Episode 195 Transcript

You're listening to The Fierce Fatty Podcast episode 195, Fat harm: The medical model of fatness. I'm your host, Vinny Welsby. My pronouns are they/them? Let's do it.

Hello. Welcome to this episode. First, fatties and fat ally. So pleased to have you here. Welcome, welcome.

I have my little brains been thinking. I've been a busy I was gonna say little bee, fat bee. Oh, cute, little fat bee buzzing around. It's the end of Jan. I'm recording this. And I have done nine trainings in January for corporate people, organizations, medical professionals and the like. Because of that, I have had interactions with folks. And, you know, talking to other humans is where I get some great ideas from, right? Every time I talk to someone, because I work alone. Can I talk to someone? I'm just like, just so much better when you can talk to other people and be like, what about this? What about this? What about this? Anyway, one of the trainings that I did in January, I was talking to one of the participants. They said, so what do you do? Basically, they were talking about how they were prescribing weight loss and how they think that weight loss is good and great. They said, weight loss is really beneficial for this condition that I treat. All the studies show that if you lose weight, then everything's great. And I asked the person, the doctor, I said, Okay, so your first step is you prescribe weight loss. And she said, yeah, and then then we'll do treatment afterwards, but that's the first step, is prescription of weight loss. And I said, Okay, so how many people come back to you after they've lost weight? And she was like, well, well, the studies show that it's, you know, weight loss is really good for this condition. I was like, no, no, just to clarify, like, how many people lose weight? And she's like, Oh, well, they don't. I was waiting for her to have that aha moment, but unfortunately, we didn't quite get there. And so I said, How about if you're prescribing weight loss, why not? Here's a wild idea. Give them the treatment at the same time.

No, no, no, no, no, we have different viewpoints. No, that's not possible. Anyway, I train lots of different people right in corporate environments, and most of the time, some good news for you, most of the time, is people are really excited. People are really on board with this stuff, especially if their organization has already done a lot of dei stuff. It's really easy to connect with what I'm talking about, to other systems of oppression. Because, you know, also I talk about it in my in my training, like they don't need to, you know, do that work themselves, but for others who are maybe still newer in that journey, or maybe are in the medical world, they can still, still really cling on to the idea that fatness is bad inherently, and we should make fat people fit. So it made me think about, how do I reach, how do we reach fat liberation community in general, people who are who want to do good by their patients, right? They're still in weight centric, you know, Bs, we talked about, I think, did we talk about the two episodes ago? Weight centric? I can't, yeah, I started, yeah. I had started a couple of episodes talking about that. Anyway, I've developed that even more the I've made a the weight centric health care

Unknown Speaker 3:52

cycle. It's on my Instagram, if you want to look a visual of what it looks like. Basically, fat people go in, they get denied care. They don't want to come back because of that, you know, and poor outcomes and provided by us, and blah blah blah, and then it goes back to people not wanting to come and blah blah blah. So I was talking to another client, and she had said, Oh, have you seen that thing from the Lancet? Anyway? So the lancet is a online publication journal, and they have funded research into redefining o word Advancing Care for better lives. Do we have to redefine o word no, no hanger. So I had looked into this to see what is it that they're trying to redefine, looking at what they're talking about, they have this infographic. If it wasn't so awful, it'd be so funny. Basically, what they're saying is the AMA said this two years ago, that the BMI is faulty. And so people were like, Fuck yeah. And then they said it's faulty and it's racist, which was great. Then I made up.

About it. But then they said, but we should still use it, and then also use it with something else to measure fatness. And it was like, Oh, so close. And the other thing that they were talking about was using waist circumference, which

