Episode 27 Transcript

Hello and welcome to episode 27 of the Fierce Fatty Podcast. I'm your host, Victoria Welsby and in today's episode we're talking about, is fat positivity, anti-health? Let's do it.

You're listening to the Fierce Fatty podcast. I'm Victoria Welsby TEDx speaker, bestselling author and fat activist. I have transformed my life from hating my body with desperately low self-esteem to being a courageous and confident first fatty who loves every inch of this jellied society teaches us living in a fat body is bad. But what if we spent less time, money, and energy on the pursuit of thinness and instead focused on the things that actually matter. Like if pineapple on pizza should be outlawed or if the mullet was the greatest haircut of the 20th century. So how do you stop a negative beliefs about your fat body controlling your life? It's the Fierce Fatty podcast. Let's begin.

Hello. Hello. Hello. Welcome to this new episode. I hope you're doing well and you're a surviving isolation, quarantine, whatever you're doing or if you're listening to this episode. In a year's time, you're like, what? I hope you're happy. I hope you good. So today we've got a listener question, which is something that a lot of folks are worried about and concerned about. And it's actually one of the biggest barriers that I see to people getting on board with loving that their fat body and that is health. And there seems to be a lot of confusion around what you should do and what's okay and what's not okay and so that's what we're talking about in today's episode. Now because we are still in the global pandemic. I wanted to update you on the news around fatness and COVID19 and whether fat people are just gonna spontaneously combust if they get COVID 19. Clue. No and it's exhausting seeing all of these fat phobic memes and fat phobic rhetoric around and Christie Harrison of Food Psych has curated and collated all the data and the studies that have come out and she wrote a piece for Wired. It's called COVID 19 Does Not Discriminate By Body Weight. I'm going to link to it in the show notes. To get to the show notes, it will be underneath wherever you're listening, but if you're driving or whatever, it's fiercefatty.com/027 because it's episode 27. So fiercefatty.com/027 for episode 27.

But let me read you a little bit about from this this article that Christie wrote. Christie is a dietitian, straight sized dietitian and she advocates for fat people in her work. She's anti diet and she's great. I was on her podcast maybe 18 months ago. I'm going to be on a new episode of hers coming out in the next month or so. But anyway, this is what a snippet of what Christie says in the article. This is the beginning of it. At this point, it's been made to seem like common sense, larger body people are at higher risk from this pandemic. Oh, and by the way, this is not in the article. This is me speaking. In this episode, there's going to be mentioned of the O words and so if you don't want to hear those at all, I'm going to be saying quote unquote. But if you don't want to be hearing those and maybe skip this episode because we're talking a lot about science and studies and things like that.

So anyway, back to the article. Larger bodied people are at higher risk from this pandemic quote. Those who are "overweight" really need to be careful. Francis chief epidemiologist declared last week. That is why we're worried about our friends in America. In recent weeks, many news outlets and a few scientific journals have sent the same frightening message. A study posted on a preprint server last weekend by researchers at New York University provided fodder for the latest round of this reporting. "Obesity" appears to be one of the biggest risk factors related to COVID 19 hospitalizations and critical illness. Newsweek claimed on Tuesday, yet this rhetoric is based on flawed and limited evidence, which only exacerbates the stigma that larger bodied people already face in a society and our healthcare system. That stigma is what truly jeopardizes their health, not weight itself. A fact that it's only more important to consider in the midst of this pandemic. The article continues. This is a quote that Christie picked out herself. Anti-Fat bias has been linked to subpar healthcare in a variety of ways, including providers spending less time with larger body patients, speaking more curtly and less compassionately to them and miss tributing symptoms to their weight instead of referring them for testing or offering evidence-based non-weight related treatment options. Discrimination against higher weight people is a known independent risk factor for all kinds of health problems that typically get blamed on weight, including diabetes and heart disease and COVID 19 is only amplifying this preexisting disparity. When you take that and then you throw a pandemic on top, it's like adding water to a grease fire says, Joy Cox. A researcher at Rutgers New Jersey Medical School Health disparities that weren't addressed when there was an opportunity to address them have been magnified. That's the end of the quotes from that article.

So COVID 19 does not discriminate by body weight. Basically in a nutshell, there has been no evidence at all. These studies have come out, they are deeply flawed. And in fact, some of these studies show that having a higher weight is helpful against COVID 19. And so Chris has really gone in, looked at the studies, looked at the floors and said this is not what she wants is showing when you look at this evidence. There simply is zero scientific evidence to show that people in larger bodies and those who have a higher BMI and we know the BMI is total bullshit at higher risk for getting COVID 19. And if they do get it at a higher risk for death, for needing to have ventilators et cetera, et cetera.

