I’m fat, and for most of my life the word "health" was used interchangeably with the word "thin." I think this is because when you’re fat, weight loss is always considered the first item on the agenda. Before any other possible health conversation can be had at the doctor, you’re expected to become thin first. The problem is that the chances of a fat woman becoming thin are quite slim. According to a study of obese individuals in the American Journal of Public Health, the annual probability of a woman achieving normal body weight was just one in 124, or less than 1%.
To me, health—like thinness—felt like a perpetual destination, and no matter how hard I tried, the goalpost kept moving. The concept of being in good health always seemed to feel like it resided somewhere out of reach, something I was constantly striving to achieve or maintain, granting me infinite lifetime membership to imposter syndrome.
I was taught that fatness was bad when I was five. Before that, I was born a fat baby into a loving fat family. My body was never a source of shame. It was, in fact, a source of incredible delight. I used to jiggle as often as I could because I loved the way my fat moved. Then came school. Every day, from kindergarten until the day I graduated from high school, a rotating group of boys in my class would remind me that there was something very wrong with my body by, for instance, yelling out how fat I was across the hallway, asking how much I weighed constantly, adding loud sound effects sometimes when I walked, and making retching noises if I dared to take off my over-sized sweater to cool down on a hot day. For an entire semester in high school I sat in front of a boy in my math class who would use his feet to dramatically propel his desk all the way to the wall any time I leaned back in my seat, demonstrating how massive I was. Classmates like him were always quick to remind me that I could stop their abusive behavior if I would just take their advice to “lose weight,” “go on Jenny Craig,” or “stop eating.”
Concerns about how my weight might impact my health began to crop up around puberty. My doctor encouraged me to lose weight by reducing my intake (even though I’d already been dieting for several years by then, and had cut most things with more than 5 grams of fat in them from my diet) lest I become a fat adult with heightened risks for diabetes, heart attack, and shortened life expectancy. If I ever had any other concerns, they were quickly pushed aside. “Lose the weight first,” was always the refrain. As an incentive, he suggested that if I become smaller I could date one of his sons. I was 11. For two decades I tried, in every way I knew how, to become a healthier and better version of myself through the only way I’d ever been advised to do that: weight loss.
Throughout my teens and early twenties, I spent hours on treadmills and ate food that was barely food at all, like Slim Fast meal replacement bars. I lived with hunger, self-loathing, and daily weigh-ins. I stopped eating milk products, then meat products. I took up jogging. I cut out all desserts. Even still, people often criticized the way I ate. More than once a complete stranger has come up to me while I was eating and informed me that if I just cut out pork/milk/bread, I could stop being fat. There was a never-ending wellspring of suggestions and products for people like me, more than I could try in my entire lifetime.
People have yelled out of their cars as I’m crossing the street that I should lose weight. Once a man screamed at me for sitting next to him on the commuter train, claiming that I would squish him. Another time I asked a woman sitting next to me if she wouldn’t mind moving a package over a little because the edge of it was painfully pushing into my leg, and she refused to do it claiming that I had a lot of nerve to be taking up more than my fair share of space on the bench seat we were sharing.
Neither they nor I saw what they did as wrong. We all believed it was in the name of a greater good—health—no matter how painful, dehumanizing or impossible it felt. The behavior of my doctors, those strangers, those classmates went entirely unquestioned largely because fat is considered unhealthy and anything that can be done to potentially encourage weight loss is always seen as a net positive. Someday I’d be thin, and I’d have all of them to thank.
At 25, I was hosting a call-in show at CBS Radio in San Francisco and got a long email from a New Zealander named Paul who had heard a few episodes. He told me he wasn’t in the habit of writing long letters to perfect strangers, but something about my voice and the way I talked about myself made him feel like he needed to reach out. He signed off with a promise that, though we’d probably never meet, he’d always be a fan. Curiosity piqued, we made a date to talk on the phone and ended up talking for about four hours. After a few weeks of talking all night, we decided to exchange photos. When I saw him, my stomach sank. He was thin and handsome with smart glasses. I was sure that he would find me as physically repugnant as those boys back in high school had, but he didn’t.
“You look exactly the way I’d pictured you,” he said. “You look like the kind of girl I used to dream about when I was a kid.” For the first time, he made me feel like my body wasn’t something to be tolerated by a magnanimous man-saint. He made me feel like I was the hottest woman on the planet. He introduced me to the idea that I didn’t have to carefully control everything I ate. “There’s nothing wrong with you,” he’d say all the time. “Eating is good.” Unlike all those years I’d spent monitoring every bite of food in the name of health or thinness, for the first time I actually felt ok. For the first time ever since those days before I was five, it felt good to be in my body.
