Tuesday, 30 August 2016

The Horror of “Obesity Autopsy”

Bad DoctorYes, the BBC is airing the autopsy of a fat person. No, it’s not ok. I can see the meeting now, someone stands up and says “how can we create programming that plays on and sensationalizes the social stigma against fat people, makes no medical sense, helps no one, and does tremendous harm?”  And thus “Obesity Autopsy” was born, eclipsing “Sharknado” as possible the most ridiculous idea to get produced and aired but, of course, far more harmful.

Let’s start with the basics. They have flown the body of a 238 pound woman, who died in her sixties of heart disease and donated her body to science, from California 5,000 miles to London so that Mike Osborn, a consultant for the Royal College of Pathologists, and Carla Valentine, an assistant pathology technician can perform an autopsy which will first be aired as part of a one hour program on BBC Three, an online service focused on the youth demographic, and then on a late-night slot on either BBC One or Two. The program will also include a panel of “obese young contributors,” who will explore the causes of obesity, and how it affects their day-to-day lives.

Before I get into this, let’s remember that fat people have the right to live and thrive in fat bodies without shame, stigma, bullying, or oppression and it doesn’t matter why we’re fat, what the consequences of being fat may or may not be, and if we could – or even want to- become less fat or not fat. Any suggestion otherwise will be some combination of sizeist, ableist, and/or healthist. The rights to life, liberty, and the pursuit of happiness are not size (or health) dependent.

Now that we’ve got that crystal clear, let’s start with the many ways that this is medically unsound:

First of all, the idea that one can extrapolate information about all fat people from the autopsy of one fat person is patently ridiculous.  This is taking what I’ll call the “Dr. Oz Fallacy” (wherein he tried to claim that all fat people have bad hearts based on the fact that the fat people who had come to him for heart surgery had bad hearts – as if the thin people who came to him for heart surgery were actually fine…) to whole new lows.

The autopsy can’t even tell us everything about this woman’s body (let alone everything about all fat people’s bodies.) For example:

It can’t tell us about her genetics in terms of body size or heart issues. It cannot tell us if her autopsy results are due to her body size, or something else entirely.  The  entire premise is completely bereft logic and I absolutely question the ethics of the pathologist and the assistant pathology technician participating.

It can’t tell us how she was affected by the culture of fat hate (Peter Muennig’s studies have found that the diseases that are correlated with “obesity” are also correlated with the stress of constant stigma, and that women who feel they are too heavy have more physical and mental illnesses than women who are fine with their size, regardless of their size.)

It can’t tell us if she was affected by the chronic dieting (and subsequent weight cycling) that is almost never successful and yet is prescribed throughout our lives to fat people by our healthcare providers.

It can’t tell us if she was affected by taking extremely dangerous drugs that doctors suggest fat people should take for a very tiny chance to get thin, despite the risk of death (often from heart problems,) or if she was affected by the tendency to prescribe to fat people what we diagnose in thin people.

It can’t tell us if her actual health problems were ignored by doctors who prescribed manipulation of body size instead of the evidence-based interventions that a thin person with the same symptoms would have received. It also can’t tell us if she avoided the doctor  or delayed seeking treatment because of their tendency to substitute shame and diets for actual evidence-based care.

It cant’t tell us if her healthcare was compromised by the epidemic of fat bias among doctors.  It can’t tell us if doctors would have worked harder to save her if she was a thin person on the table.

What it can tell us is that instead of using this woman’s donation of her body to science to advance the care that fat people receive (for example giving future surgeons a chance to work on a fat cadaver rather than seeing their first fat body when they are working on it) they are exploiting her life and death. I can’t imagine how I, or my loved ones, would feel if I donated my body to science and instead it was used in a mockery of science for television ratings.  It is inexcusable, it is unjustifiable, it is disrespectful, it is wrong.

And for everything this autopsy won’t tell us about this woman, it tells us exponentially less about every other fat person. And the people behind this are so utterly ignorant about that, that it’s embarrassing.  According to the Telegraph (not linking because of headless fatty picture) “Damian Kavanagh, the controller of BBC Three, said young people needed to be shown the impact of unhealthy eating.”

Body size is not the same thing as “unhealthy eating.” Fat people have behaviors around eating (and everything else) as varied as any other group of people. Speaking of questionably drawn conclusions,  I’m concerned about a panel of “obese young contributors  exploring the causes of obesity, and how it affects their day-to-day lives.”

First I’m concerned with the effect on these panelists. Even if one believes that “determining the causes of obesity” is a noble pursuit, it should follow that the pursuit should be undertaken with scientific rigor, not by asking fat people (who live in a fatphobic society and get messages like the one from Damian Kavanagh that suggest that “obesity” is the same as “unhealthy eating”) to speculate wildly – even if they weren’t handpicked to agree with the stigmatizing premise of this show.

I’m also concerned that they are asking about the effects of obesity on these kids’ lives, when it’s so common to try to convince us to blame on body size what is actually the effect of fat stigma.

Not to mention that even if this autopsy could draw medically sound conclusions about fat people (and let’s be super clear that it cannot) that wouldn’t change the fact that fat people should be able to live without sizeist, healthist, ableist, stigma, nor would it change the fact that there is not a single study where more than a tiny fraction of people have maintained significant long term weight loss, so if the suggestion is that being smaller would make us healthier than it’s as useful as telling us that being taller would make us healthier.

This show is an abomination that can only serve to disrespect the dead and stereotype and stigmatize fat people, and it has no place on the air.

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