So yeah, it's just sucky that if you're watching the television, I avoid watching the television at all costs. News and things like that. Don't get me wrong, I watch tons on Netflix. But to have, you know, people who are in positions of authority being like, Oh, we're scared for Americans cause that's like fact, you know, it's gonna be anxiety inducing which increases weight stigma. Weight stigma is just another word for fatphobia which in turn damages your health. So it's blah, blah, blah is what I've got to say to that. My frustration. So last week, I did a couple of webinars. I'm talking about how do you love your body and a lot of the questions I got were around health and often my Instagram, I get a lot of DMs and very often my DMS are either~I've been following you or listen to your podcast and you've really helped me. And now I feel really good about myself or I have this health condition and I'm scared or what if someone I love is fat and I'm scared for their health and what do I do? Like literally I just checked my phone and I had a message saying, my family has heart disease. And so am I fat phobic if I lose weight to try and protect myself from heart disease. And it's really heartbreaking for me to think about people out there just being really stressed about their health. And to me it's really black and white. It's really clear. And of course I'm not a doctor, but looking at the science around this, as you've heard me say many times in many episodes, there is no reliable way to reduce your body size.

There has never been one study in the history of the world to show a diet that works long term. Of course you can lose weight and you know, you can go and starve yourself or have a lifestyle change and lose weight. But in a year, two years, three years, four years, five years, are you going to still be at that lower weight? Studies show, no you were going to be fatter. And a byproduct is poor health outcomes, mental and physical health. So, dieting doesn't work to make your body smaller. It makes it bigger. And so if someone is saying you need to lose weight or that is not evidence based because there's no evidence to show what we can do to lose weight reliably. And even if there was having a smaller body will not necessarily protect you from things.

I'm like, this person is saying heart disease runs in her family genetic, genetic predispositions towards certain conditions or illnesses. Like type two diabetes, type one diabetes. It's so heavily genetic based on whether you're going to get it or not. That being, having a smaller body is not necessarily gonna do much. But as I have said in other episodes, sometimes people when they're trying to lose weight, they engage in certain types of behaviors, which could be helpful. Those behaviors could be eating different types of food could be moving their bodies in certain ways, but because they are tying a weight loss number to the behaviors. Those behaviors have been shown to be not sustainable because when inevitably the weight loss plateaus and they put our weight on, even though they're still eating in certain ways, even though they're still exercising in certain ways people stop engaging in those behaviors.

Whereas if you are focused on healthful behaviors outside of weight loss and a number on a scale, those behaviors are way more sustainable. If you're doing it just because you want to improve your fitness level or you want to happen to get a different variety of food into your life. They are studies show it's they're way more sustainable if you're not doing it when you're focused on a number on the scale. So side note on that. So in my mind is black and white. There's no way that you can reliably lose weight. And so what do people who are small body do in this circumstance? Do they take medicine? Do they move their body more? Do they exercise in a certain way? Do they build strength? Do they eat more of a certain food? Perhaps try that. Of course I'm not a doctor, but you know, I'm just looking at the science and what I would do personally myself.

Okay. So let's get to this question. It's half typed out and it's half audio. So this is from Brit and this is what Britt says and then we're going to listen to the audio of like the first half and second half is audio. Okay. So Britt says, Hey Victoria. So I wanted to kind of ask some questions. I have listened to some of your podcasts, so I know body positivity you originated from fat acceptance movement or rather it has been stolen maybe. What I mean is I believe all bodies deserve the same respect and no one should be told that their body is less or what to do with their eating the exercise habits, et cetera. However, as I've learned more about the various movements I am being faced or hearing more people being faced with the whole body positivity is health negativity. Now I happen to have recovered from an eating disorder and fix my relationship with food through saying fuck you to die. It's just letting go of all diet, culture, mindset, et cetera. But there is a line, but is there a line if you, let's say have diabetes, can't walk and numerous problems that are all said to be related to "obesity". Is it still okay to promote that now? I still hold my position that the imaginary person in this scenario is still as valued and their body should not be discriminated against, but if they would are genuinely unwell due to "obesity", should this be the point that they should seek help? And let me continue this in audio from Brit.

Sorry, I'm just going to finish the rest off in the voicemail because honestly it's so exhausting trying to type. But basically what I'm kind of getting at is if someone has got all of those conditions are related to obesity whilst we still value them. They should be looked at different society. Is it then right to say, you know, you need to look at your health. The same way we would say to somebody, you know, if they've got cancer or if just anything we'd say you need to get this look down because it could shorten your lifespan at that point. Do we need to encourage people to look at, you know, not, I wouldn't say this to say I still wouldn't say weight loss, but just fixing the relationship with food and education I suppose. What do you kind of answer to that? Cause that's the bit that I'm kind of feeling like a faith, most criticism for. If I get, I'm also don't get as much because I am in a smaller plus-size body and I am in 18 to 20, so I'm not that far out of the regular. But I'm more about self love and body positivity and body acceptance at any size. But I don't know yet how you just to follow how you look at the perspective of if someone is at that extreme and their beast is causing a lot of issues. The standpoint on that, on whether they should be seeking help for that because I have kind of heard a few opinions where people have said it doesn't matter. No, that they shouldn't start exercising, they shouldn't start changing their eating habits. It's completely fine. But obviously somebody is in, well then I'd never want to promote for somebody to, you know, miss out on all those lovely life opportunities due to that. However saying that or do you think that that percentage of people that fall into that category is very small. I think a lot of plus size people go about and have completely fine vitals and blood work and all that. They're completely healthy. They then get stigmatized with that very far money proportion of people. So yeah, I'd just love to hear your thoughts on what you kind of say when you come across that. Also thanks for your time. I know that was a really long message and then really long voice notes. Thank you.

