Women, Health, and the Politics of Fat

by Amy Winter

Published in Rain and Thunder, Autumn Equinox 2003

Malestream culture these days is so saturated with moralistic concern for health that the very word makes me squirm. Because Iím fat, Iím perceived by almost everyone as inherently unhealthy. People make all kinds of assumptions about my lifestyle and behavior often before we even meet. My friends have told me others ask them how much I eat, or if I have some metabolic problem. Doctors think they know all about me the minute I walk through their office door. Naturally, being the object of so many unfounded assumptions makes me furious.

So, Iíve done a lot of reading about the relationship between fat and health and honestly, the logic just doesnít hold up to scrutiny. If fat is a death sentence, then why are there so many fat old people wandering around? In fact, in this health-obsessed culture, why are there so many fat people period? If diets really worked, by now youíd think weíd all have found the right one, gone on it, and gotten thin, wouldnít you? And whatís with all those thin people whose bones disintegrate from osteoporosis or who drop dead jogging? If you really think about it for a minute, you have to realize that Marilyn Wann hits the nail on the head with the sarcastic hammer in her book Fat!So?:

But being healthy is not the same thing as being thin. A long life is not determined by a number on a scale. If it were, it'd be so great to be thin, 'cause you'd never get sick, and you'd never die.

For those of you who like numbers, she goes on to say that the only study that found a correlation between body size and lifespan showed a 5% death risk for fat subjects and a 2% death risk for thin subjects. Gasp! You mean fat people were twice as likely to die as thin people? Reality check: Studies show male smokers have 22 times the risk of death of nonsmokers. (And donít we all know people who wonít quit smoking because theyíre afraid of gaining weight?) Repeated dieting, or the stress of living in a society that hates us, could easily account for the relatively miniscule difference in death risk between fat and thin subjects. So when you start looking at the facts, itís hard not to suspect that the media scare tactics about fat are motivated by something other than scientific evidence.

In fact, once you get that skeptical head tilt right, itís not hard to sweep a critical eye over the cultural obsession with health in general, with some interesting results. Letís think for a minute about the many factors that negatively impact our health which are beyond our individual control. Those of us who live in or near cities routinely breathe smog-choked air. Our water supplies are often contaminated with raw sewage, microbes, pesticide runoff from agriculture, and waste dumping by industry. Our food is often steeped in chemical fertilizers, herbicides, and insecticides. The buildings in which we live and work are often inadequately ventilated, poorly lit, and constructed with materials which give off toxic fumes for many years. And then there is the work that many of us have no choice but to perform in order to survive: sedentary tasks which sap our physical and psychic energy and expose us to repetitive strain injury, sitting in front of computer screens which bombard us with electromagnetic radiation, or demanding physical work performed without adequate rest breaks, putting us at risk of chemical exposure, exhaustion, physical injury, and chronic illness.

In the face of these realities, doesnít it seem curious that most media discussions of health focus on what weíre eating or not eating, or the exercise we should be doing? The only time I ever hear mainstream media acknowledge the ways big-business-as-usual is killing us is when theyíre trying to sell us an escape hatch: bottled water, water filters, little air purifiers that hang on a cord around your neck, ergonomic keyboards, big rubber balls to stretch your back, low-VOC paint. Does this sound familiar to anyone? The words "individual solution" certainly reverberate in my headóparticularly when we consider that most of these products arenít doing much for the health of women in other countries, spending their lives in factories for pennies a day making these little items. The fact is, the poisoning of the planet benefits those with a share in corporate profit, at least in the short term, to the detriment of the rest of us, who donít have access to the resources to buy organic food, live in the country, build our own houses with natural materials, or choose our working environment. So no wonder the corporate-media conglomerate wants us to think our health status is completely a result of our personal choices. "These people," intones the mellow tenor voice-over for a TV commercial showing white people using the internet, "are getting answers to the most important questions theyíll ever ask: questions about their health." Do we agree that questions about our health are the most important questions we can ask these days? Our Bodies, Ourselves calls this healthism:

When we are overly focused on fitness or a Ďhealthy lifestyleí as goals to strive for (or as the measure of a Ďhealthyí society) we deflect attention from the more important goals of social justice and peace.

The medical establishment, of course, is right there encouraging our daily sprint, panicked and panting, on the mental hamster wheel marked "health." So Iíd like to shift my critical gaze for just a moment to focus on the institution of western medicine. Letís remember that men founded it, with the help of the catholic church, by torturing and murdering millions of women practicing indigenous health care in europe during the womenís holocaust, the Burning Times. (Indigenous systems of health care around the world are still being destroyed today, being replaced by systems based on the consumptive western model.) These self-styled doctors consolidated their power by denying women access to medical education, while making medical education a prerequisite for the practice of health care. Since then, among other things, medical men have pathologized (in order to "treat" and control) the natural body experiences of womanhoodómenarche, menstruation, pregnancy/childbirth and menopause. They cut out our clitorises if we showed too much interest in sex and locked us in mental institutions when our husbands wanted control of our property. They prescribed us, our mothers or grandmothers the dalkon shield, thalidomide, diethylstilbestrol, silicone breast implants, and hormone replacement therapy by the millions. They sterilized thousands of women without their consent. They perform "medical research" on people in prison or mental hospitals without their consent. For a hefty fee, they are happy to surgically remove a chunk of nose, breasts, or stomach so we can better fit the cultural beauty imperative of the moment. They capitalize on the confusion of women who donít fit the "feminine" stereotype, handing out a convenient diagnosis, bilateral mastectomies and a lifetime prescription for testosterone. They routinely announce discoveries about "human" health based on studies with only male subjects. They believe the despair and rage of women who have been raped, sexually abused, battered or just overworked are appropriately and sufficiently addressed with prozac. They cannot conceive of a woman collecting information, interpreting it, and coming to a conclusion different from theirs; the only word in their vocabulary for a patient who does not follow a doctorís advice is "noncompliant." In short, this system and its adherents are not on the side of women.

