“Maybe it hurts, because you are fat?” 

This is literally the question my doctor has recently posed, after hearing my pain complaint. The advice to lose weight and the referral to a dietician immediately followed. In the past I would have felt ashamed and utterly convinced that the doctor, though clearly a fatphobe, was correct. These days I manage to remain calm and simply request a referral for an ultrasound. 

After turning forty the body starts to complain a bit more. Injuries happen more often and don’t just go away on their own. One must then visit a doctor, an authority on all health matters. A doctor’s visit for someone classified as “overweight” or worse, “obese”, is almost always concluded with some advice to lose weight. Clearly, fat tissue must be the cause of all pain a person can experience! Sadly, I have internalized that doctor’s voice too. Hence, before each doctor’s visit, I must battle this internal fatphobe first. 

Is it really that strange that I have internalized these messages? Aren’t we all convinced that our health and well-being depend only on our own actions? Were we not taught that through a healthy diet and regular exercise we are guaranteed the ideal body, and as follows, a perfectly painless, happy, and healthy life? 

So how do I address my inner critic, who sometimes wakes up and asks: maybe it does hurt, because you are fat? 

First, let me assure you, that having a discussion with this critic, raised so well since childhood, is not easy. This mortally terrified fatphobe (which probably hides in most of the female-identifying people) is a tough opponent. It fires from the biggest cannons: 

• Weight and various health indicators (diabetes, hypertension and hearth disease for example) are correlated without a doubt 
• Injuries, especially those ankle, knees and hip ones, would be much easier to avoid, if the body weight were lower (logically the conclusion is that slim people do not have injuries as often) 
• Everyone obviously can lose weight, if they are motivated strongly enough, because it’s just a matter of eating less and moving more (first it’s best to heal the injury though, perhaps…) 

Sometimes I try to respond logically to these claims. I offer statistics of weight loss failure rates (95% or more, depending on the study, of the participants using diets, lifestyle changes or even bariatric surgeries, have either returned to the weight before the so called “intervention”, or surpassed it – known to every dieter yoyo effect). I try to also argue, that the correlation of the weight with health indicators does not mean causation – we still do not know, if the weight is only the symptom of some conditions like diabetes, or if it is indeed the cause of these conditions. 

I must admit that I do not know anything about the frequency or severity of joint and back injuries in relation to the weight of the person. It does make sense that injuries would happen to physically active individuals or those of us who perhaps have a bad posture from sitting for long hours at our desks. They may even happen more often for higher weight individuals. Still, logically if I should then change something in my behavior it would be to spend less time sitting at my desk and to reduce certain types of exercises. These seem safer choices than to try and lose weight where my long-term success rate is so very unlikely? 

OK, getting back to the argument I am having with my internal fatphobe. I typically cannot claim a full victory. There will always be a small spark of doubt deep inside of me: could I through a miracle be in that 5% of people who somehow manage to lose weight and keep it off? Is it possible that all my health issues are just the consequence of my weight? This brainwashing by the diet culture and the cult of a healthy and fit body, which surrounds us all, cannot be removed easily! 

Despite those doubts, after many years of observing my own and other’s experiences with dieting / lifestyle change/ weight management or whatever you want to call it – I remain convinced: I will not go on another diet. I will not radically change my “lifestyle”, nor will I start to exercise obsessively. I have personally tried all these methods before and I can say with a great conviction, that they have not given me much… I mean, not much in the realm of weightless! Unfortunately, they did have many negative side effects: food obsession, multiple yoyo effects, compulsive and emotional eating (also known as binge eating), and as a cherry on the top: generalized anxiety, depression, and low self-esteem. 

Today, I say: maybe it hurts, because I am fat – maybe not. I cannot claim to know for certain all the consequences of my fatness. I am simply choosing to trust myself, trust my body’s wisdom and trust my intuition. If you would like to learn how to trust yourself too, let’s have a chat!