Skip to main content

Big deal: You can be fat and fit

By Marilyn Wann, Special to CNN
January 3, 2013 -- Updated 1858 GMT (0258 HKT)
An activist at a National Association to Advance Fat Acceptance rally in New York wears a T-shirt to promote self-image.
An activist at a National Association to Advance Fat Acceptance rally in New York wears a T-shirt to promote self-image.
STORY HIGHLIGHTS
  • Marilyn Wann: Study confirms fat is not a death sentence, and overweight people live longer
  • Wann denied health coverage because of her size; she became an activist afterward
  • Wann: Fat people continually get misdiagnosed, receive poor health care because of bias
  • Wann: Doctors finding new Health At Every Size approach provides better care

Editor's note: Marilyn Wann is author of "FAT!SO?" and a weight diversity speaker internationally. She is the creator of Yay! Scales, which give compliments instead of numbers.

(CNN) -- After a careful review of all relevant research worldwide, the U.S. government's leading analyst of weight data just confirmed what I've long known: Being fat might not be a death sentence.

That this study reported in the Journal of the American Medical Association seems at all shocking is a measure of the intensity and pervasiveness of weight prejudice in our society and in our sciences.

Another recent study found people who were "metabolically healthy" and overweight or obese had no higher death risk than metabolically healthy "normal" weight people.

I take an interest in the topic because I'm fat and because I don't have a death wish. I'm also interested because, like so many fat people, I've encountered weight discrimination when I seek routine medical care. I was 26 years old when I was denied the right to purchase health insurance. I had no significant history of illness or injury. I was just fat. That day, I became a fat rights activist.

Being overweight linked to lower risk of mortality

In the intervening years, I've heard from so many people who fear for their lives when they encounter weight discrimination in our health care system.

Marilyn Wann
Marilyn Wann

As a fat activist, I help as much as I can, but I'm no federal agency.

One woman called in the middle of the night, hoping I knew of an MRI she could use for an important test. The machine at her local hospital, which she'd used before, was being guarded by a technician who strictly enforced the weight limits. The tray that slides in and out of the machine could break. Instead, she was denied potentially life-saving information in a crisis. How many of the deaths blamed on weight are actually caused by medical equipment -- everything from blood pressure cuffs to surgical instruments -- that fails to accommodate fat people when we need it most?

I'll never forget the teenage girl who was told by a nurse practitioner that her complaint would go away once she lost weight. Luckily, she had the nerve and the parental backup to get another appointment and the prescription necessary to treat her condition. How many of the deaths blamed on fat actually happen when people are diagnosed as fat instead of being diagnosed and treated for an illness?

Then there are the fat people who did everything their doctors recommended to lose weight ... and died from dangerous diet drugs, from starvation diets, from mutilating weight-loss surgeries. I also hear from many people who live with the devastating physical and psychological consequences of such weight-loss attempts.

Step into school, step on a scale
Doctor won't treat anyone over 200 pounds
Viewer apologizes for calling anchor fat
Cops warned to lose weight or be fired

Some of these stories are referred to as anecdata, meaning they don't count unless they're counted in research -- although there are plenty of studies to support these outcomes. Even so, I believe it still makes a difference when we tell our stories of weight discrimination and its damaging impact on our health.

Living: 'Fatshion' bloggers find beauty in all sizes

People are telling their stories of weight bias in medical care on websites like First, Do No Harm, This Is Thin Privilege and Obesity Surgery Gone Wrong. The National Association to Advance Fat Acceptance has been speaking out on behalf of fat people's civil rights since its founding in 1969.

Health professionals of good conscience are joining this effort in increasing numbers. They've developed an approach called Health At Every Size that is proving to be better for people's health than weight-loss attempts. The Health At Every Size professional organization, Association of Size Diversity and Health, this week launched the project Resolved, a response to New Year's weight-loss resolutions. It invites people to share stories about weight discrimination in health care and opinions about what needs to change.

Weight bias has been documented among doctors, nurses, fitness instructors and other professionals on whom a fat person might need to rely for help. Last year, researchers who themselves are part of an anti-"obesity" institution (Yale's Rudd Institute) surveyed medical professionals who specialize in caring for fat people and found that they had high levels of weight bias, viewing us as "lazy, stupid, and worthless."

These biases don't improve medical care. Two pioneers of the Health At Every Size approach, psychologist Deb Burgard and health promotion expert Lily O'Hara, analyze existing data to point out that using BMI as a proxy for metabolic health mislabels 51% of healthy people as unhealthy. Meanwhile, 23.5% of the thin people with risky indicators will not be screened or treated early because they "look" healthy.

In the medical literature, every time fat people prove to be healthier or to live longer than thin people, researchers call that result an "obesity paradox." I'd call their refusal to view fat people positively a form of prejudice.

Here's a finding from the recent research that didn't make the headlines: For people over 65, being fat wasn't associated with increased risk, not even for the fattest old people. When do most people die, in our increasingly long-lived society? Over age 65, perhaps?

Living: Are we really ready to take a look at 'real women'?

