Blobs of Fake Fat

Doctors in the UK are getting plastic models of fat blobs to show their patients. (Yes, seriously).

When I was 10 or so, I recall my family doctor showing me one of these plastic models. It was very hurtful. I really don't understand how the message can be anything other than "This is disgusting. This is part of you. Thus, you are disgusting." I already wanted to lose weight; it had been my New Year's Resolution for years, and part of my daily life for even longer. This experience just added more shame and more pain to being a fat child.

Experiences like these with doctors are a big part of why I chose to study medicine. There are better ways to motivate people, and better ways to promote health. One of my dreams is to one day open a multidisciplinary primary care health clinic based around Health at Every Size principles. Fake fat won't be allowed on the premises. :-)

Obesity Guidelines

I was recently looking through the Canadian Guidelines on Obesity Management. This is a monster of a document: 24 chapters and over 100 pages. It's also infuriating. A few choice quotes:

"In addition, the medical profession is failing to counsel young, disease-free adults and those in lower socioeconomic groups" [to lose weight]. Because if you haven't yelled at healthy fat people, you just aren't doing your job!

"Overweight and obese people, especially those with binge-eating disorder, lack self-efficacy. Self-efficacy refers to confidence in one's ability to do what is required to produce the desired outcome." I was pretty angry when I read this. Just because I'm fat doesn't mean I am lacking in the ability to Get Things Done. So I went and looked at the abstracts for the three articles they use to reference this statement (1, 2, 3).

The first two articles refer specifically and only to weight self-efficacy -- which, apparently, is confidence in one's ability to do what is required in order to get to a socially-sanctioned weight. That is, fat people are pretty sure that they can't diet to become permanently thin. I would describe that as "fat people have a good grasp on reality" rather than "fat people have low self-efficacy".

The third article is the only one that refers to self-efficacy in general, and it finds that fat individuals with binge-eating disorder have lower self-efficacy than fat individuals without binge-eating disorder. Which, obviously, says nothing about fat people as a group.