"Obesity," the Medical Industry and the "Health" conversation

"Obesity," the Medical Industry and the "Health" conversation

I recently read a Tweet by a doctor (that happened to be both white and male) about how he can no longer remain quiet when people equate "obesity" with good health. The tweet contained pictures of the hearts of what are presumably two deceased patients. There is no explanation of their causes of death or the circumstances surrounding their deaths. "I don't condone body shaming. Beauty is skin deep but fat deposits go straight to your inner organs," doc says. Wow, my mind immediately thinks 1. Medical malpractice - who are these unknown deceased people, can one even consent to having your inner organs publicly shamed by medical practitioners in death, and uh-oh, I hope this Dr. didn't kill these people - in any case I would never make an appointment with him. 

This Tweet inspired me to break down the hypocrisies of the medical industrial complex, which I will reiterate here. But mainly, the Tweet and its sentiment make me tired because its ideology permeates the medical industry and our everyday lives. I am tired of  living in a country that is working people to death for below a living wage, allowing corporations to poison food, water, homes and buildings with toxic chemicals while unregulated and privatizing healthcare and life-saving medications so that people can't access them, all while framing the "health" conversation around "obesity". I am tired of trying to elicit compassion for people that look different from you, that live differently than you, that have different cultures, speak different languages, listen to different music and eat different food. I am so tired of having to explain why my and other people's lives matter. Our nation has a very complicated and weird relationship with "obesity," which I believe is courtesy of the medical industry. It is considered a medical condition, yet it is discussed and regarded as the complete responsibility of individuals. However, "obesity" is an issue of class, an issue of race, and an issue of disability. Disabled people are on the frontlines of every social justice movement, including this one. 

"Obesity" is an issue of class because people with less money are more likely to become overweight. Every body is different and a combination of genetics, environment, and life circumstances produce different results for everyone. However, it has been proven that eating cheaper, unhealthy fast food can result in weight gain and/or cardiovascular diseases. It is a well-known fact that low-income neighborhoods are designed to be 'food deserts' or only contain fast food restaurants and no grocery stores that sell more expensive healthy food like fruits and vegetables. On top of this, many working class people in America do not make a living wage and are forced to work two or three jobs in order to survive. This leaves virtually no free time for anything let alone healthy meal preparation and exercise. The result? If you are working class you are more likely to become overweight AND less likely to be able to afford the cures for "obesity:" healthy food and exercise. On top of that, being working class and having to work multiple jobs to survive also means that you will be priced out of healthcare and life-saving medications in America. While the healthcare system is designed to only allow access for people that can afford it, pharmaceuticals are exponentially increasing the prices on life-saving medications for profit, which is causing people who cannot afford them to die. So there is a group of people that are priced out of healthy food, healthcare and medication and do not have leisure time for exercise. 

"Obesity," is an issue of race because its main unit of measurement or BMI (Body Mass Index) is an inconsistent marker that does not account for different body types, especially those of women of color that naturally have more body fat in certain areas. The idea that body fat is a marker of genetic inferiority goes all the way back to the origins of Western science or scientific racism. According to a class on the history of science that I took in undergrad, Western scientists initially set out on a mission to discover how white people are genetically superior to people of color. How did they do it? By identifying the presence of body fat, I kid you not. Scientists established that white people were genetically superior because they lacked body fat and certain people of color had body fat. Which people of color you ask? Well, it was Black people, specifically Black women with curvy body types that served as their "proof." For an example of this, revisit the absolutely horrendous chapter in Western history titled the "Hottentot Venus," may this poor woman's soul rest in peace. This was also around the time that white scientists created the first racial categories: "Caucasoid" or white people, "Negroid" or Black people, "Mongoloid" or Asian people and "Australoid" or Australian and Papa New Guinea aboriginal people. These scientists also "proved" that white people were smarter than people of color because of brain shape and size (no joke, look it up). Why is this a problem? Because this legacy continues today: Black and Indigenous people are still being discriminated against and killed by every U.S. institution, including medicine.

"Obesity" is an issue of disability because disabled people are disproportionately impacted by excess body fat. What the individual-blaming narrative fails to account for is that many people gain excess weight due to their genetics, mental health disorders and/or as a symptom of real diseases or their medications. Equating individuals' worth with their "good health" (read: thin bodies) and ability to exercise is ableist or discriminatory towards disabled people. Some people are not able to physically move or exercise due to physical disabilities. The narrative around "health" and "obesity" in the U.S. is really an exercise in American capitalism. It pathologizes body fat through the term "obesity," describes it as a "disorder" or "condition," and blames this newfound "disorder" on individuals while failing to account for the factors of capitalism that have increased it. This narrative promotes the idea that people with diseases or disabilities and anyone who falls ill is to blame for their sickness, conveniently vindicating our failing healthcare system and the role played by corporations. If one were to effectively address the "obesity epidemic," workers would make a living wage and be able to afford healthy food, healthcare, medicine and have the time for exercise. Healthcare would be universal and accessible for everyone regardless of income/class. Pharmaceuticals would not be allowed to increase the prices of life-saving medications for profit, resulting in preventable deaths. And most importantly, corporations would be regulated and prevented from placing poisonous chemicals into Americans' food and water (see: Flint, Michigan water crisis) and they would be prevented from continuing to build homes and buildings with asbestos and lead, materials proven to cause cancer and other diseases.

I am as tired of discussing "health" in terms of "obesity" as you probably are of hearing about it, but here we are again. The American medical industry and society continue to push an idea of "good health" that revolves around body fat and obscures the roles that capitalism, our healthcare infrastructure and corporations play in keeping Americans sick. This narrative conveniently fits the capitalist "bootstraps" theory that has been used to shame and blame working class people since the advent of capitalism. The capitalist "bootstraps" theory is the belief that anyone can become rich if they just work hard enough - therefore working class people that do not move up the economic ladder are lazy, have weak moral values and are at fault for their position in society. They are then told that they just need to "Pick themselves up by their bootstraps." Similarly, the "obesity" narrative posits that anyone can become thin (not healthy, not even weigh less, just thin) if they work hard enough by only consuming healthy food and exercising. Those that do not exist in thin bodies are then labeled as lazy and having weak moral values, etc. However, as illustrated in this essay, that is just not the reality. I mentioned that people of color are discriminated against in the healthcare industry, by doctors, etc. In a similar fashion, overweight people are discriminated against by doctors and the healthcare industry and face high rates of being misdiagnosed or just outright not treated as documented in this article. I am sure that people from other minority groups face similar discrimination from doctors including disabled people, working class people, etc. It is such a complex and multi-faceted issue and should not be treated as lightly as it is. A good rule of thumb to remember: objects are "healthy" or "unhealthy" such as food, activities and behaviors. Human beings are not "healthy" or "unhealthy;" people live with conditions, diseases and disabilities and are equal to able-bodied people and should be treated as such.