Notions of willpower are easily stigmatizing: It becomes OK to dismantle social safety nets if poverty is a problem of financial discipline, or if health is one of personal discipline. An extreme example is the punitive approach of our endless drug war, which dismisses substance use problems as primarily the result of individual choices.
Such a fantastic read on a topic that permeates our health and social systems.
We’re starting our “metabolism” module at med school this week, and I’m dreading it with every fibre of my being. You see, I am going to be a doctor, and I am fat.
I’m not the type of fat you feel after you’ve had a big lunch, and your usually flat belly is protesting against the waistband of your jeans. I’m the real kind. My BMI hovers a couple of points below “morbidly obese”.
I worry a lot about what people will think of me as a fat doctor. For the smartarses among you, of course I’ve tried to be non-fat, it goes without saying. The thing is though, bodies don’t really like weighing less all of a sudden and are pretty good at reversing things in the long run. Mostly my body settles back to the same size 18 shape eventually.
I am always aware of my fatness, but perhaps more so here at medical school. We are training to work with bodies, and mine is a type of body we warn our patients not to have. It is the first thing described in every list of ‘modifiable risk factors’. A colleague suggests “just don’t let yourself get too fat” as we talk about preventing a certain type of cancer. A final exam question asks us to list four poor health outcomes associated with obesity. I sit through lectures with slides that have sniggering titles like “how BIG is the problem?”
“There’s some truth” to claims that people of color are suspicious of clinical studies, this epidemiologist, who is Latino, said, “because there’s discordance in who gets studied and who’s doing the studying.”
This has enormous implications for the applicability of health research.
Becoming disabled demands learning how to live effectively as a person with disabilities, not just living as a disabled person trying to become nondisabled. It also demands the awareness and cooperation of others who don’t experience these challenges. Becoming disabled means moving from isolation to community, from ignorance to knowledge about who we are, from exclusion to access, and from shame to pride.
Disability studies should be required for the health professions.
