An Unacceptable Sacrifice: Fatphobia, Ableism, and the COVID-19 Pandemic
Over the past several weeks, I have encountered online discussions about the coronavirus pandemic that attack fat people, either because they have supposedly brought COVID-19 risk upon themselves by eating “too much,” or because they are dispensing weight-loss advice for people who fear becoming fat while being socially isolated, or because they simply enjoy punching down at others. The rhetoric I’ve seen surrounding fatness, health, and COVID-19 is strikingly similar to some of the ableist discourse I’ve seen about disabled people and the coronavirus: Whether you’re fat or disabled or both, you’re an acceptable sacrifice to protect the rest of the population, whether you have a say in it or not.
I don’t believe fatness is in and of itself a disability; however, I do think that both fat people and disabled people live in marginalized bodies and fat disabled people exist. What is a marginalized body? Marginalized bodies are those that are deemed “less than” by society at large: women’s bodies, trans people’s bodies, disabled people’s bodies, fat people’s bodies, old people’s bodies, Black and Brown people’s bodies. Marginalized bodies fail to conform to a stated or tacit ideal, whether that ideal is thinness, youth, or gender conformity. Fatphobia resembles ableism and other forms of bodily marginalization because they are rooted in similar principles:
- The lives of people in socially valorized bodies are more valuable than those of people in marginalized bodies, and
- Existence in a marginalized body is an intrinsically undesirable state.
Moreover, medical models of fatness do view it as an inherently diseased state–the demeaning label of “obesity”–regardless of whether someone’s weight requires additional support needs. The existence of “obesity” as a disease state is an unexamined truism that reduces discussions about weight and health to an apolitical conversation denuded of context, individual and social determinants of health, or cultural perspective (Cooper, 2016). People wedded to this idea can scarcely imagine a world where weight and health are independent of each other, or at the very least, are less dependent than they thought. Despite the patina of scientific validity, “obesity”-prevention advocates approach their work with a crusader’s religious zeal (Strings, 2019). Sometimes the religious analogies are explicit: I distinctly remember the “Ten Commandments of Dieting” in Richard Simmons’s late-80s Deal-A-Meal cookbooks. In other cases, the religious undertones are subtler: thinness is equated with morality, while fatness is immoral by its very existence. Losing weight through dieting and exercise is an act of penance. Achieve your ideal weight, lest you be condemned to a lifetime of sinful gluttony. Fat people must be whipped into shape with Biggest Loser-style “tough love.” By turning complex biological realities into simplistic moral truisms, anti-”obesity” advocates strip body size, health, and nutrition of all context. In Fat Activism, the British scholar, therapist, and fat activist Charlotte Cooper (2016) writes:
Obesity discourse is totalitarian, by which I mean it presents itself as the only authority on fat, nothing else counts. Fat is a crisis brought about by a mismanagement of energy balance, it offers nothing of value, it is only an opportunity for intervention. It is always about health, and health is presented as an apolitical fact.
The idea of fatness as an unqualified ill is also dubious: Empirical science “proves” that fatness is unhealthy as much as Pioneer Fund-supported studies on race and IQ “prove” that Black people are intrinsically less intelligent than white people. Race and IQ studies explain lower scores among Black people as signs of our intellectual inferiority, rather than indicators of environmental racism, lead paint, malnutrition, centuries of discrimination, educational inequities, and other factors that exist outside our brains. Poorer results on IQ tests may show that people are drinking lead-filled tap water and going to dilapidated schools with harried teachers who can’t give students the individualized attention they need, but people who are invested in the idea of Black intellectual inferiority don’t care about people’s lived realities. And that’s not even accounting for the problems with IQ tests in and of themselves.