Okay, so that was from Britt and I said to Britt I'm going to answer this question in my podcast because it's a juicy question and I get it a lot. So to answer this question, I want to share and an article that was published in BCMC med in 2018 and pick out some points in this article. That is going to inform how we think about how to answer this question. So this is from Tomiyama, Carr Granberg et al and it's called How and Why Weight Stigma Drives the Obesity ‘Epidemic’ and Harms Health are linked to the article in the show notes. And by the way, the reason why I said quote unquote epidemic is because, well, they do quote unquote epidemic because there is actually no such thing as the obesity epidemic.

If you don't know this, when there was a study published to say, Oh my God, we're all dying because we're also fat. A study was published, so I can't remember how many, it was like let's say a hundred thousand deaths in America or a year or a million deaths a year attributed to people having higher body weight. And then everyone was like, Oh my God, it's an epidemic. And they'd got the numbers wrong. The figures were wrong, you know Popeye and Spinach and we all, the Popeye has spinach because it's got iron loads of irons. That's another case of a study being published and they put the decimal point in the wrong place and that's finished, has got lots of iron, but it's not got this magic amount, but makes Popeye's muscles big. But you know, it's something that perpetuates. And so this idea of obesity epidemic is not based in science and it's just, it's simply not true. They got their numbers wrong and there was all sorts of other flaws in this study which has now been seen as fact and it's infuriating. And as well, if you're wondering why I'm saying "obesity", "overweight", I did a whole episode on the O words and why they are harmful and why we shouldn't be using them.

Okay. So in this paper, I'm going to summarize some of the things they say. So weight stigma is harmful to health by the way. Weight stigma is just another word, a softer word to say fatphobia. It's easier to say weight stigma because then people can be like, Oh, okay, well I don't want to perpetuate weight stigma. But when you label someone has having as being a fatphobe or fat phobic, this is me talking by the way, this is not the article. They get very defensive, but when we talk about weight stigma, it's a lot easier for people to get it and want to say no wasting. We don't want to do that. Okay, so wasted mine is harmful to help over and above objective body mass index. Okay, I'm going to break this down. What all of this means at the end. Weight stigma is prospectively related to heightened mortality and other chronic diseases and conditions. Most ironically, it actually begets heightened risk of "obesity" through multiple "obesogenic" pathways. Weight stigma~ obesogenic in case you haven't come across that word, it means tending to cause obesity. So multiple obesogenic pathways, multiple ways that's fatness is caused. Weight stigma is particularly prevalent and detrimental in healthcare settings with documented high levels of anti-fat bias in healthcare providers. Patients with "obesity" receiving poorer care and having worse outcomes and medical students with quote unquote obesity reporting, high levels of alcohol and substance use to cope with internalized weight stigma. In terms of solutions, the most effective and ethical approaches should be aimed at changing the behaviors and attitudes of those who stigmatize rather than those towards the target of weight stigma.

So basically, this is the beginning of the article what it's saying is that weight stigma is harmful to health. So being fat phobic is harmful to health of the general population over and above body mass index. So it's more harmful than anything that the BMI tells us. Okay. So that's basically what that is saying. Okay. So the next section, I'm taking bits out by the way so I'm not reading it for full. But the next section says weight stigma, triggers obesogenic processes. So again, obesogenic is tending to cause obesity. Common wisdom and certain medical assert that stigmatizing higher weight individuals and applying social pressure to incite a weight loss improves population health. We argue the opposite. The latest science indicates that weight stigma can trigger physiological and behavioral changes linked to poor metabolic health and increased weight gain. In the Boratree experiments when study participants are manipulated to experience weight stigma that eating increases their self regulation decreases and their cortisol brackets own obesogenic hormone. So cortisol is something that makes people fatter and their cortisol levels are higher relative to controls. Additionally, survey data reveal, but experiences with weight stigma correlate with avoidance of exercise. So that section is saying if you are shaming someone and not even shaming someone, just saying, do you have that person? Have you heard about exercise and eating less food? Just something like that or a weight stigma. Fatphobia can be in many hundreds of different ways and it could be something that's very slight and it can be something overt. Anything which is weight stigma has a poor effect on someone's health and makes people fatter. Now they are two separate things. Poor health and fatness doesn't mean that fatness equals poor health. Okay? That's not what they're saying. But if you want to make people thinner by stigmatizing them and perpetuating weight stigma, you're making them fatter. And another byproduct is not because of the fatness, the physical health is damaged and it makes fat people, it makes people not fat people. It makes people less likely to exercise. Isn't that interesting? So shame does the opposite effect. Okay.

So next section, the harmful effects of weight stigma may even extend to all cause mortality. Let me just explain more what mortality means. So the word mortality it means death, the term all cause mortality is utilized on reading from something I got from the internet is utilized in reference to a disease or a harmful exposure such as to radiation or dangerous chemicals in a statistical context. It is typically expressed as a total number of deaths due to that condition during a specific time period. Okay. So let's go back to the article. The harmful effects of weight stigma may even extend it to all cause mortality. From two studies, which total 20,000 people they say people who reported experiencing weight discrimination had a 60% increased risk of dying independent of BMI. The underlying mechanisms explaining this relationship which controls for BMI may reflect the direct and indirect effects of chronic social stress. Biological pathways include, this is a difficult word. Dice regulation in metabolic health and inflammation such as high at C reactive protein among individuals who experienced weight discrimination. Okay. So what that section says is you will die sooner if you experience weight stigma no matter what your weight is. Okay. So this affects everyone, straight sized people and fat people. Weight stigma affects everyone. And so if you have been stigmatized, so say if a straight sized person was constantly told or you're, you're already fat, you should lose some weight, you should really exercise. They have increased risk of dying just because of that and not because of the size of their body. Now we do this to fat people to say, Oh, you should lose weight but it doesn't matter if you are actually fat or not.