same as BMI, right? It's just bullshit. And so these,

these people, they've gone a step further right. Not only should we use BMI, which is, again, they say it's not good, but we should use it and waist circumference and do a DEXA scan, so direct body fat measurements such as a DEXA scan. So scanning people, and use waist to hip ratio, waist to height ratio, and waist circumference. And then, and then, and then, and then, and then, then they recognize the evidence that there are fat people who are healthy. I mean, that's that's not controversial, right? It's just fact, right? There's fat people that are healthy, and there's then people that aren't healthy, right? And so they say fat people who are healthy, or people with a high BMI but have had a DEXA scan, who have a certain amount of muscle or their fat distribution is different. They don't have o word, but what they have instead is pre clinical o word, and so they've come up with a new term, pre clinical o word. So that's for fat people who are all of these different things, people just living their lives. If you're fat, you've got pre clinical o word. It's just, it's just, it's mind boggling, the the lengths I go to in order to diagnose a group of people with with a disease when their own infographic and research is showing that actually having a body size is not a good indicator of someone's health status or what conditions they may or may not have, because The thing is, like, when a disease, right? Is this, this cluster of of of outcomes, of symptoms, right? That this is what qualifies someone having a disease. So I don't know, say I have asthma, right, you know? And so all asthmatics have some struggle with breathing whenever the criteria is, right? But you can't just say everyone with brown hair is an asthmatic, because a certain portion of people with brown hair have asthma, because it's not the brown hair that links everyone, although many brown haired people might have asthma, and it's the same with fatness. I did a whole episode on is fatness a disease, and go into all of this stuff, anyway, anyway, anyway, anyway. I'm going off all these side tangents to build up why we're talking about what we're talking about today. It's, you know, so this is like this, like new, new study from the Lancet Commission by the lancet is not new or groundbreaking. I mean, just this summer, Reagan Chastain was talking about, someone was suggesting the body roundness index instead of BMI. So is what it says. You know, we're measuring someone's rotundity to determine if they're diseased, which is as just ridiculous as it sounds, right? Which leads to this framing, this framing of fatness as disease. For many people, it's good news, right? Because, especially for a lot of fat people, because, because, because, because, because, what they hear is, I'm not at fault for my fatness. Thing is, fat liberation also says that you're not a fault for your fatness. Without making something into something, it's not right. And if you know, if you're listening to this, and you're like, I feel good about the idea that fatness is a disease, if that works for you, you know, go for it, right? If that it feels healing, whatever. But the thing is, with disease is, what do we need to do? We need to cure them. And because fatness is just a normal way to have a body, we don't need to cure it, right? There's we don't need to fix. But if there are things associated with fatness, because of fat bias, because of health care, because of yo yo dieting, then we should fix those, that bias and those outcomes, right? Versus fixing FAT, FAT nurse adipose tissue, as we know diet, diets don't work, and diet companies are like, okay, how can we get really smart about marketing to people? Because we all know diets don't work. Diets don't work, and so, you know, Noom went we're with psychology, although, uh, Noom is now prescribing GLP ones. We go via Zep, that type of thing, because their psychology, surprise, surprise isn't working, isn't making people fun. This is the playbook. This is the playbook, how to sell how to make money off fat people. I did a post a while ago, and I did a podcast how weight loss and pharma companies are scamming us into thinking they are advocating for fat people. Because this fucking annoys me so much when I hear people who mean well, who have been educated by Pharma.

Pharmaceutical companies about how to talk about fat people, and that comes with like language, like person with O word and saying that fatness is a disease, because it's just the same playbook you know how to sell your weight loss product to make gigantic profits. So the so the steps I defined were first step one is measure bodies to determine who is fat, so doesn't matter that it's not based in health. We want to measure bodies. And this new thing from the lancet is measuring bodies. We need to convince everyone that falls into the correct number is good and an incorrect number is bad and diseased, and bonus points for pushing lower BMI ranges, which is what they've done. We also need to tell everyone it's not fat people's fault that they have a disease, and trick people into thinking that we care about fat people and so they won't notice that our real motive is to sell weight loss products. Lol. Next Step four is to use the language of social justice and fat liberation activists to convince authorities approving our product is about access and not about lining our profits, because fat people deserve rights, lol, aka, pay for our weight loss drug. And so it's like convincing well meaning people to use the phrase people with O word and in reinforcing the idea that fatness is a disease and doing with a smile on your face. But still, we need to erase fat people also then donating millions of dollars to step five, donating millions of dollars to advocacy groups who call themselves grassroots movements, and they are the people who educate health care providers about how to talk about fat people, not actual fat people,

