Tag Archives: fatphobia

Various Thoughts about Medical Racism

America's History of Medical Misogynoir, with stylized images ofo women with skin tones ranging from very dark to very light
picture from DocumentWomen

Debbie says:

I listen to a lot of podcasts, many of them about race and racism issues, but the idea for this post came from The Allusionist, which is about words. Host Helen Zaltzman interviewed Moya Bailey, who coined the term “misogynoir” when she was doing work on racism in the medical community. As part of the conversation, Bailey relates the story of Dr. Susan Moore, a Black physician who died of COVID-19 in 2020. Despite her profession, Dr. Moore received woefully inadequate treatment for the virus because she was perceived as a “drug-seeker,” undoubtedly because of the color of her skin.

Examples like Dr. Wood’s are legion; perhaps more is to be gained from looking at the theory and practice of medical racism than the horror stories. This brings me to two things I’ve learned recently from Pod Save the People. First, race correction. When I heard the term, I thought (naively), “Wow! Sounds like a way to do evidence-based work on the medical issues that disproportionately affect the Black and Brown communities. I couldn’t have been more wrong.

Race correction, which is in use today, is the misuse of what author Cathy O’Neil calls “weapons of math destruction” against the health of (especially) Black people. Jacque Smith and Cassie Spodak wrote about it for CNN.

The New England Journal of Medicine article “Hidden in Plain Sight” [link requires registration] includes a partial list of 13 medical equations that use race correction. Take the Vaginal Birth After Cesarean calculator, for example. Doctors use this calculator to predict the likelihood of a successful vaginal delivery after a prior C-section. If you are Black or Hispanic, your score is adjusted to show a lower chance of success. That means your doctor is more likely to encourage another C-section, which could put you at risk for blood loss, infection and a longer recovery period.

[Dr. Samuel] Cartwright, the racist doctor from the 1800s, also developed his own version of a tool called the spirometer to measure lung capacity. Doctors still use spirometers today, and most include a race correction for Black patients to account for their supposedly shallower breaths.

Turns out, second-year medical student Carina Seah wryly told CNN, math is as racist as the people who make it.

On a somewhat more encouraging note, Pod Save the People also hosted Dr. James Wood, a Black orthopedic surgeon. I was especially pleased to hear Dr. Wood address fatphobia and medical bias against fat people in the context of medical racism:

And there’s bias against obese patients because patients who are very obese– everybody wants to blame whatever disease that is on the body habitus. But there’s new study and new research now on obesity that’s talking about people in their best body. I see people who are obese by any standard.

They walk in, their BMI, 38-40. But then their best body, these are the same people that can run five miles. They can hike. They can ride bikes at 20-30 miles, in great shape. It just big people, doing their best body. So being able to really have people understand this and respect this is something else that’s coming on new in the future.

So people who’ve been fat shamed and other things like that– and this is happening. It has happened to doctor’s office where they walk in and say, well, you’re too fat. I can’t take care of you. Or you’re too fat, you’ve got to do that, so you could take care of your diabetes or your hypertension or your arthritis in the joints. Being more cognizant of what the conversation is now about obesity would be very helpful as well, just as an example.

I’m not sure what research Dr. Wood is citing on this “best body” concept, and I will keep looking. In the interim, it was genuinely exciting to hear a medical professional talking about medical bias and using terms like “fat shamed,” which I tend only to hear in body image circles.

I’ll close with a comment from Moya Bailey which applies both to misogynoir and medical racism:

“I’m hoping that this is perhaps the flourishing before the end. If we talk about it a lot now, perhaps that means we’ll get to a place where we can actually transform and get rid of it.”

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Do No Harm: Declare a Cease-Fire on Fat Kids

Laurie and Debbie say:

We didn’t recognize Aubrey Gordon’s byline, but her bio reveals that she is “Your Fat Friend,”  which means she’s a nationally known activist for fat people everywhere. In a New York Times opinion piece last week, she sings our song about how fat kids are treated … and why this has to change.

I will remember the pediatrician’s words forever: It’s probably from eating all that pizza and ice cream. It tastes good, doesn’t it? But it makes your body big and fat….

As the holiday season approaches, with its celebratory family meals and seasonal treats, I worry about the children across the country who will endure similar remarks, the kind that shatter their confidence, reject their bodies and usher them into a harsh new world of judgment.

Debbie remembers the 1950s version of this. Laurie remembers the 1980s version of raising a daughter who wasn’t thin. With each passing decade, fat shaming of children gets more medicalized, more obsessive, and nastier.

Gordon doesn’t give her age range, but she identifies the rest of the problem:

My body wasn’t just a body, the way a thinner one might have been. It was perceived as a burden, an inconvenience, a bothersome problem to solve. Only thinness would allow me to forget my body, but despite my best efforts, thinness never came.

The more I and others tried to change my size, the deeper my depression became. Even at such a young age, I had been declared an enemy combatant in the nation’s war on childhood obesity, and I felt that fact deeply. Bodies like mine now represented an epidemic, and we were its virus, personified.

In case you missed the connection here, depressed people often eat more. People who feel hopeless often eat more (or depressed and hopeless people starve themselves, which is equally awful).

In 2012, Georgia began its Strong4Life campaign aimed at reducing children’s weight and lowering the state’s national ranking: second in childhood obesity. Run by the pediatric hospital Children’s Healthcare of Atlanta, it was inspired in part by a previous anti-meth campaign. Now, instead of targeting addiction in adults, the billboards targeted fatness in children. Somber black-and-white photographs of fat children stared at viewers, emblazoned with bold text. “WARNING: My fat may be funny to you but it’s killing me. Stop childhood obesity.” “WARNING: Fat prevention begins at home. And the buffet line.” “WARNING: Big bones didn’t make me this way. Big meals did.”

You can Google the Georgia billboards if you are so inclined. But you don’t need to see them to recognize the damage they do.  Debbie — and Laurie’s daughter — didn’t have to worry about seeing ourselves on billboards. We may have been the warning parents we knew gave children we knew, but we weren’t public figures of doom and decay. By the way — neither of us were fat in any way except by cultural comparison. If there’s one thing Laurie and Debbie have learned doing this work for 35 years it’s that when you body-shame anyone, everyone starts hating and fearing their body. Either you’re already in the shamed group, or you’re on the edge of possibly being in the shamed group, or you need to desperately preserve your image as not being in the shamed group: no one is unscathed.

And although no one is unscathed, of course fat shaming — like all body shaming — is racialized. Where Black girls should be raised on Lucille Clifton’s “Homage to My Hips,”

these hips are big hips
they need space to
move around in.
they don’t fit into little
petty places. these hips

are free hips.

instead they are slammed by all of the mainstream’s narrow definitions of beauty (and Black boys and nonbinary Black kids are too). If you can’t be thin, or blonde, or have the magazine models’ kind of dream hair, each of those adds to your shame and self-hatred. Add to that what it feels like when you know you can be killed by people in power because you look the way you do, and the toxicity levels go off the charts.

Gordon’s new book, What We Don’t Talk About When We Talk About Fat, was released just two days ago. She ends her opinion piece with a plea we want to amplify:

Yet, despite its demonstrated ineffectiveness, the so-called war on childhood obesity rages on. This holiday season, for the sake of children who are told You’re not beautiful. You’re indulging too much. Your body is wrong. You must have done it, I hope some parents will declare a cease-fire.

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