Okay, so next section. It's juicy stuff, isn't it? So weight stigma also has profound negative effects on mental health. National representative data from the United States show that individuals who perceive that they have been discriminated against on the basis of weight are roughly 2.5 times as likely to experience mood or anxiety disorders as those who do not. According court accounting for standard risk factors for mental illness and objective BMI. Also in the article, they say it's not just the US it's studies across the globe has showed the same thing. So weight stigma, so we've established hurts your physical health. It also hurts your mental health. So next section, a rapidly growing set of studies now shows that these associations cannot simply be explained by higher weight individuals, poor health, or greater likelihood of perceiving weight related discrimination. In fact, the mere perception of oneself as being "overweight" across the BMI spectrum, I even among individuals at a quote unquote normal BMI is prospectively associated with biological markers of poor health, including unhealthy blood pressure, C reactive protein, ACL cholesterol, triglycerides, glucose and HB1 and HB1 C levels.

So what that is saying again is it's not the, what it's saying is it's not that they are fat that is making them unhealthy. It is weight stigma. Okay? Next health care is a setting in which weight stigma is particularly pervasive with significant consequences for health higher weight patients. A sample of 2,284 physicians showed strong, explicit and implicit anti-fat bias. High levels of bias are observed even among clinicians specializing in quote unquote obesity related issues with the proportion endorsing explicit anti-fat bias sentiments. For example, fat people are worthless increasing in recent years. The nature of healthcare provider bias encompasses endorsement of negative stereotypes of patients with quote unquote obesity, including terms like lazy weak-willed and bad feeling less respect for those patients and being more likely to report them as quote waste of time. So fat people are stigmatized by healthcare providers, very well established. And what do you think that does to the health of fat people? Not only exactly what this article is saying, when fat people go to the doctor they are seen as noncompliant. They are seen as having caused whatever ailment they're coming into address and then are prescribed weight loss versus if a straight sized person came into see a healthcare provider and so have the exact same thing, they were are more likely to be looked at as a human being and given appropriate treatment. So the conclusion of this article is weight stigma is likely to drive weight gain and poor health and thus should be eradicated. Yes. Thank you very much. It should be okay. So let me summarize the article just in a few sentences. Fatphobia can make you physically and mentally unwell. Shame makes you fatter. Not that being fatter means you're more unhealthy.

You're more likely to die if you experienced weight stigma slash fatphobia. Having more adipose tissue. So adipose tissue is just fat on your body, isn't why people are experiencing health, worse health outcomes. And finally, doctors are hella fat phobic and so people, so fat people avoid the doctor and when they do go, they get shitty prescriptions of weight loss. And they go and they have they're in a later stage of their illness or whatever it is because they have avoided going therefore having a poor health outcome because of that, avoiding the doctor. Okay. So, why am I talking about this? This article will, I want you to get all of this information out around. I've spoken about, you know, shaming people on how it is, it's not helpful and how it hurts people. And so I want it to tie it back to Britt's question now. Brit has asked a great question and it sounds like being a fat person herself or be it a smaller fat person. And in the stage of embracing Britt's body and embracing letting go of that eating disorder and all that type of stuff. Questions are coming up from people in Britain life and also questions that she's been seeing, you know, maybe from people that she's getting information from. And I want to address that. So I've broken down some of the key things that's in Britt's question so we can look into and break down some of the maybe assumptions or, you know, look at a different way of looking at a different way of looking at it. Okay. So the first thing that jumped out to me is Britt's saying I'm being faced or others are being faced with BOPO is health negativity. Okay, this is great. This is so good. I'm so glad you brought this up because this is so wrong. This is wrong. It is literally the opposite and I kind of love it when people bring this one up cause I'm just like I can just tell you know, you know, whoever's told you that is, you know, misguided, misleading, whatever. Okay. So body positivity, fat positivity is saying what it is. It's saying that people's value as a human being is not dependent on their size and we should raise up marginalized bodies so that they are discriminated against less and are not further marginalized, full stop. So there is no message in there of fat positivity and body positivity is saying fuck you to health. Let's all be as unhealthy physically and mentally as humanly possible and die. That's not what body positivity is all about. Positivity is just not. So whoever told you or gave you that idea that it's anti health has a very limited and skewed idea of what this political movement is about. And I get it. I get it. I get it. I get it. Because a lot of the imagery that you see around fat positivity, body positivity is fat people doing things that society have told them they're not allowed to do. For example, eating a donut. A lot of donut imagery in fat, positivity, body positivity. And the reason for this is not because to be body positive, you have to only ever eat donuts for breakfast, lunch and dinner. And that if you don't, you need to be thrown out and your goal is to eat a thousand donuts a day. The reason is it's political as a fat person, being able to eat something that society has told you that you shouldn't eat in public on social media is saying a massive fuck you to diet culture, which is what Brit has done, said fuck you to diet culture and everything that it entails.

