Fatness and Healthcare: Fat Studies and Fat Activism Perspectives and Intervention

Cat Pausé introduces her fat studies and activism series, featuring artwork from Barry Deutsch and articles from Kristen Hardy, Rachel Fox and The LadyBears, exploring the experiences of fat people with the healthcare system, drawing attention to the need for change in the medical and socio-political framing of fatness, and offering practical solutions.

Across my life as a fat person, my experiences with healthcare have ranged from dismissive to oppressive. I learned before puberty that most in the healthcare system would not elect to look past the size of my body to see me as a person or consider other factors that may contribute to my health and well-being. As a middle-aged super fat woman with a PhD, I now have the confidence to advocate for myself in these spaces. But I should not have to work so hard to be seen as a person. I should not have to insist that my healthcare providers suggest something other than weight loss; I should not have demand for whatever treatment or diagnostic testing they would provide to a non-fat person with similar symptoms.

As a fat activist, I am aware that my experiences with healthcare providers are common. I know that fat people die because of the anti-fat attitudes of their providers. As a scholar, I have explored the barriers to ethical evidenced based healthcare for fat people (Lee & Pausé, 2016; Pausé, 2014), including in the areas of mental health (Pausé 2021, 2019) and maternal health (Parker & Pausé, 2018, 2019). I am well familiar that the evidence that anti-fat attitudes are stronger in healthcare providers than they are in the lay public; that many nurses and doctors find fat bodies disgusting, and very few are educated/trained in how to complete basic diagnostic tests upon our fat bodies (see Lee & Pausé, 2016 for a full review of this lit). In turn, many fat people avoid healthcare settings all together. As noted by myself and Jennifer Lee (2016), “Fat individuals are less likely to access healthcare, and are less likely to receive evidence-based and bias-free healthcare when they do engage”.

Photo by AllGo – An App For Plus Size People on Unsplash

My current focus is on the need to ensure that fat people receive adequate and equitable care during the COVID-19 pandemic (Pause, Parker, & Grey, 2021). I have watched as Western governments pushed renewed energy into the moral panic around fatness, positioning fat people as subjects of blame for poor self-management and burdens on healthcare resources and community well-being. Instead of explaining why they were caught out unprepared to handle CV19, many governments are throwing fat people under the bus, framing them as the problem. Fat people must be part of the planning, training, and preparedness for natural disasters and global pandemics. Otherwise, we are simply left to die. Fat activists know this, so they’ve been mobilizing around the world to create mutual aid groups and develop materials to help fat people advocate for themselves during CV19. We find anti-fat attitudes impacting the administration of the CV19 vaccination as well.

I am grateful to The Polyphony for this chance to have a FAT takeover of the blog. We hope you engage with us over the week and reach out for further conversation.

We begin the week with an essay from Kristen Hardy, exploring the links between biomedical oppression and fat liberation. Kristen spends time explaining where anti-fat attitudes come from, and how these influence our healthcare settings. Next up is Rachel Fox, a student in the medical humanities, who shares her experience in being regularly exposed to the doctor-writer/fat-patient encounter narrative. Rachel shines a light on how it feels to read narratives about dehumanised things (fat-patients) from those meant to care and protect (doctor-writer) as a fat person herself. At the midway point we seek to lighten things up a bit; we are still exploring the anti-fat nature of the healthcare system, but through an animated story by Barry Deutsch. Barry is a political cartoonist who often uses his platform to highlight fat oppression; in the comic he has approved we use for the FAT takeover, he illustrates a farcical experience that is all too common for many fat people. And we close out the week with two-part piece from The LadyBears, highlighting key requirements for a fat medical utopia. The LadyBears provide practical and concrete actions that healthcare providers can engage with/in to improve the care they provide for fat people.

We hope that this week allows you to consider fatness and fat people from a human perspective. We encourage you to adopt a fat ethics of care; working to rid yourself of your anti-fat attitudes and ensuring that you are providing size affirming care to your fat patients. And we are optimistic that your work in this space will not end here, but that you will seek out additional information and opportunities for growth.

References

Lee, J. A. & Pausé, C. J. (2016). Stigma in practice: Barriers to health for fat women. Frontiers in Psychology, 7, 2063.

Pausé, C. J. (2021). Inside out: Fattening therapy. In V. Hutton & S. Sisko (Eds.), Multicultural responsiveness in counselling and psychology (pp. 243-258). Palgrave Macmillan.

Pausé, C. J. (2019). Hung up: Queering fat therapy. Women & Therapy, 42(1-2), 79-92.

Pausé, C. J. (2014). Die another day: The obstacles facing fat people in accessing shame-free and evidenced-based healthcare. Narrative Inquiry in Bioethics, 4 (2), 135-141.

Pausé, C. J, Parker, G. & Grey, L. Resisting the problematization of fatness in COVID-19: In pursuit of health justice. International Journal of Disaster Risk Reduction*. https://doi.org/10.1016/j.ijdrr.2020.102021

Parker, G. & Pausé, C. J. (2019). Productive but not constructive: The work of shame in the affective governance of fat pregnancy. Feminism & Psychology, 29(2), 250-268.

Parker, G. C., & Pausé, C. J. (2018). “I’m just a woman having a baby”: Negotiating and resisting the problematisation of pregnancy fatness. Frontiers in Sociology3, 5.

Parker, G. & Pausé, C. J. (2018). Pregnant with possibility: Negotiating fat maternal subjectivity in the “war on obesity”. Fat Studies: An Interdisciplinary Journal of Body Weight & Society, 7(2), 124-134.

About the Editor

Cat Pausé, PhD is a Fat Studies scholar at Massey University in New Zealand. She is the lead editor of Queering Fat Embodiment (Ashgate) and the International Handbook of Fat Studies (Routledge), and has coordinated three international conferences – Fat Studies: Reflective Intersections (2012), Fat Studies: Identity, Agency, Embodiment (2016), and Fat Studies: Past, Present, Futures (2020). Her research is focused on the effects of fat stigma on health and well-being on fat individuals and how fat activists resist the fatpocalypse. She has called for a new fat ethics, acknowledging the role science has played in the oppression of fat people and ensuring that research around fatness centers fat epistemology. Her work appears in scholarly journals including Fat Studies, Journal of Law, Medicine, and Ethics, Feminist Review, and Narrative Inquiries in Bioethics, as well as online in the Huffington Post, NPR, The Conversation, and her blog. Her fat positive radio show, Friend of Marilyn, has been showcasing fat studies scholarship and fat activism since 2011.

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