Body Positivity and WLS


Picture from the No Body Shame website

I have previously talked about my struggle with the cognitive dissonance between wanting to support/promote/embody body positivity even though I have had WLS.  Cognitive Dissonance

My news feed this morning sent me to Dances With Fat, specifically to a post talking about not allowing weight loss talk in body positive spaces.
Do Body Positive Spaces Have to Allow Weight Loss Talk?

And this led me to another post by the same person about Weight Loss and Size Acceptance

These two posts got me to thinking hard about body positivity and weight loss, specifically weight loss surgery. I don't want to think that I am not an advocate of body positivity. But the Size Acceptance (SA) community, the Fat Acceptance (FA) community, and the Body Positivity (BP) community seem to have a blanket exclusion for anyone who wants to change their body size/shape, regardless of the reason.

There are two separate issues I identified with the articles linked above - speech and behavior in SA/FA/BP spaces, and where people who want to change their bodies for whatever reason fit in the movement.

I agree that SA/FA/BP communities need safe spaces in both internet space and meat space, away from talk about weight loss. I totally get that and wholly support it. I don't expect to go into SA/FA/BP spaces and say or do anything that sends the message that people of size need to change themselves. It's their space, and they establish guidelines for speech and behavior in order to protect the other people in that space. It would be pretty rude of me to go in there and say that people are okay at whatever size but that it's still better, for me at least, to be smaller.

Then there's how people who have or want to lose weight fit in the SA/FA/BP movement. I know a lot of people through my WLS support boards who got fed up with their body and size and looking "better" is their primary motivation for weight loss. That's totally cool, and I consider that as valid of a reason for weight loss as any other. But I'd have a hard time saying that they promote body positivity or size acceptance.  They can advocate against discrimination and bullying of people of size (and most do), but when aesthetic reasons are their primary motivation, it doesn't mesh with the ideals of body positivity.

Then there are people who share my mindset about weight loss. My primary motivation is my health, period. If I could have affected the health improvements I have had through WLS through any other means, I would have done it. I wasn't all that unhappy with my size, and would never have done anything this radical just to fit in smaller clothing. I am finding myself thrilled with some of the superficial changes, but they are absolutely secondary (or even tertiary) to my health goals. I had WLS *because* I love myself.  But the SA/FA/BP community doesn't just want me to respect their need for safe spaces without diet talk, they want me to believe that I'm not SA/FA/BP because I want to be healthier.

Therein lies the problem for me. One woman commented  that she needs to lose some weight because the fat itself is impeding her from being able to take care of herself. Her lymphedema (extreme swelling of the extremities) requires her to compression wrap her legs and she's unable to physically do it because of the amount of belly fat she carries. Her health is impaired by the fat itself. It's not a theoretical exercise of whether fat people can be healthy, or if losing weight really leads to better health. Her fat keeps her from taking care of herself. She doesn't care about fitting into smaller clothes or an airline seat, she needs to be able to move well enough to maintain her own hygiene, dress herself, and take care of her medical needs. Yet the author's response was that losing weight is never permanent, and the commenter needs to focus on accepting herself where she is.

As a nurse, this kind of one-way thinking horrifies me.  Hell, as a rational thinking human, this horrifies me.

Yes, the evidence shows that diet and lifestyle changes are rarely successful long-term. The evidence also does not support the idea that being overweight automatically means that someone is not healthy, or that someone who is thin is automatically healthy. Weight is not the only factor in health, and it needs to stop being treated as if it is. The overweight patient with an ear infection needs treatment for the infection, not to be told to lose weight. The overweight patient who tears a major ligament in their knee needs surgery and physical therapy, not to be told there's nothing to be done until they lose a set amount of weight. Shaming someone about their weight is counter-productive. No one should feel bad about themselves because of their weight/size. And frankly, if you're not part of that person's medical team, their weight and size is none of your concern.

But when the excess tissue ITSELF is causing health problems, it is irresponsible to maintain that the person should do nothing about it in the name of SA/FA/BP. And some health conditions, even if they are not directly caused by excess weight, can be vastly improved by losing weight. It is irresponsible to tell a person that there is no benefit to losing weight because it cannot be kept off. Shaming a person for wanting to better care for their body should be completely against the tenets of Body Positivity. That person is not saying other people need to make the same choice or preaching that her size is unacceptable. She is saying that she - and she alone - needs to try to do something in order to maintain or improve her health.

Interestingly, when doing a little research for this post, I found that the Health at Every Size (HAES) curricula does not, in fact, teach that everyone is at the size/weight they should be, and instead states that many people have weight-related health concerns. HAES advocates learning to eat intuitively and physical movement to improve health. The difference is that HAES wants people (especially medical professionals) to start looking at more health indicators than weight and de-emphasize weight as a primary health indicator.

Here's what I believe. People of all sizes need to learn to love their bodies and quit buying into society's media-driven image of what beauty is because diversity is beautiful.  People who don't fit society's warped view of an appropriate size/weight suffer a great deal of discrimination right now. Size shouldn't impact your ability to get a job or raise or promotion. It shouldn't impact your ability to exist in public spaces (doors, chairs, etc.). It shouldn't be the only thing medical professionals look at, and it absolutely shouldn't be a determining factor in treatment decisions. Fat is not a moral failing, and it shouldn't be treated as one. Fat people aren't lazy, and they are not fat because they have no self-control. No one should be harassed or bullied in any fashion because of their size. In fact, someone's size/weight is none of your business unless you're on their medical team. Even then, the person deserves nothing less than professional and compassionate care.  Diets don't work and are very damaging to health.  Weight-cycling is more damaging to someone's health than being overweight alone.  Basically, I believe almost everything that the SA/FA/BP groups purport to believe.  The only point I differ on is the exclusion of people who have reasons to need to change their body.

So I'd like someone to educate me as to why I have no place in the SA/FA/BP movement. Because I just don't get it.

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