It is being rebellious. The truth is fat people just like straight sized people eat a variety of things, but it's not so controversial or shocking. If you saw a fat person saying, Oh Hey, I'm just having a nice bowl of soup, you know, he'd just be like, okay, cool. Because you know, it's not one of those controversial type foods. So, you know, fat people have been told to be ashamed of what they eat. And so, you know, if someone comes into body positivity and they see a picture of a fat person eating a donut, they could clutch their pearls and be like, Oh my God, that trying to tell me to only eat donuts. They're trying to tell me that I should be unhealthy. That is what body positivity is about, but it's not. It's literally not. It's just not at all. At all, at all. And the reason why it's actually the opposite is because when you embrace and love your body, when you say, okay, I'm not going to further marginalize other people, I'm not going to further marginalize myself. Things happen, things like having a higher self esteem and then you're able to do things like potentially if you need to heal your relationship with food which is obviously wonderful and that's something really healthy physically or mentally because diets hurt us physically and mentally. You could do things like heal your relationship with movement, not that you need to because who knows what your relationship was, but you're more likely to then want to advocate for yourself. For example, go to the doctors. And so when people say it's anti health, they are so far from rights and they've just interpreted a political movement into something nefarious, you know, fat positivity, body positivity is just saying, Hey, let's treat fat people like they're people. Weird, I know, but it's not saying, Hey, let's treat fat people like they're people and also help fat people become unhealthy for whatever reason. Fat phobes think why? Why would people think, Oh, anyway. And so any kind of, you know, a little bit of research into fat positivity we'll kind of come to show. No, that's not what it's about. Okay.

So let's go on to the next bit that I picked out. Britt says, is there a line where if you say have diabetes, can't walk and have numerous problems said to be related to quote unquote obesity, is it still okay to promote that? So is it okay to promote fat positivity when someone is unhealthy? Is my question like, is it okay to promote fat, positivity, body positivity when someone is unhealthy? I would say fuck yes. That's when it's especially important because of the healthiest society we live in. Health is healthism, valuing someone's health, viewing the body as a machine. In our healthy society that says that people who are unhealthy, people who are disabled are less worthy than those who are able bodied those who are healthy. That's when we need movements that help people who are marginalized. So, yes. But I'm not a hundred percent sure if that's what you mean when you say is it okay to still promote that if someone is has health problems, we'll get into that a little bit more.

So the next point you've said is if someone is genuinely unwell due to quote unquote obesity, should this be the point they seek help? Is it then right to say you need to look at your health the same way we would with cancer as it could shorten your lifespan? So that's something that has said that. So there's lots of assumptions here that I want to break down. Now a lot of people have the same questions. Like, this is such a good question. I'm so pleased that Britt has brought this up because we can break down these assumptions that we have and realize, Oh, okay, that's not necessarily helpful to think like that or to have these beliefs. Okay. So some assumptions, not necessarily saying that Britt has these assumptions, but some, you know, sometimes people have these assumptions and these are some of the things I picked out. Assumption number one is that fatness caused whatever condition that they have. That's the first assumption. Number two, that having these conditions leads to a shorter life. Number three assumption that the fat person doesn't necessarily know that they're fat and that they don't know that they have these conditions. Assumption for that fat people are somehow unable to look after their health without the intervention of a thin savior or a well meaning fat friend to tell them to go to the doctor. Number five, assumption that we are able to assess someone's health by looking at their body or knowing a little bit about them. Really the only person who knows about their health is, is them their lab reports. You know number six assumption that we are more qualified than the person who owns the body when it comes to what to do with their body. So is it right to what Brett said, is it right to say you need to look at your health the same way we would say to someone who has cancer, you need to look after your health. And if someone is genuinely unwell due to obesity, quote unquote obesity. So referring back to that article that I picked information out from what we've established is a lot of health conditions that are linked, big word linked to having a bigger body are caused by weight stigma.

So type two diabetes, here is an example. Type two diabetes look into it yourself, but I've looked into it already because I'm interested in this stuff. Fat people are more likely to get type two diabetes. Having more fat on your body is not necessarily the reason why. In fact, no one knows. No one knows why fat people are more likely to get type two diabetes. There's just no science to show us to tell us, Oh, it's because you know you know, the extra fat tissue on the body does this. And then it does that. And that's why fat people are more likely to have type two diabetes. There's just no science to show that there is science to show is that fat people have poor health outcomes because of the stigma that they experience. What we do know is that type two diabetes is massively, massively down to genetics. Also, there's certain types of ethnicities that are more likely to experience type two diabetes.

