The body hate movement

You're not fat because you're a failure. You're fat because society failed you.

Like most microtrends, body positivity had a very short lifespan. For a few years, it was okay to be fat, and now thanks to Ozempic and shrinking Hollywood celebrities and HRT being pushed as a cure all for every version of midlife malaise including the post-menopause Santa Claus stomach, we are no longer positive about certain kinds of bodies. Fatties, we lost.

For cancer patients, and breast cancer patients in particular, however, we’re still being told to love our bodies, embrace our bodies, return to feeling at home in our bodies and every other kind of therapy speak, self help hoo hah that we heard during the brief lifespan of the body positivity movement. The problem is that like body positivity, this kind of sloganeering often translates into empty gestures with no actual action happening as the result of it. Fashion briefly became more size inclusive before fatties were sent back to whatever polyester version of hell passes for “inclusive” style these days.

I am fat, and have been various forms of fat since I made it into midlife, but I used to be borderline fat. After cancer, I am now just straight up fat. While most people picture a cancer patient as a gaunt, sallow figure in a hospital gown dragging around an IV pole, breast cancer patients usually gain weight during treatment. One of my doctors said that for premenopausal cancer patients, the average weight gain during treatment is fifty pounds. The combination of yearslong aggressive medical treatments, steroids and hormone blockers turns many people with breast cancer who could formerly shop at any department store into people banished to the plus size section.

I didn’t achieve anything that impressive, but I got fat enough that several people I know have not recognized me, and have still not lost any weight in spite of being a pretty active person. This is where our thinness-as-virtue based culture forces me to insert a bunch of caveats. I am fat, but eat a plant based diet and normal portion sizes, don’t suck down sugary drinks, do cardio and strength training and yoga, don’t drink alcohol, and my bloodwork is pretty much normal. I am fat, but I have always been an outdoorsy person who thinks a day of hiking in the splendor of Northern California’s redwoods is the closest thing we have to paradise on earth. I have cancer, but I am fat.

None of those caveats are going to save me from the judgement of those who equate fatness with laziness or failure. Our fear of fatness, as many others have written, is also tied up in social class, racism, and, of course, misogyny. For those with diabetes, Ozempic is a game changer. For wealthy celebrities, it’s yet another tool for making those without the money for GLP drugs feel terrible about ourselves. Thinness is virtue, fatness is shame, and this never really changes.

This, I think, is where the body positivity movement went wrong. By telling people they not only needed to simply exist in their bodies but that their bodies must be lovable, worthy of celebration, sexy and triumphant, the bar was set impossibly high. For those of us who grew up in the eras when Weight Watchers pummeled women into believing that stepping on a scale in front of a room full of strangers was going to produce encouragement rather than shame, being told we were supposed to love the bodies we’d learned to see as enemies to be conquered was a mental shift that felt impossible. We briefly pivoted to “body neutrality,” but the keyword here is brief. As soon as crop tops and low rise jeans showed up again, it was clear that it was all over.

And when you get cancer, how are you supposed to love a body that is actually trying to kill you? Your body has turned against itself, and fatness is a side effect of the medications that are used to prevent the cancer from coming back. I once read an account of a person writing about her friend whose small, thin body was pummeled by breast cancer treatment, but chemo is actually dosed based on height and weight. Fat people get more chemo at higher doses than thin people, and run a higher risk of side effects as a result. In an echo of the Weight Watchers meetings I sometimes attended as a younger person, every time I got chemo I had to step on a scale in front of a room full of people, only the shame wasn’t that we were fat or thin. The shame was that our bodies hated us.

For a good percentage of people who take Ozempic, it doesn’t actually help them to lose weight, and as soon as they stop the drug, all of the weight comes back. It’s a similar problem for those of us with breast cancer. The only thing preventing the cancer from returning and gobbling up our lungs, livers, brains and bones are the hormone blockers we take. Those hormone blockers also make us fat. Go off the hormone blockers and you lose weight (along with a reduction in a bazillion other horrible side effects) but you’re also much more likely to die.

I think it’s reasonable to say that when you’re caught in this conundrum between fat and thin or sick and well, you’re going to hate your body. Maybe for the rest of your life, maybe just temporarily. That doesn’t mean you can’t or shouldn’t take care of it, but that this artificial messaging that we should love a body that is regularly told that it is sick, disgusting and wrong is a cognitive switch some of us just could not and cannot throw.

Self hatred happens to all of us, and only the most narcissistic person would say they haven’t hated their body in one way or another. Being angry that your body is aberrant or wrong in a society that prizes thinness and health as normative but does nothing like having socialized medicine or affordable healthy food to help people achieve those things means you’re angry at yourself because you are the victim of systemic forces you cannot control. And it’s only once you realize that the root of that anger is not really about your body but about the way other people judge it? That’s when you can start seeing how the society that made you hate yourself is what needs to change.