Fat, Guest Bloggers, Health at Every Size

Guest Blogger Vesta44: WLS/Dieting and Fat Acceptance

Over at Rachel’s place, another commenter asked me if I’d ever considered giving space to someone who’d had a negative experience with WLS, as a counterpoint to Heidi’s controversial guest post. It was a timely question, because I’d just read Mariellen/Vesta44’s account of her failed Vertical Banded Gastroplasty (VBG) on her blog, Big Fat Delicious. As soon as I saw it, I knew it was at least getting a big, fat link over here — and it would be even better if Mariellen would give me permission to repost it here. Turns out she was kind enough to do that, so you’ll find it below, as well as on her blog.

One thing Mariellen’s story highlights is the lack of viable options for fat people who are in serious pain and having trouble functioning normally — something that can get lost in our discussions of whether we can ever, under any circumstances, get behind someone having WLS. In Mariellen’s case, she has absolutely, 100%, ruled out ever having WLS again — yet she’s suffering from many of the same problems as Heidi, and doctors continue to recommend WLS, even when she tells them she won’t do it because she already did it, and the consequences were terrible.

When you’re in pain and you cannot get a doctor to address anything other than your weight, what do you do? And what do we, as fat acceptance activists, do when some fat people, suffering and desperate for relief, are browbeaten into believing that nothing other than surgery can help them? What do we healthy fat people think we’d do, if we had to walk in their shoes?

Thanks very much, Mariellen, for sharing your story with us. It’s a really important one. –Kate

I have read various things at various times on FA blogs where some think that anyone who has had/is having/is contemplating WLS does not belong in the FA movement. If that is so, then I don’t belong here either. I say that because 10 years ago, I had a VBG, which I have said before, and posted in comments on other blogs. Yes, it failed, and yes, I’m still alive and still fat, and still healthy, just like I was before the surgery. Do I have complications from it? I don’t know, mainly because I can’t afford to see a doctor to have the problems I’m having diagnosed for causes.

Now, 10 years ago, I was in a totally different headspace than I am now. Back then, I didn’t know that fat acceptance even existed, let alone what it could mean for a fat woman like me. I had minor mobility problems (yeah, they were minor compared to what I’m going through now). I couldn’t walk for more than a couple of blocks without my back cramping up and causing pain. I was still able to sweep and mop floors without having to take a break halfway through, I could vacuum the whole living room without having to stop, and I could do a sink full of dishes without having to sit and take a break till my back quit hurting. I didn’t have to use the motorized cart at Wal-Mart to do my shopping. I didn’t have any problems getting in and out of the shower, or even being able to stand long enough to take a shower. All of those things are more difficult for me now, after the WLS failed and I gained an additional 40 lbs.

Why did my nurse practitioner recommend the WLS? Not because I was diabetic, or had high cholesterol, or high blood pressure. I didn’t have any of those, and still don’t. She recommended it because I have arthritis in my right knee, and it’s getting worse all the time (degenerative joint disease, and it runs in our family). I did a lot of roller skating when I was a teen and young adult, and every time I fell, I landed on that knee. Did that start the arthritis early? Could be, since I was diagnosed with it at the age of 33 after a particularly nasty fall and had to have fluid drained off the knee. She said that there was no way an orthopedic surgeon would even think of replacing my knee at my then-weight of 350 lbs.

So I took her advice, since I couldn’t take the phen-fen anymore (yeah, she had prescribed that too, and it worked, till it was taken off the market). I went through with the WLS, and I can say now, looking back, that it was the worst mistake I ever made. Yeah, I lost 70 lbs in the first few months, but when I followed the surgeon’s recommendations to start adding regular food back to my diet and stop relying on the mashed/pureed food, it all went to hell. I couldn’t keep anything down, no matter how well I chewed it or how small I cut it up. My stapling came undone, and I started gaining the weight back. But it didn’t stop there, I not only gained back the 70 lbs I had lost, I gained an additional 40 lbs. I also gained a side effect that no one told me anything about, and it’s one of the reasons I don’t eat fast food very often anymore. Lovely side effect, it is. If I eat at McDonald’s, or Hardee’s, or Burger King (or anywhere even remotely like that), I had better be near a bathroom within an hour of eating, or I will need to take a shower and change clothes (I really don’t want to get more graphic than that, it’s totally embarrassing for me to say that much).

I didn’t want to lose a lot of weight, all I wanted was to go from my then-weight of 350 down to 250, maybe 225. I would still have been fat, but fuck, at least maybe I wouldn’t have had so much trouble walking and standing. Now, damn it all, I just wish I was back at that 350 lb mark. At least then I could do a hell of a lot more than I can now. Now, I’m lucky if I can walk half a block before I’m in severe pain. I have to sit down in the middle of vacuuming, sweeping, and doing the dishes. I have to use a motorized cart at Wal-Mart when I shop because there is no way I can walk all the way through the store without severe back pain. And I totally relate to Heidi when she says she can’t even wipe her own ass and how that makes her feel (I’m not there yet, but if I gain any more weight, I could be). I can’t sleep flat on my back in bed because my back cramps and it hurts to move. I can’t keep my right leg straight in bed because then it doesn’t want to bend without pain. I had these problems before the WLS, but they’ve gotten worse since. My nurse practitioner back then didn’t want to see if anything else was causing the problems, she was just positive it was my weight, and I was fool enough to believe her. Yeah, when I lost the weight, before I gained it back, I felt better and could move more easily (after I healed), but that short period of time where I felt better and could do more was so not worth what I’m dealing with now.

When I applied for SSDI and had to go see their doctor, he said “Yeah, you’re disabled all right. Have you ever thought about WLS?” Told him been there done that, no way is it happening again, it doesn’t work, and I’m proof. He said I should try the RNY (a friend of mine in New York City had it done last year, he went from 325 to 265 and he’s currently at 290). Yeah, right, I am so not going there. No more WLS for me. I have enough problems from the last one, why the hell would I want to give them another chance to fuck me up even more? But that is my personal decision, based on what has happened to me.

I am not going to pass judgment on people who are considering WLS/WLD because I haven’t walked in their shoes. I don’t know how bad their lives are, nor do I have any idea what they have to cope with. If I were to be asked if I thought it was a good idea, I would have to say no, just from my own experience. I know diets don’t work in the long run, been there done that too many times. I know WLS didn’t work for me, and it killed my best friend, so I don’t have a lot of faith in it either. However, for some people, this may seem like their only chance to improve their life and they may be willing to deal with all the possible complications and the possibility that they may even die. If their lives are so bad that risking death via WLS seems like a viable option, who am I to tell them no?

Banning people from the FA movement because they are desperate for an improved life is not kind or compassionate. I can understand that it’s hard to see how someone who is having WLS could say that they love their body when they are willing to mutilate it. But it’s damned hard to love a body that doesn’t let you move, that you can’t take proper care of, and that causes you pain every hour of every day. Those people can bring a needed perspective to this movement, just by telling us what is happening with them and how they got to the point that WLS seemed to be their only option. Why wasn’t something done earlier, before a person got to the point that WLS seemed to be the only way out? What illnesses/diseases weren’t diagnosed because all a doctor saw was the fat and refused to look further? What can we do to stop this insanity and get people to realize that fat is not the enemy, it’s the blindness and bigotry that says everyone must be thin to be worthwhile?

I know this is not going to be popular with some, but it’s the way I feel. I’m working hard to love the body I have, but I can tell you, there are days when I go “Body, I don’t like you much today, you hurt and I can’t do what I want/need to do, and I’m so tired of this shit.” I also have days that are pretty good and I like my body and what I can do, and I’m looking forward to more of them as I get in better shape. But it’s not an easy road, and I’ve made a lot of wrong turns and detours on the way. I’ll get there, eventually. But shutting me out, and people like me, because we’ve made those wrong turns, doesn’t advance anything.

97 thoughts on “Guest Blogger Vesta44: WLS/Dieting and Fat Acceptance”

  1. Maybe the best way to consider WLS in the context of FA is as something like leg amputation – a last resort.

    If you went to a surgeon with a severely messed up ACL and he recommended amputation, you would think he was an idiot. But that’s not an automatic condemnation of amputation – in some cases, there’s just no other alternative. If you’ve got gangrene all over and it’s either amputate or die, hey, I’ve got 0% problems with amputation.

    I sympathize completely with Heidi – she’s at a point where the gamble is worth it for her. But that always has to made at an individual level. Being universally anti-WLS is about as retarded as being universally anti-amputation.

  2. You know, it’s discussions like this that should really make people THINK. I know it’s made ME think.

    My cousin had WLS in… 2000 (? something like that). She did it because she was convinced by her doctors that it was the only thing left to do to save herself. She was born with a heart condition that had always been potentially life-threatening. So she had the surgery, and she seemed to be doing well. She had definitely slimmed down the last time I saw her.

    Then, in late 2003, not that long after I moved halfway across the planet, she died. From a heart attack. To be honest, I’d always wondered if it was the surgery itself that caused the heart attack. But hearing all these stories about how doctors won’t even consider treating the REAL problem until the patient either A) goes on a DIEt or B) has WLS has really made me think. Maybe Celia would still be around today if her doctor had been able to see past her fat?

    I have to be honest and say that for a long time, I said to myself that if I had the money I’d have WLS. But recently I’ve started learning more and thinking more and realizing that having surgery like that – FOR ME – would be pointless. Even if I came through it unscathed and it “worked,” it wouldn’t solve the real problem: the fact that I can’t accept myself for who and what I am.

    Which is a FAR cry from where Heidi and people like her are at. Like MikeyT said, she’s at the point where it’s do-or-die for her. And I have to say, if I were faced with her choices, I wouldn’t hesitate to say “yes, I’ll have the surgery.”

    Maybe I’m not “educated” enough to even comment… but I read somewhere (I think it was The Rotund, but I can’t be sure – I’ve read an AWFUL lot the last couple of days): you can support the PERSON even if you don’t support their DECISION. It’s called unconditional love. And I, for one, think there’s far too little of that in the world. We should try to practice it as much as humanly possible.

    (Okay, y’all can tell me to shut up now.)

  3. MikeyT, your comment is astute, but your use of the word “retarded” is not.

    Attention Shapeling/Prosies/what have you: please don’t use “retarded” as an insult. If you do, I will call you out on it every single time. Thanks.

  4. Thank you, Mariellen, for telling us about your experience.

    One thing which your post, and others I’ve read recently about the WLS debate, allllllmost touches on is something that’s also come up within the past few months – the idea that some of us feel as though we may be “too fat” for the movement.

    I know Kate, Fillyjonk, Sweet Machine and others have made it plain that they don’t believe there is such a thing as being “too fat” for the movement, and I believe them. I agree, as well, that there should be no such thing. Even if one does not count among the “fat and fit” (and heaven knows I don’t), they are still deserving of human dignity and compassion, they still have the same right to proper health care and a base-line quality of life as all the rest of us.

    But while WLS is something that might occasionally be suggested to someone who is 250 pounds by scalpel-happy doctors and other health professionals, for people who are extremely obese, it is less a suggestion and more a compunction. “Oh, you’re 400 pounds? Well, you need WLS.” And as Mariellen mentions, there are doctors out there who will withhold treatment until a patient complies with their demands.

    Fat Acceptance, as a movement, cannot possibly profess to truly serve all fat people if we decide that those who suffer the most from hatred and prejudice in our fat-hating culture are only deserving of our support and compassion so long as they manage to not fall victim to that hatred.

    Even the staunchest among us, the most passionate of activists, occasionally falls into exhaustion and despair. We all must take breaks from time to time, from the constant battle for rights and respect for fat people. Not all of us have that strength. We try, we believe, but some of us are not as strong as others. Some of us face struggles that others cannot possibly comprehend.

