Fat’s Real Barriers To Health

Fat Justice Activist Aubrey Gordon tackles discrimination and systemic issues in healthcare for larger bodies with practical advice on demanding better treatment.
A graphic features an illustrated woman with long, curly hair, wearing a yellow shirt and an orange skirt. To her right, text reads "YOUR FAT FRIEND." At the bottom right corner, there is an image of ten almonds with the text "10 almonds" beside it, highlighting the barriers to maintaining health.

Fat Justice In Healthcare

This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?

When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…

There’s a lot of discrimination in healthcare settings

In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.

Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”

Other things may be more systemic, for example:

When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.

That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:

  • Surgeons being untrained (and/or unwilling) to operate on fat people
  • Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
  • MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place

…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.

It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.

Read more on this topic: Shedding Some Obesity Myths

Does she have practical advice about this?

If she could have you understand one thing, it would be:

You deserve better.

Or if you are not fat: your fat friends deserve better.

How this becomes useful is: do not accept being treated as the problem!

Demand better!

If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.

See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:

“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon

Are you saying fat people don’t need to lose weight?

That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.

Rather: some people might benefit healthwise from losing weight, some might not.

In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.

For details of that and more, see: When BMI Doesn’t Measure Up

But what if I do want/need to lose weight?

Gordon’s not interested in helping with that, but we at 10almonds are, so…

Check out: Lose Weight, But Healthily

Where can I find more from Aubrey Gordon?

You might enjoy her blog:

Aubrey Gordon | Your Fat Friend

Or her other book, which we reviewed previously:

What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon

Enjoy!

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  • Stop Cancer 20 Years Ago

    Dr. Jenn Simmons shares vital tips on preventing cancer and inflammation, advocating for lifestyle changes and proactive health management at any age.

    Get Abreast And Keep Abreast

    This is Dr. Jenn Simmons. Her specialization is integrative oncology, as she—then a breast cancer surgeon—got breast cancer, decided the system wasn’t nearly as good from the patients’ side of things as from the doctors’ side, and took to educate herself, and now others, on how things can be better.

    What does she want us to know?

    Start now

    If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.

    What this means for those of us without breast cancer (or a history therof) is: start now

    Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.

    Start what, you ask? Taking away its roots. And how?

    Inflammation as the root of cancer

    To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.

    Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:

    “and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”

    So, fight inflammation now, and have a reduced risk of a lot of other woes later.

    See: How to Prevent (or Reduce) Inflammation

    Don’t settle for “normal”

    People are told, correctly but not always helpfully, such things as:

    • It’s normal to have less energy at your age
    • It’s normal to have a weaker immune system at your age
    • It’s normal to be at a higher risk of diabetes, heart disease, etc

    …and many more. And these things are true! But that doesn’t mean we have to settle for them.

    We can be all the way over on the healthy end of the distribution curve. We can do that!

    (so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)

    If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.

    So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:

    See: Focusing On Health In Our Sixties

    Fast to live

    Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.

    This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.

    See: Intermittent Fasting: We Sort The Science From The Hype

    While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.

    It’s never too late

    All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”

    The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.

    Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.

    Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:

    1. Knowing stuff
    2. Doing stuff

    So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.

    Want to know more?

    We recently reviewed her book, and heartily recommend it:

    The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

    Enjoy!