Nobody Owes You Fat Positivity: On Weight Loss Surgery as “Betrayal”

I’m tired.

I’m tired of the circles we run in every time we read some high-profile story about a fat person choosing to get weight loss surgery rather than cope with the social pressures of being fat anymore. Even for those folks who credit health reasons for their decision — The Choice That Must Be Defended — it is important to recognize that health and our understanding of health do not exist outside of cultural fat hatred. If they did, I’d have dealt with a lot less fat bias with doctors over the course of my entire freaking lifetime.

But I am getting ahead of myself. First, let’s talk about body autonomy. Body autonomy is paramount. It is a basic human right. Body autonomy needs to be the foundation on which fat positive (and “body positive,” I GUESS) activism is built on. Autonomy dictates that I get to make decisions regarding the state of my body that are both personal and private, and you do as well, and so does literally everyone else in the world. Autonomy means I get to stay fat even when lots of people do not want me to. Autonomy means I get to embrace being fat even when the dominant culture I live in is powerfully opposed to this. Autonomy also means other people get to make decisions about their bodies that I think are troubling or unwise. Or that you think are troubling or unwise. People get have the consensual sex they enjoy, even when others think it’s perverse or gross. People get to have tattoos that others think are unprofessional. People get to eat food that others think is unethical or unhealthy. This is what body autonomy means.

Last month, The Nib published a frankly bizarre comic about a woman who had chosen to have weight loss surgery, and her reasons and experiences with it. I call it bizarre because a lot of it reads more like a revenge hit on the fat acceptance community the author has rejected, rather than a personal narrative. She sets up several straw man arguments to knock down. For one, she asserts that people in fat acceptance refuse to admit that it’s easier to be thin; irony of ironies that this is actually at the core of fat acceptance’s reason for being, that injustice of the reality that it IS easier to be thin, far easier, in a world built to accommodate bodies only up to a certain size. She blames her poor fitness on being fat, refusing to understand that while this may be her perfectly valid experience, it is far from a universal one for all fat people, and more to the point, not being able to run without gasping for breath may be frustrating, but is not shameful — or at least, it shouldn’t be. She lists a litany of toxic-stereotype-reinforcing things that are terrible about being fat; she indvertently hints at what seems to be a serious and unaddressed eating disorder; she complains about thigh chafing (again, not exclusively a fat person problem); finally she states that weight loss surgery is considered traitorous in fat acceptance as a whole, a generalization that may be true of individuals, but with which I take extreme exception in the broader sense.

The title of the comic itself asks a question that turns out to be utterly insincere: “Am I a traitor?”

This is a question that I imagine every fat positive person who’s ever had weight loss surgery has asked herself. And yes, there are fat positive people who have had weight loss surgery. Within most of fat positivity — which is not a monolith, by the way — surgery is viewed with extreme suspicion and care for many reasons, most of which have to do with the lack of long-term, large-scale research on its chronic, often debilitating side effects, and its unknown impact on life expectancy and overall quality of life in the decades to come. Aside from the murky and unsettling individual effects, surgery also has wide reaching cultural effects, and the frequency with which it is prescribed even to people not seeking weight loss reinforces a culture in which fat bodies (and therefore fat people) are perceived as diseased, dehumanized, and disposable. Surgery is questioned within fat positive movements because fat people have no reason to trust a medical community that has consistently shown such disdain for our actual health, relying instead on bias and assumptions rather than treating us like individuals. We question the need for surgery because we care about fat people and want them to live.

Still, body autonomy is paramount to fat acceptance. We cannot ask the world to affirm our right to conduct our bodies as we wish if we cannot offer the same affirmation to everyone else. If you want surgery, you get to have it. That does not mean you still get to participate in or be embraced by fat acceptance communities — although it doesn’t mean you will be excommunicated either. That outcome will depend on how you conduct yourself afterwards. Still, I maintain that this suspicion with regard to surgery has nothing to do with people who get it being seen as a “traitor” to fatness or fat activism.

The truth is, lots of fat-positive acceptance-advocating activists have had weight loss surgery. And lots of them managed to do it privately, and not to publicly list all the reasons being fat sucks, because they know those reasons will only be turned around on those of us who remain fat, and used against us, as they always have been. Certainly, these personal struggles are things anyone is free to discuss candidly with friends. But in this case, by making a public account of an improved de-fatted life, the author of the comic linked above however unintentionally (although I think it is intentional) paints a picture in which all fat people suffer from the author’s miseries, when many of us don’t have these issues at all. She reinforces the stereotypes and generalizations that made it so hard for her to be fat, and she does so with a total disregard for those of us still in that fight. So, really, the author is a traitor. But not because she had weight loss surgery; she is a traitor because she has rejected fat acceptance not only for herself, but for everyone.

Earlier this week, as part of her excellent Unruly Bodies series for Medium, Roxane Gay wrote about her decision to have weight loss surgery in January of this year. I’m not here to comment on that specific decision, because — as I hold body autonomy to be inviolate — it is 100% pure grade-A none of my fucking business. Am I cranky about another high-profile narrative in which being fat is depicted as ostensibly one of the worst things ever, a narrative that I and others like me must then fight against even harder to ensure our own experiences and voices are heard and not erased and replaced with the comfortable, sweeping assumptions that we all suffer identical horrors and pain as a result of our shared fatness? Yeah, if I’m real honest, I am cranky about that. That doesn’t mean I get to question her choice. That doesn’t mean I get to suggest she should have made a different one.

