This article by AP medical writer Mike Stobbe recently ran in my local paper under the headline “Help smokers, overeaters–or let them die?” The subhead read, “Faced with the high cost of caring for so-called health sinners, experts say society must grapple with this blunt question.”
So now I’m a sinner because I’m overweight? And getting help from “society” (presumably, thin “experts”) or dying are my only choices? And according to so-called bioethicist Daniel Callahan, a senior research scholar and president emeritus of The Hastings Center, I deserve to be deliberately, relentlessly, publicly shamed for being overweight because I am literally and figuratively a burden on society and something must be done?
Anyone who is as heavy as I am, regardless of any other aspect of my health, apparently deserves scorn, censure and outright discrimination (denial of health or life insurance, perhaps? You betcha!). So if people point at me and laugh when I’m out walking my dogs, call me “fatty, fatty two-by-four,” question whether I can fit in the seat when I make an airline reservation, or refuse to allow me to order dessert when I’m at a restaurant, that will “help” me change my “evil ways”?
Sure it will.
Smoking and overeating are not analogous
Callahan has the gall to equate a behavior (smoking) with a complex biological fact (being overweight):
“The force of being shamed and beat upon socially was as persuasive for me to stop smoking as the threats to my health,” he wrote. “The campaign to stigmatize smoking was a great success turning what had been considered simply a bad habit into reprehensible behavior.”
That same pressure could be applied to overweight people, perhaps leading to increased efforts by people to eat right, exercise–and actually succeed in losing weight, Callahan argued.
Apparently good health now equals pure virtue in the minds of some in the medical community (and elsewhere), and is, naturally, synonymous with an “appropriate” weight. Is Callahan serious that overeating should be properly regarded as “reprehensible behavior” that threatens public health?
For Callahan to equate overeating with smoking is unfair and illogical. A person who smokes around other people harms those people as much as she harms herself. Other people who do not choose to smoke should not be forced to breathe second-hand smoke. Smoking is an activity, a choice, and a behavior that is non-essential to survival. Any one person’s being overweight is none of those things.
People of all weights overeat all the time (the holidays!), and nobody is harmed by that. Talking to, touching, even being in the same room with a fat person poses no risks to your health, no matter how delicate your health may be. Watching a person eat 4,000 calories in one meal might gross you out, but it will not actually make you sick. And it’s none of your business what they eat or what they weigh. It’s not your place to judge them and it’s not your job to save them. People who are so concerned about the “weight of the nation” or our collective health should turn their attention exclusively to what they can control: their own weight and their own health.
What would those who seriously want to “help” me have me do?
Does anyone still seriously think that overweight people don’t know that if they “eat right and exercise” that they will lose weight? If it were just that easy, everyone would do it. Gaining weight is easy. Losing weight is hard. Long-term success in weight loss is rare for many reasons, some of them biological (the body’s metabolism does not adjust with significant weight loss, making maintenance cruelly difficult) and some of them social (not everyone has a family or social circle that will support them in losing weight, for any number of reasons).
Really, what would Callahan have me do differently? I buy only “real” (not prepackaged) food, I cook at home, I exercise every day, I rarely drink soda, I never skip breakfast, I don’t raid the fridge late at night. Do I chronically overeat? Yes. Obviously I do that or I would not be overweight. So I should eat less, exercise more (yes, of course) and enjoy my life a whole lot less by trying to become something other than what I am because … why? For whose satisfaction? For whose benefit? Not my own, because I’m happy with myself as I am right now.
Every woman’s magazine and daily talk show and hell, scientific study of obesity tells me that I am supposed to hate my body and hate myself for not having the face and figure of a 20-year-old gamine but you know what? I don’t. I am a middle-aged woman with a fondness for butter who looks exactly as you would expect a middle-aged woman with a fondness for butter to look. I have no problem with that. People who have a problem with how I look have a problem. It is not my problem unless I choose to make it so. And I don’t.
Who has the standing/authority/right to shame me and others like me?
Some people have to work hard every single day to maintain a “normal” weight, while for others it comes naturally no matter what they eat. Which of them gets to judge those of us who are heavy? And all those “normal-weight” people who have wildly expensive chronic or acute health conditions, whether because of genetics, lifestyle choices or accident, do they get to judge me, or must they abstain because of the burdens they place on our national healthcare system that I, personally, do not?
What about the mentally ill who must be institutionalized for the safety of themselves and others? The people born with severe birth defects who will never be able to care for themselves? The combat veterans who have suffered permanent brain trauma or lost limbs? The elderly who have Alzheimer’s and other forms of dementia that require around-the-clock residential care? The junkies against whom this country has waged its ruinously expensive and largely ineffective “war on drugs”? The criminals who prey on society? The slackers and scammers and low-life losers in general who siphon off resources from honest people every chance they get? Do they all get to judge me as defective and “reprehensible” simply because I am fat and they are not?
My point is that healthcare costs are driven by many factors, and to target smokers and the obese as the primary culprits seems to me to be merely plinking at easy targets.
What am I really costing you?
I have been seeing more and more articles blaming the overweight and obese for “skyrocketing healthcare costs,” such as this article by Kristen Houghton:
Carrying 80 to 100 pounds extra on your body causes problems in movement and ease of getting around on your own. Today we are seeing more and more people in their 20s, 30s and 40s having handicapped stickers on their cars, using canes and motorized chairs, and generally having chronic health problems due to their obesity. The health aids that were once used only by the very elderly and frail are now being used by those who truly shouldn’t need them. Unless they are ill or injured, a person in those age groups should not need aids to help them get around. They are paying a high price for their weight and so is the rest of the American public in terms of skyrocketing health care costs.
As if those who are overweight don’t contribute to the insurance pool the same as everyone else. As if everyone who isn’t overweight is perfectly healthy. As if excess weight were the only cause of poor health and therefore these people are entirely to blame for their problems.
The crude generalizations and outright prejudice in these articles pains me no end. I don’t have any trouble getting around on my own, thank you very much. I am strong and active–I walk a lot, I ride my bike, and I do a boatload of housework and yard work all on my own. All my joints are in great shape. I have not been to a doctor in several years for any reason. I have never used a dime of my health insurance benefits for anything other than routine checkups and minor injuries. Anyone who points a skinny judgmental finger at me and says that I am to blame for “skyrocketing healthcare costs” simply because of my weight can kiss my ample backside.
Maybe you could tell, this issue gets me mighty riled up. I have my reasons for weighing what I weigh. This is my own body to do with what I choose and I do not want or need to be “saved” from myself. How long I live is up to God (or, if you prefer, fate). Callahan claims that “Your freedom is likely to be someone else’s harm,” but I’m certainly not hurting anyone with the choices I make, and I do not deserve anyone’s censure or scorn because of those choices.
Being a woman in Western society is hard enough as it is, as most of us suffer enormously from our own and society’s expectations of how we should look, act, think, couple, reproduce, vote, etc. Adding to that a public health policy of stigmatizing and shaming heavy people (more than they already are, for heaven’s sake) is ludicrous. I hope Callahan’s nonsense is quickly recognized as such so that he will be shamed back into his lab or office or wherever he came from and that he will stay there and stop talking to the media.
Related: Living large