    We must support each other, and have compassion for each other, even when we weaken. Even when we falter. Otherwise we are not the movement we claim to be.

  5. Whoo. Pardon me. That got windy, eh?

    Well, it’s the last you’ll get from me today – I’ve got nephews inbound, ETA 30 minutes! Yay me! :D

  6. No, Mikey. Fat Acceptance doesn’t have to embrace and affirm the amputation of digestive systems as a “last resort”. Very fat people do have unique challenges, but that doesn’t mean we should say, “Okay, no fat acceptance for you. Don’t bother trying.” That’s not acceptable. I oppose weight loss not because I want to withhold it from people who want it. I oppose it because I know its not an answer. I know that for the overwhelming majority, it will not do what they want it to. There is not a point where I can cheer it on. Weight loss hasn’t been an answer and wanting it really badly isn’t going to make it more of one. Weight loss isn’t fat acceptance and no amount of shaming people will make it fat acceptance. The problem is not fat acceptance being intolerant of dieters. The problem is dieters being intolerant of fat acceptance. Dieters being unwilling to allow others to feel differently. Dieters demanding that we affirm their justifications for wanting to lose weight. We can’t do that. We just can’t.

    I get why people want to lose weight. EVERYONE in fat acceptance gets that. It doesn’t mean we have to agree with that decision. Its our right and something we must stand behind. No one is obligated to agree and attacking people who disagree is profoundly counterproductive and stupid. But we should never feel obilgated to agree with weight loss. We have a right to our own beliefs.

  7. What really intrigues me is why we don’t get people help before they get so big that it is a “do or die” situation…..why do doctors look and just see a “fat woman who needs to lose weight.”

    Luckily for me I was my own advocate and found my problems…1) my insulin levels (not glucose) were off the charts and so I’m insulin resistant..solution…eat less simple carbs and sugars…and 2) I emotionally eat because I was unsatisfied with myself as a whole. Learning to accept myself as a person has actually helped me LOSE weight and become healthier.

    While I wouldn’t say I’m completely gung ho on the FA movement ( I know too little about it) I think it’s sad that people judge others based on decisions…my feelings are that people’s bodies are their OWN business and what they do to them, the decisions they make are their own business. Good for Heidi for making the decision that fit best for her….everyone is different and it sounds like the above poster was pushed into WLS when it wasn’t what was best.

  8. I read this in its original post, and it made me cry.

    Agree or disagree, as far as I can tell (and yes, I’m a n00b in this arena), this movement, like many other social movements before it, is partly about embracing the differences we have with each other.

    For the Black movement, you had two different styles of leadership: MLK, Jr, and Malcolm X. Both still worked for Black rights. For the feminist movement, there have been so many branches that believe this or that part of the “general creed” is wrong, but who are still feminists.

    I guess my point is, that I totally support you and everybody else in the FA movement, even if I disagree sometimes with what some people have to say. Its their right to say it, and my right to dis/agree.

  9. Fat Acceptance, as a movement, cannot possibly profess to truly serve all fat people if we decide that those who suffer the most from hatred and prejudice in our fat-hating culture are only deserving of our support and compassion so long as they manage to not fall victim to that hatred.

    Very well put Thorn.

    Mariellen brings up a good point. She (like my best friend Lisa) didn’t have WLS with realistic hopes of fitting into a size 6. In many cases, people who have WLS do not and will not become thin. They just become a less fat, fat person, who is still subject to the same marginalization by the anti-obesity hysterics. Rejecting them entirely from what should be an inclusive fat acceptance movement simply renders them movement-less.

    This is not to say that the movement should embrace WLS – far from it. We need to continue to provide a voice of reason about WLS and vocalize the not-so-publicized health risks and dangers, especially as WLS is increasingly promoted as a faster and easier alternative to dieting.

    But we also need to be cautious not to fall into the same myopic mindset seen in our fat-hating opponents. The anti-obesity hysteria is all about regulating and controlling the bodies of others. My friend Lisa doesn’t care about being thin. She has a loving husband, beautiful children, and a professional career and is very self-secure and confident. What she does care about is her health, and believed WLS to be the best medical decision she could make. Who am I to come along and criticize her decision to have the procedure? Would we be as quick to criticize one who has had heart surgery, or chooses to undergo chemotherapy?

    The way I see it, it’s like the Christian tenet to hate the sin, but love the sinner.

  10. Bstu, even by wildly pessimistic standards, the mortality rate for WLS is under 7% and the “success” rate is over 40%. There is no way you could possibly argue that for an “overwhelming” majority it doesn’t work.

    It’s risky, can have huge side effects, and can leave you in pain the rest of your life. No argument there. That’s why I say it must be a last resort. My problem is that surgeons are pushing it as a first choice. By forcing everyone in FA to be either anti-WLS or not, a lot of gray area is being ignored. I think Kate is 100% right in saying that in certain cases, you just can’t argue against it. Heidi’s is one of them. I know that if I ever got to a point where I couldn’t wipe my ass and had to spend a portion of my day sitting in my own shit, I would take those odds over having to live like that. I think Heidi is smart, disciplined, and making a well-reasoned choice after doing the research. It’s not my place to decide if it’s too risky for her or not.

  11. By forcing everyone in FA to be either anti-WLS or not, a lot of gray area is being ignored. I think Kate is 100% right in saying that in certain cases, you just can’t argue against it.

    I can’t say I quite agree with this. I am 100% anti-WLS — I think it’s medically and socially irresponsible. But I also think that being pro-choice doesn’t just apply to abortions. I don’t get to make other people’s decisions for them on things that affect their bodies alone. And I don’t get to condemn them because I disagree with their choices. I heartily disagree with cosmetic surgery as well, but I don’t believe people who get it should be excluded from the feminist movement, for instance. Shit, we still have to live in this world. Getting WLS because you’re in constant pain and still supporting the FA movement? Maybe there’s some hypocrisy there — having a conviction and still doing something out of line with it because it’s the only way to get by. But if it’s hypocrisy, it’s a kind I understand and don’t condemn. Unlike the hypocrisy of speaking on behalf of a movement to wish shame and harm on someone, after castigating others for speaking on behalf of a movement to wish them well.

    Failure to recognize fat people as individual people, with personal responsibility and personal autonomy — we can get that anywhere. Within the movement, I want to see compassion for people’s struggles — even if that struggle means finding a way to lose enough weight to be taken seriously as a patient, or to alleviate pain while you figure out what else is wrong.

    As Kate said, that’s the FA that I want to be involved in. If others want to have a kind that recognizes no shades of grey, all right, go ahead. They can take the people for whom the struggle is easy and clear. I’m happy to stand behind the ones who think it’s difficult and complicated, full of decisions that have to be made on your own, without reliance on dogma.

  12. Hi sweetmachine
    I was just thinking that Mikey’s use of the word “retarded” could well have been in the context of saying that universally supporting WLS is as backward/impeded as supporting universal amputation. At first I thought he was using it in the non politically correct manner too but then I thought about what the word retarded can me (other than being an inappropriate term for the handicapped or disabled) and I figured there was the possibility that Mikey meant it in the sense of meaning the action was backward rather than using it as a comparison to someone handicapped.

  13. Yeah, what Fillyjonk said.

    I have a question for those who are anti-WLI for any reason: does being in the FAM mean one has to accept the state of one’s body no matter how much in pain or physical distress they might be in?

    I’m curious, because that certainly seemed to be Kell’s position. Others seem to be a little more accomodating to the individual.

  14. Fine, Mikey. Name the 7% of people here you think would be better off dead. Whose lives don’t deserve to continue? Explain to me why I’m sometimes to cheerlead for something that kills people who would otherwise be alive? That’s not fat acceptance. The success rates from WLS aren’t fully known, especially on a long term. We do know that everyone will gain back weight. We know that it always stops working, and we know that a lot of people will end up dead when it does. We shouldn’t blame individuals who feel this is an answer, but there will be no day when I will allow myself to bullied into affirming that this tragedy is an answer.

    Do you know when amputating a leg is the last resort? When something is WRONG with the leg. Amputating a healthy leg isn’t the last resort for anything. Amputating a healthy digestive system isn’t either. I don’t blame people for thinking this is an answer. I live in this culture, too, and I see its effect and the promises it makes if we just lose weight. I’m saddened that people think weight loss is an answer, but THEY are why I fight for fat acceptance. Because I want better for them and for myself. The culture is flawed, unjustified, and it needs to change. We can’t go on accepting fat hatred just because fat hatred insists that we are obligated to accept it.

  15. I was just thinking that Mikey’s use of the word “retarded” could well have been in the context of saying that universally supporting WLS is as backward/impeded as supporting universal amputation.

    FWIW, I used to be sad about the loss of the word “retarded” for this reason — because it had a literal meaning that was useful. Then I realized that I was being an idiot, for several reasons:
    a) Please, like I don’t know what basically EVERYONE means (though often unconsciously) when they say “retarded”? It’s not “impeded.” And it is offensive.
    b) We already have words like “backwards” that lack that kind of connotation. English is a stunted language in many ways (see, there’s another one), but this particular way is not one of them. We’ve got a number of synonyms on this one, many with rich layers of meaning that aren’t awful. The time has long passed when we could use “retarded” to mean “slowed down,” in reference to a person or idea, and be anything but disingenuous.

    I know you’re trying to mitigate Mikey’s offense because he was talking sense. But nobody’s calling Mikey a jerk or an ablist or a bigot — just asking him to talk sense with different terminology. Honestly, most people when they’re called on this one go “oh shit, I wasn’t even thinking, sorry about that” and then stop saying it. I think that’s the correct response.

  16. BStu, thank for you speaking out here. I agree with what
    you say, and its nice to see you “speak” again.

    To those of you who think “the movement” needs to
    embrace those who have WLS for having WLS…
    People have the right do to as they please with their own
    bodies, but I shouldn’t be expected to be a cheerleader for

    I wish all people well with what ever choices
    they make for themselves, but I will never tell someone I
    support their decision to have WLS.

    I think WLS is on a similar scale as giving frontal lobotomies
    to “cure” mental illness.

    “People” are uncomfortable with the way fat people “look”,
    they could give a shit about our health. They want us
    to conform at any cost, even if that cost is our life.

    “People” want us to affirm their twisted reality in that
    “everyone” can be thin and fit if they just try hard enough.

    I easily weigh 400 pounds, I am 5’2 and I’m 48 years old.
    Don’t try to tell me that if life was harder for me I would
    consider WLS as the “last hope”. I for one would rather
    die of natural causes, fat and living life as I please than
    dead on a table because “people” don’t approve of the way
    I look.

    I am sorry that society is so fucked up that some people
    think of WLS as their only hope, but I think fighting the
    fucked up society is the only way to help any of us.

  17. I think fighting the fucked up society is the only way to help any of us.

    Nobody has yet convinced me that we need to blame, shame, condemn, and wish harm on people in difficult situations while we do this. Nobody has yet convinced me that activism must be cold and hateful to be effective.

  18. [i]”I have a question for those who are anti-WLS for any reason: does being in the FAM mean one has to accept the state of one’s body no matter how much in pain or physical distress they might be in?”[/i]

    No. But it means not falling prey to the notion that it’s FAT FAT FAT that is causing all of your problems, and if you just get rid of the FAT FAT FAT then your pain, your heart problems, etc. will go away. Instead of actually addressing those problems. This is the FAT acceptance movement, after all.

    However, as Vesta’s story illustrates (and my own mother’s story), it’s not really the people who have WLS who are the problem. It’s the doctors, it’s the establishment that won’t treat them! And [b]them=us[/b].

