It’s me, back from outer space and ready to rock your world with more AWESOME ADVICE. This week’s first letter is a heavy one (no pun intended), so let’s quit with the snarky intro and jump right in!
Dear Fluffy Kitten Party,
I have a good friend who is having weight loss surgery/stomach amputation soon. I’m feeling very conflicted because I loved my friend, but I am totally opposed to weight loss surgery. I’m not sure how to be there for her without getting sucked into congratulating her for her weight loss. I’m worried that seeing her get smaller and smaller might be damaging to me and take me back to a bad mental place. I’m also angry with her for making this choice. How do I deal with this?
Okay, buckle in, because this conversation is going to be a ride. We’re going to have to get nuanced as fuck up in here.
Let’s get one thing out of the way: There is a difference between the systemic issue of weight loss surgery and the individual people who have weight loss surgery. It’s a huge, vast, massive difference. The difference is all of the synonyms you can think of that mean “very big.” And sometimes, unfortunately, it’s hard to actually separate them. So let’s try.
Weight Loss Surgery, The Thing: This is an umbrella term that can refer to multiple types of bariatric surgeries, such as the “full” Roux-en-Y gastric bypass, vertical sleeve gastrectomy, duodenal switch, gastric bands, and gastric balloons. It’s a highly profitable surgery and multi-billion dollar industry, for surgeons, bariatric centers, hospitals, and insurance companies. Some patients do lose weight, some lose weight then gain all or some of it back, some patients have complications that compromise their quality of life, and some patients die.
People Who Have Weight Loss Surgery: Human beings trying to live their lives.
If you are a person who has worked hard to extricate diet culture from your life, learning that someone you love or even just a writer you really like has had weight loss surgery can feel like a betrayal. “Another one bites the dust,” you sigh. You thought you had an ally, someone to fight alongside you, but they sold out. They gave in. And making it all harder is the fact that when someone buys into weight loss surgery, they are usually all in. They talk about how they don’t want to die, how they want to be around to see their kids grow up. They talk in hushed tones about their blood pressure and diabetes and how terrible it is to live in a fat body. Even if you want to separate the person from The Thing, they often make it incredibly hard to do so, because they go into full Fatness Is The Worst mode.
And then it kicks in. That little voice. You know, the one that you’ve been working to quiet. The one that tells you that maybe keto will finally make you thin, maybe “WW” is actually different than Weight Watchers and you’ll have different results if you try again. It’s full of hope, that little voice. Your rational brain knows better (and has the receipts from thousands of dollars spent on diets to prove it), but your lizard brain still holds on to hope. It’s not rational. It knows the studies, it knows the statistics about maintaining weight loss long-term. It just doesn’t care. It hopes. And it says, “Hmm, maybe…”
We fight back, and we fight back hard, to get the voice to shut up. And sometimes that means making the person who stirred up the voice into your sworn enemy.
But here’s the thing. Here’s the nuance in this situation. It’s easiest to stop at the “us vs. them,” enemy stage. It makes it a lot simpler. But life isn’t black-or-white. Nor is health, nor are decisions made about our health and bodies. Everything is fucking complicated. Bodies are complicated. Fatness is complicated, thinness is complicated, health is complicated, mortality is complicated. The simplest thing about this whole discussion is on the side of the people performing the surgery: They do The Thing, and get paid handsomely for it. But it’s not simple for the people going under the knife, at any point.
