’s weight.

The writer, Harriet Brown, teaches magazine journalism at the Newhouse School in Seattle. She also found that doctors…!?…hate fatties:

Some of the most blatant fat discrimination comes from medical professionals. Rebecca Puhl, a clinical psychologist and director of research at the Rudd Center for Food Policy and Obesity at Yale, has been studying the stigma of obesity for more than a decade. More than half of the 620 primary care doctors questioned for one study described obese patients as “awkward, unattractive, ugly, and unlikely to comply with treatment.” (This last is significant, because doctors who think patients won’t follow their instructions treat and prescribe for them differently.)

Dr. Puhl said she was especially disturbed at how openly the doctors expressed their biases. “If I was trying to study gender or racial bias, I couldn’t use the assessment tools I’m using, because people wouldn’t be truthful,” she said. “They’d want to be more politically correct.”

Despite the abundance of research showing that most people are unable to make significant long-term changes in their weight, it’s clear that doctors tend to view obesity as a matter of personal responsibility. Perhaps they see shame and stigma as a health care strategy.

I need to lose weight. My GP wants me to lose so much weight I might as well cut off a leg or two to get started.

I want to lose weight, too — and for the past three months have been fighting excruciating hip and back pain. You can’t exercise when you’re in agony! One of the toughest issues when trying to lose weight is being told — over and over and over — by your family, your doctors and every single women’s magazine featuring anorexic 15-year-old models — what to do, what you must do, what is the smart, healthy choice.

You can be overweight and still have a functioning brain! We’re not deaf, you know.

Telling someone what to do is very different from helping them achieve a challenging goal. We live in a finger-wagging culture, where every self-righteous size 4 feels totally fine telling the rest of us if you just….be like moi!…we’d be fine. Going into stores to buy something pretty, even willing to spend some serious coin, and being told, oh no, we sell nothing larger than a 12 is another smack in the head. Larger sizes? Only on the website, blubber-butt!

I still make money, Ann Taylor, French Connection, J. Crew…

I often feel so totally overwhelmed by my competing responsibilities — and I don’t even have all the additional, relentless and time-consuming demands of kids and/or pets and/or a commute and/or a parent with Alzheimer’s — that going to the damn gym or taking my hour-long 4-mile walk falls right off the list after: earn money (in this recession, freelance, no small challenge), manage whatever money I’ve earned, saved and invested meticulously, get out and drum up more paid work to make sure that next month’s bills are paid, finish my book, work on the next book idea, take care of my partner and our home.

And, oh yeah, take care of my body, spirit and mind.

It is easy to feel hopeless and fed up. It is hard(er) work to do what needs to be done.

18 thoughts on “Fat Luck? The Obese Have Very Little Of It

  1. scottchaffee

    Obesity has health consequences. While I don’t like the idea of someone setting a socially acceptable mendoza line, I do understand the need to educate people as to the risks. As far as the I don’t have time to diet or excersize excuse, that’s a personal choice. Either being healthy and available for your grandkids is a priority or it’s not.

  2. Caitlin Kelly

    Interesting set of assumptions here..

    1) I have no kids, so grandkids — not an issue.
    2) Women as they enter and go through menopause hit a wall of shocking weight gain — and may have to readjust a lifetime’s behavior.
    3) “As far as the I don’t have time to diet or excersize excuse, that’s a personal choice”. I have the finances to use a gym and to buy low-calorie, unprocessed fresh — i.e. not junk food. I also work at home and have much greater control of when, where and how I consume food than many others. But this is exactly the self-righteous tone that’s really off-putting.

    The world might be filled with skinny people — who scream at their kids, abuse their employees or spouse, kick their dog or watch porn on their every leisure hour. But what a halo effect — i.e. you MUST be a good person because look how healthy and self-disciplined you are!!! — you get with skinny hips!

    When someone is large(r) than you and their putative piggishness, weakness and selfishness VISIBLE — bring out those judgmental knives!!