    I believe it is extremely counterproductive to attack the people who have or consider WLS. When we do that, we put ourselves in the same camp as the doctors and the bigots, I really believe that. The last thing any fat person (or any victim of bigotry) needs is more ostracism, more attacking their choices, more denial of personhood.

    I also appreciate Heidi and Mariellen for coming forward with their reasons. Too many of us might think it’s about the Fat, and the people having WLS are doing it for vanity reasons (and even those who do it for that reason are just as much victim to society’s messages as those who diet). When your body is falling apart, and those “in the know” are telling you it’s your FAT and forget the real causes, and they won’t even give you the time of day if you won’t have the surgery, and every day you are hurting and miserable, well, I can’t imagine the torment. I really can’t. But it makes me want to go after the establishment that treats people this way.

  19. “Nobody has yet convinced me that we need to blame, shame, condemn, and wish harm on people in difficult situations while we do this. Nobody has yet convinced me that activism must be cold and hateful to be effective.”

    I’ll thank you to point out where Cynth or I said anything like that. I think that IS precisely what was wrong with Kell’s remarks. She made this about a person and not about the culture that led that person into that decision. Its not productive. But I don’t need to agree that WLS is fun and super-fantastic to think Kell’s tactics were wrong. Its uncalled of to suggest that opposing WLS is about shaming, condemning, or wishing harm on anyway. What Kell did was wrong, but that doesn’t mean anyone should be bullied into affirming WLS and that’s now what is happening. Not of us should betray our beliefs simply because some who disagrees with us wants us too. Just because some people choose to have WLS, isn’t a reason to silence opposition to it. Its why we need to speak out. I’m sorry Kell didn’t see that here. I’m sorry she didn’t see that people who feel weight loss is the answer aren’t the “enemy” but rather the reason we need to fight for fat acceptance. We need to look past the people who want to lose weight, and towards the people and institutions who advocate weight loss. This is too big for a choice to lose weight to be seen as strictly political and that’s where I disagree with Kell. But that should mean I have to affirm that choice, either. That doesn’t mean we should set up fences around the unacceptably fat. It doesn’t mean we have to accept weight loss as an answer, much less THE answer.

  20. The hardest part of all of this, for me, is that so many are not able to separate the CHOICE a person makes from the PERSON making that choice. Just because I don’t support WLS doesn’t mean I can’t support Heidi. I wish like hell that she hadn’t been pushed to the point where WLS was her only option. But that doesn’t mean I will not hope that things turn out all right for her. No, she is not going to get thin, but maybe, just maybe, she will lose enough weight that doctors will look past the fat that is left and see a person who did her damnedest to get rid of her pain and inability to care for herself, and then look beyond her fat to find the REAL cause of her problems and not blame it on TEH FATZ.
    But from my own experience, I don’t see that happening either, not without a hell of a lot of fucking hard work on the part of those of us in the fat acceptance movement. And I’m not so sure I’ll see it happen in my lifetime, even if I live to be 100.

  21. What Kell did was wrong, but that doesn’t mean anyone should be bullied into affirming WLS and that’s now what is happening.

    I’ll thank you to point out where anyone said that. Seems to me that the dust-up was about some vicious, hateful things said about a real person simply because she made a choice someone didn’t agree with. I and others are choosing to draw a distinction between a choice we don’t support and the people who make that choice. Kell couldn’t make that distinction. It turns out she is willing to sincerely wish for someone to experience shame and suffering if it means they come around to her way of thinking.

    Me, I’m not asking Kell to affirm anything that neither of us supports. But I would ask everybody to show a little fucking human compassion. I don’t get to demand it, because I don’t speak for the movement any more than Kell does. But that’s what I’d like to see happening. Like I said, we can get treated like non-people anywhere.

  22. Wow, these are very interesting posts.

    i think heidi is so fucking brave to write what she wrote. and i also think mariellens post is very illuminating.

    that comparison to amputation, by the way, makes sense to me. perhaps stories like heidis can actually be used to illuminate the difference between when it makes sense to resort to something so very extreme, and when someone is just being forced into it for no good reason except some arbitrary weight standard. (to me it is clear that heidi is making the best choice for herself.)

    also, in a broader sense – one wonders if in a world with less fat-hysteria, science would’ve found better solutions to improve the health of people in heidi’s situation.
    not to mention the various practical difficulties that could be solved, i’m sure, with very simple tricks if these were problems that we all could feel free to discuss… i’m sure MANY people run into the same issues caring for themselves.

    what, the human race can’t invent a bathing system for someone who can’t stand or has limited flexibility? surely, someone somewhere has, but i doubt a fat person with these problems can feel comfortable asking about this at the doctors office.

    in fact, i’m sure none of those problems would be considered shameful if they weren’t seen as a result of a fat person’s gluttony or something. think about it – if someone were in an accident or something and as a result had difficulty caring for themselves, would it be as shameful?
    so i’m not claiming open communication and a fat-shame free culture could fix severe physical problems and horrible pain, but it’d certainly save people from feelings of shame over such difficulties caring for themselves and offer them practical solutions.

    but while that is an interesting theoretical question, in our current reality heidi and mariellen are clearly making the best choices for themselves given the available options. best of luck to both of them!!

    as for people trying to kick other people out of a movement that has “acceptance” right in the name, well… i don’t know much about this movement but that just sounds silly to me. it’s right there in the NAME for godssake!

  23. ah when i said “theoretical question” i meant the question of whether medical science could find better solutions than WLS… since this is all people have in some cases, i can understand it…

    tho like a lot of commenters, i agree that its done way too often and suggested as if it were an aspirin. like suggesting someone amputate a leg because they have a hangnail… and they probably came to the doctor for a sore throat in the first place. maybe if they lose the leg the doc will finally look at their throat?

  24. You know, the amputation analogy reminds me of when I was a child, and I’d complain of a minor pain in, say, my thumb, my mom/dad would grab it and say, “Well, then, we’ll just have to hack it off!” Of course they were joking, and would let go afterwards, but the impression of terror I got once or twice from that joke has stuck with me.

    I am anti-WLS, for just about all of the reasons stated above: its cosmetic a good deal of the time, doctors won’t look at a patient otherwise, there is a significantly higher mortality rate for it than other similarly invasive, and more complex surgeries, etc.

    However, when a person is being tortured, literally TORTURED every day by their own body, as in Heidi’s or Mariellen’s cases, well, I don’t know what else to say. I agree with Mariellen for REFUSING to submit to something that left her scarred and disabled once already. However, I must support Heidi in choosing to undergo that very same thing, in an effort to be able to find what else is wrong. And there is very obviously something wrong with Heidi’s body. It is not healthy, and she has no quality of life to speak of.

    Actually, this rather connects in my mind, as well, to people who are in “vegetative” states. They have no quality of life, and their bodies are only healthy because of vast steps taken to make sure they don’t die.

    Except, the difference is, those people don’t really have a choice about the matter (if they haven’t written a living will). Heidi had a choice, and she made a decision. I can not find any fault with her over that decision. Mariellen had and has the same choice, and is making a different decision. I also support that.

    I guess the point I’m getting at is, if fatties are fighting for other people to leave our bodies and all decisions about subesequent care to ourselves, why can’t we (and I use the term “we” very loosely) let Heidi make her decision without deriding her for it?

    I also have a question: if FAM accomplished its goals tomorrow, would that include something to the effect of outlawing WLS? Even in a case like Heidi’s? Why?

  25. when I was a child, and I’d complain of a minor pain in, say, my thumb, my mom/dad would grab it and say, “Well, then, we’ll just have to hack it off!” Of course they were joking, and would let go afterwards, but the impression of terror I got once or twice from that joke has stuck with me.

    I had to laugh at that… because the Hub and I do the EXACT same thing to our kids!!! *lol*

    You pose a good question, however:
    if FAM accomplished its goals tomorrow, would that include something to the effect of outlawing WLS? Even in a case like Heidi’s? Why?

    I (especially considering I’m such a n00b) don’t have an answer for that. But it definitely bears thinking about. Food for thought, so to speak.

  26. I also have a question: if FAM accomplished its goals tomorrow, would that include something to the effect of outlawing WLS? Even in a case like Heidi’s? Why?

    IMNSHO? Absolutely WLS would be outlawed.

    Okay, first and foremost – not so much that WLS would be outlawed, but rather the FDA and the AMA (American Medical Association) would condemn its use and take it off the lists of “recognized treatments” for health problems in fat patients. In short order health insurance agencies would stop paying for it, and it would be all but eradicated without anyone having to pass any laws specifically stating it is not allowed to be used.

    That said – the amputation analogy, as Brian pointed out, is seriously flawed.

    We amputate limbs which have become diseased and amputations are ONLY performed when leaving the limb where it is would endanger the rest of the body.

    When it comes to the human body, healthy tissue is healthy tissue. Removing healthy tissue from a diseased body in general does not make the disease go away. I mean, if you think about it, WLS is not much more than bloodletting run seriously amok.

    If someone is expected to turn to surgery to cure whatever problem they are having, then it damn well cure the PROBLEM, y’know? And if the surgery they’re undergoing is very risky, and even once the surgery is over there’s a strong chance the surgery will not do what it’s intended to do? That person had damn well better be DYING.

    Don’t get me wrong, here – I freely admit Heidi’s way of life pre-surgery was hell. I thank my lucky stars that I have not suffered as Heidi has suffered.

    But Heidi’s way of life post-surgery may turn out to be just as hellish, and it’s foolish of us to simply assume our love and support of Heidi can protect her from that potentiality.

    When treating any other kind of disease, surgeries as risky as WLS, with as low success rates as WLS, are generally reserved for times when there is no other choice. When things have literally come down to, “We do the surgery or the patient will very soon be dead,” that’s when risky, uncertain surgeries are done.

    As hellish as Heidi’s life had become, she was not dying. And while I feel more than a little monstrous saying this, would we all be as supportive of her choice had her surgery not gone well?

    Sandy Szwarc reported just the other day that roughly one out of every 15 WLS patients are dead four years after the surgery, and by eight years post-surgery ONE IN SIX is dead.

    Heidi is 28 years old. I’d certainly like to see her reach her 32nd birthday. Before her surgery? She had a darn good chance. Now? Her chances just got a lot worse.

    And why? Because she had cancer? Or a massive stroke or was in a terrible car accident or fell victim to some other catastrophic event? No. Because she’s fat.

    Because too many doctors think obesity is a disease unto itself, and would prefer to cure The Dreaded Fatness! than figure out what’s really wrong with a brave, vibrant, funny, amazing 28-year-old woman.

    Don’t get me wrong. I don’t judge Heidi for her choice in the slightest. In her place, living in pain every minute of every day? I’d take whatever hand was held out to me, even if I knew it to be the hand of my enemy.

    I don’t judge Heidi a bit. I reserve my judgment for those who swore to First. Do. No. Harm. and then decided they’d rather amputate part of a young woman’s stomach than figure out what the hell is really wrong with her.

    So yeah, if FAM took over the world? People would only get parts of their stomachs amputated if, y’know, there was something wrong with their stomach.

  27. All I can think about are the feminist wars over “selling out” to the patriarchy. We can’t all be lesbian separatists. Just as most of us are not willing to draw that hard line as Kell did.

    Mariellen, thank you for sharing your story. It was deeply affecting. I’ll be thinking about the questions at the end of your post for a long time.