Around our third year together I entered grad school for sexuality studies, with hopes that I would research fat women. It was 2010 and my advisor strongly cautioned against it. “Everything about fat has already been written,” she said. “It’s career suicide.” Paul happened to be listening right outside the room where she said this and I exited her office, he shot up out of his chair, enraged, and said, “You can’t let her stop you from studying what you want. I’ll help you find a new advisor.” He did. While gathering preliminary information for my research I fell down a rabbit hole. Boom. I was in the middle of a rapidly fomenting political movement I’d never heard of before: fat activism.
Within months, most of my friends were fat people who were unapologetic about their size. They taught me that what I’d experienced all those years ago wasn’t my fault, and that it had a name: fatphobia. They showed me the data that pointed to the inefficacy of diets and the ways that weight cycling was correlated with everything from anxiety to a heightened likelihood of developing an eating disorder and having cardiovascular problems. They refused to diet and taught me that—unlike everything I’d ever been told in the 28 years I’d lived on this planet in a large body—it was the culture that needed to change, not me. They were the first people who encouraged me to question the idea that thinness was the same as health. In fact, they encouraged me to question the notion of health altogether.
A few months into learning all this I was introduced to Health at Every Size (HAES). The idea behind it was the adoption of weight-neutral definitions of health. It asserted, for the first time, that fat people could be healthy without having to lose weight. I’ll be honest, it made me bristle.
When I interrogated my reaction, I found that my lack of receptivity had everything to do with my past: the unapologetic comments, the medical negligence, the sense that nothing I saw on TV or in movies ever seemed to challenge the dominant idea of health. Now here I was, at the precipice of a radical sea change and somehow it had managed to become about health yet again.
I understood the urgent importance of decoupling weight from health outcomes so that fat people could actually get proper medical care rather than just be prescribed weight loss regardless of symptomatology. But I felt HAES didn’t properly consider the encoded, layered way our culture uses the word “health.” HAES didn’t seem to pay attention to the fact that many, many people in our country are in survival mode, and don’t even have the bandwidth or disposable time to consider or prioritize their health. It didn’t assert that until we get rid of environmental racism and structural poverty, it’s unethical to demand health from every person. It didn’t assert that people should be encouraged to be the authors and experts of their own ideas of wellness. It didn’t offer a critique of the very real structural barriers—income, ability level, race, education, access to medical care, caretaking duties, imprisonment—to the health ideal.
Healthism, according to political economist Robert Crawford, “situates the problem of health and disease at the level of the individual.” This laser focus on the individual allows us to ignore that poor health as well as good health do not occur in a vacuum. They occur in a context. The World Health Organization names 12 social determinants of health that include things like early childhood experiences, social support, and access to safe drinking water, underscoring how one’s social status plays an integral role in health inequalities. In other words, even the experts on health agree that there are factors out of the individual’s control that affect their health and wellbeing.
In our healthist culture, it was that focus, that blame, on individuals like me that I’d felt all those years. It finally had a name. My experience as a fat woman had created a unique opportunity to see the limitations of how we think of health as a culture. I can never have a conversation about health without remembering all the moments when the idea of health was used to justify harm.
In the end, I truly don’t believe that health should be the battlefield upon which the fight for body justice is won. Health stigma is just another barrier to the full humanity every single person deserves; it shouldn’t be used as currency for respect, kindness, or access to life-saving healthcare. Our health is not something we owe to other people.
When we move the locus of health from “out there” to “in here”—in our own hands, in our own homes, in our own communities—we open the path to the pursuit of wellness that intuitively takes into account what we have, what we want, and who we are.
The path to my own wellness has been paved with donuts. And many hours languishing, laughing, crying, journaling, spending time with friends, being angry, moving for the sake of fun, and literally zero hours running. Unlike all those hours I used to spend on the treadmill, this is the stuff that actually saved my life. This is the stuff that helped me thrive. This is the stuff that restored my sense of humanity. This is absolutely not most Americans’ idea of a healthy lifestyle, but I highly recommend it.
Virgie Tovar is the author of The Self-Love Revolution: Radical Body Positivity for Girls of Color and You Have the Right to Remain Fat. She hosts the podcast Rebel Eaters Club, is a contributor for Forbes.com, and started the hashtag campaign #LoseHateNotWeight.