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Fat and disability: what few of you want to hear

Posted on Thursday, May 6th, 2010 at 10:57 pm

Author: Renee Martin

The personal narrative is something I have avoid, because the naked honesty also leaves one extremely vulnerable to attack. Living in a marginalized body is difficult enough without showing one’s war wounds, but when it becomes clear that hiding is only enabling the complete erasure of people who look and function like me, then it is time to speak out. You see, I am fat, Black, female and differently abled.

I can never completely be at home with any one of the labels that best describe me. In the media, I can see Black women, or even fat black women, but fat and differently abled are definitely categories that are understood to be mutually exclusive. A body like mine contradicts the mainstream social discourse.

Fat activist groups like NAAFA (The National Association to Advance Fat Acceptance) have worked hard to promote HAES (Health at any size). NAAFA’s goal is to build “a society in which people of every size are accepted with dignity and equality in all aspects of life”. Considering the amount of hatred that fat men and women face in every avenue of life, this is most certainly a laudable goal. The problem is that the HAES model often excludes disabled folks, because our bodies are seen as broken.

How can you claim health at any size when people who are fat and disabled exist in direction contradiction to the message? My fat is a direct reflection of the two chronic illnesses that have plagued my life for the last three years.

I am fat because I have been on prednisone (a steroid) for years. I am fat because the smallest amount of exertion causes extreme pain. There is nothing healthy about this fat.

There is nothing to experience pride in, because fat for me represents all of the ways in which disability has robbed me of the life that I once had. There is no room for this story in a fat activist platform, because it reminds people that yes, fat can indeed be a form of illness — and that is the antithesis of what fat activists are aiming for.

I fully understand why there is a reluctance to embrace bodies like mine. Fat shaming has become a part of our daily life. Fat men and women are both subjected to attacks and expected to perform the role of the jolly fat person, or else disappear into their homes with only the comfort of two or three cats and the internet. Our bodies are continually subject to ridicule and it has become the national narrative to assume that we are dysfunctional, lazy, greedy, and slovenly and that we simply don’t know how to eat properly.

Disability and or chronic illness does not necessarily lead to the sympathy or empathy that we present as our social myth. If for instance, one has emphysema from smoking, the role that smoking played in contracting the illness quickly eliminates any sympathy. We become gatekeepers to the chronically ill and disabled, determining guilt which in turn is used to justify apathy and discrimination.

Fat has become one of the markers that is often suggested as leading to several diseases, and or chronic illnesses. We have become socialized to believe that fat can only function as the cause of the illness and that if one avoids being overweight that somehow it will alleviate the suffering that is caused by any chronic health problems.

When I am out negotiating the world in my scooter, my fatness speaks for me long before my disability does. Strangers who barely know my name are more than willing to suggest that the problem is my weight. It is assumed that despite all the limitations that come from needing a mobility device, that this is an active choice on my part.

“Eat less, move more” – but none of this would change the state of my health! I understand that the judgements and suggestions do not come from a place of concern, but out of a desire to avoid becoming disabled. They are based in an absolute fear of losing able bodied privilege.

Even if you eat right and exercise every day, it is not a guarantee that good health will be a lifelong condition. Able bodied status is temporary for us all, and for some of us the loss happens at a relatively young age.

This is no way a suggestion that people should not try to eat healthy and exercise, rather it is an admission that effort does not suddenly grant one immunity from disability. My fat, disabled body makes people uncomfortable because it stands as visual evidence that despite all of the myths we create to make negotiating this world easier, there are still no easy answers to the many medical problems that plague us. Fat may not always be a symptom of illness or dysfunction, but sometimes it most certainly is and when fat activists ignore, belittle or silence this truth they are simply acting in the same manner that skinny people do when they fat-shame.

When the reality of my disability is ignored so that someone may feel free to fat-shame me, it reveals just how insistent able bodied privilege is. It is only out of a desire to express power coercively, that one can decide what constitutes disability and where responsibility lies.

Those who has power are those who get to stick on the labels, and this is true in many instances involving social marginalization. No person that has been “othered” has ever created the social stereotypes to which they are expected to adhere. Some may say that there is a grain of truth in each social stereotype, and in this they would be correct, because all of the ways that we have categorize people are all based in our desire to maintain a hierarchy that is not only reductive but ultimately oppressive to us all.

So here I am, waiting to be seen, waiting to be heard. My truth, and the reality of what it means to occupy my body, can never be accepted until we move away from the idea that we have to justify our existence or that all human beings have to look and feel a certain way.