which gets on my nerves. A lot, a lot, a lot, a lot, a lot. So all of this to say medical professionals are either in the place of fat people are fuck them. We hate them. Blah, blah, blah, or maybe they're at the place where they say, oh, okay, I can get behind the idea that fat people are humans, but still they they're greedy, out of control, lazy pieces of shit. But we should help them lose weight. It's not their fault, but I want to get them to a place where fat people are human and they're just as equal as straight sized people, and the health outcomes are can be largely attributed to bias and blah, blah, blah. I want fat people to be treated equitably, and I want fat people to be prescribed evidence based care. That's my goal. However, the difference between diets work, fatness is bad, and diets don't work, and fatness is neutral is too much of a goal for some people, especially medical professionals. If they've been in they've been educated in this weight centric healthcare cycle, right for their whole careers. They're just entrenched in it. So what is the bridge? And I was thinking about this, what could the bridge be harm reduction? So harm reduction is a concept where, so just a quick Google quick definition, harm reduction includes programs and services to lessen the harms related to substance use. It started as reducing harm in regards to substance use, like, for example, drugs or alcohol. And then now it, then it went to sex work, and now it can be used in in there's lots of different ways that we all engage in harm reduction. I'll give you some some examples in a moment. So the idea with with harm reduction is that say, if someone's using drugs is the best way for them to access care or to be safe, to tell them just don't use drugs. Easy. Good luck. See you later. Just come back next week when you're not using drugs again. Okay, thanks for this. Is that helpful? Probably not, you know, and sometimes, like, for example, sex work. Maybe someone is a sex worker, and that's their income, right? So it's like, Oh, don't engage in that thing, that it's your job, and you might really like it, and you know, you might potentially be exposed to harm. Maybe not. But how are ways that that we can engage in harm reduction to keep you safer? So for example, with harm reduction services for substance use, it could be things like people giving access to syringes, so people are not sharing syringes, syringe disposal, medical assisted treatment or safe consumption sites like we have in Vancouver, we have, I think, a couple now, and so people can go in and use, use whatever they've got in inside with healthcare providers right there. So if something happens in the OD, they've got Naloxone right there, right or pharmacy access or drop in centers, yeah. So you know, the thing that could cause harm is still likely to happen, but we're reducing the harm. And so the way that we all engage in harm reduction is things like wearing a seat belt or sun cream when we're out in the sun. Because, you know, we go out in the sun, we're like, we know the sun is harmful, but you know, I want to go get in some have some fun sometimes, right? And so we put on sunscreen to.

