AN ARTICLE IN the British Medical Journal this week complained that doctors sometimes discriminate against fat people and refuse treatments and care based on weight. The article, which raises some serious points about accessing appropriate treatments from reticent doctors, prompted a flurry of fat people complaining about the behaviour of their doctors and highlighted the wider societal negativity surrounding fatness.

Being overweight is challenging. We live in a time of abundance that is unknown to history and we have shifted ourselves from a mostly agrarian, industrial, manual labourer society to sedentary office one over the past century. Rising GDP and expanding waist lines go hand in hand. We are genetically trained to eat what we can, when we can,  on the basis that, in times past, any meal could be your last for a long while. The foods that have the worst impact on our waistlines are precisely the types you need if you’re, say, a nomadic hunter, and our bodies respond by releasing some fairly addictive hormones when we get them.

Our lifestyles have changed dramatically 

Take yourself out of the jungle and into a city with 24 hour take away food, sugary drinks in every shop and a lifestyle of relative leisure compared to what we’ve come from as a species and you are at risk of getting fat. As creatures evolved for hunting and gathering, we’ve had to creative a massive industry in artificial exercise. If you’re engaged in physical activity that doesn’t involve chasing down dinner, building a camp fire to survive or doing your daily work then it is a contrived simulation to replace what our lifestyles have moved us away from.

With these challenges in front of us, overweight people might feel aggrieved that they’re singled out for fat shaming or whatever we’re calling it nowadays. Essentially what we’re being asked every time a story comes up about some instance of people being “discriminated against” based on their weight is, “Should we consider being overweight to be socially acceptable?”

If being fat was socially acceptable, then doctors wouldn’t bring up weight every time you attend. People would be pilloried for throwing looks at overweight people in the street, just as if they singled out a gay or a black person. It wouldn’t be acceptable for comedians to demean the overweight. And so on.

I think that the issue of weight is a nuanced one in places, but ultimately we shouldn’t be giving overweight people a societal pass for their – mostly – self-inflicted behaviour. Genetics and evolution aside, we have free will, and just as with quitting smoking or reforming an overly fond relationship with alcohol, as two relatively socially unacceptable behaviours, folks have to take responsibility for themselves. Societal pressure is one of the ways to motivate them to do that.

This is not about body image – it’s about health 

We don’t need a nation of size 8s. Indeed, body image and health issues are often mixed up. We need a nation with healthier weights, not Disney-proportioned cartoon characters. But we are getting fatter and fatter and it is having an impact both in shortening lives and costing the state and society. The state body Safefood reckons that treating obesity is costing some €400 million a year; with a further €700 million in indirect costs around related illnesses, absenteeism and premature deaths. Even below the level of obesity, there are costs. Plus, being overweight is the first step on the road to obesity and all the trouble it brings – from sore backs to clogged arteries.

I’m overweight. I’m tall, so can carry it off better than if I was short, but over the past three or four years in particular I’ve been on a slow and steady road up the scales. Now I can look at myself in the mirror and say, with no uncertainty, that I don’t have a ‘beer gut’ – I’m fat. Why? Because I eat too much, exercise too little and haven’t taken any steps towards addressing either in a few years.

I don’t want society to give me a pass, because ultimately continuing on this path will shorten my life, bring costs and misery onto the people around me and the state come the end.

The motivation to slim down comes from that moment you look at yourself in the mirror and recognise that it has gone too far. But that check doesn’t happen in isolation. Your doctor will mention it at a check-up. Good friends will tell you quietly that you’ve put on some weight. Your mother will tell you – and anyone else present – that you’re getting fat. (And then offer you a fry. Because you might be hungry. Irish mammies…)

Once you’ve had a few of those cues, it dawns on you and you begin to take the steps required to get healthy again. Eat less. Track your diet. Take walks and get in the habit of exercising before you drop a couple of hundred on a gym you’ll not go to (as I’ve discovered, there’s a gap between intent and result). Start taking the steps to move in the right direction.

If we lived in a society where being fat was acceptable, more of us would be fat and less motivated to do anything about it. Substitute “being fat” for just about anything and you’d get more of it. Drunkenness. Drug taking. Public nudity. Being a politician. Societal acceptance or otherwise is a driver of behaviours. It also tends to ignore the negative consequences of an action.

We don’t need to spit at fat people in the street. But so too anyone moaning about being discriminated against on the basis of being 5ftNothing and 20 stone needs a bit of a reality check. The problem isn’t with society, or doctors, or your friends, or the person at the bus stop throwing eyes. It’s your problem. Because you’re overweight. Get on that.

Aaron McKenna is a businessman and a columnist for TheJournal.ie. He is also involved in activism in his local area. You can find out more at aaronmckenna.com or follow him on Twitter @aaronmckenna. To read more columns by Aaron click here.

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