A lot of people who opt to get weight loss surgery would have never have considered it when they were fat, but smaller. (Or, Small Fat, if you will.) But if they gain weight, and graduate from Small Fat to Mid-Fat or Super Fat, it gets a little harder. They start to feel their oppression in ways they haven’t before. They can still find clothes in their size, but they are relegated to plus-size stores exclusively and they carry fewer options in their sizes. They start to experience not being able to fit into airplane seats or concert seats or booths at restaurants — chairs become a problem. They were never a problem before, but now, the mental math keeps getting more complicated. Need to use a public restroom? There’s a 50/50 chance the standard stall might not have the space they need. If they’re on a plane, forget it, they better hold it until they get to their destination. Visits to the doctor become even more fraught and produce more anxiety. When they go in for a physical or to address a health issue, they know their weight will be the first thing mentioned. Blood pressure cuffs stop fitting, and they may need to bring their own with them to appointments. Scales can’t weigh them accurately anymore; they can’t fit in an MRI machine. (There might be one that can accommodate them somewhere in their state, but no one knows where it is, or whether it’s in-network.) Perversely, the only place where they can find medical equipment that is built for them is in bariatric surgery centers. And doctors may refuse treatment for painful medical issues until they submit to losing weight.
And the barriers just get higher and more challenging the higher up the size spectrum you go. People who wear above a size 32 might not be able to find clothing that fits them properly, at all. The fatter someone is, the more they are discriminated against in every area of life. They might find it harder to get a job — and it’s perfectly legal to discriminate against people because of their weight in 49 states. Even dying gets more expensive, and they won’t have life insurance to help with the cost, because insurance companies will refuse to cover them. This is how people slowly get shut out of society and forgotten. Those people on those horrible weight loss surgery reality shows? That’s how they get to the point where they don’t leave their houses. Society boxes them in, discriminates against them, refuses to accommodate them, refuses to let them participate, and then wonders why they’ve withdrawn.
It seems like the most vocal opponents of weight loss surgery skew smaller. It’s easier on that end of the size spectrum, when fat activism is all about posting pictures of your double chin with a cute hashtag on Instagram and showing off your latest fatkini. It gets a little trickier when the question is, “Do I wait for massive shift in society so I can participate fully and enjoy a better quality of life in the distant future (knowing that the shift may never actually come in my lifetime and my quality of life may continue to degrade as I continue to be discriminated against), or should I just submit to having my stomach cut up so I can participate more and maybe have a better quality of life in the near future (but may also die or have an even worse quality of life)?” It’s not an easy question, and there are no easy answers.
Size oppression intersects with other oppressions. It compounds any other marginalization you experience. So, if you are a person of color, trans or non-binary, LGBTQ+, disabled, older, or any combination of these things … you carry the weight of all of your oppressions around at all times. And the more you carry, the more you feel the weight. The more exhausted you get. These systems of oppression wear you the fuck down. You get tired and fed up. You want to unload. What can you take off your back so you can keep walking? You can’t change your race or your age or your disability, but you have these doctors telling you that you can lose weight, if you’ll only have this surgery. Maybe it’s a gamble you’re willing to take, because you’re tired.
“But Fluffy Kitten Party,” you say. “My friend doesn’t belong to any marginalized groups I don’t, and I’m still able to resist.” Okay! But here’s the thing: People are different. Some can carry a large load and still press forward, some can’t. Some people are better at being uncomfortable than others. (And, to be clear here, I’m not saying that being fat is uncomfortable. These systems of oppression make it uncomfortable.) Some of us are people who feel strongly that it’s the chair’s fucking fault our asses don’t fit into it and get angry at the lack of chair options and write letters to business owners asking for a better chair situation and blog about the tyranny of chairs with arms. And some of us just want to sit the fuck down and would sell our souls to the devil himself if it meant that we had more chair options everywhere we went and we never had to devote another second to thinking about chairs. And some people might be fine with going under the knife even knowing they will never fit into all chairs, but stand a pretty good chance of being able to fit into more chairs. Different strokes for different folks.
And so, it’s not the people we should be angry at, it’s the systems, it’s The Thing. You can resist weight loss surgery, if you feel that’s the best decision for you, without seeing the people who choose to have it as agents of your oppression. They are just people, and they are making the choice to have weight loss surgery in response to being oppressed.
