So, yesterday an endocrinologist told me that I had no sign of a glucose disorder and was at very low risk. Goodo! Then he weighed and measured me, told me I needed to lose a couple of kilos and 4cms of waist circumference (80cms is apparently "desirable" in women; thought back; yes, that was the phrase). I looked extremely skeptical.
Then he pulled out a "kilo of fat", which broadly looks a bit like a fat, urine-coloured sausage. And told me to lose "one or two" of those.
My response was probably not what he expected. I wasn't angry yet, I was just a little bit weirded out by the strange man with his strange fat. After I failed to react in any way other than, "Huh. ...yeah?" he wrapped it back up in its Gladwrap, put it away with some sheepishness, and continued the consultation as though it had never happened.
Further investigation has yielded two friends who have experienced this treatment.
My initial confusion was this: "I'm not sure how I'm expected to respond, man. You just pulled out a kilo of freaking fat and dumped it in your desk. I think this is a step in a social dance for which I am really not prepared."
(When I spoke to my Mum later, I said, "It would be like if I had a liver in my fridge, and if I had guests over, and I pulled out this liver and went, hey guys, this came from a duck, what do you think?" It's a poor metaphor, because the answer is obviously, "I think it's pate.")
(I now wish I had said to the man, "I think it's pate," for added surrealism)
Asking around, apparently, my response is supposed to be shame. The kilo of fat is supposed to shame me into losing weight. My problem with this is twofold. Firstly, I'm not sure how the kilo of fat is supposed to incite shame of any kind. It's an inanimate entity on a desk. In my body, it's a biological entity. It's storing nutrients should I need them. In and of itself, there's actually nothing wrong with fat. Perhaps we should not forget a generation whose grandmothers try to insult them (shame them) by saying, "My dear, don't you look healthy." (Translation: you're fat)
I lack grandmothers in the extant sense; that's an anecdote I've heard from several female friends whose living grandmothers happen to be on the catty side. Another one said to a friend, perfectly pleasantly, "You're quite skinny. Are you unwell?" This friend is on the narrow side in terms of build. The fact that we couldn't work out whether it was (a) a genuine inquiry based on concern, (b) a compliment or (c) an insult suggests we live in a world that is seriously fucked up.
But I digress. I don't think I can be shamed with a kilo of fat any more than I could be shamed with duck pate, or any internal organ from any animal, human included. (I now wish I had asked what animal had produced the fat, presuming it isn't actually plastic) I simply don't link those kinds of emotions to bodily stuff. I'm not saying I'm beyond body image issues; I have them, and have had them, and was miserable about my supposed fatness all the way through primary school and high school. I feltugly, yes; I didn't feel ashamed about being ugly, though, because it wasn't my fault. I felt crappy that I was unattractive. That's it. I had bigger things to occupy my overactive guilt/shame centers. I had other things going on at home, at school, and so on, that meant feeling ashamed of my body was way down the list.
Note: I draw a line between being ashamed and being self-conscious. They are not the same thing, and this brings us to the next point: the idea of being shamed for being fat, whether you are actually fat or not (as though there is some arbitrary line rather than an n-dimensional continuum of body shapes).
I felt horribly self-conscious in high school, yes. I didn't want people to look at me too much, because I felt ugly. However, I didn't feel as though I had done anything wrong.
This is key.
At what point, in shaming people about being fat, do you say, "Gosh, you have done the wrong thing. I want you to feel bad. Feel bad yet? Right, now that you feel bad, go and do something good for your health."
I know for a fact I am not the only person who sees a disconnect here. I know why I've put on a small amount of weight while writing a thesis. It's because I'm not going to gym, or swimming, or diving, and I'm stressed. I'm not actually eating more junk food than usual, or anything like that, but I'm not doing exercise, and I should be. I should be, because it makes me feel good and it makes me feel alert and excited; I should be, because it makes me strong.
Feeling ashamed, feeling bad about yourself, feeling bad about your body, from my experience, do not make you want to go out and do exercise. In my experience, anecdotally, this feeling makes you want to curl up in bed in a depressive lump. Feeling crappy makes you feel tired, not energised. Not motivated. If at some point a doctor felt the genuine need to tell me to get more exercise, all s/he would have to do is explain, in simple form, the health risks associated with my not doing so. If a doctor felt the need to tell me to change my diet, again, all he or she would have to do is list what I needed and for what reasons.
Then I would respond, not according to shame, but according to freaking common sense.
Instead, what do I get? Gosh, your fat is bad.
Now, these arguments apply to this sort of treatment regardless of your size. I am also deeply concerned because, with a dietician doing a quick back-of-the-envelope BMI calculation and saying I am perfectly fine (although should I even use BMI to prove a point? Maybe not), a jeans size of 12 (Just Jeans), and with a waist-hip ratio of (I just worked it out, from sheer bloody mindedness) 0.78* (which is apparently also fine from my swift googling), and now an endocrinologist saying that I have no sign or indication and am at very low risk for a glucose disorder, he still felt the need to say, "Gosh, your fat is bad."
Look, I'm normal. There are two problems here: the first is with anyone being treated this way, and it involves the paradigm shift as we come to realise that supposedly "excess" weight is not the terrible health threat that we've all been hearing about our whole lives. It is a red herring and an exaggeration. Everything we hear about what obesity costs taxpayers is complete freaking bollocks.
The second problem is that, even for a doctor who does believe that being above a certain weight counts as a significant health risk, he classed a person of my size as having that risk. Nowhere can I find any evidence to support his claims. Mind you, Googling is obviously not on a par with the ridiculous amount of education required to become a specialist in a medical field, but if he's working from a standard, however arbitrary, shouldn't that standard be available somewhere? Just how small do you have to be?
And my next question is, what do they do to underweight people? I have several friends who have had doctors constantly telling them they need to put on weight, that they are too small, that their low BMI is "undesirable" - what's the tactic for them? Do they get shown the kilo of fat and told that, it's not gross, it's awesome, and you need more of it? That's no better, but it does break the logic of assuming that fat is always bad.
I'm still angry.
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EDIT: realised that being measured around the tummy is not your waist, so I remeasured it myself. WtH ratio is now 0.73...
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