Skip to main content

Big deal: You can be fat and fit

By Marilyn Wann, Special to CNN
updated 1:58 PM EST, Thu January 3, 2013
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
updated 12:11 PM EDT, Fri August 29, 2014
Leon Aron says the U.S. and Europe can help get Russia out of Ukraine by helping Ukraine win its just war, sharing defense technologies and intelligence
updated 1:24 PM EDT, Fri August 29, 2014
Timothy Stanley the report on widespread child abuse in a British town reveals an institutional betrayal by police, social services and politicians. Negligent officials must face justice
updated 9:06 PM EDT, Fri August 29, 2014
Peter Bergen and David Sterman say a new video of an American suicide bomber shows how Turkey's militant networks are key to jihadists' movement into Syria and Iraq. Turkey must stem the flow
updated 11:16 AM EDT, Thu August 28, 2014
Whitney Barkley says many for-profit colleges deceive students, charge exorbitant tuitions and make false promises
updated 10:34 AM EDT, Fri August 29, 2014
Mark O'Mara says the time has come to decide whether we really want police empowered to shoot those they believe are 'fleeing felons'
updated 10:32 AM EDT, Thu August 28, 2014
Bill Frelick says a tool of rights workers is 'naming and shaming,' ensuring accountability for human rights crimes in conflicts. But what if wrongdoers know no shame?
updated 10:43 PM EDT, Thu August 28, 2014
Jay Parini says, no, a little girl shouldn't fire an Uzi, but none of should have easy access to guns: The Second Amendment was not written to give us such a 'right,' no matter what the NRA says
updated 1:22 PM EDT, Sat August 30, 2014
Terra Ziporyn Snider says many adolescents suffer chronic sleep deprivation, which can indeed lead to safety problems. Would starting school an hour later be so wrong?
updated 9:30 AM EDT, Fri August 29, 2014
Peggy Drexler says after all the celebrity divorces, it's tempting to ask the question. But there are still considerable benefits to getting hitched
updated 2:49 PM EDT, Fri August 29, 2014
The death of Douglas McAuthur McCain, the first American killed fighting for ISIS, highlights the pull of Syria's war for Western jihadists, writes Peter Bergen.
updated 6:42 PM EDT, Tue August 26, 2014
Former ambassador to Syria Robert Ford says the West should be helping moderates in the Syrian armed opposition end the al-Assad regime and form a government to focus on driving ISIS out
updated 9:21 AM EDT, Wed August 27, 2014
Ruben Navarrette says a great country does not deport thousands of vulnerable, unaccompanied minors who fled in fear for their lives
updated 9:19 AM EDT, Wed August 27, 2014
Robert McIntyre says Congress is the culprit for letting Burger King pay lower taxes after merging with Tim Hortons.
updated 7:35 PM EDT, Tue August 26, 2014
Wesley Clark says the U.S. can offer support to its Islamic friends in the region most threatened by ISIS, but it can't fight their war
updated 7:26 AM EDT, Wed August 27, 2014
Jeff Yang says the tech sector's diversity numbers are embarrassing and the big players need to do more.
updated 4:53 PM EDT, Tue August 26, 2014
America's painful struggle with racism has often brought great satisfaction to the country's rivals, critics, and foes. The killing of Michael Brown and its tumultuous aftermath has been a bonanza.
updated 4:19 PM EDT, Tue August 26, 2014
Ed Bark says in this Emmy year, broadcasters CBS, ABC and PBS can all say they matched or exceeded HBO. These days that's no small feat
updated 3:19 PM EDT, Tue August 26, 2014
Rick Martin says the death of Robin Williams brought back memories of his own battle facing down depression as a young man
updated 11:58 AM EDT, Tue August 26, 2014
David Perry asks: What's the best way for police officers to handle people with psychiatric disabilities?
updated 3:50 PM EDT, Mon August 25, 2014
Julian Zelizer says it's not crazy to think Mitt Romney would be able to end up at the top of the GOP ticket in 2016
updated 4:52 PM EDT, Mon August 25, 2014
Roxanne Jones and her girlfriends would cheer from the sidelines for the boys playing Little League. But they really wanted to play. Now Mo'ne Davis shows the world that girls really can throw.
updated 12:29 PM EDT, Mon August 25, 2014
Peter Bergen and Emily Schneider say a YouTube video apparently posted by ISIS seems to show that the group has a surveillance drone, highlighting a new reality: Terrorist groups have technology once only used by states
updated 5:04 PM EDT, Mon August 25, 2014
Kimberly Norwood is a black mom who lives in an affluent neighborhood not far from Ferguson, but she has the same fears for her children as people in that troubled town do
updated 5:45 PM EDT, Fri August 22, 2014
It apparently has worked for France, say Peter Bergen and Emily Schneider, but carries uncomfortable risks. When it comes to kidnappings, nations face grim options.
updated 1:27 PM EDT, Tue August 26, 2014
John Bare says the Ice Bucket Challenge signals a new kind of activism and peer-to-peer fund-raising.
updated 8:31 AM EDT, Fri August 22, 2014
James Dawes says calling ISIS evil over and over again could very well make it harder to stop them.
updated 9:05 PM EDT, Sat August 23, 2014
As the inquiry into the shooting of Michael Brown continues, critics question the prosecutor's impartiality.
updated 6:47 PM EDT, Fri August 22, 2014
Newt Gingrich says it's troubling that a vicious group like ISIS can recruit so many young men from Britain.
updated 10:50 AM EDT, Thu August 21, 2014
David Weinberger says Twitter and other social networks have been vested with a responsibility, and a trust, they did not ask for.
updated 7:03 AM EDT, Fri August 22, 2014
John Inazu says the slogan "We are Ferguson" is meant to express empathy and solidarity. It's not true: Not all of us live in those circumstances. But we all made them.
updated 8:23 AM EDT, Fri August 22, 2014
Retired Lt. Gen. Mark Hertling says he learned that the territory ISIS wants to control is amazingly complex.
updated 3:51 PM EDT, Wed August 20, 2014
Cerue Garlo says Liberia is desperate for help amid a Ebola outbreak that has touched every aspect of life.
updated 1:42 PM EDT, Thu August 21, 2014
Eric Liu says Republicans who want to restrict voting may win now, but the party will suffer in the long term.
updated 11:38 AM EDT, Thu August 21, 2014
Jay Parini: Jesus, Pope and now researchers agree: Wealth decreases our ability to sympathize with the poor.
updated 8:00 AM EDT, Thu August 21, 2014
Judy Melinek offers a medical examiner's perspective on what happens when police kill people like Michael Brown.
updated 6:03 PM EDT, Tue August 19, 2014
It used to be billy clubs, fire hoses and snarling German shepherds. Now it's armored personnel carriers and flash-bang grenades, writes Kara Dansky.
updated 1:27 PM EDT, Wed August 20, 2014
Maria Haberfeld: People who are unfamiliar with police work can reasonably ask, why was an unarmed man shot so many times, and why was deadly force used at all?
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT