Q&A: Epic Weight Loss Edition.

By | February 26, 2010

This has been a slow blogging week for me for a few reasons, and unfortunately I’ve yet to finish the part two of the “Dealing With Parents” post about dealing with kids, with a side of constructive criticism of the drumbeats leading up to the war on childhood OMGbesity, i.e. fat kids are easy targets! (Actual post title will probably be shorter.) Nevertheless, I’ve been trying to keep up with my Formspring questions, so for those of you who don’t follow me on Twitter, this should be new content. As an aside, there are a few questions currently in my queue that are a week or two old, because I’m still working on answers to them, so if you’re waiting… I’m sorry you have to wait some more.

In the past couple of weeks, I’ve weighed in on the Amanda Palmer/Evelyn Evelyn debacle, whether it’s a problem that it’s mostly fat people who care about fat issues, being confronted with other people’s fat hate confessions, and what I’m listening to lately. Below I’ve collected recent questions and answers all revolving around the topic of weight loss, including some potentially-surprising thoughts on WLS and the difference between personal politics and individual reality.

Q. I’m confused about your anti weight-loss views. Are you also anti weight-gain for people who are underweight? What about muscle gain for athletes in training? What is so bad about purposefully changing your body’s weight or shape in a healthy way?

A. You are correct! You ARE confused!

Body changes are inevitable. I am quite in favor of changes in one’s body, though I admit this is because opposing them is automatically and perpetually a losing battle. We all age; we have accidents and injuries; hormones shift; so does flesh. No getting around that, no matter how many cosmetic surgeries a body may have — change is unavoidable and plentiful. I am not opposed to change, because it’d be like opposing the sunrise.

I am, rather, opposed to a $40 billion dollar industry of diet and weight loss products that promise health and happiness for a price and consistently fail to deliver. I’m opposed to a culture that sets forth one narrow standard for an acceptable body and refuses to acknowledge or represent alternatives. I’m opposed to a health care environment that candidly and blatantly places more emphasis on sheer poundage than on the overall health and wellness of each unique individual. And I’m opposed to a world in which abusing, harassing, bullying, demeaning, humiliating, and hating fat people exclusively because they are fat is considered an A-OK way of life.

I hope that clears things up.

Q. If you could magically wake up tomorrow and be thin–knowing you would be healthy at that weight, knowing you’d stay that way without bouncing back, et cetera–would you?

A. This is a question I have posed to myself for literal years, and my answer is still the same.


I’m probably one of very few people who can say this and absolutely mean it. This is not to imply that I should get Extra Activist Points, or any such nonsense, and in truth, I would not fault anyone who took part in your hypothetical magical fat-dropping system. My motivation, certainly, is rooted as much in my nature and personality as it is in any grand commitment to fatness. I may well be the most stubborn person you’ve ever met; the person who knows me best in the world, my husband, will attest to this. The fact is, even if EVERY OTHER FAT PERSON ON EARTH shrunk before my eyes, I would stay fat. Partly to make a point: no one but me gets to dictate, by coaxing, pressure, or force, what my body looks like. Because even if The Magic Thin Pill existed, there would still be people in the world with bodies and shapes that don’t adhere to what culture glorifies as “normal”.

And partly: well, because I sometimes enjoy pissing people off, particularly when pissing people off is a side effect of making them witness and face their own shallow prejudices and hypocrisies. I’ve still never read the comments to the Boston Globe article about me, though I am led to understand that many of them focus not on my IMMINENT DEATH but on sheer disbelief that I could actually, honestly, literally be, as the title says, “fat and happy”. I’d stay fat, cheerily, just to make those people climb the walls with rage.

I don’t do well with conformity. Or authority. As it happens, it’s only recently that this aspect of my personality has become somewhat useful.

Q. So, I’m 32, was diagnosed as diabetic a year ago, diet and exercise aren’t managing it–and I’m terrified. I don’t care about losing weight–but being diabetic–I’m considering WLS. I know your general position-and I know you aren’t a dr, or an oracle,

A. Simply put: you need to make the best decision for you, and your health, and your long-term quality of life.

(Formspring cut this off again, but I think I can get at what you’re asking here even in an incomplete query.)

