Obesity and health have long been a topic of conversation for the American public. For years, fat has been condemned as undesirable by society and it has felt like the health care system has done it’s best to further that narrative by the way they address weight. You can’t walk into a doctor’s office without being weighed, being offered a diet plan, pill or program and some conversation designed to guilt you into losing weight. It has happened so much that various fat activists have been birthed who vehemently oppose the conversation of weight and health. Weight neutrality, health at all sizes (HAES) and other ideologies of this sort have gained traction and popularity as the rise of fatphobia conversations occur.
But is there actually any link between being fat and health?
The short answer to the aforementioned question is yes. However, I think it’s important that I address a few things here before I dive into the scientific aspect. Just because there is a link between fat and medical issues or illness, it does not mean that all fat people are unhealthy or going to experience any of the ailments I’m going to discuss today.
There are many factors that play into a person’s health which includes but are not limited to: gender, ethnicity, environment, nutrition, genetics, finances, accessibility to health insurance and doctors. You cannot look at anyone and decided their health status based purely on size. More importantly, even if you for a moment in your head assumed that a fat person you encountered was unhealthy, that fact should not have anything to do with treating them with decency and respect.
To assign an individual’s value as a person or lack there of on their body type or their presumed health status is just stupid. Regardless of a person’s health or body size, you should STILL treat them with respect. Using health or size to justify the hatred or disdain society spews towards large bodies is unconscionable.
With that being said, let’s get to the science of it.
The Link Between Fat & Inflammation
A while back I wanted to delve into if there was an actual scientific basis for the discussion of fat and health. I always see the warnings that if you’re obese you are at a higher risk of developing diabetes, insulin resistance, high cholesterol, cardiovascular issues etc. However, I never had one medical professional explain to me why this was or how any of it actually worked. Then in February 2021 I was diagnosed with Chronic Inflammation with high risk of Metabolic Syndrome by my Rheumatologist.
How did I end up with a Rheumatologist? I suppose I should back track just a bit. For years I had been dealing with joint pain all over. My left hip had already been diagnosed with osteoarthritis. However, with the edema, mild fever and random pains my body would experience, my primary care thought it would be beneficial for me to see a specialist. The Rheumatologist ran labs and it included the following:
- CCP Antibodies – an antibody the immune system produces with Rheumatoid Arthritis
- ANA (antinuclear antibodies) w/Reflex – an antibody the immune system produces when it is attacking its own body
- Sedimentation Rate Westergren – an inflammatory marker; signs that there is increased inflammation in the body
- C-Reactive Protein – a protein your liver releases into the body in response to inflammation
- Creatinine Kinase – an enzyme the body produces in response to damage to the skeletal and or muscle system
The results of my labs were negative for significant CCP and ANA antibodies. However, my Sedimentation Rate, CRP, and CK were off the charts high. In addition to that, my phosphorous was really low which was an indication of joint stiffness, bone pain, fatigue and my glucose was elevated although my A1C was still normal. It was after these results that my Rheumatologist diagnosed me with Chronic Inflammation.
What is the Link Between Inflammation & Obesity?
You might be wondering how any of this had to do with my weight. Buckle up and stay with me if you can. I will try to put it in the most basic language I can.
Adipose tissue (fat tissue) is considered a “central site” for inflammation (Inflammation in Obesity Related Disease). So while adipose tissue serves purpose for storage, in excess it can create inflammation. This inflammation triggers an immune inflammatory response within the body. It can attack joints, muscle, bones, and the metabolic system (pancreas, liver, gallbladder, thyroid). This is why insulin resistance and diabetes are often linked in conversation to being overweight or obese.
When my Rheumatologist explained to me that the symptoms could be treated, but my best option was weight loss, I was not surprised. I was already in the process of pursuing bariatric surgery and would go on to have the duodenal switch in August of 2021. I wanted to be angry because after years of being told weight loss was the answer to all my health issues, this was one of 2 diagnoses I could not get relief from until I lost weight (the other diagnosis being arthritis).
We of course discussed body movement and nutrition choices (which I was already working on) and how weight loss would provide me relief. He also took the time to explain that adipose tissue carries estrogen, which is an inflammatory hormone that also impacts weight gain, menstrual cycles, fibroids and cysts. I sat quietly taking it all in because he was the first medical profession to truly explain the link between fat and health to me instead of just saying “being fat is unhealthy.” It was a lot to digest and I won’t pretend that it was easy to accept, and I will tell you why.
The Healthcare System Traumatized Me
If you are fat, a person of color or a woman; you can probably relate to this. I shared on this blog my experiences in the healthcare system and how dismissed I had been to my detriment. After years of doctors lazily approaching my health, I did not want to accept that in this scenario, my fat was in fact hurting my body. There are a gazillion health care professionals and activists that exist on social media screaming the exact opposite. With so many self proclaimed wellness experts defiantly telling us that weight means nothing in conjunction with health, I wanted to believe that they were correct. But the more reading and research that I delved into, I couldn’t argue with the science of what my rheumatologist and later my bariatric surgeon were telling me.
I had to make a choice of whether I was going to allow my bad experiences in the healthcare system keep me from doing what I needed to do, or if I was going to forge ahead with the information provided to me.
The End Result
Ultimately, I wanted my hip replaced, and I wanted it as soon as possible. So, I went ahead with bariatric surgery. If you’re not new here, then you already know that it was a success and that I went on to have my hip replacement in June 2022.
But what about my lab work?
Within 3 months of duodenal switch surgery, my glucose levels were within normal range, my inflammation markers were non-existent, the random joint pain and stiffness resolved itself, and even though my hip hadn’t been replaced yet; my pain was so significantly reduced I didn’t need a mobility aid.
I started feeling so good I was afraid to enjoy it!
The labs and mobility don’t lie. Intentional weight loss had a positive impact on my health. My fat had, in fact, been hurting my health. I could sit here and pontificate on other possibilities of what it could be. But I’d be trying to fool myself and you.
To deny the connection between weight and health for the sake of empowering fat people is something I was never willing to do and still will not do. Knowledge is power, and what we do with that knowledge matters more.
The Wrap Up
My health circumstances are NOT an indictment of all fat people. Just because my weight was exacerbating my health does not mean it will you or someone else. The fat experience is not a monolith.
As stated at the outset of this post, size nor health is a reason to condemn someone or provide unsolicited advice or opinions on other people’s bodies.
Acknowledging that there is a connection between health and weight does not mean you’re fat fatphobic or have internalized fatphobia, and the discussion of such things is not shameful. Autonomy will always be key.
I can only speak to my experience, and I know that someone reading this will be able to relate and perhaps make changes for themselves as needed. Navigating the healthcare system is hard enough in a marginalized body. We need to know all we can in order to make informed decisions.
I know this article may be triggering to many, and my apologies for that because that is never my intention. But as I always say, triggers are a sign of an unhealed person. Perhaps it’s time to start doing some inner work.
Until next time,