Juicy harm. We might drive a certain speed limit, we might use birth control or filters on cigarettes. These are all examples, right? When I'm talking about harm reduction, I'm talking about the harm caused by healthcare providers. That's called io tragenic harm. Iotrogenic harm, iatrogenic is harm? Is the or iatrogenesis is a causation of a disease, a harmful complication or other ill effect by any medical activity, including diagnosis, intervention, error or negligence. So the idea that fat people experience harm by engaging with healthcare providers, hands up, if that's you. Yes, most fat people can say that's us. We've experienced irogenic harm so irogenic harm reduction, in regards to interactions with healthcare providers, know what you're doing, what they're doing, and so I was thinking bridging the gap. We don't tell them that what we're doing is helping them engage in harm reduction, because they probably don't perceive themselves as causing harm, even though we all know that we all do cause harm. And I guess we engage in harm reduction when we interact with healthcare providers, because we might take many different use many different techniques to keep ourselves safe. For example, you might say, if they get on the scale, not and smile and nod and say, Okay, I'm going to get on the scale because it's more harmful to fight. You might say it's less harmful for me to say, No, thank you. I don't want to be measure weighed. You could say to the doctor, I don't want to talk about weight loss today. You could just say, yep, of course, I'll go on a diet because you don't want to get them angry and because that would cause you harm, right? So we're all doing things like this already, so I've made a spreadsheet. I'm going to make it into a an Instagram post, face to face to post of ideas of what we can do instead. Okay, so before I go into that, talk to you about medical model and social model of disability. I'm just going to quickly talk about what that is and give some ideas on harm reduction stuff. But the medical model of disability says that a disabled person, that they are disabled by their limitations, by their quote, unquote, abnormal body, that their body is what is making them disabled, right the way that they move and talk, or how their brain works, that's what's making them disabled, versus the social model says that a person is disabled by their environment and its physical, attitudinal communication and social barriers. So imagine if we lived in a world where every building was wheelchair accessible, every book was in Braille, every TV show had every time you went to the movies, there was captions automatically. They're just some random examples. There was this commercial that I see, I've seen on Instagram. I've reposted it a couple of times, which is, imagine if the world was made for disabled people, and if you were non disabled person, how you could be othered by that. And so in the commercial, there's people whizzing by on wheelchairs, and then the person who's standing is like trying to get people's attention, but being ignored. And then they go into an office to talk to someone behind a desk, and the person is speaking in sign language, and the non disabled person is like, I don't understand you. And the and the person in sign language is kind of like, it looks like they're being like, come on, you know, why don't you know sign language? And then they go to a library, and all the books are braille, and the person who is looking for a non braille book can't find any because there aren't and so the world was made for disabled people. And so that's the social model, saying that the world is disabling. And so what I bring this up for fatness is we can use this, this model, to view fatness in in the same framework, right? And so with harm reduction, let's go back to harm reduction, the medical model, what they say, things that they might do in the medical model, saying that fatness is inherently wrong, right, prescribe weight loss and then provide treatment after weight is lost, or later when the weight is not lost. The social model, which is, you know, fat liberation, says, don't prescribe weight loss, instead, immediately provide evidence based care. So there's, there's the two differences in them in the middle, not necessarily that there's, you know, the social model is an extreme. It's just, you know, pretty basic thing.

But maybe to help someone who's in the medical model reduce the harm is, don't delay treatment while wasting waiting for weight loss. So, you know, they would, they're still going to tell them to lose weight, right? You've still got to tell us to lose weight, but how about while they're quote, unquote losing weight, and we all know, you know, you're not losing weight, but while they're losing weight, you provide evidence based care, you know. And so they feel like they've done their job by telling someone to to lose weight, but then they also providing care at the same time, instead of weight.

Thing. So a medical model view could be the presumption. Presumption is, if someone is fat, then they eat, quote, unhealthy food and don't move their body. A social, social model would say, understanding that weight is not a behavior, and there are hundreds of reasons that someone is fat, and if talking about food, then refer to a weight inclusive dietitian. So the harm reduction version could be ask what they eat or how they move their body, versus assuming so harm is still being done, right? You know, like, oh, a fat person, they must really Groody. But instead of assuming, then asking, so it's still not gray, if there's still harm there, but it's a bit better. So, yeah, so I'm thinking about the harm reduction way of teaching about this stuff, but it sucks, though, right? Because you just want people just just to do the right thing

and not be like, Hey, you can still prescribe weight loss.

But how about you also give them evidence based care, versus being like, just give them evidence based care. But I think sometimes, you know, it feels so extreme to walk away from that. So I don't know. I don't know. It's just the things I'm thinking about more about the medical model and the social model. So I want to give you more examples of the disability.

