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On Wednesday the Huffington Post’s long-form vertical Highline published an ambitious piece titled “Everything You Know About Obesity Is Wrong.” The story illustrates the medical community’s systematic failure to provide care to the fat and obese, and the social, cultural, and economic shame that perpetuates a cycle of abuse for fat people. Negative public perception, historically, slows progress as evidenced in a handful of horrendous personal anecdotes about past physicals, romantic relationships, and medical appointments included in the story.

The piece is fantastic; communicating the everyday inhumanities experienced by fat people. The list is long and depressing: bullying in childhood and beyond (cruelty as young as three, the article reveals), partnering with a person you’re not attracted to just to feel desired, being fired or unable to progress in a career or company, having a doctor celebrate your eating disorder as a means to lose weight, the internal struggle to separate self-worth from size, hiding eating behaviors from co-workers and loved ones, and so on.

We’ve known for years that bias against the overweight prevents us from seeking necessary medical attention, as well as misdiagnoses. It ultimately, unfortunately, leads to a near total distrust in doctors—unless, of course, you are equipped to find a fat-positive provider, one that recognizes the failure of the BMI-based system (which is a luxury afforded to the wealthy). The latter point brings about a question of intersectional fat-positivity: both in socioeconomic privilege and in racial discrimination.

For example, the Huffington Post notes that black children see double the amount of candy advertisements as white children. A 2012 study determined that black women are “more likely to become depressed after internalizing weight stigma than white women. Hispanic and black teenagers also have significantly higher rates of bulimia.”

But these facts are illustrated without a deeper dive into the racist food policies that have informed them. (There is mention, however, of government negligence that accounts for “the healthiest foods cost up to eight times more, calorie for calorie, than the unhealthiest...the gap gets wider every year.”)

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Beyond the social conventions that hinder many from engaging in what writer Michael Hobbes describes as “the revolutionary act of being fat and happy in a world that tells you that’s impossible,” there are the oppressive systems that often prevent brown and black communities from accessing healthy, affordable foods. It’s here where the distinction between “weight” and “health” is most crucial—a continuous and flawed system sets POC up for failure—not just in the injustices and insecurities that come with being fat, but in being an unhealthy and fat person.

Chin Jou’s 2016 book Supersizing Urban America: How Inner Cities Got Fast Food With Government Help gives historical context to the politics of food in urban planning. As summarized by James McWilliams in the Pacific Standard, this inequality stems from the 1960s following the infamous Watts Riots when President Lyndon B. Johnson sent the Small Business Administration to California to “eliminate the deep seated-causes of riots” through “minority entrepreneurship in urban areas as a basis for improved local employment and morale”:

Unfortunately, SBA officials, joined by members of the Department of Housing and Urban Development, decided that a particularly promising kind of entrepreneurship for the urban underclass was in fast food. A 1968 SBA conference on the theme of African-American business ownership explicitly highlighted, in its words, “franchising as a possible solution to the ghetto entrepreneur’s difficulties.”

In case there was any confusion about what kind of franchising was envisioned, the SBA invited Dunkin’ Donuts to co-sponsor the event. Two years later, Jou says, “Dunkin’ Donuts received SBA loan guarantees worth $414,700 (in 1970 dollars) to open 11 new franchises.” And thus a trend — corporations soliciting grants from the government to initiate black-owned inner-city fast food franchises — was now underway.

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Later, as Jou writes, “KFC and McDonald’s outlets in African-American communities gestured toward Afrocentrism” by “displaying artwork by African-American artists featuring black subjects, or providing employer uniforms incorporating elements of Kente-inspired designs.” For black Americans in urban centers in the early ’60s, diets moved from being healthy to becoming fast food reliant. The results were unsurprisingly mired in racism. The Huffington Post reports:

Then there are the glaring cultural differences [...] When Joy Cox, an academic in New Jersey, was 16, she went to the hospital with stomach pains. The doctor didn’t diagnose her dangerously inflamed bile duct, but he did, out of nowhere, suggest that she’d get better if she stopped eating so much fried chicken. “He managed to denigrate my fatness and my blackness in the same sentence,” she says.

As a teen, I remember hearing a strikingly similar remark about my supposed rice and beans habit after a routine physical when my Puerto Rican mother, a physician herself, left the exam room. Stories of fatness are funny that way—the degradation and hatred is so institutional, insults seem universal in scope.

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Fatness is not a problem that requires a fix. Health and healthcare are the issues: both who has access to it and for how long. Will our medical communities implement personalized nutrition plans for those who need it, will they treat the fat and obese with the empathy of a straight-sized, upper middle class, white person? Will the government ease healthcare access for the poor? They don’t seem ready but myself and millions of other Americans are.