I also learned this week that a highly accurate way to predict a person's risk of dying is to see how easily they can get up from the floor. I'm trying to imagine how different our health care system would be if, instead of focusing on weight and weight loss, caregivers did the sitting-rising test instead.

How much healthier would we be? How much more would we actually enjoy healthy living, free from weight judgment? How much time and money would we save? How much discrimination and human tragedy could we avoid? I'm guessing it'd be tons.

Follow us on Twitter @CNNOpinion

Join us on Facebook/CNNOpinion

The opinions in this commentary are solely those of Marilyn Wann.

ADVERTISEMENT
Part of complete coverage on
December 20, 2014 -- Updated 0242 GMT (1042 HKT)
Conservatives know easing the trade embargo with Cuba is good for America. They should just admit it, says Fareed Zakaria.
December 20, 2014 -- Updated 0112 GMT (0912 HKT)
We're a world away from Pakistan in geography, but not in sentiment, writes Donna Brazile.
December 19, 2014 -- Updated 1709 GMT (0109 HKT)
How about a world where we have murderers but no murders? The police still chase down criminals who commit murder, we have trials and justice is handed out...but no one dies.
December 18, 2014 -- Updated 2345 GMT (0745 HKT)
The U.S. must respond to North Korea's alleged hacking of Sony, says Christian Whiton. Failing to do so will only embolden it.
December 19, 2014 -- Updated 2134 GMT (0534 HKT)
President Obama has been flexing his executive muscles lately despite Democrat's losses, writes Gloria Borger
December 18, 2014 -- Updated 1951 GMT (0351 HKT)
Jeff Yang says the film industry's surrender will have lasting implications.
December 18, 2014 -- Updated 2113 GMT (0513 HKT)
Newt Gingrich: No one should underestimate the historic importance of the collapse of American defenses in the Sony Pictures attack.
December 10, 2014 -- Updated 1255 GMT (2055 HKT)
Dean Obeidallah asks how the genuine Stephen Colbert will do, compared to "Stephen Colbert"
December 18, 2014 -- Updated 1734 GMT (0134 HKT)
Some GOP politicians want drug tests for welfare recipients; Eric Liu says bailed-out execs should get equal treatment
December 18, 2014 -- Updated 1342 GMT (2142 HKT)
Louis Perez: Obama introduced a long-absent element of lucidity into U.S. policy on Cuba.
December 16, 2014 -- Updated 1740 GMT (0140 HKT)
The slaughter of more than 130 children by the Pakistani Taliban may prove as pivotal to Pakistan's security policy as the 9/11 attacks were for the U.S., says Peter Bergen.
December 17, 2014 -- Updated 1600 GMT (0000 HKT)
The Internet is an online extension of our own neighborhoods. It's time for us to take their protection just as seriously, says Arun Vishwanath.
December 16, 2014 -- Updated 2154 GMT (0554 HKT)
Gayle Lemmon says we must speak out for the right of children to education -- and peace
December 17, 2014 -- Updated 1023 GMT (1823 HKT)
Russia's economic woes just seem to be getting worse. How will President Vladimir Putin respond? Frida Ghitis gives her take.
December 17, 2014 -- Updated 0639 GMT (1439 HKT)
Australia has generally seen itself as detached from the threat of terrorism. The hostage incident this week may change that, writes Max Barry.
December 12, 2014 -- Updated 2020 GMT (0420 HKT)
Thomas Maier says the trove of letters the Kennedy family has tried to guard from public view gives insight into the Kennedy legacy and the history of era.
December 15, 2014 -- Updated 1456 GMT (2256 HKT)
Will Congress reform the CIA? It's probably best not to expect much from Washington. This is not the 1970s, and the chances for substantive reform are not good.
December 15, 2014 -- Updated 2101 GMT (0501 HKT)
From superstorms to droughts, not a week goes by without a major disruption somewhere in the U.S. But with the right planning, natural disasters don't have to be devastating.
December 15, 2014 -- Updated 1453 GMT (2253 HKT)
Would you rather be sexy or smart? Carol Costello says she hates this dumb question.
December 14, 2014 -- Updated 2253 GMT (0653 HKT)
A story about Pope Francis allegedly saying animals can go to heaven went viral late last week. The problem is that it wasn't true. Heidi Schlumpf looks at the discussion.
December 14, 2014 -- Updated 1550 GMT (2350 HKT)
Democratic leaders should wake up to the reality that the party's path to electoral power runs through the streets, where part of the party's base has been marching for months, says Errol Louis
December 13, 2014 -- Updated 2123 GMT (0523 HKT)
David Gergen: John Brennan deserves a national salute for his efforts to put the report about the CIA in perspective
December 12, 2014 -- Updated 1426 GMT (2226 HKT)
Anwar Sanders says that in some ways, cops and protesters are on the same side
December 11, 2014 -- Updated 1439 GMT (2239 HKT)
A view by Samir Naji, a Yemeni who was accused of serving in Osama bin Laden's security detail and imprisoned for nearly 13 years without charge in Guantanamo Bay
December 14, 2014 -- Updated 1738 GMT (0138 HKT)
S.E. Cupp asks: How much reality do you really want in your escapist TV fare?
ADVERTISEMENT