So there's a blog post from someone called Aaron human, and this links for everything that I'm talking about is going to be in the show notes. But Aaron made this infographic that goes over medical model versus social model and what the differences are, and and I'm going to take out the word disabled, and put fat in its place, and so you can see how it relates to fatness, right? Okay, so the original word is disabled and I'm putting fat instead. The medical model says fat people are harmed by the abnormalities and deficits of their own body and brain. So it was originally disabled people are harmed. The social model says fat people are harmed by their environment and its physical, attitudinal communication and social barriers. Medical model says fat people are broken, abnormal or damaged versions of human beings and should be fixed, cured and or prevented. Fat people are normal, valid varieties of human beings and should have equal rights and access to society just as they are. COVID goes perfectly, doesn't it? The medical model says, Since the fat person's impairments prevent them from functioning normally, they need caregivers and professionals, professionals to make decisions for them. The fat person is an object of charity and a receiver of hell help. The social model says since the fat person is inherently equal, they have a right to autonomy, choice and free and informed consent of their own lives, in their own lives. And lastly, the medical model says the fat person should adjust to fit into society, since they are the only one who is not normal, being part of society means rising above their fatness, so it was rising above their disability. The social model says a fat person should be supported by society because they are equal and have a right to inclusion. Their community should adjust its own barriers and biases. So Erin ends with the social model of disability matters because disabled people are your equals. We can't achieve true inclusion in society if we are seen as lesser, even in a seemingly benevolent way, ding, ding, ding, ding, ding, ding, benevolent way. That's exactly tell the Fauci to lose weight, but don't be mean about it. Do it with a smile on your face. It's not their fault that they're fat. Continuing, Aaron says all disabled people have a right to autonomy, no matter how much support they need to communicate their choices. So it's super relevant, isn't it? So let's, let's really kind of bring it home to exactly what the difference is in in fat, because some of the, you know, there's a few differences there about, you know, we should be kind or charitable to fat people. We don't really get that as much. But anyway, anyway again, I'm gonna make this into into an Instagram post. So the thing is, right, here's the thing, here's, here's a little criticism, here's a little criticism of the social model. So folks have said that the social model could diminish the realities that fatness could be disabling. I mean disability, disability, they you know, they lived realities of of disability, and how say, if light is too bright, you're in you're at home, and the light is your it's painful for you to have a light on that pain that you're experiencing isn't because of society's attitudes towards you in that moment, right? It's the light because of the impairment that you have that makes the light too bright, or whatever, and so you turn off the light. And so that's a criticism of this. But what I.

Me I really like is the medical model, attitudes and perceptions, and so that framing of disability is bad, fatness is bad. That's an attitude, right? And so I want to talk about that attitude between the two. Before we do, let's let's hear from a disabled creator, and I just want to play a video of of them giving examples of of the two models. So we'll listen to that now. By the way, you can watch this, watch this podcast on YouTube, and so if at any point you're like, I want to see the I want to see the visuals for it. It was on YouTube. Oh, you there. Be quiet. The show is starting. You're stimulating. It's distracting the audience. Welcome everybody to tonight's performance. Now, tonight's performance is going to involve some audience interaction and some flashing images. If you feel the need to stim or feel the need to talk, feel free to do so. There are many ways of approaching disability you've just seen too the social model and the medical model. Hello, I'm Kim binci. We are access all areas, and this is access, not denied.

Historically, the medical model has influenced attitudes and treatments to disabled people, but things are beginning to change. A lot of this social change was due to the disabled people's rights movement in the 1970 we weren't gonna take it anymore. We had to have our civil rights and one activist in particular that is responsible for this is Mike Oliver. You don't have our permission, who brought the disability social model into the public eye in 1983 while I didn't invent the social model of disability, I am responsible for naming it. Now, in my opinion, the social model is not perfect, but it is a massive improvement on the medical model. Rather than just wanting on about this all day, what does it look like? Well, I will show you, as I was saying, the thing that disables people is their impairment and their condition.

