Aubrey Gordon writes a searing indictment of American culture. Her book is also a plea for understanding. What We Don’t Talk About When We Talk About Fat is a heartfelt description of her life as a “very fat person.” Those words are hers not mine. When we see a fat person, do we see a real person? Do we recoil or do we want to help them? Gordon challenges us to rethink our assumptions about fatness and to change our behavior. Not a book for a thin person who has a clear vision of what it must be like to be fat.

Acceptance is what Gordon asks from us. She has accepted her fatness. I would not say that she is fat and proud, but she is fat and unapologetic. On the first page she informs us that “I do not struggle with self esteem or negative body image.” She embraces the terms body positivity and body sovereignty. She rejects the healthism she faces every day of her life. The author feels revulsion when confronted by relatives, friends, and complete strangers who are “concerned for your health.” She admits that “They don’t want to hurt me, but they do.”

Discrimination and abuse follow the author everywhere she goes. Most major airlines have a policy to “eject fat passengers from their flights.” Such practices occur to provide extreme embarrassment to the victim. Despite other factors that contribute to fatness in our population, too many of us blame the fat person. We condone discrimination against a fat person that we would not consider in other circumstances. She calls out those engaging in “fatcalling” and other indignities. Gordon notes “that fat shaming leads to weight gain, not weight loss, and worse health outcomes.” Then there was the woman who followed her around in the aisles of the supermarket chastising her for her selections. She contends that such behavior is more about the person doing the shaming than their target.

Accused of particular offensive behavior is the medical profession. The cause attributed to such maladies as “strep throat, ear infections, a Charlie horse, or a common cold” was her obesity. Take care of that first, and then we will treat you. The author describes the time a nurse could not find a blood pressure monitor that worked. It turned out that Gordon had a normal blood pressure. That could not be right as the patient was too fat!

Speaking of obesity, Gordon considers the term and all of its derivatives as a “healthism slur.” She prefers the word fat. In my book, In Defense of Processed Food, I preferred the term fat over obese. We all have a concept of who is fat, but few of us really understand obesity. Healthism is discrimination against someone who doesn’t meet our standards as healthy. Such discrimination extends to smokers, drinkers and others who engage in unhealthy habits.

In the best chapter of the book, the author reviews how television and movies portray fat people. Most of her critique recoils at the caricatures we see in visual media. We view all the negative characteristics associated with being fat. The fat character is the butt of the joke in too many situations. Her favorite character highlighted was Lee Israel in the movie Can You Ever Forgive Me? The character was fat and despicable, but she came across as a real person not as a stereotype.

Dieting is not successful for most fat people. Gordon suggests that “dieting for weight loss may actually be hazardous to our health.” She contends that yo-yo dieting induces more damage to our bodies than staying fat. Her thoughts agree with advocates of Intuitive Eating. Thin people may also suffer the consequences of the shock of dieting. During my professional years I went on several diets. I lived in both ‘overweight’ and ‘normal’ states. I crossed the mythical border of a BMI=25 many times in my life. Would I be a healthier person today if I had ignored my BMI? Who knows?

Fat justice is the topic of the last chapter in the book. The author states that “There are no prerequisites for human dignity.” She closes with six demands. She asks for an end to discrimination against fat people. She pleas for more equitable “healthcare for fat people.” She also tells us to “stand up for fat kids.” Gordon challenges us to rethink our thoughts on fatness, obesity, or whatever term we use.

A fable. One year when we were young, my wife went to a Halloween party as the Great Pumpkin. She made it from chicken wire and paper mâché. Then she spray-painted it orange. When we were getting ready to go to the party, we found we could not get it out the door of our upstairs garage apartment. We removed a screen on our porch and lowered the pumpkin down to the ground. Then we couldn’t get it into our Datsun. Our landlord drove her with the pumpkin to the school party. She was the hit of the party and won the best costume award. The costume was also a curiosity with many party-goers hitting the outside of the pumpkin. It became very uncomfortable to be inside to take a beating.

Moral of the story. Inside every Halloween costume and fat body there is a real person. Treat that person with respect. We all deserve that.

Next week: Blaming the person for being fat