  3. Gutsy post. One thing that you mention that bears at least a follow-up post is: How do you (can you?) exercise while experiencing some physical pain, especially when exercise would eventually take some stress off the injured joint or muscle group? What’s the work-around? It’s cortisone in the NFL, but we commoners don’t have access to such great sports science.

    1. facility

      It would have been gutsy to accept responcibility.
      Just wonder, is there anything left for which a grown-up person would want to make a stand, like “I do it because I like it, and if it is self-destructing so much for the better – the enjoyment is so much sharper.”
      As of now the only position is always that “this is not a choice”, but guess what – this IS a choice, all the time. So stop complaining that people dont like you the way you are, make yourself into something they would like, your weight notwithstanding.

  4. Caitlin Kelly


    The classic safe choice, if you can get to one, is a swimming pool — you can really work up a sweat doing water aerobics but your body, there, is weightless and there is no stress on the joints. That’s likely where I will start PT as soon as my pain is under control.’

    You can (not great, but something) do upper body work (if that’s not injured) with free weights or machines. Yoga. Although one much younger friend is now, as I am told to REST after a lousy yoga class strained her….

    One MD said I could actually use a stationary or real bike as it really uses your bum, not your hips…

    Best bet ($$?) is to consult an orthopedic surgeon, a physical therapist (they treat so many amateur athletes and aging jocks, real folk) or sports medicine specialist.

    My softball team is playing tomorrow…I am so frustrated not to join them as I’m often the lead-off hitter…But I may join them for lunch. Last time I played, mid-November, I limped off the field with a stress fracture in my left foot. Such endless amusement one’s body can provide!!

  5. john

    When it comes to exercise, if you are injured – don’t. First priority is to get healthy period, and it sounds like you’re suffering from our poor upright human design since it is hip/back related.

    One thing I would like to point out, is that being a city dweller (and here my assumption is that you rarely drive anywhere) you already exercise quite a lot. I’ve always found city life to be very healthy due to its constant walking. You cannot beat walking for exercise. It is low impact, aerobic and it very VERY good for us. If all you ever did was walk for exercise you would be in fine shape. In terms of caloric burn it’s counter intuitive but walking is comparable with running. The only difference is the metabolic effect that running has over walking due to its vigorousness, otherwise, the amount of energy (calories) it takes to move 140 pounds a distance of 3 miles is a fixed number, it doesn’t matter if you walk it or run it. It’s a great thing to remember the next time you’re motoring down the sidewalk.

    Anyway, none of this matters until you address injury. You can’t walk well if you’re in pain.

  6. Caitlin Kelly

    John, the problem is that, in fact, I live in the ‘burbs of NY where we have very few sidewalks — making walking dangerous at best unless on marked, safe trails. I used to live in Toronto and Montreal where my weight was much lower and, as you point out, partly because I walked everywhere and schlepped all my groceries home by hand. Driving everywhere, (and we are atop a very steep hill, dangerous even in a car when it’s snowy and icy) means it’s scarily easy to gain weight.

    A totally sedentary job (writing at a computer, versus my reporting job where I was running all over NYC) doesn’t help.

    I will indeed be eager to get back to my sports and my 4-mile walks when I can actually…walk. Today is the first day in almost a month that I am not holding back tears from 24/7 pain.

    walterbithell, I’m not sure I feel conflicted as much as frustrated. While I appreciate my GPs candor and insistence on losing weight — I’m the one who has to find and pay for a gym or equipment or a trainer or a nutritionist, and stick to it for months. And change my diet…again. I have been plagued, incessantly, with painful, slow-healing injuries that have made it virtually impossible to exercise vigorously and pain-free — stress fractured left foot in December 2009 (which I only discovered in the fifth innning of my softball game as I ran from first to second); right shoulder surgery May 2008…

    As someone who lives/loves to be outdoors and physically active (see yesterday’s post on this), I loathe feeling weak, injured and out of shape!

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  9. Caitlin Kelly

    facility, people like me just fine as I am; I’m blessed with many dear friends. So, thanks for your “concern” but not to worry.