It is the physical environment and the society's attitude that disable and impair people. Look now we know what people can and cannot do. No, no, we ask people what works for them, and we work towards removing barriers. Scenario, one education, you are a neurodivergent student. You're in school, and you communicate differently to the other students. You boy, Stop fidgeting. Look at me when I'm talking to you. It is very disrespectful not to make eye contact. I am aware that some of you find it distracting giving constant eye contact to the person talking to you. If you want to look elsewhere while I'm talking to you, that's absolutely fine. Scenario two, an audition, you are an actor that requires support, and you've just been given a script for a very important wall. Oh, forget the fake. It's a light too bright for you. Oh, that show business, that's just the way it goes. Now I've got some very important questions to ask you. I need you to be listening, because I'm going to fire them at you very far. Is that light level okay? For you, we can always turn it down. Now, when I ask you a question, if you don't understand, feel free to ask me again. I will repeat them as many times as possible until you understand. And also, there's some creative support for you. Yeah. Oh, and one more thing, good luck. What kind of models of disability Do you want to see disgust in videos like this? Is there anything that you would like to see that I haven't mentioned? If so, please let me know in a comment down below. Okay, so let's look at the medical model, attitudes and perceptions. What they say is fat people and fatness is a problem. The social model says anti fat bias is a problem. Medical fat people are abnormal. Social fat people. Fat is a normal way to have a body. Medical, fatness is a disease or fat people are unhealthy. Social, fatness is not a disease and fat people can have different outcomes. Fat people can be healthy and unhealthy, and both are morally equivalent. Medical, fat people should become thin in order to not experience bias. Social, society should be inclusive to people of all sizes, and fat, people should have equal access and rights no matter their size. Medical says that we have criteria for defining who is fat from the medical establishment, and if you are too fat, your inferior abnormal or unhealthy. And that medical criteria is the BMI, the social model says we have a guideline on understanding body sizes in regards to levels of privilege and access. And that's the fat spectrum made popular by ash from the fat lip podcast. And so that's the small fat, medium fat, super fat, infinity fat, et cetera. Someone said to me once when I was on the BBC TV.

Show. She was like, she was, didn't like being fat, and was really into the medical model of fatness. And she was like, well, you think that the BMI is awful, and then why are you doing you've just got the same thing with the the fat spectrum. It's the same thing. It's even worse. I didn't like her. She was a dickhead. And it's not the same right because because it is led by the community and instead of saying this person is good and this person is bad it's saying this person has more or less privilege and privilege is not good or bad it's just a tool that we can use and have access to or not have access to we should center those with the least privilege versus the ones with the most privilege right. Whereas and so let's help the people who have the least privilege whereas the BMI is saying let's target the ones who are abnormal the most abnormal and so harming them. Okay so the medical model says we should work to make fat people thin so they can physically fit into society, the social model says we should consider inclusive design, inclusive design is another concept within disability where you you know exactly what it says if you think about all people when you're designing products or spaces anything that humans are using right. So basically design it for humans not just for a small section of society and the same with fatness right so we know the amount of spaces that we go into and we don't fit physically or things that we can't use because they're not related to us. You know I was on a clothing website and they have do you know what I just do you know what I really fucking hate it's on clothing websites always another thing elevator remind me in a second elevator. Clothing websites they have women men and home and blah blah and then they have curve as if curve is you're not a woman or a man it's like it just gives it just reeks of subhuman you know and then so anyway I was on the curve section and then on the curve section it has okay here comes in these sizes and there's another button and it said normal sizes and I was like normal?

Fuck you. Do you know what the other thing I guess on my nerves the amount of clothing companies that are like we are we are no matter your body we've got you no matter your size we are in color six. I was looking at this gorgeous brand and they were just all of it all of it all of it inclusive inclusive inclusive I was like yes yes. Then I went to look at the sizes and they go to like you're size 26 or over then you're fucked because you're not human. You know the other thing I'm doesn't make me mad the elevator thing the elevator thing so I'm moving down to the first floor of my apartment because the elevator is going to be is being renovated it's going to be down for like six months and because I'm disabled they need to move me to an accessible apartment it's not perfect but whatever. I've been thinking about this about ableism coming up in my brain of using the elevator to go to the first floor and I was just thinking about this and that same day I was thinking about it I got into the elevator and someone I said someone else came in and I said oh what floor and they said oh two I'm being so lazy and I was like um no you're not being lazy it's efficient it saves time why do you want to get up to the second floor he was eating some delicious snack and be out of breath and in the I was just like no you're not lazy and I don't want to hear this anymore people getting into elevators and being like I'm so lazy because I'm using the elevator to go to the first or second or third or whatever floor they're going to because it's fucking ableist and it's shaming it's shaming yourself and shaming the other people in the elevator if they one day decide that they want to take the elevator to the first floor so let's get rid of this let's get rid of that from our vocab you know this is just something I've just realized oh the amount of times when I used to work in this corporate environment it's corporate environment and we were on the second floor and we had these really swish offices and we had a cafeteria on the on the bottom floor every motherfucker would use the stairs and it was a glass staircase and inside the glass staircase was a glass elevator and the amount of times that I got went and got my lunch and I was like I want to get in the elevator if I was here alone I'd be getting in the elevator but because of shame that I was a fat person and everyone else was using the stairs no fucking way would I use the elevator no and I bet you so many of my colleagues were thinking the same oh well you know Vinny's using the stairs and they're fat if they can use the stairs and they're fat I should be up to use the stairs it's so it's so fucked up on so many levels so listen up here now listen up here if you were one of those people who are shaming yourself for using the elevator or saying out loud oh I'm so lazy for using the elevator or anything like that let's get rid of that shit let's just put it in the bin because you know it's all kinds of dog shit right and if you hear someone else saying I'm so lazy but ah ah ah no no you're not okay you know laziness that's just why it's supremacy culture capitalism colonialism no thank you I don't want to be a part of that I'm gonna use the elevator as much as I'd like it's quicker it's quicker come on now and the elevator and the elevator door is closer than the freaking stairs door anyway when I'm down there and the elevator is broken I won't be using the elevator anyway so my rant my rant about things okay so the medical model says that fat people are uneducated on how to be healthy that's another thing from um the BBC program I've got so much trauma from being on that BBC program if you uh are interested I did a two part of how uh being on that show almost killed me literally that's not hyperbole because of the edit you know RuPaul says don't blame it on the edit you know when drag queens are like I got a bad edit RuPaul no I'm not with you on that one no because the edits are absolutely scandalously bad in so many reality tv shows or documentaries I was on a documentary.