So, you know, it's complicated. And so we can't say, okay, well it's because they're fat that they've got type two diabetes. What does anyone in their family have type two diabetes, just do straight sized people ever get type two diabetes. You know, it's just not as simple as that. And so by saying like, you need to look at your health the same, they, you know, whatever way that you might say it, what you're doing there is increasing weight stigma, which is increasing poorer health outcomes. It's assuming that fat person is like, huh, I'm fat. Oh my God. I didn't realize. There's some conditions that are linked to, you know, weight and stuff. I'd never heard that before. I should look after my health. What's health? Health? Never heard of that before, right? It's assuming that fat people are just wickedly ignorant to everything that they've heard their whole life, right. And so why would you want to, why would you want to increase weight stigma for them? Now, I'm presuming like if there's someone in your life and you're like, Oh my God, they're so fat and unhealthy, and if I don't tell them that they're fat and unhealthy, then they're just going to continue to be fat and unhealthy. And the reasoning behind that is mostly probably because you care for them, you love them, you want them to live for as long as possible. Well, if you care for them and you love them and you want them to live, live as long as possible, you will stop stigmatizing them by thinking of them in that way.

And you will work to eradicate fatphobia. You will not perpetuate fatphobia by saying, Oh Hey, by the way, I don't know you've noticed, but you fat. Don't know if you know this, but you've got diabetes or you know, don't know if you notice, but you're probably going to die any minute now because you're so fat. That's not helping them and if you love them and you want to help them, then become a fat activist. Don't tell them that they need to behave in a way that you've decided is best for them. Next thing in this question is, should we encourage people to fix their relationship with food or education? So this is, as I'm saying, is this a solution to when fat people are unhealthy? So I think, yes, having a healthy relationship with food is great. It's lovely. And when I say healthy, I mean being free from disordered eating being able to feed yourself with joy, being an intuitive eater. But what I hear from this is, should we encourage people to fix their relationship with food or education? Should we coach them to fix it because it is broken? It feels like there is an assumption here that fat people all have a disordered relationship with food, which is not based in reality. Fat people are fat for literally hundreds of reasons, literally hundreds of reasons and to say, okay, all fat people are disordered around food and so they need to fix that eating disorder or disordered eating pattern that they have, then they'll probably lose weight and they'll become more healthy. Is this not helpful, right. It's not helpful thinking now I used to, I remember so clearly sitting in the car with my then boyfriend saying to him, I think every fat person has some type of eating disorder now. This is years ago. And he was like I don't know about that which looking back I was like, I'm pretty impressed that he said that because he had some fat phobic beliefs, but he was like, I don't know. And I was like, yeah, you know, because how would they have got fat if they didn't just eat loads of food and why were they eating loads of food and there must be something wrong and I was so misguided. That was, no, that's not. No. Now of course there are fat people who have eating disorders. Of course, of course there are fat people who have disordered relationships with food. The most, the most common way that people, fat people have a disordered relationship with food is dieting. Dieting is increasing your chances of having an eating disorder or having a disordered relationship with food. So another layer to this is we're presuming that fat people don't necessarily know how to feed themselves.

When I was in the, Who Are You Calling Fat TV show house, one of the fat photos. Like we need to educate people and tell them to eat fruits and vegetables and tell them that processed food is bad and blah, blah, blah. Is that news to you? That fruit and vegetables are something that are good for you to eat? Is that news to you? Oh no. Is it something that you've heard hundreds of times in your life? Yes. Of course. Like, duh. We know, you know, everyone knows I'd say everyone, you know, most people know that, you know, having a variety of food in your life is good. And sometimes that's not possible for people and that's fine too, right? So, you know, education like education in what way? Education. Hey, fatty. Have you thought about eating a carrot? Well, you know, fat, he's going to be like, no shit Sherlock. Have I thought about eating a carrot? You know, did you not see me try that carrot soup diet when I was 23 and all I ate was carrots and my skin turned orange like hello. So, but if someone does have a difficult relationship with food, then yes. You know, encourage them to fix it if they want to. They don't have to like I promote intuitive eating because it was a great way for me to stop dieting and heal my relationship with food. But I'm not going to force it on other people and say, I've decided because you are unhealthy that you should be an intuitive eater. Not that is what I'm saying in this fitness section, but just FYI, although it was a big part of me, a big one of my so I have a diary. It's like a five year thing where it asks every day asks a different question. Like, if you're a song, what if you're a song? What song would you be today? And things like that. And the question a couple of days ago was, what is your worst habit or your worst trait? My worst trait is trying to get people to do what I think is best for them. So, you know, like say if a friend is dating a loser boyfriend, I'd be like, dump him. That guy's a loser. I would also be, you know, empathetic and all that type of stuff, but I really be like, let's take action here. You know? And so that's my worst habit is trying to get people to behave in ways that I personally think is best for them, which is wrong because I, I just believe that's what's best for them. I don't, you know, they know what's best for them. It's their lives, right. Okay. So moving on.

