How to help a fat person

Updated: Jul 30, 2020

It’s really quite simple, don’t. At least not in the traditional way. Not in the way we’ve become accustomed to and has been highlighted by yet another “obesity crisis” in the media - this time with a Covid twist.

What the government is marketing as a "world-leading plan", claiming "These bold measures will help us tip the scales on obesity. The argument for action is the clearest it’s ever been."

Aside from how triggering the term "tip the scales" is, hon, it doesn't matter how clear the argument for action is, if the action doesn't or can't yield results. There I've said it. It's the biggest load of hokum I've seen since I last saw BoJo downing a kale smoothie.

Don’t help fat people by making them feel: like a failure, ashamed, judged, wrong, incapable, stupid, invisible, patronised, unhealthy, scared, in danger, powerless, excluded.

I’ve grown up with a Mum who has been "morbidly obese" for my entire life. I'm now 41 and am wondering if it was a misnomer because she's outlived my gym-going father by 17 years. What I have witnessed over the years is her simple inability to lose weight. She just can't. Now in her 70's with limited mobility, I'm certain she won't in the time and to the level expected by Matt Hancock MP - the press release from urges us to "lose weight to beat coronavirus". Mum's relationship with her body is multi-dimensional, as it is for all of us. Telling her she's at higher risk now, just serves to scare her.

You know, research shows some people just drew the lucky card when bodies were being handed out. We may find it easier to be thin, that doesn't make us experts. Doing varied research makes experts.

What I know from Mum and from those I've interviewed for my work, is that such shame can be felt around fat bodies as to make it a subject that is agony to broach, even to themselves. A sort of body rejection / body separation can happen and an element of denial. I have witnessed my mother's handling, or for the most part, not handling of her relationship with her body and I've seen the impact it has had on her self esteem. No, thankfully, it hasn't killed her, just made her life less. A lot less.

I am thin / have thin privilege but have had my body adapted through cancer and now am an advocate for valuing real bodies. Through my business, BodEquality, I educate organisations in empathy and understanding of our own and other people’s relationships with their bodies. It is an essential conversation in both the wellbeing arena and the diversity and inclusion one. In creating the online training, we went deep into what helps form the shape of our bodies and what influences maintain them. I want to state the case that we’re getting it really wrong.

During the current obesity sham, as a response, the Department for Health and Social Care have taken to twitter and offered the following:

What follows is a stirring 24 second film entitled “Obesity Makes Us Vulnerable”. I'm imagining this is the brainchild of a bunch of white, middle-everything, privileged, out-of-touch men, just a hunch.

Let’s see what’s going on over on the NHS website dedicated to “better health”. As expected, under the title “Kickstart Your Health” we have nods to BMI, calories, meal planning and weight-loss goals. Eat less, move more, lose weight. That is health. That isn’t health.

Meanwhile anyone (such as the charity Mind) calling for the need to reduce the stigma around mental health are going to be left wanting. Mental health has been given exactly zero airtime on this subject and let's remember, the subject is health. I scroll down the NHS "better health" website to find a quiz entitled “How are you?”. A glimmer of hope, but alas, it asked me if I’d rather eat ham than a burger, to ignore my (temporary) disability and focus on what I eat instead (dear God), it then gave me a health score of 6/10 and some handy tips for moving, eating, drinking and smoking. So not really “how are you”, more… what are you.

And it's a hoax, what it actually amounts to is "nearly 8% of critically ill patients with COVID-19 in intensive care units have been morbidly obese, compared with 2.9% of the general population" (who are "morbidly obese"). These stats have been used in such a skewed way as to be transformed into "fat people will die of Covid" - not even all "morbidly obese" people will die of Covid. Yes they have a higher chance, but they still account for less than 8% of critically ill Covid patients.

And we aren't in the midst of an "obesity time bomb". In his book The Truth About Fat, Anthony Warner sets out that the population’s weight has increased steadily and proportionately in accordance with height and income since the 1920s. This means less people are starving. Shown on a graph, it looks like a bell, a small proportion of people being severely under weight and a small proportion being severely overweight. Most poeple are in the middle. That shape has moved but it has not changed, the natural variance and diversity in bodies hasn’t changed.

Something else that has happened since the 1920s, as the government’s own website through the Office of National Statistics shows, is a clear increase in life expectancy. So all the scaremongering about worsening outcomes in the face of cancer, diabetes and now Covid-19, really only amount to one thing. The one thing we are so fearful of, we’ll try anything to avoid it. That one thing is the cold hard truth that we all will die and we can't avoid it, no matter what body we're in. As a cancer survivor, I don’t take that truth lightly. But by their own admission, we are living longer and longer.

In reality the group of people this research impacts is the very extreme of obesity - 2.9% of society who make up the group that might need some very specific multi-dimensional approaches to initiate positive change. For example this might be counselling around a binge eating disorder or tackling childhood trauma. Maybe we could spend the "better health" budget on that?

From the research I did in developing the BodEquality programme and from many academic researchers before me, we know that our mental health has a massive impact on our eating and exercising behaviours. As The Mental Health Foundation pointed out during Mental Health Awareness Week in 2019, having negative feelings about our bodies is linked to depression, self harm, suicide and unhealthy eating practices. So I'm arguing that adding more fuel to that fire, by condemning fat people under this Covid umbrella is misplaced.

We also know that crash dieting is more likely to result in weight yoyoing and ultimately a higher BMI than we started with, or at the other extreme, an eating disorder. You could almost argue that by making a show of fat people in this way, the message compounds the problem.

I don’t mean to nit-pick, it’s just this trajectory of conversation is so dated. Which would be fine if it worked but it hasn’t worked in the past; it won’t work now. We’ve got an opportunity to get smarter and put some genuine thought into this. Or at least stop doing this while the research strongly advocates against it. It's not just that its dated, it's that it's uninformed.

What the BodEquality course concludes is that progress looks like treating people as individuals. Empowering people and their choices, history, genetics, abilities, allowing them their story. We can offer ourselves acceptance, compassion and encouragement and extend it to those around us. That may induce weight loss, it may not. That almost doesn't matter. Government and its small-minded ways might see it as a helpful bi-product.

What needs to happen, is the opposite of obesity scaremongering, but compassion on a social scale. Letting people know, they can be who they are, that they are valuable people, empowered to be who and how they want. We can acknowledge that none of us are here forever, but honour the time we do have by supporting ourselves in the best way we can.

And as for the 6% - BoJo needs to pump some money into the NHS to deal with it. To take responsibility and stop blaming a natural and historical social trend.

Postscript: Mum says "My Mum used to ring me up and the first thing she'd do was ask if I'd lost any weight. It used to send me straight to the fridge. Made me feel powerless. What I don't understand is that people think I want to be like this! You've got this spot on, thank you for understanding."

Emi Howe runs BodEquality, an online training package to help educate businesses and organisations around the nuanced relationships we have with out bodies. Helping individuals forge better relationships with their bodies, unlocking personal potential and an improved understanding of bodies around them.

Helping organisations to nurture: diversity, wellbeing, morale and "well" days. If you would like to integrate BodEquality into your employee wellbeing package, please get in touch. #valuingrealbodies

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