What is "fat acceptance"?

by Dr. S. Russell Vester, MD 14. April 2013 11:29

Sorry about being a couple of days late with this entry. This is my ninth straight day of work without a break. And I don’t get paid extra for nights, weekends or emergencies. But this is not a whining session. I’m not looking for sympathy. I knew these kind of hours were going to part of the game when I got into this line of work. I have accepted this responsibility.


During this last stretch of work, an episode of the Dr. Phil Show came up in conversation in the O.R. It was, I’m told, entitled “The Fat Debate.” The other folks on my team wanted to know what I thought about “fat acceptance.” I don’t know what the show had to say about this because I was working when it aired (and I reserve my TIVO time for car racing). So I asked what “fat acceptance” meant. Did it mean that we should accept being overweight as some variation of normal since it was now so common or did it mean that we needed to accept the fact that it was indeed a real and serious, society-wide healthcare problem?

To this they replied “Well, what do you think?”

I think this question bears serious comment.

I want to be clear about this. Putting on fat from over eating in times when food is plentiful is a survival adaptation given to us by Mother Nature. It was meant to allow us to survive those times when food was scarce or to help insulate us from the cold. Our ability to survive as individuals has greatly improved with the evolution of modern society. Food is readily available and cheap. We can get pretty much whatever we want whenever we want it. The survival benefit of putting on a layer of fat has gone away for us. We as a population have not yet learned to manage this last fact. Hence the 70% or so incidence of our society that is overweight.

There are indeed people for whom being overweight is the unfortunate byproduct of a slow metabolism or some problem with their stomachs not telling their brains when enough food is enough (medically speaking an aberrance of normal satiety). These people are in the minority. For the rest of us, we eat too much and have chosen to ignore this fact for whatever reason that seems most convenient. Asking others to be accepting of our decision to be overweight is fine in my opinion. But don’t ask me if I think that decision is a good one. It’s not. And, by the way, don’t ask me to pay higher premiums for my own health insurance because you made a choice that you want me to believe you are “comfortable with.” Being overweight is a health risk. Period.

Look. This is America. You can do whatever you want (as long as it’s legal). If you choose to be chronically overweight, take responsibility for that decision. And take responsibility for the fact that you will consume more health care resources than those with normal weight. The cost of paying for this decision should be yours as well. If this were to happen, I would be a lot more comfortable with “fat acceptance.”

This would be the beginning of real health care reform.

But don’t get me started

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From the Heart...

Comments (1) -

Jamie Mades
Jamie Mades
4/19/2014 5:13:36 PM #

I don't understand why anyone would choose to be overweight...I work at being cognizant of what I put into my body and feel uncomfortable if I gain a few pounds of fat.  Being seriously overweight has got to be painful.

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