I woke to the news that the National Institute for Health and Care Excellence, part of the British government's Department of Health, wants thousands of people to have gastric bands in order to prevent the National Health Service paying for diabetes treatment.
Dear NICE,
It is 6.30 in the morning and I am burning when I should be dozing.
You are slime.
I just want to call you names because I am so angry.
Let's talk about treating fat people with diabetes but let's not pretend that you have found a risk-free, health-enhancing way of enabling people to lose weight, or that weight loss is The Answer to Everything.
Instead let's talk about your treatment of fat people as guinea pigs and scapegoats.
Or the conflation of fat and diabetic.
Or pre-diabetes.
Or the obesity epidemic.
Or how fat people "cause climate chaos".
Or food addiction.
Or how fat people are responsible for The Deficit.
Or the need to tax sugary things.
Or The Children.
Or obesogenic environments.
Or the thousand other bullshit ways that hatred is leveraged to reconstitute and dehumanise fat people in the public eye through fatphobia, and how this affects a population's health.
You have no idea how difficult it is to access adequate healthcare if you are fat. That fat people's lives – probably including mine – are shortened by fatphobic 'care,' aka iatrogenesis, is the real scandal here. It is really hard to be healthy in a culture whose major institutions and centres of medical excellence want to obliterate you.
Now you have made it a lot worse.
A gastric band is a surveillance device. You throw up what the band decides is superfluous. Your body then eats itself because you are really really hungry. This is how you lose weight.
This government loves surveillance.
But like all surveillance, people inevitably find a way around it. It is a faulty surveillance device. It doesn't make diseased fat people into healthy thin people, it makes people have really fucked-up relationships with food and it causes the kinds of problems you would imagine would be caused if a major organ was messed with. Surgery is a relatively recent intervention and it is hard to know long-term outcomes. It's a gamble. It doesn't keep people thin. People still regain weight after a band has been installed. Diabetic people too. What then?
Gastric bands further medicalise people, including those with diabetes, for the rest of their lives. How does this save the NHS money?
I cannot believe that you would mandate more weight loss surgery. You want to invest in something that is entirely duff and requires expensive and risky procedures to install.
You want to invest in this rubbish instead of no-risk, cheap, community-based health promotion rooted in Heath At Every Size. Models that have success records, that fat people are happy to engage with because they/we are seen as agentic authors of our own lives with lived expertise to offer.
It makes no sense at all. Whose sponsorship is behind this decision? Who is making money out of this? What further crap will this recommendation inspire?
With horror,
Disgusted of E15
PS. Insert Headless Fatty here.
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