I am fat and I am disabled and yes, the two can co-exist in one body and still be a celebration of life and that which is good.

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  1. This is such a great article and will hopefully inspire more people who shame fat people and who feel it is their duty to “warn” fat people that their fatness will cause an illness to think deeply about the words they choose.

    I especially loved the paragraph about the stereotypes surrounding the labels society has made up that are put on people who are disabled, plagued by illness of any kind, or who are simply and “other” is oppressive to us all. Great post–I thoroughly enjoyed reading it.

  2. My mother had thyroid disease that basically required her thyroid to be severely damaged. Her weight has gone up and up and she now has diabetes and many other health problems.

    My aunt and sister deal with it also, and as they are all older than me, I know it is something I am on the verge of facing also. We all all poor functioning thyroids, chronic fatigue, severe allergies, lymphatic problems, and basically endless minor chronic problems that all cause each other and are caused by each other.

    These kinds of health problems all cause and are caused by lack of exercise and weight gain. It’s a chicken vs the egg phenomenon and the reality is for each human being there are different reasons they are faced with unwanted weight gain.

    Since I am adopted, and my sister was adopted and we both grew up knowing NONE of our biological family members, I can testify that biology has a lot more to do with these kinds of issues than people want to think. My sister grew up with parents who HATED that she was over weight.

    They thought she needed to diet more, to exercise more, to CARE more, to try more. Come to meet her biological family members and she finds that it’s something we have all struggled with too, and on her dads side she is Native which can make the Standard American Diet bad news to begin with.

    This issue isn’t easy to talk about.

    But we should all look at how we frame people dealing with weight problems, because the reality is there is no one answer for one person and the more we research it, the more clear it is that the “magical losing of weight” if you apply yourself hard enough can’t always happen for every human being. Not to eliminate diet and exercise as a means for some people to loose weight, but that isn’t an option for people who a differently abled, for people who have no thyroid (which regulates metabolism and weight gain) and for many other reasons that different people face, down to just plain biology that spans generations of people who have been adopted into totally different families.

    There is no one answer and to make one is to ignore the lives of real human beings.

    Renee, your voice is radiant in this piece!

  3. Very sharp analysis — yeah, the reason people often try to find a definite cause is their own fear that they too are susceptible to illness and disability. Which, of course, we all are. And the way disabled people are left out the HAAS analysis is something I never considered.

  4. Wonderful article, Renee, and one that deeply speaks to me as a woman whose fat is sometimes healthy and sometimes not.

  5. Renee’s writing is outstanding, and she makes many valid points. I have been active in size acceptance for 41 years, adding a HAES focus in the last 20. Her points about the movement not being sufficiently inclusive about differently abled participants is well taken. Over the 41 years in the NAAFA setting, this has varied from year to year, depending on who takes the initiative, especially at conferences.

    This topic is discussed from time to time in ASDAH (Association for Size Diversity and Health)(www.sizediversityandhealth.org) as we promote HAES. Indeed, as an international organization, that is the most important thing that we do, and there are members who give voice to the concern that due to their own health problems, they may not be good representatives of HAES. This is, of course, not the case–but the public, which is pretty ignorant on the subject to say the least, can be expected to react mainly to sound bites and visual images.

    A third of my personal friends have scooters or power chairs, and many are fat, for a multiplicity of reasons. Lack of physical activity and so-called “overeating” are relatively small components of their size. Their weight is a relatively small component of their mobility problems. Seeing this with my own eyes makes me even more of an activist.

    I believe that when a person of size is differently abled, and uses a scooter or power wheelchair, there are those in size acceptance and HAES who are uncomfortable, and it is probably more fear-based than anything else–a fear of losing their mobility. But many of us just accept it as the diversity of the human condition.

    Bill Fabrey
    member, ASDAH, advocating for Health at Every Size

  6. I welcome the writer’s heroic identification with various identities. I am sad that her understanding of the Heth At Every Size approach doesn’t include what I consider to be its primary strength – the refusal to participate in blaming. In my view of HAES, there is welcome for people of all ability levels. I find HAES essentially humane in its support for people living as well as we can in the bodies we are right now. I certainly hope for fat pride to be in solidarity with disability rights ande vice versa!!!

    Best wishes…

  7. Thank you so much for writing and sharing this piece. As someone who is terrified of losing my able-body and able-mind, either by accident, disease, misuse or maltreatment, your writing has really struck a chord. Lots to think about! Thank you again.