Now, wait a minute before you start getting all guilty, defensive, and pissed off at me because you just had your pap smear at Planned Parenthood, or youíre a nurse and you think youíre doing some good, or you take psych meds and they make it possible for you to function in the world. Hear me out here. Iím not saying we should smoke and drink and eat candy bars all the time. Corporations profit from that too! Iím also not saying western medicine never did any good and weíre evil collaborators if we use it. For many of us, particularly those who have public health insurance, itís the only game in town. And, as an "allied health professional," I pay my bills with their money too.

So what exactly is my point? I think there are two levels upon which we need to take action. On the individual level, as we make the best choices we can about health-related behaviors and our use of the existing health care system, I would like women to recognize that health and illness are very complicated. We donít understand all the factors that interact to produce either state, and a lot of the environmental and genetic factors that impact our health are beyond our individual control. Therefore, letís try to remember as we go through our lives that you canít tell by looking. You canít determine what or how much I eat, my cholesterol level, or the state of my coronary arteries when you meet me. Likewise, you might meet a thin, able-bodied-appearing woman and assume sheís perfectly healthy, only to discover on further acquaintance that she has multiple sclerosis or lupus or sickle cell disease or breast cancer. And couldnít we refuse to spend any more time feeling guilty about the "bad food" we ate or the exercise we didnít do? Instead, letís spend that energy encouraging each other to resist healthist media rhetoric.

The collective level is even more important, and is completely ignored in the current media focus on individual solutions to health problems. The call that sparked this article read, in part, "What kind of a future for womenís health are we working towards?" I donít have the answer, but I do have some ideas. I donít advocate directing resources to western health care systems, particularly when such systems disallow treatment they consider alternative. I think we ought to get more serious about organizing ourselves to combat the corporate environmental poisoning of our world, recognizing that the activities of industry negatively impact women first and profit us last. As just one example of what we could do, think of how much energy women spend organizing and participating in walks/runs/rides and other fundraisers for various illnesses. And the money raised goes to help women struggling with those diseases, right? Well, no. That money goes to fund medical, usually pharmaceutical, research. What if even some of that woman-energy was directed towards creating networks to help women who are struggling with the limitations illness places on their daily lives, right now? Or to work on cleaning up the environmental causes of disease? Or to support community gardens on vacant city lots to raise fresh, locally grown, chemical-free produce? Why do we participate in raising money to hand over to the male-dominated medical system, putting aside the needs of women right now for the possibility of some probably invasive, side-effect-riddled chemical-based future cure?

At the same time, we ought to be thinking about what health care would be like in the world we want to live in, and about how we can work together to realize our visions, for ourselves and each other. What if health care were a collaborative effort, rather than a hierarchical system where some people are "experts" and others passively accept their prescriptions? What would it be like to give and receive all kinds of health care in naturally lit buildings with windows that open, looking out onto gardens rather than asphalt? What if these buildings were also community centers where we could participate in discussion groups, artistic collaborations, gardening, group meals, exercise classes, craft work, continuing education, internet research, and community organizing? What if these centers were collectively organized to include more women in decisions about the centerís activities? What if the centers were funded in a variety of creative ways, including sliding scale self-pay, private health insurance, grant funding, subscriptions, memberships, donations and ways we havenít thought of yet? This is the kind of center Iíd like to go to, where people would ask my opinion rather than making assumptions, where Iíd get information from a variety of sources, have a range of options to choose from, and where I could say "Iíll think about it," without dire warnings of the likely outcome of my "noncompliance." This is just my vision; whatís yours? Creating change will undoubtedly take a lot of work on the part of feminists, but letís get started together by resisting the mediaís attempts to blame us for our health problems and organizing to create a society that doesnít make women sick.

Brief Bibliography

  1. Boston Womenís Health Collective. Our Bodies, Ourselves For the New Century. Simon and Schuster, Inc., 1998.
  2. Dykewomon, Elana. "the real fat womon poems" in Nothing Will Be As Sweet as the Taste. Onlywomen Press, 1995.
  3. Ehrenreich, Barbara, and Deirdre English. For Her Own Good: 150 Years of the Expertsí Advice to Women. Doubleday, 1978.
  4. ----. Complaints and Disorders: The Sexual Politics of Sickness. Feminist Press, 1973.
  5. ----. Witches, Midwives, and Nurses: A History of Women Healers. Feminist Press, 1973.
  6. Fraser, Laura. Losing It: False Hopes and Fat Profits in the Diet Industry. Plume, 1998.
  7. Scharff, Sue. "The Defective and Doomed Female Body." Said It: Feminist News Culture, and Politics, January 2001.
  8. Schoenfelder, Lisa, and Barb Weiser, eds. Shadow On a Tightrope: Writings by Women on Fat Liberation. Aunt Lute Press, 1983.
  9. Wann, Marilyn. Fat!So? Because You Don't Have to Apologize For Your Size. Ten Speed Press, 1998.