morbidity |

Today, I got an email pointing me towards some new research on fat stigma. There has been an ever increasing pile of evidence indicating that weight stigma is making us miserable and sick. We know that weight stigma makes us fatter, increases inflammation, increases disease burden and decreases quality of life, increases the chances that we will engage in risky behaviors and may contribute significantly to diseases like diabetes and heart disease. We know that weight-based discrimination increases blood pressure and reduces our ability to think clearly. Now we have further proof that weight stigma is shortening our lives.

It has always been supremely frustrating to me that concern trolls are so ready to tell us that they beat us up about our weight because they are concerned for our health. But as a person who has been on the end of concern trolling, I can tell you that it doesn’t feel anything at all like genuine concern. It feels like people relishing the fact they have an excuse to be a bully. It feels like having a license that allows some people to spew hate under the micron-thick veneer of caring. It feels like complete B.S.

And this new study indicates that the results of this hate can be profound and life-threatening. The study states:

The ultimate cumulative effect of these hostile social interactions may be lower life expectancy. The present research examined whether the harmful effect of weight discrimination reached beyond morbidity to mortality and whether common comorbidities and health-risk behaviors accounted for this association. We also compared weight discrimination with other forms of discrimination (e.g., age, race, sex) to examine whether they share weight discrimination’s association with mortality risk. Finally, we examined whether the association between discrimination and mortality varied by sex, ethnicity, age, or body mass index (BMI). We tested these associations using data from two large longitudinal studies, the Health and Retirement Study (HRS) and Midlife in the United States (MIDUS).

After reviewing the data from both the HRS and the MIDUS, the study group came to some rather startling conclusions. It appears that weight stigma can increase risk of mortality by a significant amount:

Weight discrimination was associated with an increase in mortality risk of nearly 60% in both HRS participants (hazard ratio = 1.57, 95% confidence interval = [1.34, 1.84]) and MIDUS participants (hazard ratio = 1.59, 95% confidence interval = [1.09, 2.31]). This increased risk was not accounted for by common physical and psychological risk factors. The association between mortality and weight discrimination was generally stronger than that between mortality and other attributions for discrimination. In addition to its association with poor health outcomes, weight discrimination may shorten life expectancy.

If people are truly worried about the health of fat people, they are going to have to give up on concern trolling. Outside of the fact that you can’t hate someone for their own good (thank you Marilyn Wann), there is hard statistical evidence that it just may be your hate that is making fat people sick and giving them a shorter life. Not to mention the horrible effect you have on their quality of life. The study goes so far as to suggest that the harm of weight discrimination may be more harmful than any other effects of being overweight:

The present findings indicate that the harmful effect of unfair treatment that is attributable to body weight is not limited to psychological distress and morbidity: It also extends to risk of mortality. This association was apparent in two independent samples that covered different periods of the life span, and the association persisted after we accounted for behavioral and clinical risk factors. The effect of weight discrimination on mortality was generally stronger than that of other forms of discrimination but was comparable with that of other established risk factors, such as smoking history and disease burden. Moreover, the association between weight discrimination and mortality risk was in sharp contrast to the protective relation between some of the BMI categories and mortality risk. These findings suggest the possibility that the stigma associated with being overweight is more harmful than actually being overweight.

This type of research can have a profound effect on the lives of fat people around the world. But just because it can doesn’t mean in necessarily will. The media doesn’t jump to report these stories. For many reasons, these articles aren’t popular with media outlets and are especially unpopular with advertisers. If we want these studies to have an impact, we have to make sure that people in the world at large know about them. We need activists.

That’s why I’m so excited that the Fat Activism Conference is starting tomorrow. It’s not too late to get your tickets. We have dozens of amazing speakers lined up ready to share ways that you can be an activist and an advocate for people of all sizes. We’ve got speakers talking about activism and medicine and activism and art and activism and sex and many other topics. I hope you’ll consider joining us for the conference. This study indicates that activism against weight stigma may do more than just make us feel better and feel better about ourselves. It just might help to save our lives.

Love,

Jeanette DePatie (AKA The Fat Chick)

Well we’ve survived another U.S. “tax day”, so I thought I’d share a little post about inevitability. Most of us have heard this quote, “In this world, nothing is certain but death and taxes.” And while most of us understand the notion that taxes are inevitable (well at least unless you are a multi-billion dollar corporation) we have a little harder time with the whole death thing. We know on an intellectual level that everybody, including us, will die. Yet on an emotional level, many of us believe that if we eat enough fiber, do enough exercise, and stay thin, we won’t die.

Now don’t get me wrong. It’s perfectly reasonable to want to make choices that can potentially extend our lives or improve the quality of our lives. That makes sense. But I’ve often wondered at the emotional response to my acceptance of my own size. I understand that not everybody agrees with me. Some people think I should do anything and everything that just conceivably might help me at least for a short time to lose weight. But it’s the emotional involvement with this disagreement, the hatred and anger and spitting vitriol that comes with it, that sometimes throws me for a loop.

I recall sitting in a crappy and inadequate paper gown in a medical center where a doctor was nearly frantic in telling me that since I was fat, I was going to die. He wasn’t offering me any statistics or research indicating increased risk for mortality or morbidity. He was simply doing that finger wagging, nagging, since you’re fat, you’re going to die speech. And I replied, “well you know, I don’t have an M.D. after my name, but I’m pretty sure we’re all going to die.” Which gave me at least 10 seconds of respite before he started in on me again.

If you want to talk to me about increased risks for morbidity and mortality that may or many not be attributable to being fat, well okay. I’m armed. I’ve got data. Let’s rumble. But if you want to argue that all fat people are going to die, guess what. You’re right! All people, everywhere are going to die. Even if they eat whole grains, and their chi is perfectly aligned and they run a marathon every day-even if they are thin, they are still going to die.

I think this is at least a small part of what freaks people out so much about my decision not to actively pursue weight loss. Because at least in a small way, I’m not buying into their emotional fantasy, that if they do all the right things, they just won’t die. Here’s the thing. I’ve lost many who are close to me. And some of these folks did everything “right”. They ate well, they slept eight hours per day, they managed their stress, they went to the doctor and they simply got sick and died–sometimes quite young.

Am I suggesting that we should just ignore our health? Absolutely not! I am suggesting that there is no day in our life that is guaranteed. And I for one refuse to spend so much of my life trying to change one potential (and questionable) risk factor for mortality that I don’t have time to really live. If my days are limited on this earth, and they are limited, I want to do what makes me feel good and allows me to experience wonder and contentment and joy. Sometimes that’s taking the dog for a walk. Sometimes it’s eating ice cream. Because I’m grown up enough to understand that both walking the dog and eating ice cream are wonderful. And even giving up ice cream won’t allow me to live forever.

Love,

The Fat Chick

P.S. If you’d like to hear more about that story in the doctor’s office, you might want to check out this episode of the Right Now Show. And I’m pleased to let you know that the deadline for the RESOLVED project has been extended. So it’s not too late to create and share your video about your experiences with health care.

And if you’re interested in learning a little more about the joy of exercise, don’t forget to check out my book and DVD!