I do have another question, though. In her essay, Roxane writes:

I worried that people would think I betrayed fat positivity, something I do very much believe in even if I can’t always believe in it for myself. I worried that everyone who responded so generously to my memoir, Hunger, would feel betrayed. I worried I would be seen as betraying myself. I worried I would be seen as taking the easy way out, even though nothing about any of this has been easy, not one thing. I worried.

I have watched the reactions to the surgery reveal with some interest; while most have been supportive, some have shared that sense of betrayal mentioned above. Personally, I don’t think anything about getting weight loss surgery is ever easy. I think it is absurd that people frame it in such terms, and that this itself is yet another expression of cultural fat hatred, because it portrays a difficult and — again — permanently life-altering surgery as a choice made out of laziness.

But I want to zero in on one point above:

I worried that people would think I betrayed fat positivity, something I do very much believe in even if I can’t always believe in it for myself.

I have never considered Roxane Gay to be a fat positive writer, let alone any kind of leader in these movements. She is a talented, intelligent person who has written about being fat in extremely affecting and thoughtful ways. That is not the same thing. Writing about fatness and being a fat acceptance advocate do not automatically go hand-in-hand. There is nothing to feel betrayed about when someone who does not individually subscribe to fat positivity does a thing that feels to be in tension with fat positivity, and in this case, I suspect that many people have projected a certain responsibility on to Roxane that is unfair.

To be clear, I am making this point utterly free of personal judgement; Roxane Gay doesn’t owe me or anyone else fat positivity. I am not mad about it. I am not hurt or betrayed about it. Most of what I am is unsurprised.

But there is this, which continues to give me pause:

something I do very much believe in even if I can’t always believe in it for myself.

It just doesn’t work for me. You can’t only be fat positive for other people. This is a concept I have run into again and again and again, for the nearly 20 years I have been a part of fat activist movements. I understand the idea; it is a way of saying, I do not hold fatness against anyone else, and I defend all other fat people’s right to human dignity and respect — but not for myself, I can’t, I just can’t, I don’t know how. This simply doesn’t play. You can’t be in favor of fat positivity for others if you can’t also extend that same compassion to yourself. Because as long as you fail to include yourself in that space of acceptance and forgiveness, you will inevitably wind up participating in the institutions that oppress other fat people. You will, however unintentionally, wind up reinforcing the cultural stereotypes and assumptions that make all of our lives harder than they need to be.

To repeat: I don’t believe that the choice to have surgery itself is a betrayal. Any hypothetical betrayal comes later. This is why I tend to think that the most fat positive way to have weight loss surgery is to make it as private as possible. The moment you make this choice a public narrative, you lose control of how that narrative may be used to harm fat people striving to accept their bodies and to survive in a world where self-determination on this point is already incredibly difficult. I have known a handful of people for whom weight loss surgery ultimately made them far more staunch and radical fat acceptance advocates than they ever were before. They don’t necessarily regret their choice, but they have a different perspective having made it. This is work. Self acceptance is fucking work. Body acceptance advocacy is fucking work. Sometimes it feels impossible. Even the most practiced at it have days in which it all feels so fragile that the slightest touch will shatter the whole effort into dust. But we keep doing the work. We do it not just for ourselves but for everyone who doesn’t do it, because they can’t, they just can’t, they don’t know how. Not everyone has the resources for this work. That’s all right. Still, even those individuals deserve the same dignity and respect as the activist with decades of effort and accomplishments behind her.

For awhile now I’ve been worried that one of the biggest mistakes in fat positivity movements’ current evolution is our habit of depicting the fight for self acceptance as a strictly individual effort. We portray this as an internal journey undergone by each person; and this is partly true. But that’s not all it is. While the personal experience is important, for real cultural change to happen, this cannot be just a matter of each of us coming to some kind of peace with our bodies on an individual basis, and then, as the tale usually goes, stepping out into the world to be a light to others looking for inspiration to find their own way. We must also be collectively fighting for self acceptance not only for ourselves, but for the well-being of every fat person that we have ever looked up to or admired or who has given us help, because body acceptance is a continuous process and never a final and permanent destination, and it needs support and fuel to keep going. We should be collectively fighting for self acceptance for those to whom fat positivity will never come, but who still have to cope with a medical profession that denies them adequate care, or employers who deny them promotions and pay them less, or physical spaces they cannot access.

The idea that “I believe in fat positivity for everyone else” is incompatible with this effort. You can’t believe in kindness for everyone but you; the cruelty you give yourself is enough to poison the whole batch.

If we agree on the ubiquitous maxim that “no one is free while others are oppressed,” we cannot each be practicing fat acceptance only for ourselves, and we cannot be advocating for it only for others. I believe that we must each practice it, and we must do so even for those who actively reject it, because in many respects they are the people who need it most of all. We who can do the work, must do the work, for everyone. Even the fence-sitters. Even the surgery-havers. And yes, even the traitors.

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