So, I say, do your best to be there for your friend. Try to operate from a place of compassion. If you are in a place where you can do so, talk to your friend about why she made this decision. If you are afraid for her (and it makes sense to be afraid — people do actually die from weight loss surgery, more frequently that medical professionals would lead you to believe), you can let her know. Odds are, she’s even more afraid than you are. But it’s her body. It’s her decision. It’s her life. And part of the empathy required to navigate this situation is understanding that you cannot fully understand the weight she carries, even if you’ve made a chart of her oppressions and think you’ve got a mathematically unimpeachable understanding of the weight she carries. Try to be there for her, and check in on her, because sometimes what kills people after weight loss surgery is not having a support system in place.
I wouldn’t try to persuade her against it if her mind is already made up and the machine is in motion, but if she asks to know your feelings, or asks for resources, you can certainly share those with her.
You can set boundaries, though. You can mute her on social media if the discussion of her impending surgery is nonstop, or if she takes to sharing before-and-after pictures as she loses weight. (And she probably will! Again, you have to be all in to make a decision like this.) If you need to, restrict your time with her to one-on-one hangs or phone calls instead of using social media, because that is where people losing weight are generally the most difficult to deal with. (Remember: People present their ideal selves on social media, not the full picture. So, that picture of her looking thin and fabulous might set you off, but you’re probably not going to see or hear about her running to the bathroom for an emergency shit or how she experiences horrible pain or throws up if she eats too much or how she’s really hungry.) If she brings up how awesome she feels about losing weight, you can say, “I’m so happy that you’re happy!” And leave it at that. You can even say, “I don’t want to talk about it,” if a conversation strays down a path that is dangerous or uncomfortable for you. And, as a final resort, if your friend becomes a total asshat after surgery and won’t shut up about her weight loss and diet and new life and will not stop proselytizing about weight loss surgery… well, the friendship may have run its course. You don’t have to stick around for that. If your friendship no longer serves you or brings you joy, Marie Kondo that shit.
But don’t write her off just yet. Some people find Health at Every Size and fat activism and body acceptance only after they go through something like weight loss surgery. Weight loss surgery puts your friend at a greater risk of alcoholism and suicide, and the few years after surgery can be a seriously topsy-turvy time for people. (“Bariatric divorce” is a real thing.) So, protect yourself, set boundaries, set limits if you find yourself getting sucked into a “what if?” weight loss brain spiral, but if this is a close friend? She’s probably going to need you.
Good luck, to you and your friend.
I have a good friend who makes her living as an exercise coach and nutritional therapy practitioner. Because we live in a world where one’s personal and professional online selves are increasingly merged, 9/10 of her social media posts are either about fitness, paleo recipes, or what supplements I should be adding my coffee to achieve optimal gut health (why TF is everybody obsessed with gut health these days?) We’ve been friends for years, and I love her, but NONE of this is my jam, and it’s been tricky to find balance between supporting my friend as she grows her own business and tuning out a lot of what I believe to be toxic diet culture masquerading as “health”. Lately, she’s been re-posting a lot of stuff from body/fat positive bloggers, and to be honest, I have very mixed feelings about it. On the one hand, I like that she’s making it clear that the focus of her practice is not weight loss, but on the other hand, it feels like she’s co-opting the words of folks who’ve been working for years to dismantle diet culture when she’s still playing right into its insidious hands. It’s all well and good to call yourself “body positive” and parrot platitudes like “there’s no wrong way to have a body”, but when so much of what you preach focuses on telling people what they should and should not eat and how they should and should not move their bodies, that seems at best hypocritical and at worst harmful to the people (her clients and followers) she’s purportedly trying to help. It leaves a bad taste in my mouth, and I’m not sure what I should do about it. Do I try to have a conversation with her about it, or should I just put her posts on mute and ignore it?
Oh god, your friend isn’t in an MLM, is she?! If she is, tell her to listen to “The Dream” and encourage her to run away fast.