  28. also, in a broader sense – one wonders if in a world with less fat-hysteria, science would’ve found better solutions to improve the health of people in heidi’s situation.
    not to mention the various practical difficulties that could be solved, i’m sure, with very simple tricks if these were problems that we all could feel free to discuss

    I think this is such an important point. Yes, absolutely, in a less hysterical world there would be better solutions. I’m convinced, from what I know of Heidi, that there is something going on medically with her — mind you all I know of her is from the internet and I’m not a doctor, but I feel like there’s an underlying cause to her pain that isn’t her fat. Is she ever going to be able to get that treated at her weight? Almost certainly not; those of us who are much smaller have still had the experience of having our every symptom attributed to fat. In an ideal world, someone would be able to take her pain away in a less hamfisted manner than “oh, better make you smaller so you’ve got less to lug around with your malfunctioning body.” But while we’re trying to create that ideal world, we still have to live and stay alive in the real one. Sometimes that involves making choices, for pragmatic rather than idealistic reasons, that wouldn’t even be on the table in Fat Utopia.

  29. Thorn, rock on.


    As hellish as Heidi’s life had become, she was not dying. And while I feel more than a little monstrous saying this, would we all be as supportive of her choice had her surgery not gone well?

    I would be just as supportive of her choice, though I would also be devastated. As you point out and Mariellen’s story illustrates all too clearly, we have no idea if the surgery will turn out to be a good thing for Heidi down the line — though we’re all thrilled that right now, she’s recovering well. The stakes are still as high as they can possibly be, and the outcome is still not clear.

    But I support her choice, for the reasons Fillyjonk mentions in the comment above mine. The problem is not individuals making the choice to have surgery when they truly believe they’re out of other options — and practically speaking, they ARE out of other options, because their doctors won’t fucking help them. The problem is (as you note) the WLS industry, and the doctors who refuse to treat fat patients until they lose weight.

  30. NO ONE is preventing from making those choices, fillyjonk. The day when FA is so strong that it imperils the “rights” of dieters is such a long way off, its a completely pointless thing to ponder. It IS akin to “Feminism harms men” or “Civil rights harms white people” or “Gay marriage threatens straight marriage”. In the meantime, though, ex-gays aren’t part of the gay rights movements. Men’s rights activists aren’t part of the feminist movement. White supremicists aren’t part of the civil rights movement. People who want to lose weight aren’t represented by Fat Acceptance. If they want to offer support, it cannot by with the stipulation that we affirm their choices to lose weight. That’s not an offer of support. Its an attack on everything we believe. Resisting that is not ideological purity, its standing for *something*. Fat Acceptance means something and it should continue meaning something. Why should we abandon the people who’ve believed in FA for decades because someone wants to lose weight? We shouldn’t. Those people can’t feel perfectly safe in fat acceptance. Thats not what FA is there for. Its there to challenge weight loss culture and it needs to keep doing that. A dieter needs to accept THAT and if they can’t we need to recognize that its their problem. A movement that is everything to everybody is really only nothing to the people it really meant something to. Fat acceptance doesn’t exist to affirm WLS. Not as a “last option”. Not at all. Pressuing people to affirm the rightness of WLS is an attack on Fat Acceptance. Kell was wrong to go after Heidi because she wasn’t the problem. I’m seeing a lot of people who are, though. A lot of people who don’t want fat acceptance to have a right of expression, a right to a different opinion. Dieters rights are under no sane peril, but fat acceptance actually is and maybe that’s what we should be wringing our hands over instead of fretting over people’s opportunity to try to lose weight.

  31. Brian, I agree with pretty much everything you’re saying, but the problem is, you just keep saying it in exactly the same way, and you don’t seem to be reading the arguments here very closely at all. I think you’re reacting, understandably, to arguments you’ve seen a zillion times before, but not so much to what’s going on here.

    Let’s review. This post is about a woman who had a miserable experience with WLS (before she’d ever heard of fat acceptance), lost her best friend to it, knows someone else who had it and is already gaining the weight back, and is STILL BEING PRESSURED BY HER DOCTORS to have it again.

    She is refusing to have it again. She believes WLS is terribly dangerous, and she would counsel anyone against it. She has seen the worst consequences of it firsthand. She is standing up to her doctors.

    But she’s still in pain, and she can’t get adequate medical care, because the doctors keep recommending WLS. They’ve tried nuthin’, and they’re all out of ideas.

    THAT is a fight for fat acceptance activists to take up, in my opinion, and I think you’d agree.

    Raising awareness about the dangers of WLS among individuals who are the target market for it is a hugely important thing for fat acceptance activists to do. But it’s not just up to the individuals to solve this problem. The point about Heidi and other people like her, and the reason why so many of us who are just as staunchly opposed to WLS as you are embrace Heidi, is that she was in pain every minute of every day, and doctors would not help her until she lost weight. She didn’t “want to lose weight” because she’s been suckered by bad information. She’s not asking us to support her “right to diet” — and I wouldn’t, if that were the case. She wanted to lose weight quickly so she could get someone to look at her body and find out why the fuck she was constantly suffering. And with the way things are right now, no one’s going to do that until she loses weight.

    So what sucks is not Heidi’s decision but THE WAY THINGS ARE RIGHT NOW, where people are being denied medical care until they lose weight — it’s the same thing as fat people being denied joint replacements and other surgeries until they lose weight. I completely agree with your point about the fat acceptance movement needing to be unequivocally anti-WLS and anti-WLD, and not letting ourselves get suckered by sob stories from people who want fat acceptance activists to affirm that their dieting/surgery is just peachy. But if that means we reject people who are essentially forced into doing something they don’t want to do by doctors who can’t see anything but fat, I’m not okay with that. Heidi’s not the poster girl for WLS being the answer sometimes. She’s the poster girl for fat people being denied decent medical care until they lose weight. That? Is a long-ass fight — and in the meantime, Heidi was in constant pain and wanted doctors to help her. So, after trying a million other things and spending 18 months doing research and seeing different doctors, she took the best option that was offered to her right now.

    That is why I support her choice. Because she just didn’t have a real fucking choice. If I were in such pain I couldn’t sleep lying down or stand to shower, couldn’t work, couldn’t see my friends, and every doctor I saw said, “Well, we can’t do anything about this until we cut your left leg off,” at some point? I would let them take my goddamned leg, even knowing it has nothing to do with the real problem.

    And that’s without living in a culture that tells me everywhere I look that having a left leg is dangerous and deadly, and people who accept their left legs are just in denial.

    Refusing to give quarter to WLS advocates is one thing — and something I think is vital to the fat acceptance movement. I don’t want to hear stories of how WLS was the answer for SOME people, and how they’re so much happier thinner, blah dee fucking blah. I delete those people’s comments and ban them. And the people in this community who have had WLS or are still dieting know that this is not a space for discussing the perceived benefits of weight loss — they’ve got the whole rest of the world for that.

    But when it comes to extremely fat people who are suffering, and who cannot get help for their suffering without being forced to lose weight by any means necessary, including potentially deadly means, I think it’s both cruel and counterproductive for fat acceptance activists to say, “You are not welcome here.”

    Because first, we’re talking about people who face far more discrimination and hatred in every corner of this society than those of us who are less fat, healthy, and functional. And second, we’re talking about fat people who are in pain and cannot get the help they need. I do not think WLS is the answer for them, and I’ve made that clear at every turn. But I think someone needs to give a shit about their rights, health, and dignity, and who’s going to do that other than fat acceptance activists? Who’s going to call for the change necessary to get people real medical care, not just prescriptions for weight loss? In these cases, regarding WLS as merely an individual choice and always the wrong one just doesn’t cut it. It’s not an individual choice when there are powerful institutional forces bearing down on any fat person who needs medical care. Shunning people who were forced into WLS by shitty doctors and a hateful society doesn’t cut it.

    We need boundaries, we need specific goals, we need to stand for something, absolutely. But at the point where black-and-white thinking leads to a loss of compassion for extremely fat people who are suffering physically and are ostracized and abused everywhere else they go, just because they made a dangerous decision based on absolutely maddening circumstances, you can count me out.

  32. I don’t comment much because a) I’m a noob and b) I am conflicted about some of the messages I hear in the FA community despite the overwhelming benefit I’ve gleaned for my own mental health. I know that there are medical professionals who have some serious anti-fat prejudices and won’t give care because they think an “unrepentant” fat person is just killing themselves (they use the comment “why would I treat someone who continues to smoke/use drugs/drink/etc.?” to justify their approach). But I have to wonder if, by and large, medical professionals are jumping to the Fat = Death conclusion because [i]that’s what they’re being taught[/i] is the standard of care. That [i]not[/i] telling people to lose weight is reckless endangerment of the patient. That [i]not[/i] encouraging dieting or WLS is a dereliction of duty. And it’s exhausting enough to learn everything we’re supposed to learn, let alone challenge all of it. For crying out loud, Mike “Fuck All You Fatties, I Did It And You Can Too Neener Neener What WLS?” Huckabee was the keynote speaker at the most recent convention! And the president of the AOA (the AMA for osteopathic physicians) has proclaimed that all DO’s should be actively involved in being “role models” for their fatty fat patients by eating less and running their tired, on-call bodies into the ground a little more! I mean, otherwise, these fatty fat patients won’t believe a word we say at all! So it’s a really strong model in the medical world to be anti-fat [i]because it’s dangerous[/i], and then people run with that as they choose. I accept my own fat and the fat of those around me because I believe that they are all human beings deserving of compassion and advocacy, but I also see the literal mechanical effects of adiposity as potentially inhibiting the body’s ability to move and work the way in which it was intended. I do not think that this is the patient’s fault, nor would I ever ignore underlying conditions which mimic “the symptoms of obesity” (whatever that means), but I think it’s impossible at this point (at least for me) to outright say that fat does [i]not[/i] have any impact–positive or negative–on the human body. It’s a living tissue with its own physiological and mechanical properties of which we are deplorably unaware because unbiased, curious investigations into such properties have not yet been undertaken. Anyway, just trying to convey what I’m being taught as a doctor-in-training: fat is bad (and I strongly believe that this is SOMETIMES true), WLS is good (and I strongly believe that this is RARELY true). I struggle with this concept on an almost-daily basis and while Ms Scwark’s blog is a nice remedy, it’s not a total antidote. So I hope I’m not considered a naysayer.

  33. The whole idea of WLS is sort of repulsive to me, but the idea of ostracizing and attacking a woman who has been forced into an intolerable position by the very people who were supposed to help her is even more repulsive.

    I guess I fail to see how she MUST be shunned for the purity of the movement. I mean, we never have to say Yes WLS is a great option for some people and I totally support it.

    What we do have to say is I’m sorry you’ve been forced into this position. I understand that I can’t possibly know what you’re going through. I respect your right to make what must have been a very difficult decision even if it isn’t one that I philosophically agree with.

    I mean, this is not about someone who just decided to have WLS because they didn’t like how they looked. This is someone who literally could not get treatment any other way. Are we going to tell her that she can’t make that decision? Are we going to say that it’s her responsibility to suffer for the movement? I mean, what right do we have to ask that of someone?

    I hope that WLS works for her. I hope that she has no complications, that it makes the doctors take her seriously and treat what’s actually wrong with her. Do I think this is what will happen? Maybe not. But I’m not willing to hope that a real human being suffers just to prove a point.

  34. Kate just said: “But when it comes to extremely fat people who are suffering, and who cannot get help for their suffering without being forced to lose weight by any means necessary, including potentially deadly means, I think it’s both cruel and counterproductive for fat acceptance activists to say, “You are not welcome here.””

    Yes, yes, YES!!! That’s what I’ve been so desperately trying to say ad have been unable to since Heidi wrote her story. WLS isn’t the answer I would wish on anyone, but *sometimes* desperate times call for desperate measures…and I still don’t understand how anybody could read Heidi’s post and not feel some sort of compassion or understanding for making that choice.

