Thread by @FOMNZ

Today in #FatStudyGroup, we are reading Kasten, G. (2018). A discussion of weight bias, its intersections with homophobia, racism, and misogyny. Canadian Journal of Dietetic Practice and Research, 79(3), 133-138. dcjournal.ca/doi/10.3148/cj…

This article is a version of a Ryley-Jeffs Memorial Lecture given by Dr. Kasten in June 2018 to the Dietitians of Canada’s conference.

At the beginning of the piece, Dr. Kasten identifies himself as a gay man; and he shares this to frame the overall narrative of the piece: that “sometimes, even with the best of intentions, people tell us lies” (p. 133).

In the opening, the lies he shares are related to growing up in a world that told him he would fall in love with a woman and have a happy life. He knew this wasn’t true for him, and yet others insisted it was the WAY it happened.

He then presents another great lie that continues to be told to all of us – that people can lose weight and keep it off, and cites the usual suspects of Garner & Wolley (1991) and Mann et al (2007) as evidence to the contrary.

Kasten continues with the connections to being gay as he moves forward. He notes that until he was 14, he was considered mentally ill because he was gay. He cites this as a flaw in the epistemological framing of research on homosexuality that occurred prior to the change in 70s.

He notes the AMA’s decision, against its own cmte recommendation, to designate obesity as a disease in 2013, and dismisses the suggestion that doing so will help limit the stigma. “I can tell you personally that declaring HIV a disease did not reduce its stigma” (p. 134).

He argues that, instead, we need a new epistemology of body positivity and healthy behaviors. (Fat Studies scholars like myself and Charlotte Cooper @thebeefer have long argued for a fat epistemology, in which fat people are allowed to produce knowledge about fatness).

What keeps us telling lies about fatness is weight bias, Kasten argues. Weight bias “hurts…makes us lie…makes us deny care…contributes to lack of critical analysis” (p. 134).

He continues on to review the uselessness of the BMI, and the role that social determinants of health (like racism and poverty) play in the health and well-being of many people. He suggests weight stigma may be responsible for the negative effects we associate with fatness.

He concludes with suggestions for how dietitians can do better in ensuring they are not reproducing weight bias. The best suggestion he makes it to “include fat people when we are making decisions and developing programs” (p. 136). YUP – nothing about us without us!