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On New Year’s Day I was bent over to pull clothes out of our hamper when my knee popped. Audibly. Uncomfortably, if not quite painfully. I straightened up to see if my knee was still working. It was. I took an Advil and went about my day.
Add the popping knee to the list—the running list of aches and pains that is apparently my late 40s. My right index finger froze around Thanksgiving and I’m telling myself it’s slowly recovering. My upper back pain is better…for now. The knee that popped had arthritis a couple years ago, though lately, it’s been better.
It’s ironic that at the same time I finally stopped wishing I had a thinner or stronger or just generally different body, this body I do have started, well, breaking down. “Oh, now you’re okay with me?” my body seems to be saying. “Well, too little, too late.”
Like everyone else with an ailment and access to the internet, I spend a lot of time googling what do to all about all these aches and pains. I read through the symptoms trying to figure out if my finger is carpal tunnel or arthritis or something even more exotic (my favorite is Dupuytren’s contracture). I look at the list of risk factors, trying to calculate the likelihood that this is what’s wrong with me.
Do you know what risk factor appears on every single list? Back pain, knee pain, lower back pain. And, yes, even carpal tunnel. Obesity. Obesity, apparently, is a risk factor for everything that can possibly go wrong with your body. Including, somehow, your fingers. What? How does being obese lead to carpal tunnel? When did obesity become the root of all evil? Can this be right?
I’d been reading about the problems with body mass index (BMI) as a measure of obesity for a while. BMI is a measure developed by a geometrician in the 19th century. It treats your body as if it’s two-dimensional (it is not) and ignores things like actual body composition (is your weight mostly fat or muscle or bone?). Elite athletes show up as obese according to their BMI, which either means elite athletes are unhealthy or health isn’t what’s being measured. I’m going with the latter.
Most people at this point know that BMI is not a good way to measure the health of a human being. And yet, doctors will still weigh and measure you, every single visit. Last year I went to the doctor to have a mole removed—this was the sole purpose of the visit—and they still wanted to weigh and measure me.
BMI sticks around because it’s easy. You get one number. It takes less than 30 seconds to weigh and measure someone, compared to asking a series of complicated questions that would provide a fuller picture of a person’s health. BMI is deeply embedded in the functioning of the health care system. There’s a code for obesity that can be entered into the computer. You can get discounts on your health insurance by losing weight and lowering your BMI.
In sociological language, we have reified BMI. BMI is a concept we made up (not, originally, even, as a measure of health). Then we institutionalized it—made it an essential feature of the medical system. Then we forgot that we made it up and started treating it as if it were something real and natural. There are obese people, because their BMI tells us there are obese people. These obese people are different from the rest of us and they’re also deeply unhealthy. Their obesity leads to a whole host of diseases and disorders including, apparently, carpal tunnel syndrome.
I’d already gotten this far in my thinking about weight when I started reading,
, which is all about the dangers of diet culture. Diet culture is the way we take all the complex factors that go into our overall health and reduce them to nothing more than appearance and body shape. Diet culture tells us that controlling our body through relentlessly obsessing about what we eat is normal and how we should all live. Diet culture labels some foods as good and others as bad. Then we become good or bad ourselves based on how and what we eat, as well as how often we move. Diet culture is bullshit.Also, diet culture is pervasive. It is everywhere. I have been steeping in it my whole life. I can’t remember a time when I wasn’t both worrying about what my body looked like and trying to make my body look different. One of my earliest memories is of being on a “diet,” which meant not eating anything all day, then biking two miles on hilly roads in the summer heat to my grandmother’s house where—no surprise—I almost passed out.
Of course, later, when I got more sophisticated, I told myself I was trying to get “healthy” rather than “thin.” This was a lie. Since I turned eighteen, my BMI has never been in the acceptable range. This includes time periods when I was regularly running over twenty miles a week and when I came home from India, sick and emaciated. According to my BMI, I was still overweight, even though in those pictures, I look far from “healthy.”
Now it’s another New Year’s and the commercials for weight loss programs are everywhere. The temptation is real. Every single message in our culture tells us that we should be trying to lose weight. Always. It is literally the work of a lifetime. The quest to lose a few pounds never ends, largely because diets do not work. Most of them are not healthy and almost everyone gains the weight back, leading to a yo-yo of gain and loss that is very unhealthy.
I’m not done with diet culture because undoing it’s deeply-seated way of seeing the world is also the work of a lifetime. I’m not sure if I’ll ever be able stop engaging in constant body comparison, asking myself if I’m fatter or thinner than that person or that person or that person.
But here is my New Year’s resolution—I will never step on a scale again. Not in my own house. Not in a doctor’s office. Nope. Never. That is my first small step away from diet culture.
I’m giving up the scales as a favor to my body, part of the new gentleness toward my flesh and bones. There is nothing gentle about diet culture, in which we treat our bodies as an unruly mass that must be tamed and always, reduced. Disciplined. Sometimes tortured with deprivation and exercise that pushes us past our limits. This is not the relationship I want to have with my body for the years we have left together.
Maybe there’s a different way to look at the aches and pains of aging—the popping knee and the stiff fingers. Maybe these aren’t all caused by my BMI, obesity as a physical defect. Maybe instead of looking at my body as deeply flawed, I might instead think of my sore back as a plea for gentleness and love. Maybe instead of obsessing about my body’s shape or size, I might pay attention to all its other daily needs. The quiet voice that would like another glass of water, please. Or a nice long walk to work out the tension out that comes from sitting at a desk for hours. Maybe my body would like another nap and an orange after lunch but sometimes, yes, a piece of chocolate, too.
What if we saw our bodies not as a perpetual fixer-upper, but as our wise and insistent friend? That’s what I’m going for in 2023.
I’m leaving this open to comments from everyone, but please, no body-shaming or rants in defense of diet culture or the evils of obesity. If you want to learn more about diet culture, check out or this essay in the Scientific-American asking, what if doctors stopped prescribing weight loss?
This makes me think of an article by Ynestra King in which she suggests the whole diet culture is but one facet of our endeavor to control and subdue the natural world more broadly. That rings true to me.
I've been listening to the podcast "Maintenance Phase" and it has really helped me. I gained quite a bit of weight due to important psychiatric medication and while I want to make sure I exercise and eat well, I don't want to focus on the weight aspect of it.