  35. Thanks, sweetmachine!

    WLS right now reminds me “bleeding” a patient, or using leeches, back in the 18th century; it was a cure-all for everything from influenza to stomachaches. Sometimes it worked, a lot of times it didn’t. And there was always a risk that the patient would bleed to death.
    WLS is a personal decision, and should NOT be automatically prescribed by physicians to their overweight patients. And the folks who choose it shouldn’t have to be villified. But it should be A CHOICE. Responding to prejudice with still more prejudice doesn’t solve anything.

  36. I also have a question: if FAM accomplished its goals tomorrow, would that include something to the effect of outlawing WLS? Even in a case like Heidi’s? Why?

    If FAM “took over the world,” especially if you could go back and wipe out fatphobia over the last, say 30 years, Heidi probably wouldn’t be in the situation she’s in now. She’d never have gone on a stupid diet in her life. She wouldn’t have to have been hammered over the head with 800 squillion magazine and newspaper articles and TV shows telling her “thin is in!” from the time she was old enough to read or work a remote or a mouse.

    Hell, even if we could have gone back only five years and wiped out all fat hate, every single doctor, every single mental health practitioner, and every single allied health practitioner (nurse, physical therapist, etc.) would have been down with HAES principles and she would have gotten the help she needed, both for her ED and for her mobility and chronic pain issues, before it became such a horrible clusterfuck that she was backed into a corner with no other choice. There would be universal public accommodations for people her size and nobody would give her a disgusted look when she did go out in public.

    She wouldn’t be constantly bombarded by propaganda about how she’s the Worst Person Ever for “letting this happen to her,” and she wouldn’t have to be exposed to hysterical bleatings about how In The Oh So Scary Future, all of us, other than a few virtuous upper class skinnies, will be exactly like her, having Dug Our Graves With Our Kitchen Utensils and be completely unable to care for ourselves, and Oh The Public Health Crisis You Haven’t Seen Anything Yet! Everyone in the West will only live to be 10 years old because they’re so Fatty Fatty Fat from McDonalds’ greasy air, and the Chinese will take over everything! Which only serves to make a person who already can’t do anything else just want to keep…eating. And eating. And eating.

    Think she’d be offering up her stomach for ritual sacrifice if we could have taken over? I don’t.

  37. After reading her guest post, I feel like I am absolutely in no position to judge Heidi or her choice. I am a firm believer that a great deal of the symptoms and illnesses society ascribes to omg teh fat are really due to other things (and that the culture of congratulated deprivation of bodily needs is probably far worse). I find the pushing of such a risky surgery that causes death by complication, malnutrition, suicide, and who knows what else in a not-insignificant percent of patients to be horrifying.

    But… I have never been in a situation where the size of my body itself caused me the pain that Heidi has been living with. Where I could neither live my life in peace nor seek medical treatment.

    I do find it disgusting that we live in a society where a large portion of doctors will not look past their patients’ weight and will assume that thin patients are compliant and practicing recommended habits and fat ones aren’t and therefore the former is more deserving of medical care and the latter really just needs to lose weight. My god, but I would like to see that changed.

    It’s fine to be idealistic and it’s fine to believe that something like WLS is a terrible choice. But in each person’s life, it’s that person’s choice whether to engage in WLS, drive without a seatbelt, eat cookies or have unprotected sex. It’s not my business. I think that’s one thing I’ve really gotten from the FA movement and it seems rather shortsighted to be okay with someone treating their body as they wish *but only in certain cases.*

    I think that losing weight for its own sake and losing weight to please others are choices I have trouble supporting. But I have never been in Heidi’s place and I can’t imagine I’d be able to make a different choice. Yes, WLS is pretty terrible, but when life itself is hellish, I’d probably resort to the choice that got me taken seriously and offered a chance, albeit a risky one, of being free from that hell. Yes, in an ideal world, society would look at the person and their health beneath what’s visible. But we’re not in that society and I can’t imagine I’d be strong enough to wait out a life like that for it. I commend everyone who is, but I’m a person, not a principle. And I like to think that is okay.

  38. Now I don’t know about that, Alyssa.

    Why should it be a choice (for anybody NOT being tortured by their own body as Heidi is)? I agree that it should be a choice for somebody who is so desperate for proper medical care (that she can only get AFTER this surgery) that she has sobbed her eyes out, wishing she would just die already. But even then, it isn’t really a choice, now is it?

    However, I really don’t think it should be a CHOICE for anybody who’s not in that situation. I don’t think that anybody who is “certified” to give this procedure and does so without regard to how healthy the person actually IS should ever hold a scalpel again, or even a stethoscope for that matter.

    Now, I may have misunderstood, but you make it sound like an average American housewife should be able to walk in to her doctor and say that she wanted this surgery, and as long as he didn’t suggest it first to cure anything else she might have, it would be ok. I absolutely and unequivocably deny that “physician” the right to cut open any more of my fellow human beings.

    And I absolutely disagree with anybody who wants to BE that middle-aged American housewife.

  39. Oh, and thanks to everybody who’s considering my question… Its really helping me clarify my own thoughts on this!

    And of course, thanks to Mariellen again for being so generous and courageous and letting us all stuff our noses into her business right along with Heidi’s!

    Public vulnerability has got to be one of the worst things in the world to submit to, but of course, we all at least kind of know about that, since we do it every time we walk out our front doors.

  40. Charli,

    In an ideal world, we would have responsible physicians who would lay out exactly what WLS entailed. The risks, the lifestyle required to live with the damage done, the chances of permanent weight loss, of debilitating complications, of death. Given full information and a psychiatric evaluation, then it’s still a choice.

    But then again, in an ideal world, people wouldn’t be this desperate to be thin.

    Frankly, not too get too political, but I think that one of the problems is the incentive system in our medical system. WLS is one of the hugest profit margins, not just for insurance companies but for doctors and hospitals. Not only is it easier to assume the fat is the problem, but the incentive is to take the windfall procedure rather than the hard road that might be a money-loser. (and I don’t mean this to stamp on everyone in the medical profession as out for money. sometimes these are hard choices and hospitals need the money. the incentives in the industry are pretty messed up across-the-board.)

  41. “Nobody has yet convinced me that we need to blame, shame, condemn, and wish harm on people in difficult situations while we do this. Nobody has yet convinced me that activism must be cold and hateful to be effective.”

    My heart goes out to Heidi, I cried for her when I read her story.

    I in no way meant to imply that activism should be cold and hateful towards people who choose to have WLS.

    I am sorry if my post was taken that way. I am not the best at expressing my thoughts in text which is why I do not “blog” or respond to posts very often.

  42. I in no way meant to imply that activism should be cold and hateful towards people who choose to have WLS.

    Cynth, I didn’t mean to imply that you had, and I’m sorry. I was conflating Kell’s post with the people who were supporting her, which wasn’t really fair — though in my defense I was doing it because I saw people taking up a tired and I think generally over argument (must we support WLS/WLD or not?) when the issue is really “must we avoid letting our political convictions, whatever they are, turn us into idealogues?” I think rehashing the old argument, railing against the straw men who are demanding that we go “rah rah WLS” for every person who wants to get skinny, is hiding from the real issues that Kell’s post and subsequent retreat brought up.

    And all of this is tangential to Mariellen’s post — sorry hon!

  43. This is exactly why there needs to be a medical specialty field looking specifically at the needs of fat people. So they can be healthy and fit in their bodies…not so they can be ignored or given ineffectual treatments until they become the immobilized prey of bariatric surgeons.

    (As you can tell, I do not think the “field” of bariatrics counts as a medical specialty catering to the needs of fat people. More like catering to the extermination of fat people.)

  44. Fillyjonk said: >Maybe there’s some hypocrisy there — having a conviction and still doing something out of line with it because it’s the only way to get by.

    I have a minor point to make, for the sake of the larger discussion. I really don’t think there is any hypocrisy involved here, and I want to point that out since I feel ‘hypocrisy’ could be interpreted in a pretty inflammatory way.

    The way I understand it, hypocrisy is pretending to hold a belief that you don’t really hold, and therefore acting out of line with that belief whenever you think you can get away with it. But Heidi, and many other people in her position, do sincerely believe in fat acceptance, and, as much as they can, behave to their own standards. If Heidi were a hypocrite for being fat accepting and yet having WLS, then all of us are hypocrites, because I’d bet cash money every single goddamn one of us has wished, even for a split second, we could magically lose weight, or stepped on a scale hoping for a lower number, or ordered the salad instead of what we really wanted — at some point, while also sincerely believing in fat acceptance.

    I see these kinds of things, and Heidi’s situation, as plain old human inconsistency, not deliberate hypocrisy. In an ideal world, yeah, we’d all adhere perfectly to our values. In the real world? Sometimes we screw up, or are backed into a corner so fierce there’s no way out except to break our own code of conduct in order to escape.

    So, just in case people are ever tempted to start throwing the word ‘hypocrisy’ around in these situations, I’d prefer we all agree that there’s a difference between pure hypocrisy and simple inconsistency. Because we’re human, and life happens.

    /end semantics lecture

  45. Fillyjonk, you were smearing people for something they weren’t advocating. No, that’s not “fair”. Its bullying, but you want to pretend that doesn’t happen, right?

    There aren’t “straw men” insisiting we support WLS whenever anyone wants it. There are people in this very thread suggesting it. There have been people suggesting it for years. That’s not a straw man. Its happening RIGHT NOW. The “Straw-man” position here is YOURS. Following the tired old accusation that believing fat acceptance should stand for something means you are an idealogue. I’m sick and tired of hearing that. Kell was wrong for personalizing an issue by attacking an individual instead of the culture. She assigned blame on an individual instead of the culture that drives individuals into WLS and WLD. She most certainly was NOT wrong for believing that fat acceptance shouldn’t affirm and promote WLS and the rush of people trying to prove her right by disagreeing with THAT is a much greater threat to FA than anything Kell could ever say.

    But right, I’m “retarded” for thinking that. Good thing I’m just imagining that people don’t think I have a right to be opposed to WLS. Maybe all of us “retards” as we’re now called should just leave so you won’t have to worry about us believing in something.

  46. The way I understand it, hypocrisy is pretending to hold a belief that you don’t really hold, and therefore acting out of line with that belief whenever you think you can get away with it.

    You know, I was thinking of it as acting in a way that is inconsistent with your beliefs, but your definition is more specific and makes more sense. Since clearly there is a difference between acting in a way that’s inconsistent with your beliefs out of exigency and doing it out of insincerity.

  47. But right, I’m “retarded” for thinking that. Good thing I’m just imagining that people don’t think I have a right to be opposed to WLS. Maybe all of us “retards” as we’re now called should just leave so you won’t have to worry about us believing in something.

    Oh, Jesus CHRIST, Brian. Considering A) two of the writers for this site already told the one person who said that that we don’t use the word “retarded” around here, and B) many people other than you have disagreed with that guy on this very thread, trotting that out again 50-odd comments in seems… well, incomprehensible, frankly.

    The “Straw-man” position here is YOURS. Following the tired old accusation that believing fat acceptance should stand for something means you are an idealogue.

    Bullshit. Bullshit, bullshit, bullshit. Fillyjonk said being rigid and blinkered to the detriment of fat people who need help is being an ideologue. That’s a far cry from claiming that standing for something makes you an ideologue. She also said, you’ll notice, that she’s 100% anti-WLS. It IS something she stands for, and believes fat acceptance should stand for. Just like me.

    You are arguing in bad faith, and you’re smart enough to know it, so I really have zero patience with that shit. If you were an idiot, I’d have other things to say to you, but you’re not. You’re smart, you know what you’re talking about, you hold a philosophical position that most people here — and all official representatives of this blog — agree with, and yet, for some reason, you insist on either not reading what people are saying or being disingenuous in your responses. What the hell?

  48. In the meantime, though, ex-gays aren’t part of the gay rights movements.

    They probably were around 1965 or so, when total closeting was more common than not, even in major cities. As late as 1970, the only representations of gay men in traditional media were in plays/movies like The Boys in the Band, in which a gay character says, “Show me a happy homosexual and I’ll show you a gay corpse.” (Yes, the author was a gay man.) And this was thought to be an advance at that time in terms of “enlightening” straights about gays. As recently as about 25 years ago, it was widely assumed that virtually all LGBTs could be straight if they chose to be, or (for the more “compassionate” straights among us) simply had a mental illness that kept them from “choosing” heterosexuality, which any “sane” person would be assumed to default to if they were able.

  49. kateharding said: Heidi’s not the poster girl for WLS being the answer sometimes. She’s the poster girl for fat people being denied decent medical care until they lose weight.

    Excellent way of putting it. Thank you for saying it like this.

    The situation is confusing enough that I even found myself wondering whether WLS is the answer, sometimes. But I think BStu is right: you don’t amputate a healthy leg, and you shouldn’t amputate a healthy digestive tract. People may get their digestive tracts bypassed when they have a gastric disease, but WLS, as far as I can tell, is never the answer. I just wish doctors and researchers would look harder for a real one.

    I do respect people’s decisions to do whatever they want to their bodies, but I question the ethics and judgment of any doctor who performs a major, invasive surgery, with its attendant risk of death, for purely cosmetic/social reasons.

    People who choose these surgeries cannot make a fully consensual “choice” if they are depending on the advice of an unethical (or sadly misled) doctor to inform that decision. Unless the individual is their own surgeon, I have a hard time believing anyone truly “chooses” these surgeries at all. It’s more like being forcibly channeled into them.

    There’s a power differential involved with doctors and patients, and when evidence indicates that a treatment is risky and ineffective, then the decision to pursue that treatment anyway is the result of pure coercion.

    The sad part is, many WL surgeons probably honestly believe in the treatment they promote. They can’t all be money-grubbing sociopaths (though I’m sure some are.) And in that case, the coercion originates in the culture of constant and insidious fat hatred, which affects the doctor, and then is passed to the patient — along with a handful of good intentions.

    That culture is the part we’re trying to change. Unfortunately, that change is probably a long time coming. In the meantime, I don’t know wtf people are supposed to do when real treatments simply aren’t available, or are actively refused until they reach a more ‘desirable’ weight. Chop off body parts until the scale reads right, I guess.

  50. “I wish I was strong and healthy and could honestly say that my weight isn’t negatively impacting my life. But I can’t, not now.” Heidi, 9/18/07

    I agree that part of Heidi’s decision to go through with WLS was because she couldn’t get proper treatment for her ailments given the medical establishment’s known biases against fat people. Still, having read her very moving post, I don’t think that’s the whole story. Heidi also decided to have surgery because she could no longer perform her life in a reasonable manner at 530 lbs, and that has some people outraged. The idea that weight loss should NEVER be desirable in order to embrace the philosophy of fat acceptance and HAES is, in my opinion, just as narrow-minded as the more pervasive societal viewpoint that fat is ALWAYS harmful and dieting is ALWAYS beneficial. Viewing the world in terms of moral absolutes blinds us to the struggles of ordinary people trying to negotiate their way through the grey areas of life without sacrificing their principles.

    Heidi describes being a prisoner in her own body, paralyzed by her weight, not as a moral judgment. Heidi never advocated weight loss for anyone but herself. She’s well aware that she’ll never reach a weight that will make her “socially acceptable.” She doesn’t want to. But she wants her mobility back, she wants a decent nights sleep. It wasn’t a decision based on vanity.

    I don’t think WLS is “the Answer.” I agree that it’s dangerous and over-performed. I wish Heidi had been given better options. I wish the medical establishment had taken her more seriously before it got to the point she felt she needed to chose between WLS and being bed ridden for the rest of her life. If someone else her size told me they felt okay I would never try to encourage them to lose weight. I wouldn’t encourage them to undergo the risks of surgery. Heidi is a very intelligent woman and she knew what she was getting into when she made her choice. She’s no more a dupe than she is a traitor. That doesn’t mean I think “diet talk” should be tolerated on fat acceptance blogs – I don’t! But I do feel that in sharing her experience, as painful and humiliating as it was for her, she gave us a different perspective that ultimately enriches us all. Now is the time to give her our love and compassion. It’s not the time for moral judgments and second-guessing her very difficult and personal choice.

  51. I’ve only recently come to this site and found the idea of FA, and I’m still trying to completely grasp the concept. I do weight training and yoga b/c I enjoy it, plus some tramping and cycling (at least I did before going overseas for grad school). W/o changing my diet, but including those activites, I tend to lose a couple of lbs, not much but it happens. To be honest, given some of what’s been posted over the last week or so, I’d assume that that fact alone would make me ineligible for the FA movement. Like I said, total noob to the idea, so maybe I’ve just gotten the wrong handle on the situation.

  52. TI, you have the wrong handle on the situation. FA is against dieting for weight loss and/or weight loss surgery, because those things don’t work, make people miserable, and are bad for your health. But if making changes in your life that make you feel happy and healthy result in some incidental weight loss, that’s not a problem. As long as you’re not coming on this blog and talking about how wonderful the weight loss makes you feel, the weight loss is not a problem for anybody here.

    Mariellen, I”m so sorry you had to go through all that.

  53. Becky,

    But if making changes in your life that make you feel happy and healthy result in some incidental weight loss, that’s not a problem.

    If that’s truly the case then why is there such angst over a woman making as informed a decision as possible to meet the same goal? I don’t want to cause problems, but I don’t understand some of what I’ve seen over the last bit. I understand the reservations about WSL, overall I don’t think it’s a good thing, but where is it my right to tell someone else what to do w/ their body?

    Crap, unfortunately, this will be my last post for a bit. I’ve got to get some work done. Stupid last week of semester!

  54. I brought up that first post, Kate, because it was the FIRST post and it took the exact position Fillyjonk accused me of making up as a straw-man. Forget the specific insult he choose, but I do recall his comments being quickly lauded as “astute” by an official representative of this blog. So, yeah, I felt it was appropriate to act like that actually happened. I don’t really think that’s bad faith. There absolutely are people who want to insist on fat acceptance affirming WLS and telling me I’m making it up is bad faith just like accusing Cynth and I of doing what Kell did was extremely unfair and extremely bad faith.

    No, we shouldn’t be shunning people who want to lose weight, but only one person made that suggestion. A lot of people are insisting on the rightness of WLS and thats not right. Its a difficult decision people are put into and I sympathize with it, but its still not right. Its not an answer and the costs of WLS are extraordinarily high. We’re not supporting anyone by affirming WLS. A person’s choice is their choice and its NOT threatened by anyone disagreeing. We shouldn’t have to say, “yes, WLS is right for you”. That kind of affirmation is unnecessary and anti-thetical to fat acceptance. If you oppose WLS, then oppose WLS. You don’t get to just oppose WLS when its people you don’t know. That doesn’t mean shunning someone for having WLS. It doesn’t mean criticizing them. That was absolutely wrong, but its now served to empower people who want to affirm the rightness of WLS and that’s a disturbing development and one which will only serve to exclude people who believe in fat acceptance. And don’t tell me people aren’t affirming the rightness of WLS. Its all over this thread and I can damn well read. Like I said, it started right from the first “astute” comment.

  55. The idea that weight loss should NEVER be desirable in order to embrace the philosophy of fat acceptance and HAES is, in my opinion, just as narrow-minded as the more pervasive societal viewpoint that fat is ALWAYS harmful and dieting is ALWAYS beneficial.

    Rose, I think it’s more complicated than that. As I was just saying at The Rotund the other day (and have said elsewhere), the philosophical opposition to weight loss dieting/surgery in the fat acceptance movement has nothing to do with people’s reasons for wanting to lose weight. It has to do with the fact that deliberate weight loss attempts usually do more harm than good and do not have permanent results.

    Unfortunately, that holds just as true for the person whose fat constitutes a disability as the person who wants to lose 10 lbs. for vanity. I oppose deliberate weight loss because, despite all the hype to the contrary, there is no proven, safe way to do it over the long term. Period. It doesn’t matter how good someone’s reasons are; trying to lose weight is not the answer because it doesn’t work, and it often causes harm, not because the world would be a nicer place if people accepted their bodies (though it would).

    It’s not that anyone begrudges Heidi or Mariellen or anyone else a smaller body that might be more comfortable to move around in. It’s that here’s no known method for them to achieve that in the long term. That’s why we need doctors to treat fat people as fat people, instead of insisting that they must lose weight.

  56. And don’t tell me people aren’t affirming the rightness of WLS. Its all over this thread and I can damn well read.

    And several people, including you and me, are telling them why they’re wrong in the same thread. I can read, too. So can all of the reasonable people who come here. Why would you assume Mikey T’s argument is more persuasive than yours?

  57. Tattooedintellectual said: If that’s truly the case then why is there such angst over a woman making as informed a decision as possible to meet the same goal?

    This is a tough thing to get a handle on, but this is how I see it: because of the culture we live in, with the pervasive mentality that FAT IS ALWAYS THE CAUSE OF ANY PROBLEM and that WEIGHT LOSS IS A SAFE AND EFFECTIVE GOAL, any decision a person (whether patient or doctor) makes on this issue cannot be truly informed. The fact that considerable evidence points to WLS being ineffective in the long-run, and dangerous right out of the gate, further makes it unlikely that a person arrived at a decision to have WLS through being truly informed.

    Even doctors are subject to the biases of their culture, not to mention the very lucrative nature of prescribing weight loss treatments, no matter how ineffective or dangerous (see fen-phen, any number of amphetamines, any number of crackpot late-night infomercials advocating weight loss through the use of magnets, etc.)

    Weight loss sometimes happens as a side-effect of positive changes. But not always, or often. It’s never guaranteed. More evidence exists to show that people who purposely pursue weight loss ultimately fail, often hurting their health in the process. So to make weight loss the primary goal of a person’s attempt to improve health perverts the attempt to be healthy, and actually puts their health at risk in an attempt to achieve the desperately desired social approval of weight loss.

    It’s a very difficult trap not to fall into, even for the aware.

    The ultimate goal of weight loss is always weight loss. The ultimate goal of HAES is health, regardless of weight. This can seem like a negligible difference when weight loss sometimes results incidentally from practicing HAES, but there is actually a huge difference.

  58. Becky’s right, TI. Most people don’t maintain a perfectly stable weight. Many of us don’t even weigh ourselves regularly. The HAES (health at every size) philosphy is linked with fat acceptance. The point is that, while we may do things to improve our health or expand our abilities, and some of those things might trigger a change in weight, we don’t see changes in weight as goals. We don’t try to lose weight or gain weight. We concentrate on how we feel and on what we can do.

    Mariellen. I always enjoy hearing what you have to say on BFB and the other blogs. As usual, your post is very insightful, yet down to earth. I’m looking forward to reading your blog!

  59. Could someone point out the people who are affirming the rightness of WLS?

    Am I one of them? I get the strong impression that I’m under that list,and I can’t figure out why…is it because I’m supporting Heidi in making a choice that will hopefully improve the quality of her life (cuz honestly, I don’t see how it could get much worse)?

    I’m just curious, because I don’t see anybody shaking their pompoms in favor of WLS…

  60. To sum up what I rambled about fifty comments or so ago, Heidi’s body and what she does with it are her business. If having WLS suddenly got her promoting it all over fat acceptance blogs, that would be a problem. But that’s not what’s happening.

    People are not saying that we should accept that WLS is a good idea, ever. All they’re saying is that it is her decision to make and we should not boot her out of the FA movement for making it. That’s way different from saying that we agree with the decision. Fat Acceptance is philosophically opposed to dieting, too, but people don’t get thrown out of the movement for it. If they did, there wouldn’t be much of a movement left. I’m sure that almost every person posting here has dieted at some point or another, but we’re not saying ‘oh, that’s hideous, get out of my movement.’ We just feel that it’s unfortunate that they feel they have to resort to that.

    I fail to see how this is any different.

  61. If that’s truly the case then why is there such angst over a woman making as informed a decision as possible to meet the same goal?

    Because WLS is not something that you do in the course of being happy and healthy. It is, quite literally, a rerouting (and often removal) of parts of the digestive tract. That is in no way analogous to yoga. You don’t do it because it makes you feel good. You do it to lose weight.

    The problem is that sometimes it’s the only option you’re offered. You can fucking BET on it that part of Heidi’s informed decision included being informed that WLS was a pretty terrible idea, but no other ideas were forthcoming. Many of us prefer to practice a type of FA that recognizes that people sometimes have to make shitty decisions.

    Which, incidentally, is all I saw Mikey T saying either. I vocally disagreed with him when he said that we couldn’t declare ourselves anti-WLS and still understand why it might come down to having WLS. But I saw a non-regular commenter doing a really hamfisted job (come on, “retarded”?) of saying exactly what everyone else has been saying — that we don’t “kick people out” for making a bad choice in an extreme situation where no good choices are available. The position that we have to be excited about everybody’s decision to get skinny if they want to is still not coming from anyone in the movement, or even anyone in this thread right now.

  62. Kate, we should agree to disagree on this one. I am a advocate of body autonomy as well as fat acceptace, and those ideals sometimes clash. I was touched by the spirit of your introduction to Heidi’s guest post, in which you acknowledged that there were sometimes exceptions to the rules and Heidi was one of them. Perhaps you have changed your mind since then, sometimes that happens when you have time to think about things.

    Having graciously given Heidi the space on your blog to tell her story, the kindest thing to do for her now is to agree to disagree with her decision, wish her all the luck for her recovery and encorage others to do the same. I wouldn’t suggest to you or anyone else that you should celebrate Heidi’s decision to do this. But since she has already gone through with the surgery and has asked for our support, we should simply respect that, however wrongheaded and futile you may believe it to be, it was her decision to make. She needs to know she’s still wanted in the movement, I think it’s important to her.

  63. She needs to know she’s still wanted in the movement, I think it’s important to her.

    Not only is Heidi still wanted in the movement (at least by FA activists like myself), she will still need the movement long after she recovers from WLS! Sure Heidi will probably lose a drastic amount of weight in a relatively short period of time. But at 530 pounds, any weight loss resulting from WLS alone will not make her a thin person. She will just be a less fat, fat person. Although she might be more tolerated by the anti-obesity establishment because she underwent WLS, she will not be accepted by them until she fits within some ridiculously narrow body size margin.

  64. “This is a tough thing to get a handle on, but this is how I see it: because of the culture we live in, with the pervasive mentality that FAT IS ALWAYS THE CAUSE OF ANY PROBLEM and that WEIGHT LOSS IS A SAFE AND EFFECTIVE GOAL, any decision a person (whether patient or doctor) makes on this issue cannot be truly informed.”

    Are you kidding? Heidi is not a brainwashed thinbot. She made this decision because she had basic mobility problems, and while FA wants to never attribute a health problem to weight, there is not anything else you can attribute her problems to, as she described them (not being mobile to clean herself, for instance). The problem is the elephant in the living room of FA (and I’m not trying to be funny at all). What if a problem IS about fat, and losing weight is the only way to fix it?

  65. What if a problem IS about fat, and losing weight is the only way to fix it?

    It sucks large, because there is still no proven safe method for long-term weight loss. Which is exactly the problem Mariellen describes in the post, btw.

  66. Are you kidding? Heidi is not a brainwashed thinbot.

    I in no way think Heidi is brainwashed. But I do think the pervasive culture I mentioned has contributed to the fact that there are NO valid options available for someone in her position. Like Kate said.

  67. Or, to put it more succinctly: a decision is not a decision, informed or otherwise, if there’s only ONE option to choose from.

  68. TI, there is a difference between saying: “You can’t do that” and “I disagree with your decision and think if you had all the facts you wouldn’t be going through with this”. Because the fact is, WLS is dangerous. And there is no evidence that it does improve health or quality of life. As Mariellen’s post indicates, Heidi could end up sicker or fatter or unhappier as a result of her surgery. Or she could end up dead. I sincerely hope for her sake she doesn’t, but it is a valid concern, and that is why there is so much angst over her decision. A lot of it comes from people who don’t oppose her decision to have WLS, but oppose a fatphobic culture in which the only health care presented to very fat people such as Heidi is (as I think Meowser said): “Hand over your stomach and then we’ll talk.”

  69. Becky, this is exactly why I keep telling doctors no way will I ever do that again, and I’m not relying on them for help with my mobility issues. It’s why I’ve been reading FA blogs so voraciously and checking out HAES. The doctors refuse to look past my fat for underlying causes, so fuck them. I’ll go for my yearly check-ups to make sure my BGs, blood pressure, and cholesterol are still under control, and I’ll do the female things that are considered necessary, but other than that, nada, zip, zilch. I’m tired of the hassles (one of the main reasons it had been 8 years since my last physical when DH forcefully suggested I do so this year, after we got married).
    I’m not handing anything over to doctors anymore, not when it comes to my weight. Kell did do one good thing for me. She made a comment on one of my posts that exercise bands could be used sitting down and that they were not expensive. So I went to Wally World and checked them out. They were cheap (I got one set for under $10, and a second set for less than $7). I use them a couple of times a day, sitting in front of my computer and listening to Def Leppard (awesome to exercise to). Then every other day I do my yoga (Megan Garcia, thank you for making that DVD). I’ve only been doing this for about a month, and I’ve seen some very small improvement, so I’m hopeful that the more I can do, the better I’ll get, and the more I’ll be able to do.
    I’m also working on the healthy eating thing, mainly because DH is diabetic, so cooking for him means I’ll be eating the same way, which is probably not a bad thing, and I’m finding recipes and stuff that are pretty good.
    So there are things that even those of us who are super-fat (I love that term….lol….me in my cape) can do if we have some mobility left and the ability to research and research and take what works for us as individuals and discard what doesn’t. And without the FA movement, I would not have known about any of this. I wouldn’t have known how to help DH or myself. So I’m glad this movement exists, and I hope we eventually can get the medical establishment to see us as people first, not just fatties.

  70. I also want to thank everyone who has read this and commented. I appreciate the different viewpoints and the support. Everything I read expands my horizons and broadens my mind, and that is a good thing.

  71. I still believe, whether we agree with what Heidi and others are doing or not, we have no right to tell anyone what to do with their bodies. Her body, her choice. Heidi weights 530 pounds and cannot wipe herself (among other issues). I do not feel I could make a comment about an extremely painful and frightening decision like that until I had walked in that person’s shoes. No one has to agree with what she has done. But she has a right to do it. I think looking at someone with compassion might be called for here. Heidi has a long road ahead of her. She will need support–not condemnation. She’s not some rah-rah girl trying to “get skinny and wear cute clothes.” I read her blog–she was afraid for her life. And she was in no way advocating WLS for anyone else. I wish the best for Heidi and for anyone who has struggled with their health. I’m a diabetic, and though I wouldn’t have WLS (my body, my choice) I understand what it feels like to be so sick you are close to death. I have been there. That why I will not condemn anyone who is trying to save themselves.

  72. Brian, give me a break. You take one word of my comment, “astute,” which is pretty fucking general and which I still stand by (given that what I see MikeyT saying is that it seems that Heidi has taken a grave risk that she sees as worthwhile) — you take that to say that “There absolutely are people who want to insist on fat acceptance affirming WLS”? That’s bullshit. Kate and Fillyjonk have been all over this thread elaborating their opinions, whereas I’ve been off the computer all day and have exactly one word around which you build your massive straw man. And then you continue to use the word “retarded” — but ooh, it’s in scare quotes, so it’s magically not offensive anymore — as if it’s some official lingo of this blog, and as if you hadn’t actually read the comment you just quoted.

    What is your goal here? Are you just trying to be a shit-stirrer? Because let me tell you, it’s getting pretty tired.

  73. Mariellen, thanks for the post. I’m sorry you had such a rough time but am glad to hear you are feeling a bit better now. I have the Megan Garcia video too :) Also, for sitting down exercise, hand weights are nice. Well, I enjoy them :) Bicep curls make me feel all buff, LOL!

  74. I still believe, whether we agree with what Heidi and others are doing or not, we have no right to tell anyone what to do with their bodies. Her body, her choice.

    I absolutely agree Julie. To deny bodily autonomy to those who undergo procedures we don’t agree with is the equivalent of the anti-obesity establishment placing weight requirements upon fat people. You can’t have your cake and eat it too.

  75. Here’s where i stand on this whole shebang (and i do mean ALL OF IT, so apologies in advance for the length): i am against WLS, but pro-choice. I think it’s a bad decision, but i think people have a right to make their own decisions regardless of what i think. Then again, i also believe people should have the right to such other controversial things as assisted suicide, abortion, and medical marijuana. I am, after all, a dirty hippie.

    I think if i had a whole load of cash, i’d get Heidi and Vesta the best, most caring and empathetic doctors i could find. I think it’s possible that their size is not a cause, but perhaps a symptom of some other underlying medical condition that a myriad of doctors will refuse to treat – all because of their size. Or not – maybe their size is completely, 100% genetic, and neither cause nor symptom of their pain. Whatever the cause, they deserve decent medical treatment for their health and mobility issues..

    I think that WLS is a bad idea, but if someone feels they’ve exhausted all other options, then i don’t feel i’m qualified (in the professional, medical sense) to offer them any feasible alternatives. Also: they do not require a permission slip with my signature before they make decisions regarding their own bodies.

    I ALSO think that the majority of people here probably agree with at least one of the things i just said. And i think that there’s room for more than one opinion in this community. And i think that all of this in-fighting is about as productive as spitting gobs of mustard onto the cafeteria ceiling to see how many dinosaurs we can catch – and just about as ridiculous.

    It’s a big enough world that we don’t all have to be in the same carpool. It’d be nice, but i don’t think we’re all required to agree with each other 100% of the time. I don’t think “can’t we all just get along” is feasible – nice idea, but while i’m dreaming, i’d like a pony. The more options we have within this community, the more we potentially have to offer to people. We have a multitude of differing ideas and personalities? Let’s use that to our advantage instead of letting it hinder and cripple us.

    The trick is that we have to recognize that ultimately, we’re all FOR the same thing: recognition that fat people are human beings, and deserve to be treated as such. Whether we do or don’t agree with each other on the petty details is, ultimately, entirely fucking irrelevant.

    Now – we can sit and bitch at each other until the sun goes down and comes back up about who doesn’t like who, or who doesn’t agree with who, but all that does is distract us and present a highly unstable image to anyone who happens to walk in. Do we need to care about these sorts of things? Eh, maybe. I know if i were new here and saw all this before i saw anything else, i’d want no part of the bloody mess.

