ABSTRACT
Chapter 10 highlights weight stigma and binge eating disorder (BED). Terms such as “overweight” and “obese” are denounced as emerging from a medical system that has harmed patients through a focus on weight and dieting. This chapter focuses on individuals in larger bodies, sometimes preferring to call themselves “fat” in order to address vital concepts of size diversity, privilege, and social justice. Medical offices have historically alienated those in larger bodies. Diets do not work, and I never recommend them for my patients, regardless of medical problems. Studies have found that cardiovascularly fit individuals with higher body weights live longer than their thinner peers. These data are important to combat the misconception that thin equates with healthy. The number one medical complication of BED is poor overall medical and surgical care that patients in larger bodies receive. Patients may be inappropriately denied necessary surgeries unless they lose weight. The philosophy Health At Every Size (HAES) focuses on eating adequately and satisfyingly, moving for joy within one’s ability and as desired, and attending to one’s mental health needs, while accepting the natural diversity of body sizes and shapes. Bariatric (weight loss) surgery, or gastric bypass surgery, is noted to be a potentially harmful intervention that should only be considered in extreme situations, if ever.
