We need to listen to Aubrey Gordon- and watch, and read
The fat activist makes a compelling case for empathy and societal change. We doctors should be first in the queue to listen.
Your Fat Friend- film by Jeanie Finlay
What we don’t talk about when we talk about fat- book by Aubrey Gordon
Maintainence Phase- podcast by Aubrey Gordon and Michael Hobbes
In considering the recent oeuvre of the fat activist, author and broadcaster Aubrey Gordon, it is hard to separate the output from the woman herself. In part, this is because she projects so much of her bountiful, generous personality into her work. But it is also because she shows strikingly different aspects of this personality across the different aspects of her output.
I am going to start with ‘angry Aubrey’, who is the person we meet in her book, What we don’t talk about when we talk about fat. An unapologetically polemical and political book, it can be best interpreted as an appeal for equality and respect for fat people (the term that Aubrey herself advocates for). It skilfully blends evidence of systematic discrimination with personal anecdotes which are often almost unbearable to read- people really can treat fat folks like trash, far too often.
The book also makes a scientific case against the medical ‘war on obesity’, in which I was a somewhat ambivalent combatant in my role as health improvement officer for the Royal College of Paediatrics. Her case is that the assumption that a fat person is necessarily unhealthy is flawed, and that, for instance the BMI is a poor measure for predicting a person’s health. Here she is entirely correct- the BMI survives in the medical armoury mainly because it is easy to perform and highly scalable.
The second plank of her case against the ‘war on obesity’ is that dieting and weight-loss intervention just doesn’t work, and is in fact a net harm for most people. The case against dieting is compelling- if it was a medically prescribed treatment, it would pass no meaningful scrutiny, being both ineffective in its principal aims and having significant metabolic side-effects. I find her case against bariatric surgery less compelling- of course surgery is a major step, with complications both immediate and longer term. But the evidence is it does improve people’s health, something that she can be a little dismissive of at times.
She also rather skates over the evidence that, while is is possible to be fat and metabolically healthy, fat people are far more likely to have worse health that those of a lower weight. Of course, discrimination, poor healthcare and the metabolic stresses of dieting all contribute, but at core, fatness is a less healthy state, on average. And while it is completely valid for Gordon to ask “well, what are you gonna do about it?”, I still have a nagging feeling that she hasn’t quite explained why the prevention of child obesity, for example, should not be a valid public health objective.
So I end up with a great respect for the ‘angry Aubrey’ of the book without quite agreeing with her, and being somewhat frustrated by some of the lacunae in her argument.
I tend to be quite a lot more lenient with ‘funny Aubrey’, the aspect I have encountered most in her brilliant podcast alongside the equally talented Michael Hobbes, in which they tear down health fads including, on several occasions, the diet industry. In part this is because they are mainly in critique mode, and their targets are such a shameless bunch of grifters, but also because she is just so damned charming on the podcast. When she is cackling and whooping delightedly at some revelation of misconduct by a healthcare huckster, it is hard not to join in, so infectious is her laugh and personality. Maintenance phase is unafraid to prick medical orthodoxy, and is one of the very best podcasts out there of any kind so I unreservedly recommend it.
So I went into Jeanie Finlay’s documentary about Aubrey quite familiar with both her arguments and at least an aspect of her personality. What the documentary does, in a way that perhaps film can achieve far more effectively than either print or podcast, is connect Gordon’s activism and arguments with her own life, and, crucially, her family.
The film is affecting in a number of ways. Firstly it connects the anecdotes of “what we don’t talk about…” with the everyday reality of life, which we see through her eyes as deeply steeped in anti-fat prejudice. Scenes with family friends are rendered incredibly awkward by their bland insensitivity and barely-concealed pity- not because these people are bad, or malicious, but because they swim in the waters of western society and its prejudices.
Secondly it really engages with Gordon’s body in a way that is loving and celebratory without feeling manipulative or rose-tinted. This is especially apparent in the scenes where she is underwater, an environment in which Gordon feels free and powerful. These are beautiful scenes in every sense.
Finally, and this moved me in a way that to be honest may be as much about my history as Aubrey’s, there is a real evolution in the relationships between her and her mum, Jackie. Jackie goes from being unwilling to join the project, to confronting her previous hang-ups and guilt about Aubrey’s weight, to a loving acceptance of herself and her daughter in a way that really defies description, especially as she does the whole thing in such a gentle and understated way. She was at the screening that I attended, along with Aubrey herself, and it was all I could do not to leap up and give her a hug.
Obviously, partly my affection for Jackie is part of my own issues, but also she represents what I think ought to be the response to Aubrey’s work- empathy and acceptance. Whatever quibbles I might have with her scientific arguments, Aubrey Gordon has been an exceptional advocate for fat people, and her work will shift the perspective of anyone who encounters it with an open mind.
So, go and see the film. Then read the book, and for a steady diet of Gordon goodness, subscribe to the podcast. Otherwise you are missing out on a unique voice. And laugh.