Studies that link “obesity” to diabetes, heart disease, and other poor health outcomes fail to acknowledge how larger bodies are stigmatized within society, and how medical inequities can make it more difficult for fat people to seek out healthcare to address diabetes or cardiovascular disease before they cause long-term damage. Stigma on its own, independent of weight, contributes to worse health outcomes among fat people. Moreover, the definitions of “obesity” are based on the Body Mass Index (BMI), a crude measure of how much someone is “supposed” to weigh based on their height. The BMI doesn’t account for assigned sex at birth, race, muscle, fat, or other data that may influence someone’s health (Harrison, 2019; Strings 2019) . If you’re above a certain BMI, you’re pathologized and diseased, regardless of your lived experience.
The devaluation of marginalized bodies and minds leads people in power to treat our lives as expendable if we don’t–or can’t–meet their criteria for “normality.” Both fat people who want to exist in the world without intentionally losing weight and autistic people who refuse to be trained to be indistinguishable from our non-autistic peers are ostensibly violating a cosmic order to pursue an unhealthy lifestyle. Like anti-“obesity” discourses, normalization-focused treatment for autistic people is totalitarian. It admits no other options for healthy existence. Weight-centric medical models and treatments that force autistic people to suppress ourselves are forms of what I call compulsory assimilation, or an ethical stance that prioritizes the performance of normality over individual or collective wellbeing. It doesn’t matter if you suffer if you meet our ideals…or die trying to meet them. This morally tinged medical model gives practitioners a justification for denying care to people in marginalized bodies: Because fat people refuse to be “normal,” and because disabled people can never become “normal,” we are expendable in a pandemic. Politicians and practitioners who devalue marginalized bodies have made it clear: we are the first to be left to die when doctors, nurses, and other health professionals make difficult triaging choices. There’s no point in asking us; by virtue of the bodies we inhabit, we are expendable. The British government’s guidelines list being “severely overweight” (as defined by a BMI above a set cutoff) as a risk factor for severe reactions from the coronavirus, in addition to more concrete risk factors like diabetes and heart disease.
Prejudice against people in marginalized bodies is deadly.
My body is marginalized many times over: I’m queer, fat, Black, disabled. I am terrified that if I encounter serious complications from the coronavirus, I will be left for dead for one reason or another. When I encounter people on Twitter or Facebook blaming the “obese” for the spread of coronavirus, or advocating for triaging that protects the young and healthy and leaves disabled people high and dry, my pulse quickens. My blood pressure and sugar levels rise. An overwhelming sense of panic suffuses my body. I am reminded, yet again, that my life is somehow worth less than people without marginalized bodies.
It doesn’t have to be that way. We are people, not just BMI scores or diagnoses. I am not your cautionary tale. I am not your epidemic. Humane healthcare policy looks beyond actuarial tables and at the complex social, material, and medical realities in which we live. History will judge us by how our leaders handled the COVID-19 crisis. Medical practitioners are therefore faced with a moral dilemma: Do we embrace Social Darwinism, or do we embrace humanity?
Finn Gardiner is a disability rights advocate with interests in educational equity, intersectional justice, comparative policy, and inclusive technology. He holds a Master of Public Policy degree from the Heller School for Social Policy and Management at Brandeis University and a bachelor’s degree in sociology from Tufts University. He also recently finished a fellowship in Leadership and Education on Neurodevelopmental and Developmental Disabilities—LEND—at the University of Massachusetts Medical School’s E.K. Shriver Center.
He is currently the Communications Specialist at the Lurie Institute for Disability Policy at Brandeis University. Throughout his work, Finn combines disability advocacy, policy analysis and research, and written and visual communications through policy briefs, original reports and white papers, and contributions to research projects. His research and advocacy interests include education and employment for autistic adults, comparative disability policy, inclusive technology, LGBTQ cultural competency, and policy that takes into account the intersections between disability, race, LGBTQ identities, class, and other experiences.
Campos, P. (2004), The Obesity Myth: Why America’s Obsession with Weight Is Hazardous to Your Health. New York: Gotham Books.
Cooper, C. (2016), Fat Activism: A Radical Social Movement. Bristol, UK: HammerOn Press.
Harrison, C. (2019), Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness through Intuitive Eating. New York: Little, Brown Spark.
Strings, S. (2019), Fearing the Black Body: The Racial Origins of Fat Phobia. New York: New York University Press.
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