My position on WLS is a philosophical and political one. And our bodies are, necessarily, political. But they are also private, and the decisions that you make in the interest of your own health are inviolate, in my opinion. I have the luxury of having a strict policy about WLS as a concept because that’s all it is to me: a concept. A vague idea. Someone else’s distant reality. An overprescribed surgery, too often “sold” for profit by corrupt physicians. I don’t have to think about it seriously, as a real possibility in my life; I never have. So my opinion here is inextricably tangled up in this perspective, no matter how hard I try to sympathize with folks whose lives are taking different turns (and I do try). I acknowledge that as a personal limitation.

If you firmly believe that WLS is your last hope to survive and manage this disease, then you do it. You do what needs to be done. I will strongly suggest you do some thorough research on diabetes-related outcomes for WLS; the success of WLS in curing diabetes is not at all established, and even its ability to manage it isn’t a sure thing, and WLS is an awfully big gamble to make if you don’t have assurances it’s going to help. I will also strongly suggest you get a second opinion with regard to treating your diabetes, if you haven’t already, and assuming you have access to healthcare that will allow you to do so. WLS has saved people’s lives. There is no debating that. But it’s a big decision, and one that will absolutely affect you for the rest of your life, for good or ill. If you’re going to do it, you want to pass through that doorway with your eyes open, and with a complete understanding of what to expect, and how different people’s experiences post-surgery can be.

(Also, and this may go without saying: get the best surgeon you possibly can, ideally someone who’s done this surgery many many times, with a high rate of success, and ask about how often he or she’s faced patients with post-surgery complications. If they resist giving you a straight answer, find a different surgeon. This is advice I’d give anyone having surgery of any kind, for the record.)

I can only dimly imagine how scared you must be, but your decision here is about you, and your life, and nothing else — including what people like me have to say about it — really matters.

I hope you can be strong and get through this, and I sincerely wish you the best and offer my support, no matter what you decide.

Q. I am surprised to see you say “WLS has saved people’s lives. There is no debating that” below. What resources do you have that make you so sure?

A. My resources are purely anecdotal. The main reason I don’t go into The Health Issue very often is twofold: one, my health (or your health) is no one else’s business; and two, I have an immediate kneejerk mistrust of statistical research and studies on both sides of the issue. Now, I spent many years trying to be a veritable expert on various studies discounting the efficacy of dieting & weight loss, and their long-term damaging effects, and I still believe that’s true, but I’m less reliant on numbers than I once was. It is my opinion these days that an over-reliance on using some medical studies to disprove other medical studies only gives credence to a medical culture that enables pretty much anyone to buy the result they want, usually so they can use said result to sell things and turn a profit. I no longer trust that ANY of this work is unbiased.

Thus, my certainty is based on the handful of people I’ve met who have expressed that they believe WLS saved their lives — and not in an evangelical, you-can-too! way, but an honest acknowledgment that while they may even now be conflicted about having made the choice, they still would make it again.

Now, it’s certainly true that WLS has ruined at least as many lives, either via post-surgery complications, long-term unforeseen health consequences, or just plain killing people. However, I simply can’t say, sweepingly, that WLS has never done any good to anyone ever. That’s just unlikely. I’ve no doubt that it has. Does a small number of “success stories” justify its continued use? Nope. Not to me. The return is not worth the investment of human lives.

Am I going to tell someone, an individual who’s scared and feels like he or she is up against the wall, “Don’t have WLS”? HELL NO. I don’t want that responsibility. And I certainly don’t want anyone else to feel like they have the right to tell me I SHOULD have WLS, or that I should diet, or that I should stop wearing so many cardigans, and so forth. I simply want people to make critically-informed decisions about their bodies and their health, and to respect the right of others to do the same, and to extend privacy on this issue to everyone, no matter their private and individual choices. Yes, I am individually opposed to WLS, and I think it’s really a long-term barbaric experiment on “disposable” fat bodies, JUST TO SEE WHAT WILL HAPPEN! But I won’t tell someone what they should do with their own damn self. How can I expect people to respect my choices about my body if I don’t respect other folks’ choices about theirs?

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