So Britt said that she had heard people say no, they shouldn't start exercising or changing their eating habits. It's completely fine. So what Britt is saying is that she's seen comments or heard comments from wherever when someone said a fat person is unhealthy, that no, they shouldn't start exercising or changing their eating habits. There's one part of this that's correct. The part it's completely fine. It is completely fine not to exercise and to eat in a way that you want, right? FYI is totally, you can do what you want, you can do, you cannot exercise. So fat, positivity, body positivity has nothing to do with telling people not to exercise or telling people to only drink melted butter milkshakes. It's just not, it's just not. A part of healing your relationship with food could be eating certain foods that foods that maybe you classes unhealthy. I'm a part of healing. Your relationship with movement could be to not engage in exercise and harmful workout routines for a bit or ever again because your relationship with movement has been damaged. That could be your journey, that you just don't move your body because it's harmful for your mental health and that you eat in a certain way because you need to rebuild your relationship with your body and food. So it's not like I've never seen anyone in fat positivity ever say, listen up here, no one should be exercising. No one should be eating in this way or that way or you should eat this way. You shouldn't eat that way. That whoever said that, I don't know. I don't know like this, just let's just know what fat positivity is. It's all about choice. What you want to do with your body, you know, like not fat positive is all about choice. But a lot of things around this political movement is doing what's right for your body. And if you happen to be a fat person who loves exercising, great. If you're a fat person who is not interested in exercising gray. So it's hard to imagine. So if someone said, Hey, so whoever this person is, it's hard to imagine. Well this is my experience. If someone said to me, Victoria, I am unhealthy and I am fat. Should I exercise and change my eating habits? I can't imagine a world in where I'd say, no, no, no, no, no. You should never move your body exercising is bad. Or no, you shouldn't explore food. Eating different foods is bad. Like it does not compute. That wouldn't happen in my world anyway. And so who knows who this person is but, or what happened here, but it doesn't align with, you know, feminism and, and body positivity and health at every size and all that type of stuff.

So next Britt says, I never want to promote anybody to miss out on all of those lovely life opportunities due to that. And due to that, I think that was due to being unhealthy or, you know, not being able to move their body or whatever. So that sentiment is, you know, I want what's best for them because if they are unwell and if they're not able bodied, if they're disabled in any way their life is not going to be as good and they're going to miss out on lovely life opportunities that sentiment is healthiest and ableist. So to say that someone who is less mobile or somebody who has type two diabetes that they are going to miss out on life opportunities. It's not true because people who have all different types of illnesses and abilities have incredible lives. And to say that they not is problematic and yes, absolutely, things can be more difficult. If you've got things that you need to deal with. So for example, in my life, I am not healthy by the way. But I've got a whole thing about health and what is health and blah, blah, blah. So I have asthma, IBS hypothyroidism, depression, eczema. So life is slightly more difficult for me because of those things. Like, you know, I have to go out of my way and take medicine. Sometimes, I don't feel good but I'm not missing out on any life opportunities because of that. And of course there's, you know, there's a spectrum and things could be harder for you know, different things going on. But to say like, Oh, sorry, not that you're saying this, Britt, like, Oh, sorry, you're unhealthy. That's it. Your life's over but you know it's not some, it's not an idea that we want to perpetuate, right. Okay.

So next thing I want to pick out is it says a lot of fat people are healthy and get stigmatized with the tiny proportion who are not, what do you say when you come across that? Okay. So it's not accurate that only a tiny proportion of fat people are unhealthy. A lot of fat people are unhealthy. A lot of thin people are unhealthy. What, what I think that you're getting at is that a small portion of fat people are unhealthy because of their fatness. I think that's what you're getting at and that some people will say that that is the fat person's fault. So you know, some people who say, okay, well they've got a high blood pressure and they're fat, therefore it's their fault. I think that that's what you're talking about fatness, which is the fault of fat people. Not that, you know, you're saying that, but I think that's the idea. And a reminder that the conditions that are linked, remember that word linked is not caused by correlation is not causation. Remember that correlation is not causation. But it's not caused by fatness, even if it was caused by fatness, even if it was self-inflicted. Whatever it is, that person still is valid and you know, deserves treatment and all that type of stuff. And also something to think about is about this. There's, you know, there's only a small fraction of fat people who were kind of like, you know, the bad fatties who were, you know, causing it themselves. And most of us fatties are good and our blood work is good and all that type of stuff, which is, you know, not true.

There's lots of unhealthy fat people, there's lots of healthy fat people, unhealthy thin people, healthy thin people. Think about the ways where it's okay to be unhealthy. So for example, if I go out and I break my arm riding my bike and I break my arm, that I seen is way more acceptable. If I go out and I'm like, Oh my God, I'm having a heart attack. They'll be like, mm, look at her. She's fine. Whereas if I'm riding my bike and good for her, she was riding her bike, she was trying to get thin, right? Health is not black and white. It's not on or off. You're not either healthy or unhealthy. It's a spectrum. You can't arrive to this destination destination of health. Now health is it, you know, the idea is being free from disease, you know, if we look at like the definition of it, but really it's about what's going on with our bodies and how we're our brain is working, how our body is operating. And, I would struggle to say that anyone's body is working 100% perfectly because we're not machines. You know, we're human beings. And as well, a lot of times our health outcomes are out of our control. I've mentioned this before, but a lot of what, you know makes up the chances are, or us having better health outcomes are, is associated economic things like the color of our skin, the country that we're born and how much we're paid. Our access to healthcare, how much we are marginalized, et cetera, et cetera, et cetera. So we don't have as much control over our health as we like to believe. It's nice to think that we, you know, we just need to eat seven salads a day and we will never become unwell. It's nicer to think like that because it feels like we're in control. But the truth is, you know, not as close to that as we like to believe.

