Delve into the challenges fat individuals face in healthcare, where weight loss prescriptions often hinder true care. The discussion critiques outdated metrics like BMI and debates whether fatness should be classified as a disease. Advocating for harm reduction and compassionate care, the podcast contrasts the medical model with a more inclusive social model. Listeners are encouraged to reflect on societal biases and the importance of respectful language to foster understanding and reduce harm in discussions around body size.
The podcast critiques the medical model of fatness, which wrongly classifies fatness as a disease while disregarding health complexities beyond body size.
Harm reduction strategies are proposed to empower fat individuals in healthcare, enabling them to assert their needs and mitigate systemic harm.
Deep dives
The Ineffective Prescription of Weight Loss
Many medical professionals still prescribe weight loss as the first course of action for treating various health conditions, despite evidence showing that most patients do not achieve sustainable weight loss. A discussion with a doctor revealed a disturbing trend where weight loss is prioritized over immediate treatment options, with the understanding that the majority of patients do not return after unsuccessful attempts to lose weight. This cycle reinforces the medical community's weight-centric approach, which disregards the well-being of fat individuals and their need for timely and effective care. A suggested alternative encourages providers to offer treatment concurrently with weight loss prescriptions, challenging the traditional medical perspective.
The Flawed Medical Model of Fatness
The podcast critiques the medical model of fatness, highlighting how it erroneously defines fatness as a disease and uses outdated metrics like BMI, which have been criticized for being inaccurate and racially biased. Despite acknowledging that BMI is a faulty measurement, recent guidelines still recommend its use alongside new terms like 'preclinical O-word' to categorize fat individuals, further stigmatizing them. This highlights a failure to recognize that health is not solely determined by body size, as there are healthy fat individuals and unhealthy thin individuals. Ultimately, the podcast emphasizes the need to shift away from this medical model in favor of recognizing fatness as a normal variation of human bodies.
Harm Reduction as a Bridge to Better Care
Harm reduction is introduced as a concept to address the negative experiences fat individuals face within healthcare systems. It involves recognizing that while the system may inherently cause harm, there are ways to mitigate that harm during interactions with healthcare providers. For example, patients can be encouraged to set boundaries, such as refusing to be weighed or avoiding weight loss discussions, while still receiving necessary medical care. This approach acknowledges the difficulties fat people face while striving for autonomy and ensures their needs are met without perpetuating the cycle of harm.
The Importance of Social Models for Fat Liberation
The podcast discusses the difference between the medical and social models, both of which frame disability and fatness in fundamentally different ways. The medical model views fat people as abnormal and in need of correction, while the social model emphasizes societal attitudes and structural barriers that marginalize fat individuals. Advocating for a social model recognizes that fat bodies have equal rights and should be treated as valid variations of humanity. This perspective empowers individuals to challenge biases, leading to a more inclusive society that accommodates all body types and embraces fat liberation.
How can we convince healthcare providers to examine the harm they cause when they tell fat people to lose weight and deny us care? It can be pretty hard to realize that you haven’t been providing evidence-based care so it’s a challenge! That’s where the work of the disability community comes in with their medical and social models of disability. This lets us communicate how medicalizing fatness is not helpful in the same way it’s not helpful for many in the disability community. Alongside that, let’s talk about harm reduction ideas! We’re getting deep today, come join me :)
Episode show notes: http://www.fiercefatty.com/195
Support me on Ko-Fi and get the Size Diversity Resource Guide: https://kofi.com/fiercefatty/tiers
Body Roundess index: https://weightandhealthcare.substack.com/p/reader-question-what-is-the-body?utm_source=publication-search
Lancet article, TW BS and O Words https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(25)00004-X.pdf
Lancet iraphicnfog, TW BS and O Words: https://www.thelancet.com/infographics-do/clinical-obesity-25
How weight loss and pharma companies are scamming us into thinking they are advocating for fat people: https://www.canva.com/design/DAEvLxpBSdA/bOOUbgoQmhPGxC1ukae9Jw/edit
Medical Model vs Social Model: https://eisforerin.com/2017/08/05/disability-101-medical-model-vs-social-model/
Access all areas about Medical Model vs Social Model : https://youtu.be/QT7cyMNDRh8?si=JRiZ6n2bzgWNBBw9
My examples (1st of mm vs sm, then harm reduction): https://docs.google.com/spreadsheets/d/1CTI2CJPU9d3a95ibFwsZkEPWH3XbZ5IgPn9bRB4bAe0/edit?usp=sharing
Disability 101: Medical Model vs Social Model: https://eisforerin.com/2017/08/05/disability-101-medical-model-vs-social-model/
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