    Your reply really doesn’t make any sense. This post was not “OMG people don’t like me, sob” personally, which they do, whatever my size this week or month. The people in my private life know very well, and understand, the effects of the physical limitations of recent injury and recovery that have slowed me down much more than I might ever have anticipated.

    I am making a much larger point — see the link! — to how fat/obese people are easily, frequently targeted for insults and abuse. This thread, as I knew it would, is bringing it out. Love it!

    1. facility

      Don’t thank me, it was not any concern with or withiut “”.
      It’s a clever gambit to claim that people _will_ abuse you. Though I can’t see any abuse or insult over your weight so far, but I am sure you are experienced in finding it so sooner or later you will luck out.

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  11. john

    I see, well I think a lot of us have sedentary jobs so we have to make up for it with lifestyle. Clearly, you have an ability to make some lifestyle choices when you heal, and that’s perhaps the larger message. Exercise doesn’t have to be about going to the gym and blowing out your guts. In most cases, much more modest activities can be just as beneficial but Type A types overlook them because they’re not tough enough. Roar! 4 M.P.H.! ROAR!

    Part of it is moderation. You can fight this all you want, but then you have to deal with pesky little things. . . . like stress fractures. <== see how we know you're a Type A.


    I'm teasing you because, after you heal, I want to make sure you back the knob off 11 before you start up again. You seem to be placing all this pressure on yourself (and please, what is up with women and women's magazines?). So you read kind of like a caged animal, and you'll want to guard against coming out of the gate too quickly. Yup, that whole Tortoise and The Hare story went right by you didn't it? This doesn't bode well for your recovery. Any chance a stress fracture to a foot 4 months ago leads to torquing a body in such a way so as to facilitate jacking a hip and a back for 3 months? Hmm? Well, at least you know I'm paying attention.

  12. Caitlin, Gina Kolata, the New York Times Health columnist recently wrote a book about the difficulty of getting and staying slim–how genetics and many other factors are involved. The whole moral judgement thing is what really tics me off. It’s especially harmful to kids. People love to be self righteous–it makes them feel good to be better than someone, and everyone who’s not fat feels that they’re better than anyone who’s fat. It’s an easy feelgood moment: “At least I don’t look like her.” Of course it’s not healthy to be too fat–is that a reason to heap contempt on overweight people? Unfortunately studies have shown that only a tiny percentage of people lose weight and keep it off–obesity is a lot more complicated than calories in, calories out. But then complicated will never sell tabloids.

  13. Caitlin Kelly

    John, thanks. You are a sensitive soul — and moi, Type A? Eh? In some ways, yes…certainly when it comes to treating my aging body like a machine and being annoyed as hell when it won’t rev, or rev as high. My Dad, at 80, has more energy than I. So annoying! In the old days, I used to yell at my body when it failed me. Very mature. Now I yell at my doctors…:-) Sort of.

    The altered gait thing may well have played into this as the dox are trying to figure out what has triggered all this. It might be too much damn sitting at the computer, (or perhaps a really bad chair?) between blogging here and writing my book and writing stories for pay. Exercise has always been my go-to source of joy, social life, stress reduction…so, yes, a lonely, bored caged animal I have indeed become with a month of pain, limping and isolation. Today was euphoria…with the new meds, my pain is already at least 60% reduced.

    Erica, so true! The finger-wagging, evidenced here, is rarely matched with the wisdom and compassion of you and John. My granny was large. My Mom is fighting both back pain (i.e. forced inactivity after years of 3xday walks) and consequent weight gain.

    My initial point remains the same. It is vicious and alluring to laugh at fat people. Not everything is as easy and simple as the self-righteous believe, but it’s soooooo comforting to think so!

  14. ebizjoey

    First I must say I have to get swimming again as the winter, no eating too much this winter has me with a bulge. That said I always say some peoples problems show, and some peoples don’t. This may be the new thing to go after, remember how it used to be no big deal to have a drink at lunch? Looks like the obesity epidemic is may start to get that type of attention.

    We just need to be a little careful, good eating is a huge part of a quality life I think, there is a difference between living and just being alive. Too much of anything is no good!

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