  8. I’m fat due to disability as well, so I know what you mean! I’ve found better acceptance and more listening as a feminist disability activist with fat activism on the side, rather than the other way around. I don’t know whether you’d get the same result (because who knows, maybe the fact that I’m white and USian is the reason this works for me, and the additional prejudices someone who is Black and Canadian faces would change the dynamic enough that it wouldn’t work).

  9. I come down firmly on the side of treating everyone with respect regardless of body size, ability level, or pursuit of “health”, whatever that means to anyone. I strive to be as healthy as I possibly can, but as a fat person with a disability, that’s not always easy, and I do feel like sometimes, I’m a “bad fattie” because I’m not doing yoga or half marathons or being a vegetarian.

    I am glad to see this piece making its way around various blogs that I read and I thank you for it.

  10. As someone who’s been involved in fat acceptance and HAES for years, I’m always sorry to hear it when people whose disabilities or health problems have affected their weight say that they feel marginalized by the idea that it’s possible to be fat and healthy. Because it IS possible to be fat and healthy. Many fat people are healthy. Others are not, or have disabilities. Some people are fat, disabled in some way, and otherwise healthy. Everyone’s story is interesting and valid. So, I guess I have three points:

    1. HAES is flexible enough to include people with disabilities, if they’re interested in it.
    2. Fat acceptance and HAES aren’t the same. Fat acceptance is about social justice and HAES is a personal thing. It’s not hard to find fat acceptance activists who have no interest in HAES.
    3. When other people speak from their experience, it is not usually meant to invalidate someone else’s different, equally valid experience.

    I’m glad that you’re here telling your story, and am interested to hear more about you. However, I was a little sad to hear that you think that people like me want to suppress what you have to say.

    I am, by the way, a bit disabled myself. I have a fairly new artificial hip. I can walk without an assistance device, but I walk more slowly than I used to, my body feels misaligned, and I’m dealing with chronic pain. However, my disability hasn’t affected my weight much (I’ve gained a little since my hip started to limit my level of activity – about 20 pounds) and I see my size and my disability as two separate issues. I don’t have any fat-correlated health issues even though I’ve been fat for 30 years (since I was 10).

    This is just in my case. For other people, fat and disability interact in an at least partially causal manner one way or the other. I understand that and I have no interest in silencing people who are experiencing it. In fact, I wish more people would speak up. And, I hope it’s okay to tell my story too.

  11. I feel the writer has misunderstood what HAES is (agree with Marilyn Wann on this point). Also, no one chooses to be fat whether they are orthopedically disabled or not – people are fat because of some metabolic or physical or genetic (or a combination of all three) problem which basically comes down to the fact that even eating moderately in the American way renders them fat unlike the 83 percent of the population who can enjoy the American lifestyle and only gain a few lbs (if any). The idea of NAAFA is celebrating humans at any size and seeing that beauty resides in the person and not in the size and kind of saying that if a person doesn’t want to starve to stay slimmer (which is what it takes for someone who is metabolically/physically and/or genetically challenged) then that doesn’t make the person any less beautiful or any less of a person and that our food choices are really none of anyone’s business anyway. As a TV shrink says “it’s not what happens to you – it’s how you react to what happens to you”. To this author, I would say, find the beauty in life, in you and in other people. And “it’s altitude which determines altitude.” Finally, an important thing for anyone who is different “no one can make you feel inferior without your permission!” (Eleanor Roosevelt)

  12. I guess my first reaction was, “Are people seriously doing this [saying that disabled people can't participate in HAES/saying fat can never be a symptom of a health problem]?” But I guess the cynical side of me isn’t too surprised. (I’m not involved with NAAFA, which is what you specifically reference, so that might be why I haven’t noticed it.) Certainly there are also people out there who believe in Health At Every Size and define “health” as something highly individual that will depend on the details of the particular body involved.

