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 12:42 PM EDT, Wed April 16, 2014
Rick McGahey says Rep. Paul Ryan is signaling his presidential ambitions by appealing to hard core Republican values
updated 11:39 AM EDT, Wed April 16, 2014
Paul Saffo says current Google Glasses are doomed to become eBay collectibles, but they are only the leading edge of a surge in wearable tech that will change our lives
updated 2:49 PM EDT, Tue April 15, 2014
Kathleen Blee says the KKK and white power or neo-Nazi groups give haters the purpose and urgency to use violence.
updated 7:56 AM EDT, Wed April 16, 2014
Sen. Sheldon Whitehouse and Rep. Henry Waxman say read deep, and you'll see the federal Keystone pipeline report spells out the pipeline is bad news
updated 7:53 AM EDT, Wed April 16, 2014
Frida Ghitis says President Obama needs to stop making empty threats against Russia and consider other options
updated 5:29 PM EDT, Tue April 15, 2014
Peter Bergen and David Sterman say the Kansas Jewish Center killings are part of a string of lethal violence in the U.S. that outstrips al Qaeda-influenced attacks. Why don't we pay more attention?
updated 12:41 PM EDT, Tue April 15, 2014
Danny Cevallos says families of the passengers on Malaysian Airlines Flight 370 need legal counsel
updated 11:23 AM EDT, Mon April 14, 2014
David Frum says Russia is on a rampage of mischief while Western leaders and Western alliances charged with keeping the peace hem and haw
updated 7:56 AM EDT, Mon April 14, 2014
Most adults make the mistakes of hitting the snooze button and of checking emails first thing in the morning, writes Mel Robbins
updated 1:54 PM EDT, Mon April 14, 2014
David Wheeler says as middle-class careers continue to disappear, we need a monthly cash payment to everyone
updated 7:55 AM EDT, Mon April 14, 2014
Democrats need to show more political spine when it comes to the issue of taxes.
updated 11:55 AM EDT, Mon April 14, 2014
Donna Brazile recalls the 50th Anniversary of the Civil Rights Act as four presidents honored the heroes of the movement and Lyndon Johnson, who signed the law
updated 9:17 AM EDT, Mon April 14, 2014
Elmer Smith remembers Chuck Stone, the legendary journalist from Philadelphia who was known as a thorn in the side of police and an advocate for the little guy
updated 2:56 PM EDT, Sun April 13, 2014
Al Franken says Comcast, the nation's largest cable provider, wants to acquire Time Warner Cable, the nation's second-largest cable provider. Should we be concerned?
updated 11:22 AM EDT, Fri April 11, 2014
Philip Cook and Kristin Goss says the Pennsylvania stabbing attack, which caused grave injury -- but not death, carries a lesson on guns for policymakers
updated 3:06 PM EDT, Fri April 11, 2014
Wikipedia lists 105 football movies, but all too many of them are forgettable, writes Mike Downey
updated 10:32 AM EDT, Fri April 11, 2014
John Sutter and hundreds of iReporters set out to run marathons after the bombings -- and learned a lot about the culture of running
updated 12:49 PM EDT, Fri April 11, 2014
Timothy Stanley says it was cowardly to withdraw the offer of an honorary degree to Ayaan Hirsi Ali. The university should have done its homework on her narrow views and not made the offer
updated 10:16 AM EDT, Fri April 11, 2014
Al Awlaki
Almost three years after his death in a 2011 CIA drone strike in Yemen, Anwar al-Awlaki continues to inspire violent jihadist extremists in the U.S, writes Peter Bergen
updated 9:21 PM EDT, Fri April 11, 2014
David Bianculli says Colbert is a smart, funny interviewer, but ditching his blowhard persona to take over the mainstream late-night role may cost him fans
updated 1:31 PM EDT, Thu April 10, 2014
Rep. Paul Ryan says the Republican budget places its trust in the people, not in Washington
updated 5:28 PM EDT, Thu April 10, 2014
Aaron David Miller says Obama isn't to blame for Kerry's lack of progress in resolving Mideast talks
updated 11:22 AM EDT, Mon April 14, 2014
David Weinberger says beyond focusing on the horrors of the attack a year ago, it's worth remembering the lessons it taught about strength, the dangers of idle speculation and Boston's solidarity
updated 12:32 PM EDT, Thu April 10, 2014
Katherine Newman says the motive for the school stabbing attack in Pennsylvania is not yet known, but research on such rampages turns up similarities in suspects and circumstances
updated 7:03 AM EDT, Fri April 11, 2014
Simon Tisdall: Has John Kerry's recent track record left Russia's wily leader ever more convinced of U.S. weakness?
updated 12:40 PM EDT, Thu April 10, 2014
Mel Robbins says Nate Scimio deserves credit for acting bravely in a frightening attack and shouldn't be criticized for posting a selfie afterward
updated 2:39 PM EDT, Wed April 9, 2014
Wendy Townsend says the Rattlesnake Roundup -- where thousands of pounds of snakes are killed and tormented -- is barbaric
updated 9:45 AM EDT, Thu April 10, 2014
Dr. Mary Mulcahy says doctors who tell their patients the truth risk getting bad ratings from them
updated 9:28 AM EDT, Wed April 9, 2014
Peggy Drexler says the married Rep. McAllister, caught on video making out with a staffer, won't get a pass from voters who elected him as a Christian conservative with family values
updated 7:43 AM EDT, Wed April 9, 2014
David Frum says the president has failed to react strongly to crises in Iran, Syria, Ukraine and Venezuela, encouraging others to act out
updated 4:57 PM EDT, Wed April 9, 2014
Eric Liu says Paul Ryan gets it very wrong: The U.S.'s problem is not a culture of poverty, it is a culture of wealth that is destroying the American value linking work and reward
updated 7:51 AM EDT, Wed April 9, 2014
Frida Ghitis writes: "We are still seeing the world mostly through men's eyes. We are still hearing it explained to us mostly by men."
updated 10:08 AM EDT, Thu April 10, 2014
Chester Wisniewski says the Heartbleed bug shows how we're all tangled together, relying on each other for Internet security
updated 3:26 PM EDT, Wed April 9, 2014
Danny Cevallos says an Ohio school that suspended a little kid for pointing his finger at another kid and pretending to shoot shows the growth in "zero tolerance" policies at school run amok
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT