everyone they interact with that their size is nothing to apologize for. “When you pity someone, you think they’re less effective, less competent, more hurt,” he says. “You don’t see them as capable. The only way to get rid of stigma is from power.”
Solution: Size is not an apology, reclaim power
Your conscious mind is busy the whole day with how many calories is in everything, what you can eat and who’s watching,” she says. After a few intrusive comments over the years—should you be eating that?—she has learned to be careful, to perform the role of the impeccable fat person.
Consequence: Self Harm-mental and physical
Erin Harrop, a researcher at the University of Washington, studies higher-weight women with anorexia, who, contrary to the size-zero stereotype of most media depictions, are twice as likely to report vomiting, using laxatives and abusing diet pills. Thin women, Harrop discovered, take around three years to get into treatment, while her participants spent an average of 13 and a half years waiting for their disorders to be addressed
University of Washington Research Harrop
And so, working within a system that neither trains nor encourages them to meaningfully engage with their higher-weight patients, doctors fall back on recommending fad diets and delivering bland motivational platitu
Causes: insurance reimbursement, performance review, poor recommendations-fad diets/bland motivation platitudes
Many of the financial and administrative structures doctors work within help reinforce this bad behavior.
Causes: Poor training, not enough time in appointment
In a 2013 journal article, bioethicist Daniel Callahan argued for more stigma against fat people
Claim 5: Shame can help people lose weight
No matter what you go in for or how much you’re hurting, the first thing you will be told is that it would all get better if you could just put down the Cheetos
Consequence 3: Poor Medical Care
If you looked at anything other than my weight,” Enneking says now, “I had an eating disorder. And my doctor was congratulating me.”
Consequence 2: Fat people cannot have eating disorders
weight and health are not perfect synonyms
Claim 3: Weight and Healthy are Synonyms
The first is that diets do not work. Not just paleo or Atkins or Weight Watchers or Goop, but all diets. Since 1959, research has shown that 95 to 98 percent of attempts to lose weight fail and that two-thirds of dieters gain back more than they lost.
Claim 2: Weight loss is possible to get to a healthier weight
“Baby Beluga” as she boarded the school bus, another said she has tried diets so extreme she has passed out and yet another described the elaborate measures he takes to keep his spouse from seeing him naked in the light. A medical technician I’ll call Sam (he asked me to change his name so his wife wouldn’t find out he spoke to me) said that one glimpse of himself in a mirror can destroy his mood for days.
Consequence: Shame, Depression and Bullying (Pediatrics)
Obesity, we are told, is a personal failing that strains our health care system, shrinks our GDP and saps our military strength. I
Claim 1: Obesity is a personal moral failing
People’s Institute for Survival and Beyond, Race Forward, Western States Cen-ter, the Haas Institute for a Fair and Inclusive Society,
Other institutes doing the work....
Pervasive Northern Slavery
1) To history we owe our frames of reference, our identities and our aspirations...battle with historical creation attempts to re-create oneself according to principle more humane and more liberating 2) To wrestle with it and finally accept it to bring myself out of it 3) Personal incoherence from unable to release themselves from history 4) Do not blame me, I was not there. I did not do it. 5) in private chamber of his hear...he does not wish to pay..has profited so much 6) Deserving of our fate..fear black people long to do to others what has been done to them 7) Color Curtain 8) "trust life and it will teach you in joy and sorrow, all you need to know" 9) White man barricaded behind guilt...junkies on hundred dollar a day habits
A clearer understanding of what we know, and what we don't know, is a better path to ensuring that our investments in social factors truly pay off.
Summmary: A clearer understanding of what we know, and what we don't know, is a better path to ensuring that our investments in social factors truly pay off.
1) Values are judgements 2) Factors not mutually exclusive 3) Outdated evidence like HIV which used to behavioral but now determined by healthcare 4) Evidence associative not causative and important to delianate cross sectional vs. time bound 5) Priority for individuals may be different. How do you weight those? 6) Lifestyle/Behavior change may imply that's it within purview of indivuals
I
COVID-19 response shows the caste system within healthcare system as low wage workers disproportionately have less protection and less communication channels to understand what's occuring.
Structural Racism as SDH: -Examples: 1) Home Health workers not eligible for paid leave causing disproportionate harm when injured 2) Nursing Home: SSA funded private long term care for the elderly and prohibited funding for institutions for AA individuals Laws 1) Often don't address root causes. For example, anti-discrimination laws legitimizes existing structures