    I think there is a big difference between seeing fat as sometimes [but more often not] a symptom of a health problem vs. purely a cause of a health problem, though. I believe most doctors have a strong tendency to over-ascribe fat a causative role ind disease, but I think it would be completely stupid to say it could never be a symptom of a problem. I’ve heard people say that fatness might be a symptom of T2 diabetes rather than a cause and that might explain the correlation, but there are seriously people out there claiming that, say, thyroid problems don’t exist? *mind boggles*

  13. Whether or not some well-meaning people mean HAES to come across that way, it does. There’s a lot of “fat Amazons”, for lack of a better word, loudly talking about “I’m fat and yet I still hiked 10 miles last weekend so therefore you can’t say fat is bad!” I totally understand why they do it – but it does have the effect of making chronically ill fat people like myself (and the author of this piece) feel like maybe we don’t fit or aren’t wanted in this movement. I hate feeling like the bad, sick fatty who is dragging down all the virtuous fatties who are hard core exercising vegetarians, even as it’s nice to know there is at least someone in the world who doesn’t think automatically upon looking at me that I *must* eat three greasy meals a day at McDonald’s when they see what size I am. In short I think HAES might be getting a wee bit – overemphasized? I don’t know. Fat people DO get sick, sometimes they get fat because of their sickness, sometimes they are already fat and get sick just like thin people do. My biggest issue as a fat personwith chronic health problems is going to the doctor and trying to actually get my conditions treated instead of my fat. That’s a remarkably hard task.

  14. Raven–insightful comment. I think you’re right about HAES getting overemphasized; oftentimes it does feel like the primary emphasis is on “most fat people don’t sit around eating all day!” and the secondary emphasis is on “my health and health-related habits are unrelated to my moral worth as a person!” when it should really be the other way around.

  15. Renee,

    I share your struggle. I have hesitated to join fat positive communities for years for the very same reason. I am a large disabled woman as well and for a very long time I have twisted my fat and my diseases into each other, unsure of which one is responsible for what challenges I face and seeing them both as inescapable.

    But two years ago I began a journey that is helping me sort out the history of my body and my relationship to it. I began treatment for my eating disorder and began to heal my relationship with food. (NOTE: From the looks of it, pretty much all American women have an unhealthy relationship with food and dieting. New studies are showing that the numbers of women with food issues that qualify as an eating disorder are far far higher than anyone previously thought).

    Here are a few of the things I have learned:

    1. My body doesn’t hurt because I am fat. My body hurts because I have a spinal disease and fibromyalgia. My pain, stiffness, aches and difficulty being active are not punishment for food choices I made as a child, young adult and grown woman. They are the result of a very real medical condition. People who have my condition and are thin ALSO suffer from all the aches and pains that I have. This pain is not about my weight. (But yes, my excess weight makes this harder. Keep reading.)

    2. My weight is a problem. It is a problem for me because I am larger than is right for my body.

    3. My weight problems are the result of several different factors coming together. The one I have the most control over is my diseased relationship with food. Fear of fat and a culture of diets taught me to have a complicated punishment/reward relationship with food. As I have been in recovery and I am regaining my ability to eat what I want, when I want and nothing more than what I want, I am healing.

    4. Scientific studies that tie weight to disease risk are poorly conducted, completely biased and no one in the scientific community takes them seriously. They have a hold on the public, but in research communities it is clear that it is DIETING, not fat, that causes these increased health risks. Our bodies weren’t built to fluctuate in weight again and again, starved of this kind of food, gorged on that kind. Dieting is the enemy to good health, not fat. In the public dialogue, “fat” became the abbreviation for “eating poorly and getting very little exercise”. This is not accurate at all as there are both large women who eat well and exercise, and thin women who eat poorly and don’t exercise.

    5. I will never be able to lose enough weight to fit my appropriate BMI numbers without starving myself. Never. It is not healthy. My body shape, bone size, pelvic bone structure and general genetics all indicate a very different body type than the one that is on television. It’s like asking someone who is short to just keep trying to grow taller. It’s not going to happen.

    So what do I do to be healthy? How to I address my excess weight while I am trying to take care of my body as a disabled woman? I listen to my body. I stretch when I need to, rest a lot more than I used to and I stopped fighting/being afraid of food. I have been listening to my body and eating what makes me feel good (not what my emotions might want me to eat) for a year now. I am losing weight slowly, around a pound every week or two. It’s gradual. It’s healthy. Slow weight loss like this is not shocking to my body and will not kick up the kinds of health risks I was talking about before.

    But let’s be clear. I am NOT DIETING. Dieting is the problem. I am simply not fighting with myself anymore. I don’t deny myself the donut and then get angry later and eat a whole bag of chips. I don’t hide the amount of sugar or salt or butter I put on my food. I don’t eat because I am upset, I eat because I am hungry. I pay attention to my hunger and I try not to get too hungry or too full (either one limits my ability to really feel my body’s nutritional needs). I am just paying attention to my body and loving myself enough to follow through. If carbs in the morning leave me feeling lethargic, I skip the bagel, not because of the calories or some other crazy diet ideas but because MY body doesn’t use that kind of fuel well at that time of day. I don’t judge. I don’t make mistakes, I just eat. If I eat emotionally or eat too much of something, I notice it, think about what led me to that and take note.