Diets are going through an awkward rebrand these days, because no one wants to diet. They want a “lifestyle change.” They want to “eat clean.” They’re sharing recipes for cloud bread (which I’ve had and can report is vastly inferior to actual bread) and bulletproof coffee (get your BUTTER and COCONUT OIL away from my coffee!) and obsessing over gut health. (I’m pretty sure you can thank Michael Pollan for that last thing, he’s been writing and lecturing and rhapsodizing about gut bacteria since at least 2013.) It’s getting increasingly hard to tell what is a diet and what is not. And when it comes to people who are marketing their nutrition services, they’ve found that injecting a little Intuitive Eating and Health at Every Size ideology piques people’s interest and gets them new clients (and will maybe help them get on a podcast or land a book deal). At the very least, it allows them to use all the best hashtags on Instagram. I’m fed up with it, too.
While you’re raging against a machine that’s bigger than you, your friend, or me, there’s a few different ways you could handle it:
- Call her in instead of calling her out. Is it possible your pal is not sharing these memes for the likes and engagement on her posts, but because she’s actually agreeing with them? Maybe, just maybe, the internet meme machine is working here. Maybe these messages are starting to sink in. And maybe she’s toying around with the notion of incorporating a little Intuitive Eating or Health at Every Size into her practice, or is at least curious to know more. And MAYBE you can be the friend that gives her a little nudge. Do you have Linda Bacon’s Health at Every Size? Lend it to her. There’s also a slew of great books that have come out more recently: Just Eat It by Laura Thomas, PhD, which I’ve read and has the potential to really appeal to someone entrenched in nutrition science and fitness because it was written by someone who was similarly entrenched and saw the light, Body Kindness by Rebecca Scritchfield and The Fuck It Diet by Caroline Dooner, which I haven’t had the chance to read yet (sorry) but I know will be awesome because everything she says on Instagram is spot-on. If she’s a podcast person, why not point her toward Christy Harrison’s Food Psych podcast? YOU COULD BE HER GURU. You could tip her from being a pro-diet, Paleo-recipe sharing nutritional therapy practitioner and fitness coach into an awesome, evidence-based, anti-diet nutritional therapy practitioner and fitness coach. That’s… actually not a huge shift, believe it or not. Pretty much every dietitian or nutritionist who is out there preaching the HAES gospel made that shift at some point.
- Leave a breadcrumb trail. So, if your friend is decidedly NOT a burgeoning HAES practitioner, and is doing this for the likes, consider popping into her comments to provide supplementary information. She wants to share a meme from a fat positive blogger? Leave comments that link to a related blog post, or recommend a book or podcast you like that goes into the topics the post is about. Maybe you can passively engage with her, and leave a breadcrumb trail for people who follow her. Because of your breadcrumb trail, they may be able to find their way out of the hell of being sold vitamins and shit by people on the internet who tell them how to eat.
- Talk to her and lay it all out. If you prefer to address it more directly, invite her out for coffee. (Or a smoothie or bulletproof coffee or a grain bowl or whatever floats her boat.) And just tell her how you feel. Ask her questions, try to see her side of it. Use your words! Hopefully the two of you can have a better understanding of where you’re coming from, and who knows, maybe you’ll find out that she’s questioning some shit in her life’s chosen work and help her work through it.
- MUTE HER. So, on Facebook, you can mute someone for 30 days, which is great. I mute people all the time when they’re bugging me. On Instagram, you can mute them indefinitely. I don’t know what you can do on Twitter because it’s the only internet hellscape I don’t enter, unless I have to, for work. But you can probably do something. Your friend won’t know you muted her, unlike an unfollow or unfriend. You can even mute her just until you want to figure out how to play this. But, if you really don’t want to see this, if it bugs you, and none of the above options appeal to you, mute away!
The only other option, and one I don’t recommend, is going nuclear and calling her out in front of everyone. You can do that, if that’s your prerogative, but it’s generally not a good look and doesn’t win us fatties many fans.