The other day, I got fat-shamed. When you get fat-shamed often, like every time you turn on a television, it takes a lot to make an impact. My husband, Chris, and I went to our city’s second annual Afro-Centric Pregnancy Fair in Portland, Oregon. I had high hopes of being in a supportive environment of people who care about the unique challenges facing black women as they enter pregnancy, childbirth, and childbearing. I fantasized about talking with midwives, doulas, and new mothers about their amazing experiences and horror stories of hospitals, birth centers, and their living rooms. Instead, I got a major dressing down by a black doctor manning an information table for a clinic.
When Chris and I approached the table and said we are considering starting a family, almost immediately this doctor told me that black women are more likely to face high blood pressure, diabetes, C-sections, and die in childbirth (true). She told me that black babies are more likely to have low birth weight, birth defects, be stillborn, or die (also true). And she said the only thing I could do about these (complex, systemic) issues is lose weight.
The only thing I can do to make sure that I don’t die or that my child doesn’t die is lose weight — an interesting perspective because, based on my ample research, those things impact black women disproportionately even when controlling for weight. Many argue that this is a logical outcome of systemic, institutional racism and socioeconomic disparity where black women have less access to resources (like good nutrition and healthcare) and deal with the continued physical impacts of racism.
The devastating health disparities that black women experience in pregnancy and childbirth were not the doctor’s biggest concerns, however. She continued to tell me that black people don’t know anything about health and exercise so it’s not surprising that I’m fat and that black people have health problems and her mother was a big girl and she doesn’t want anyone to have the terrible life that her mother had. So, whenever she sees a “sista,” that’s why she stops them and asks “Whatchu doin’ ’bout some exercise today?” So before I even think about getting pregnant I need to lose a lot of weight because, otherwise, I’m putting my health at risk, but more importantly I’m risking the life of —
At this point, I stop her and say, “Yes, actually I’m well aware of the health risks associated with obesity and race on pregnancy which is why I’ve already lost more than 10% of my body weight.”
“That’s great!” she says. “Obviously, you’ve got a lot more to go.”
That’s when I made my awkwardly smiley escape. As Chris and I visited the other tables, rage and shame started boiling in my “obviously” over-large gut. After much discussion with my conflict-averse husband, I decided I wanted to call her out on fat-shaming me, let her know the impact of her words, and tell her not to do that to other people. Which I accomplished… sort of. I did go back, and when I told her that she’d just fat-shamed me and that her words made me feel unworthy of being a mother simply because of my size, she apologized. She got up, looked me in the eyes, sincerely apologized, and hugged me. I thanked her for her apology. It was a beautiful moment of sistahood… except, not really.
This sort of thing happens to me all the time. If I took the time out to have an emotional reaction for every time I experience sizeism, racism, sexism, micro-aggressions, etc., I would cease to function. However, what I wanted to say to that doctor is the same thing I failed to say to another medical professional (and the entire medical profession) the other day. It’s that part about not doing this to other people. If I could do either over again, it would go something like this:
As you so smartly deduced and eloquently spoke about, I am fat. Based on my appearance (read: race and size) you may not have assumed that I am relatively well-educated; lead a socially and (mostly) financially stable life; and have ample access to the internet, libraries, and bookstores matched with a desire to learn and college-level researching skills. As such, I am well aware of the health impacts of obesity because I’ve intentionally sought out that information. Similarly, it’s possible that I know more than you do about how to lose weight. I say that because the way you’ve spoken to me indicates that you have no concept of what it’s like to be fat and, further, no concept of the fact that as a fat person, I am constantly bombarded with “guidance, tips, and advice” on how to lose weight. Whether or not I want to be, I am an expert on how to get thin. It’s somewhat analogous to the way that white people have no idea that people of color in predominately white communities are experts on whiteness — whether they want to be or not.
Based on my access, ability, and desire to obtain the information, it should follow that I know a great deal about the negative impacts of obesity (and race) on pregnancy and childbirth. One thing comes through loud and clear from my research: Only a portion of obese mothers have these experiences, NOT ALL. It’s not a majority, it’s not even a large portion. But it happens more with obese women than with “normal” women, so, apparently, you think you have the right — dare I say, duty, even — to scare me into losing weight. You are not educating me. You are not telling me anything I don’t know. You are fat-shaming me and patronizing me.
Stop. Please stop doing this to your other patients. Instead, I would urge you to be supportive, thoughtful, and more knowledgeable. You also need to check your bias. Be able to provide resources to your patients like information sources, community resources, and other health (including mental health) support. Keep in mind that you are dealing with other human beings and not just stupid fat blobs with no feelings. Remember that our whole culture is telling this person that ze is fat and therefore disgusting and unworthy. Ask yourself, do you want to be just another voice telling this person that ze’s disgusting and unworthy, or do you want to help your patient make some changes?
These are some of the things I wish I had said to these medical professionals. In some ways, the hardest thing about these experiences is that I don’t really want to lose weight, but I’m trying to because I want to have a baby and I’m sick of these conversations.
The society and dominant culture in which I live have succeeded in making me very uncomfortable in my fat body. But, stubborn as I am, I cling to my fat as an act of defiance. My fatness runs counter to what is deemed culturally acceptable and is, therefore, a revolutionary act. Unfortunately, the medical establishment sees my revolutionary act of defiance simultaneously as a burden, a cash-cow, and high risk when it comes to pregnancy. For those reasons, I’m much more likely to be highly scrutinized and criticized, required to submit to (possibly unnecessary) medical interventions, and have a C-section.
The real world implications of bigotry create unnecessary stress on my body and will for my baby. Stress during pregnancy is strongly linked to high blood-pressure, diabetes, maternal death, low birth weight, premature birth, birth defects, stillbirth, and infant death (truth). Funny how that works.