I mean quotations it was like basically reality tv they're scandalous and they really harm people I was just watching the dark side of reality tv it's vice you can find it on youtube but I'm watching it in Canada on Crave which I think is HBO in the US anyway you can find it it's on it's on um it's on um youtube the dark side of reality tv and they it's it's good like they do next top model and they were doing Joe millionaire Joe millionaire which was like a bunch of women dating a guy and they said that he was a millionaire he wasn't he was a blue collar worker anyway and they were saying what did they call franken franken edit or something they used that phrase anyway so one of the girls went on a date with Joe millionaire there was no camera footage of it but all you heard was they were in a park and you heard her giving him a blowy and what they did was they just like took sections of you know her you know maybe they got a section of her licking her lips and then they got they got a sound of someone doing a slurping noise and they just did a franken edit and made it sound like she gave him a blowy and she didn't anyway what was I talking about ADHD oh yeah on the tv show on the tv show um that same person she was so do you know what really annoyed me about her she was really really privileged she was really rich came from a really privileged background and she was one of those types of I don't know I'm gonna stop slagging her off anyway I don't like her anyway she was like fat people don't know how to feed themselves no fat people don't know and it was kind of like fat fat people poor people don't know how to feed themselves like they've never heard of vegetables it was really elitist that's what it felt like it was really elitist that you know well fat people think that they should just inject lard into their veins they're just so fucking stupid which is ableist right and the word stupid is ableist so fat people are that's a medical model fat people are uneducated on how to be healthy they're out of control around food and lazy it's best to either shame them which is what we've you know seen a lot of in the past and more recently or be charitable and help them learn how to lose weight as they don't know how to the social model says fat people are likely to be more informed than straight-sized people or even experts on how to lose weight right many people in bigger bodies have spent their lives trying to become smaller and it's not a lack of willpower education or laziness that stopped them but the inherently faulty diet finally the medical model says fat people who successfully become thin should be heralded and cherished fat people who remain fat or gain weight after losing it should be ashamed the social model says weight loss or gain does not equal moral worth and moral word the moral worthiness or lack there of so because people are probably more familiar with the medical model social model of disability.