    There is no such thing as bad food.
    There is no such thing as the “right” amount of fat on a person.

    My disability isn’t something I can change. My disease is genetic, chronic and degenerative. But I can listen to my body about how I eat and how I love myself. I can work to see myself and other large women as beautiful (which we are). I will never be skinny. And why would I want to be? I was made to be a large curvy woman. It’s in my genes. What I want to be is the right size for MY body, to minimize both the stress on my back and the struggles I deal with in my daily life.

    The fat didn’t cause my disabilities (or my pain). My disability contributes to my weight in that it is harder to move around and exercise, but exercise is just another external idea. Bodies want to move. That’s what we want to do. I listen to my body and I move. I dance, I stretch, I do what makes me feel good. If I feel like a walk, I take a walk. If I feel like resting, I rest. No laziness. No “shoulds”. Just me, listening to my body and loving myself enough to follow through.

    That is what HAES is really about. Learning to be healthy for your body type. Learning that healthy isn’t a dress size, it’s a way of life.

    I would like to HIGHLY recommend two books:

    1. “Intuitive Eating” by Evelyn Tribole and Elyse Resch could save your life. This is the paradigm from which my therapy work stems. They give clear directions on how to heal your disordered relationship with food. No more diets. No more tricks. Just learning to eat based on what your body feels. If you read it, this is the last “how to eat right” book you will ever have to buy.

    2. Paul Campos’s book, “The Obesity Myth” will give you everything you want to know about the fallacious ties between fat and disease. The medical studies in there not only show that the fat-disease studies are falsely reported by you learn why. It shows other studies that indicate clearly that large women who eat well and move around a bit are far healthier than thin women who don’t. That book really changed my life. It’s amazing.I wish more doctors knew this, but they are just as susceptible to public discourse about fat as everyone else. But read the book. I promise it will help.

    Health is about behaviors. It is about eating good food, moving around, being happy, limiting your stress, surrounding yourself with loving people and finding purpose in your life. Health has never been and never will be about how much fat there is on your body.

    With love and support,
    Katie*

  16. Whilst the writer makes many valid points, HAES has been mischaracterized. HAES is emphatically not a *guarantee* of “health at every size”, it is an *approach* to health. HAES is an approach that individuals can strive for good health for them, at any size.
    HAES doesn’t say “you have to lose weight first” , nor does it promote being a particular weight as a route to health.

  17. Renee, thanks for this essay. I feel differently about HAES as a movement and being a disabled fat person in general, but your lived experience is *more* valuable than mine, because you’ve experienced marginalization. I’m dripping in white privilege and have the privileged experience (college degree, licensure) of working with hundreds of people with disabilities in my career. So, I don’t have much fear of my disability and I am not subject racial oppression. And as a scientist, I have privileged access to the overwhelming evidence that weight is mostly unrelated to health and fitness.

    I think a lot of the good fattie / bad fattie dynamic that HAES can play into is part of the process of self acceptance that so many people go through when they encounter fat acceptance. Realizing that your lived experience doesn’t match cultural myths and finding like minded people is a heady experience, and celebrating that is overwhelming. It’s almost like a religious conversion, I think. And many people going through this are relatively young TAB folks.

    In my experience, people prone to support HAES are also prone to support a view of health as including disabled people. The essence of HAES is the rejection of health moralism, and ableism is just that. It’s just a fact of life that some people gain weight when their ability to exercise is limited, and that many medications cause weight gain and prevent weight loss. I understand how the word “health” in this cultural climate is alienating and marginalizing, and I think that we HAES proponents need to take that seriously and address it. So I’m really grateful for your opinion, and if you’d like to write about how the HAES movement could stop marginalizing you, I’ll do my best to bring it up with colleagues and on blogs.

    [Please note that this isn't a demand for you to write what I want. I just wanted you to know you have an active listener from within HAES IF you want to write more!]

  18. I want to go back and find the Christine Northrup speech to play to Kat because she has one of her books, but essentially at one point Northrup says the objective should not be longevity, that this is a terrible idea, that the objective is to be as pain-free and vital and happy as possible… and then die. We’re all going to cross that bridge one way or another. I think there is so much unnecessary pain which worry and shame and guilt and embarrassment impose on life, and for what great reason ultimately?

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