Shriver writes that her older brother is "a sadly good test case for the claim that one can be 'healthy at every size.'" He weighs 330 pounds, and suffers from compressed vertebrae, diabetes, emphysema, and heart problems. Shriver says he received serious injuries that left him unable to exercise, but that "he also eats too much." And while she has "buckets of sympathy for the obese" and "respect [...] for their feelings, for their humanity," she also writes,

I won't simply accept that my brother is fat. And his only chance at a future is to refuse to accept himself that his weight gain is irrevocable. [...] My brother is only 55, and without drastic intervention – gastric bypass surgery or a sudden resolve on his part that I fear is unlikely – I doubt he'll see 60. My brother is eating himself to death. I love him dearly, and I can't support any political movement that would have him believe he can be "healthy at any size."

Shriver's piece is heart-wrenching to read in light of its coda — her brother died of cardiac arrest soon after it was written. Even without this information, Shriver's concern for her brother's well-being is palpable — she's not that family member who says "I'm just worried about your health," but really wants you to fit into a size 4 dress. Not all fat people are healthy, and it's possible that losing weight would have improved Shriver's brother's life.

But. Health At Every Size did not kill him. First of all, fat acceptance doesn't mean believing every fat person is in perfect health — fat people with cancer obviously still have cancer, no matter how you feel about their weight. Being fat does seem to raise the risk of some health conditions — but so does being thin. Ultimately, the message of Health At Every Size isn't that fat people suffer no health problems, it's that the way to combat health problems (usually) isn't major weight loss — because most of the time it doesn't work. Would weight-loss surgery have extended Shriver's brother's life? Maybe, but the surgery carries risks too. And whether or not he might have benefited from some sort of drastic intervention, the message of Health at Every Size isn't that he was healthy, or that he should have simply ignored his diabetes or heart issues. In fact, it's possible to believe in fat acceptance and have weight-loss surgery. What's not possible: that a movement that teaches that you can be healthy and fat made a man unhealthy.

The trailer for Fat Girls Float, currently seeking funding on Kickstarter, is a good place to get the truth about fat acceptance. (Thanks to the tipster who sent it in this morning.) The film, by self-described "300lb. filmmaker" Kira Nerusskaya (pictured) lets "fat women from four countries (England, France, Russia, and the United States) tell their tales of sorrow and success, wow and woe; discussing size discrimination, political activism (fat and size acceptance), and social networking communities." Interviewees include Velvet D'Amour, who points out that fat characters in Disney films are always evil, and asks, "when is fat Cinderella?" But the real show-stealer of the trailer is a woman named Colleen (pictured above), who says,

If anyone thinks that they are so important and so special that I will give them the power to change my life, to change my attitude, my smile, my frown, if you think you are going to have any effect on that whatsoever, you're mistaken. You have no power. You have no power over me.

Shriver's essay is more moving and personal than the mainstream media's typical anti-fat screeds, but at bottom, its message is an old one — that if we don't keep harping on the idea that fat itself is unhealthy, fat people are going to keep dying. Unfortunately, this is true. Fat people are going to keep dying no matter what we say to them. So are thin people. Everyone dies. While Shriver's brother's death is tragic, stigma definitely wouldn't have saved him. When Shriver calls HAES a "political movement that would have him believe he can be 'healthy at any size,'" she misses the point — nobody could truthfully call her brother healthy when he wasn't. All HAES and fat acceptance aim to do is to decouple health from fat discrimination, and to help fat people protect the self-respect that society tries to take away. Shriver says she has "buckets of sympathy for the obese," but Colleen doesn't need her sympathy. She's secure enough in herself that stigma can no longer hurt her — and she is the real face of fat acceptance, not some notional fatty feeding a sick man lies.

Lionel Shriver: My Brother Is Eating Himself To Death [Guardian]
Get In The Pool! With Fat Girls Float [Kickstarter]

More on walking in the runway show:

"If people are only exposed to imagery of fat people as jokes in movies, TV, etc., then that limits our perception to degradation. So what then is the solution? Not to take the opportunity to proudly embrace my curves in a global venue? One must take advantage of these rare opportunities when presented by people who are willing to take the risk on you. I had utter confidence in both Galliano and Gaultier to represent me in a fashion inclusive of their impeccable style, and I knew their intent to be positive. I don’t think it is so ludicrous for people of such immense creativity and broadminded natures to witness beauty in what mainstream people may have blinders to."

On "regular" fashion models:

"Whilst models are esteemed by the general public to have it all, merely by the luck of the gene-pool, (and likewise, professed to have an attitude to accompany that), they more often than not grew up equally outcast by virtue of extreme height and thinness. Thus I find models tend to be quite sympathetic and kind/curious for the most part and this certainly held true backstage at the runway shows. Its an eclectic, buzzing atmosphere."

On the term "plus-size":

"I recall as a fat child having my Mom take me to the HUSKY store, and that seemed rather humiliating at the time. I had initially pictured some Alaskan dogsled hideaway, but soon found myself amidst frighteningly outdated décor, with racks of polyester knit bellbottoms in puke green, or ‘KICK ME HARD’ red, guaranteed to ensure a wedgie or two, in a era where you were nothing if you didn’t wear straight cut Levi’s. I am sure its origins were well intentioned though, and it’s certainly better then Negative-size, ay?"

Our Interview with Velvet D'Amour: Part I [5 Resolutions]

Related: Gaultier's Largesse Reply To Skinny Debate [Sydney Morning Herald]