I don't know maybe this is because i'm in the dei world i think everyone knows this you know maybe they don't maybe people don't know i don't i don't know maybe that's my ignorance my ibt i don't know being in a silo of people who talk about this type of stuff i don't know anyway i'm just really interested in making this stuff more accessible and being a better communicator so that people who i think i think many health care professionals deeply deeply care about their patients and want the best outcomes and reaching them the people loretta j ross um she's an amazing black educator she talks about our spheres of influence she has a book coming out by the way she talks about spheres of influence we've got the people around us who love us and who are like probably on board with what we're saying but the people who are kind of on the fence maybe there might be acquaintances you know either all right and then you have the people on the outer sphere or ring of influence where they they they're on the other side right they're deep into right wing ideology you're not going to reach those people likely you're going to reach the people who are closest to you and there were ones on the next ring the ones who were on the fence and so the ones are on the fence are saying we should be kinder to fat people when we tell them to diet you know they're there they're almost there you know we should be kinder to fat people yes full stop full stop and then not tell them to diet like that's the end of the sentence should be perhaps this way of communicating it about the medical model versus the social model could be helpful and on top of that giving them ideas on harm reduction without telling them it's harm reduction kind of be like here's how to frame it i wonder how to frame it because it's kind of we it's almost like we don't want to let them in on the on the idea we're trying to get them to stop being harmful because it might turn them off right it might say people get defensive and say i don't cause harm i just wish some people you know would be like we all cause harm we're all f***ing biased and have s*** to learn and blah blah blah i guess it's hard for some people anyone got an idea how can we frame it because i think here's the thing i don't want to say it's acceptable to say to lose weight you know because we know it's not evidence-based and it causes harm causes poorer health outcomes maybe we do reframe it as a harm reduction technique i don't know if anyone's got any ideas i'll probably have it sorted out by next week anyway i'll be there thinking in my bed a bit like oh i have it at you know one o'clock in the morning need to write this down it could be like moving towards weight inclusivity looks like ah i don't know because they can be like no i am weight inclusive already i i i help fat people get weight loss surgery and say weight inclusive it could be step one two three anyway whatever i'm thinking out loud you don't need to be listening to me babbling about their s*** um links for everything that i'm talking about is in the show notes uh i still have i have a health care survey right if you're fat and you've experienced had any experiences in health care good or bad whatever um big or small then there's a link to do the fat and health care survey and already so much information but if you want to add in your story i haven't yet started to collect them into a report that's going to be in february because i'm busy fat b in january like i said um so you still have time to do that but it's probably going to be um cut off in the next couple of weeks so if you have anything and listen if you if you think oh my story's not good enough or it's not you know outrageous enough I know i want to hear everything even if you're saying i've had good experiences right because i want to know what's happening so far you won't be surprised you won't be surprised it's looking like i think off the top of my head 89 percent of people saying they've 89 percent of people who are all fat say that they've experienced anti-fat bias that's just from in health care that's just from the first question which says have you experienced anti-fat bias what we found with the last survey which was fat at work survey was that most people said i've experienced harm some people didn't i think it was like five or 10 percent something like that then the next question was have you experienced a boss making fat jokes have you been fired for being fat have you and so listed out a ton of different anti-fat experiences and almost every single one of the people who said that they hadn't experienced anti-fat bias in the workplace then went to describe experiences of anti-fat bias so i think sometimes we don't realize what is anti-fat bias so anyway so that 89 is from that very first question and not me delving in i did do a quick delve in to find out how racialized people are more impacted and racialized people that number went up a few percent so i mean obviously right and if i look into we've got it then separated into lots of different identities you know for example in the last survey in the fat fat at work survey what we found out was that racialized poor and disabled people were the most affected also older older people older people had the most harmful anti-fat experiences in the workplace and i think that's a shifting in in attitudes that maybe younger people have not had as egregious anti-fat experiences but still as we know the more marginalized you are the worse the world treats you anyway thanks for hanging out with me today we're 195.

I started the podcast like i don't know like six years ago um what are we going to do when we get to 200? I don't know all right i'm gonna i'm gonna let you go um my dog doogie at the when i started recording this podcast is like oh they're getting up we're gonna go for a walk and then he saw me sit in my chair in my chair to record he was like oh all right well thanks for hanging out with me today uh the show notes will be fierce fatty forward slash fiercefatty.com forward slash one nine five for links to everything and remember you are worthy you always were and you always will be stay fierce fatty we'll see you in the next episode fatty hugs and love to you goodbye bye bye you.