    So i’ve said it elsewhere and i’ll say it here, too: if all we want to do is break as much glass as we can in this china shop, then by all means, let’s keep doing what we’re doing. But if we want to actually be productive and get something accomplished, this sort of infighting shit has got to stop.

  76. Mariellen, I’m very glad to hear you’ve succeeded in making some improvements in your health! I hope you keep feeling better =)

  77. Dammit. I leave for a couple days and miss so much stuff. Anyhow, in my own post I address the issue of WLS and support. Essentially, supporting the PERSON does not mean you’re supporting the PROCEDURE. It’s horrible that doctors shove WLS in people’s faces instead of treating their patients just as they would slimmer ones. It’s horrible that often a fat person’s only option is to rearrange organs just so doctors can get to the bottom of what’s wrong.

    What I hope, however, is that we can get past this so that NO OTHER PERSON has to feel cornered by such a decision. IMHO, it makes no sense to war within the movement any longer. If we, as FA activists, are truly pissed at the options set before fat people, let us not argue amongst ourselves. Let us work together to press–nay, force!–the medical community to acknowledge that WLS is NOT the magic bullet, diets are NOT the be-all end-all of health, and that thin does NOT equal healthy.

    If we cannot be at peace within the movement, we cannot adequately delcare war on the true opposition.

  78. This reminds me that the local news station, NBC..I think. I don’t know if it’s going to be only on Chicago NBC, or all NBC stations. They’re doing a segment about how WLS could help teens.

    Every time I see the ad for it, I want to whap the person who thought it was a good idea to create the segment. I think every newscaster should have to go to a ED clinic, or visit someone who has had WLS and has alot of problems because of it, before going on TV. I’d like to see them encourage this self-destruction when they personally have seen the horrors that result from it.

  79. Now – we can sit and bitch at each other until the sun goes down and comes back up about who doesn’t like who, or who doesn’t agree with who, but all that does is distract us and present a highly unstable image to anyone who happens to walk in.

    See, I disagree. I’m with you on the fact that for progress to happen, we need to either agree on some goals and some boundaries or split off into separate branches.

    But I don’t think (YMMV) that threads like this make the movement look “unstable.” I think they make it look thoughtful and passionate, because that’s what everyone here is. When there’s no simple answer to a thorny question, there’s no sense in pretending there is one for the sake of faux-unity. That’s what fundamentalists do. It’s intellectually dishonest, and all it does is turn open anger into buried resentment, which is just as bad for the movement.

    And on top of that, I think we’re accomplishing something with this very thread. It’s great to think bigger than blogs, and to want to organize people to take on big opponents out in the real world. But as I said in comments the other day, my mantra is always “Remember the lurkers.” There are a lot of them. And when they read threads like this, they can see both sides — or a dozen sides, as the case may be — to an argument they might not have thought about before. There are new people coming here every day who haven’t considered this shit, or seen any of these arguments before. I think if I were coming here for the first time, I’d find this thread really informative — I know that’s been the case for me with other blogs, when I’ve read threads on contentious issues.

    Maybe it’s a matter of one’s threshold for confrontation, but frankly, mine is not nearly as high as it may seem. I don’t like arguing. Comments in this thread have made me feel oogy in the tummy more than once, because I knew I’d have to publicly disagree. But in the big picture, I don’t think it’s useful to force unity where there is none.

    Yes, we all have one big common goal, but “We want everyone to be nice to fat people” isn’t an action plan. And when it comes to focusing on specific projects, there will be disagreements, and there will be infighting. Every single social justice movement, EVER, has dealt with infighting — and most of them make plenty of progress anyway.

    I think the idea that we need to be at peace before we move forward is a myth (sorry, FashionableNerd). We don’t need to be at peace, we just need to know what different people/groups within the movement stand for specifically, and we need to work with the people whose political positions and goals most closely align with our own. And even then, there will be infighting, ’cause there always is. It sucks, but it’s the cost of doing business, ’cause once again, a movement without open internal disagreement is just fundamentalism.

  80. Oh, but I should also point out — though I think it’s clear from my previous comments on this thread — that I don’t think there’s any point in manufacturing disagreement where there basically is none, either.

  81. Kate, since you disagreed with the exact sentence that I so openly agreed with, I felt I should clarify exactly what I meant when I said that.

    To me, open internal disagreement (to use your words) and fighting are two TOTALLY different things. Disagreements are good. Debates are good. FIGHTING, on the other hand, is bad.

    You can disagree and/or debate with someone without it escalating into fighting. That is what I was agreeing with when I agreed with fashionablenerd’s comment. Whether or not that’s what SHE meant I can’t say (‘cuz… you know… I’m not psychic or anything ;) ). But when I read those words, THAT’S what popped into MY head.

    I absolutely agree that key points to ANY belief system should be debated upon and re-evaluated. But it IS possible to do that without it devolving into FIGHTING.

    That’s where I’m coming from. And if anybody wants to disagree with me, that’s just fine. :D

  82. CHARLIE-

    I understand what you mean. Perhaps I should have said “informed choice.” What I was getting at is that I don’t believe anyone should feel as if it is their only option if they want to receive proper medical treatment, or even to live a full, happy life, but neither should they be vilified for deciding to have the surgery.
    Btw, I agree that the fewer surgeries there are in the world, the better. We have turned plastic surgeons into rock stars, and it’s VERY dangerous.

  83. Just to clarify – agree with what was said about diff between infighting and disagreeing. disagreeing is necessary, infighting is not. the fighting isn’t all happening here, but it is happening. i’d comment more, but not well atm. perhaps that unwell is cause of my extreme upset from last night. apologies if i was overboard.

  84. vesta44, thank you so much for sharing your story, and I am so happy to hear that the yoga and bands seem to be helping with your mobility. I love strength training for myself and think it can also be a great option for other fat folks who want to do it, because exercises can be varied to accommodate mobility issues or injuries, and you are actively improving the ability of your frame to carry your weight and to otherwise function well. It just feels like such a self-loving thing to do. Plus I personally enjoy being strong and feeling like I could kick some ass if I had to, and being big is an advantage there too. After all, as a large person I have lots of tissue of all kinds and that includes muscle. I am speaking in general here, not preaching to the choir since I know you are already strength training. Anyway, I hope you continue to feel better. The strategies you are using sound great. You deserve some good developments after what you went through with the WLS and subsequent medical encounters and I am so sorry you experienced those things.

    I wanted to thank Rose, Currer Bell, Kate, and everyone else for solidifying what I think is a very compassionate position toward people who choose WLS, while clearly articulating why WLS can still not be considered a good, safe, or likely-to-succeed choice. I feel like I understand the issue quite a bit better now. It is really tempting even for FA people to want to believe that WLS is a good or positive choice in certain cases, since in those cases it is the only choice. It is just too heart-wrenching to accept that there is NO good option for someone who is sick and in pain, even if that is the cold, hard truth. I think the slippery slope from “WLS is your only choice and I can see why you decided to do it” to “I want your pain to end, therefore I want to believe that WLS will solve your mobility problems” to “It is a fact that WLS actually does solve mobility problems” is definitely there and dangerous and I appreciate the way that the differences between these positions have been clearly outlined here as part of these discussions.

    In a similar vein, I also appreciate Rose pointing out that it is perhaps a tiny bit incorrect to say that Heidi only got WLS so she could earn the “right” to appropriate medical care (which is, as many have said, appalling). By her own words she got it largely because she could see no other way of regaining any measure of the health and mobility she had lost. I appreciate Rose pointing this out because it allowed the point to be reinforced that although Heidi was in a horrible position and practically speaking had no other choice, that still does not mean that WLS is demonstrably effective at improving health or mobility. Heidi could very well end up worse off than before, and that sucks.

    Honestly, though, I’m human and I certainly hope that Heidi’s WLS somehow works for her and she becomes able to do everything she wants to do again, and goes on to live a happy, comfortable, mobile, healthy life. I am well aware that it is unlikely that she’ll have that good an outcome, but if it can possibly happen I want it to happen for her even though that might weaken my “position” as a WLS opponent (I have always said that fucking around with people’s digestive systems has to be far more dangerous than being fat, even long before I knew there was any such thing as FA). Heidi has suffered enough and I know nobody here would enjoy seeing her suffer more in the service of proving a point.

    I would even go further and say that I would absolutely love it if WLS were somehow demonstrated safe and effective for improving people’s health and mobility in general, not just for Heidi (in the rare cases where the physical presence of their fat is degrading their quality of life and we’re not just using fat as shorthand for whatever is really wrong with them). Unfortunately, it is almost certainly NOT safe, effective, or permanent for this purpose (an educational message that FA is working really hard to put out there) and is probably actively harmful, and that to me is the problem, not the simple fact that someone who gets WLS may lose weight and losing weight is de facto bad. Not that it is up to me, of course, but I think Kate did the right thing in bringing Heidi’s guest post over in the first place because positions on WLS can too easily become overly theoretical and rigid and (apart from the obvious fact that Heidi is a human being and deserves compassion) I feel that not at least acknowledging how painful and wrenching these choices (or lack of choices, really) can be actually limits FA’s ability to function in the real world. If our only response is “Nope, never get WLS, next!” then we can get “out of practice” at seeing how painful the process is for the real human being involved.

  85. Heidi has suffered enough and I know nobody here would enjoy seeing her suffer more in the service of proving a point.

    Amen to that. And in my latest post, I said a lot of what you’re saying here, spacedcowgirl. Great minds and all that. :)

  86. Thank you so much for that post. I think it solidifies a really important point and I was “cross-commenting” to that effect over there just now. :)

  87. I’m doing a Healthy at Every Size program at my city’s hospital, which focuses on exercise and psychological stuff, understanding more about the possible underlying physical and emotional causes of excessive weight gain (including PCOS, prescribed medication, Western lifestyle) and thoughtful eating. It’s brilliant. The improvement in my mental and physical health is amazing – and I might add this has been without losing too many kilos either. Our nutritionist told us that while for a very small proportion of the population WLS may be appropriate, it should always be seen as a last resort AND we should realise that a lot of people were making a lot of money out of the surgery. That last point, I think is particularly poignant.

  88. Someone here said that since under 7 percent die from WLS and 40 percent lose weight, no one can argue that WLS works.

    First of all those are early results. The later results like at the 10 year point (Swedish Obesity Study for one) found that the AVERAGE weight kept off was 16 percent of the original weight. Many feel those type of results are not worth the induced illness of the digestive tract which WLS introduces.

    Another result from the Swedish Obesity study was that of those who were diabetic at the time of surgery, at the 10 year point, only 35 percent of these were still “diabetes free”.

    Secondly the “success” with WLS is hard to judge because I have observed that many of those who are able to keep their weight down after WLS are those who have become ill or have serious repercussions like reactive hypoglycemia etc.

    I put forth that making one ill to keep them slim seems not a good idea – although there are times our society actually sanctions illness if it helps people to lose weight.

    As one weight loss surgery surgeon stated “fat and healthy way beats slim and ill”.

    Third, an interesting thing to note is that most older fat people know a bunch of folks who died from WLS. One lady who weighs over 500 lbs and is in her 50’s, told me that she’s outlived 48 of her fat friends who had WLS.

    I think that people who choose WLS are choosing it because they feel cornered in a society which treats fat people like lepers were treated a few centuries ago, should be accepted and supported and loved. Because they are doing the best they have been told that they can do. They are courageous people willing to take risks to do what they have been told will “make things right”.

    But on the same token, we can still question whether WLS is ever a good idea – it’s not in the class of other surgeries which may be necessary – and the jury is still very out on whether it has much of a raison d’etre (other than helping to fund a very affluent industry). JMO…

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