Okay. So getting to the core of this question, what this question is about? I think from what I've heard and listened to is should we tell people who are sick because they're fat, they're sick, their fatness has caused their sickness, that they should not be sick and become healthy, right? The core question is, should we tell people who are fat and unhealthy to be healthy? The answer is no. The answer is no. We shouldn't. The more nuanced answer is if a fat person came to me and said, Hey, Victoria, what do you think to this? I have XYZ condition and I want to feel better, but I know that dieting doesn't work. What should I do? I'd say, well, I'm not a doctor, but what I would do in this situation is I would learn about health at every size. I would read the book health at every size, but by Dr Linda Bacon. I would find a health care provider that is aligned with health at every size. I would tell them to talk to a professional who can help them with this specific issue outside of telling them to lose weight.

That's if someone approached me and said, what do you think? I'd say, Hey, well you don't have to lose weight to address this health issue because weight loss doesn't look. And that's what I would do. So say if I I had type two diabetes. It's very tempting to be like, okay, well I need to lose weight because that's what a lot of people say. But I would then go to a provider that specialized in managing type two diabetes without prescribing weight loss. And so telling someone, anyone that they need to be focused on their health and they have caused their health issues because of their size or their behaviors as we have seen, increases weight stigma, which increased weight stigma leads to poorer health outcomes mentally and physically. So it is not fat positivity stance to say we reject health is got nothing to do with it. You know, at all. They're two separate things. So you've got fat, positivity, body positivity. You've got health at every size and health at every size. Basically, if you've not heard about health at every size, health at every size says surprise. You can be healthier every at any size. The work that Dr Linda Bacon has done the studies that she has they have done to to show this. The outcomes, the better outcomes that you have like I mentioned before, if you focus on improving your health outside of decreasing your weight you're more likely to scent sustain those behaviors long term. So absolutely, if you want to become healthy or improve your health or improve your mobility you can do that. It doesn't mean that you are not fat positive, just do it. You know, no one who's fat positive is, you know, going to no one that I know. I don't know why someone would say this is going to say, Oh, you, you don't feel good now, don't you exercise person just don't do it. They would just probably say, you know, have you heard about how every size, cause if you want to pursue health and that's cool. And if you don't, that's cool. You know. So I hope that this has helped you and thank you Britt for sending in that question and kind of being, you know, cause I was, you know, saying a lot of challenging things there, so hopefully you know, it's a great question from Britt and something which is I can tell Britt is, you know, that sent with love and caring for Brits and caring for those around Britt and what to say to people who are approaching Britt about this subject. Whereas I get a lot of questions, which I'm like, this is not someone who is caring. This is someone who is a troll trying to be a knob. Like I got a lot of messages saying I'm dying and I weigh 5,000 pounds, but you should say that I should never lose weight. And I'm like, ah, yeah, okay, this is a troll account. And, even if you do want to try and lose weight, go for it. I mean, seriously, if you believe that you found the magic diet that works and it does work for you, go for it. Like I'm not the boss of your body. Do what you want. But I'm just here to present information so that you can make an informed decision. Okay.

So, I tell you a little fact about me today. I've mentioned it before, but bike riding, my favorite way to currently move my body is to take Dougal my dog on a little bike ride. And what we do is because I live in the middle of nowhere and the roads are empty. Dougal will run next to me. He's on leash. And so I have my leash in one hand and then I cycle with the other one. Not with the other hand, but have the other hand on the handlebar. He runs alongside me. He's so good at it and then when we get to like a more deserted road, I take his leash off, and then he just like runs next to me. He's so good at it. When I first got him, I took him to a, like a racing track and I would run, he would run next to me riding my bike because I have a bike in Canada, which has a basket in the front that was made for him. So I would put them in the basket and cycle to a place which was enclosed and so he could like run around and chase me on the bike. So, that's something that I've been doing that's been really helping my mental health during these lockdown days in Ireland. We're only allowed to go two kilometers. And I'm so lucky that within two kilometers of my house is two different beaches and one of them is this spectacular, breathtaking beach which is it takes like an hour to get across. Like it's like a C shaped beach and you can climb a Hill on one end. And so I can cycle down to that or drive down to that and walk around it. So I'm very lucky. So yeah, if you've got a doggy, why not try and another a doggy fund, but be careful because sometimes before Dougal got used to it, he could try and like run in front of the my wheel and I'd have to be just watching him very carefully for him to not to do that. But once he got trained on how to do it, he knows to stay on a certain side of my bike and not to go near my wheel. So, and he's very athletic dog. He likes running and doing all that type of stuff.

So yeah, listen, that's my adventures around around my two kilometer area area. If you want to go to the show notes then to get the links to these articles that I have talked about to do, then go to fiercefatty.com/027, 027 for episode 27. And yeah, I shall see you in the next episode. Reminder, if you want to ask a question, feel free to send me a voice note that was over Instagram or go to the show notes and there's a little form there. If you want to do something anonymous or you can just email me. And thank you for all your reviews. A reminder, if you write a review for the show, take a screenshot before you submit it, email me that victoria@fiercefatty.com. Then I will send you a digital and audio copy of my bestselling book, Fierce Fatty. Okay. Well thanks for hanging out with me today. I hope this was helpful for you and enjoy the rest of your day and I will see you next time. Okay, goodbye. Fatty.