Yesterday I went to the world premiere of America The Beautiful: The Thin Commandments by extraordinary filmmaker Darryl Roberts. In it, Roberts is newly diagnosed with heart arrhythmia and high blood pressure, and told to go on multiple medications (that cause, ahem, erectile dysfunction). Undaunted and unwilling to take the cocktail of anti-party pills, Darryl embarks on a good-humored journey to find out if there is an alternative.
From there we get to see Darryl as he jumps from diet to diet, believing (as most Americans do) that quick, go-for-broke weight loss is the holy grail of health and vitality. Without spoiling the comedy, loving questioning, and grace of the film for you, let’s just say that Darryl doesn’t drop the pounds but he does find the holy grail… and it’s not weight loss. In the course of his journey, we meet many women in Darryl’s life. They range from super-sized to dangerously thin, and not one of them is immune from the terrible consequences of a society that equates human value with a number on a scale. For Darryl himself, he becomes aware that his own body’s health and resilience and ability to heal is there, inside him, despite the fact he is not, and probably never will be, a thin man. His doctors? They are forced to confront the surprising fact that a fat man can cure himself of high blood pressure and heart disease… and still be fat.
Then there was the panel afterwards. Other than the indomitable Deb Burgard and open-minded R.D. April Winslow, the panel looked like a bunch of startled sheep that have just been told that the world is ending. See, the screening was sponsored by several large eating disorder clinics in the Bay Area, and I don’t know that these clinics had any idea what Darryl’s conclusions would be when they agreed to sponsor the screening. The idea that BMI (which was developed as epidemiological tool to study populations – it has no proven correlation with individual health) would be challenged was clearly unexpected by members of the panel. I think I heard chirping crickets coming from a few of the panelists’ brainpans.
One panelist (who shall remain nameless) in particular seemed beyond baffled — she seemed angry. A prominent pediatrician running weight-loss programs that single out fat kids at earlier and earlier ages, she defended her use of BMI to track kids over time – too see if they “fall off the curve, or accelerate their curve unnaturally”. This is the point where my body started shaking – not with anger at her exactly, but at being confronted with the harsh reality that she firmly believed this was legitimate medicine, legitimate science. That she really thought that it was helping the kids she treated to put them on the scale, to put them on their first, second, third, fourth, or twentieth diet before they even hit puberty.
Well, every cell in my body got ready to shout out my expertise, my research, my proving points that showed her she was wrong, wrong wrong wrong. Yet, Deb Burgard, Linda Bacon, and a few fabulous women I’d never met before did a fine job of doing just that.
When the mic finally came to my outstretched hand, something else entirely came out. I shared something I’d never shared before – my personal story of being a chubby teen who was congratulated for having an eating disorder by multiple doctors, doctors who tracked my BMI on a curve and thought it was fabulous when my curve dropped off a cliff. No one asked me how I’d done it. I just got a high-five – while seeing my hair fall out of my scalp every morning, while being dizzy in the locker room, while hiding what and when I ate from everyone in my life – I got a “way to go” from the medical establishment.
You see, being fat is sooooo bad in the medical establishment that no one stops to ask HOW weight should be lost, or even whether it should be lost at all. My chubby body got me through 5-10 mile runs in cross country, my chubby body pulled me through the water at astounding speeds, my chubby body got me through my day with energy to spare. My skinny body couldn’t do any of those things. But the very people who were charged with monitoring my health just didn’t care. It’s a direct contrast to Health At Every Size – it’s Weight Loss At Any Cost.
But I wasn’t done there. Voice still shaking, I fast forwarded to my early 20s – I felt possessed to say it; possessed to make this woman understand what she was doing. This time I’m in college, and I pack on 60 pounds in 3 short months. Again, my BMI chart takes a steep curve – upward this time. I couldn’t climb a flight of stairs, I couldn’t think straight, I couldn’t function. My doctors? And believe me, I saw many of them – I was completely freaked out by the changes taking place, and felt at night like I was dying a slow death. My doctors told me that I was lazy, or depressed, or compulsive – and that the weight gain was all my fault. I was recommended diets, therapy, and anti-anxiety pills.
Almost 2 years later, I was diagnosed with thyroid cancer. Because of being dismissed, I spent two years letting the cancer grow. I had 2 surgeries, 3 rounds of radiation, and countless rounds of invasive, intensive intervention. It saved my life.
I am forever grateful to the doctors that saved my life, but I am also forever left with the question – why was I to blame for my symptoms? Now that I’ve done research into fat discrimination, I know the answer – because I was fat. Fatness was equated with lazy, depressed, complaining, and undeserving patients. Fatness was a cause for dismissal in and of itself. If I’d been my former thin- or mildly chubby self, and I’d come in saying my brain feels like jello and I can’t climb a flight of stairs without feeling like I’m dying – the battery of tests would have been whipped out in an instant.
For me, the two incidents are linked by the use of BMI as a tool to wantonly discriminate, and a tool to speciously congratulate. It’s a quickie shortcut from the actual act of practicing medicine, the actual time and energy and careful thought that it takes to look at a person as a whole and to treat them as an individual.
And so I had my say, as much as I could through the nerves running through my veins. And I have Darryl Roberts to thank for it – for speaking his mind so beautifully, and sharing his journey with the world, and being brave enough to stand up and say I AM HEALTHY – fat and all. I don’t know that everyone was able to hear his truth (or mine), but I sure feel better for having had the strength to speak my mind.
Until fat stigma is consciously removed from medical practice, there will be no way in the world that doctors can honestly say they “do no harm”.