Fat Hatred Kills: Marketing Weight Loss Surgery to Children Has Got to Stop

As if it wasn’t enough to attack adults with a mythical obesity crisis, children are being viewed as targets as well. Concerntrolling over ‘rising childhood obesity rates’ is everywhere and it’s paired with damaging, hateful, awful rhetoric. As many adult fat folks note, such programmes basically legitimise bullying of fat children; ‘I’m so glad,’ a friend said to me the other day, ‘that we have these programs now to ensure that fat children know they are disgusting and horrible and should be bullied for it.’

Fat hatred kills, in so many ways, and this is one of them. It kills when fat children are so bullied that they commit suicide rather than continuing to struggle with a world that hates them, because they feel so worthless and devalued and useless that they don’t think life is worth living. It kills when fat children go on extreme diets that are unhealthy for growing bodies, or when they descend into disordered eating because all they want, the only thing they want, the thing they need most in the world, is to not be fat anymore.

And it kills when weight loss surgery is marketed to children, which is an increasing trend in the US. Last year, manufacturers of weight loss surgery products pushed for approval to use them on children and used that to start marketing, and the pressure for weight loss surgery at younger and younger ages is only going to increase in response to that regulatory relaxation. From being bullied for being fat, fat children are now being told that they need invasive and dangerous surgeries, some of which result in permanent metabolic changes that cannot be reversed, in order to be socially acceptable.

There are a few voices of reason here, members of the medical community who express concern about the wisdom of using weight loss surgery in children, and promoting it to pediatricians and other health care providers who work with kids. But those voices are growing hard to hear because many people seem to believe weight loss surgery is a good thing, and that fat children are a bad thing, and if you add the two together, you get a positive outcome. Pediatric bariatrics is a growing specialty, just like adult bariatric medicine, and unfortunately weight loss surgery is a heavy component of that specialty.

Weight loss surgery is a strangely stigmatised procedure: Fat people are told they shouldn’t be fat anymore, and they are an offense to society and should go away, but when they get surgery, they’re told they are cheating and taking the easy way out. Because nothing says ‘easy way out’ like having a chunk of your stomach removed and your intestines rerouted, as is the case with extreme procedures. That’s completely cheating. At the same time fat people who get surgery are judged, fat people who don’t get surgery are being judged for still being fat, and are being pressured to consider it by doctors, ‘friends,’ and others in their lives.

Stay fat and you’re a terrible person, get surgery and you’re ‘lazy.’ With children, who lack medical autonomy, there are even more sinister implications here, because this is really about telling parents that their children are too fat. Parents are being told to consider surgical treatment of fatness; sure, physicians say they wouldn’t force a kid to get the surgery and they want a cooperative patient, but fat children can experience tremendous pressure. When your doctor is leaning on you to get the surgery, and so are your parents, and you’re being tormented at school for your weight, are you really making an independent choice?

Parents, too, have an additional fear in the form of multiple reported cases of fat children being seized by child services for being fat. Having a fat child is viewed as evidence of unfit parenting, which means that some parents are undoubtedly worried, even if they are body positive or neutral on the subject of fat, that their children might be taken away from them because they are fat. Those parents might be forcing diets and exercise and other measures on their children, and could respond positively to a recommendation for weight loss surgery when these measures don’t work. Because they are afraid, and who can blame them?

The fact that weight loss surgery can be actively marketed at all is disgusting, and I strongly wish the US had tougher regulations on marketing medical procedures and products. That it’s marketed to children, both directly in advertisements and indirectly through pressure in medical offices, is vile. No one should have to endure the experience of being told their existence is so vile that they should have risky surgeries to permanently alter their bodies to fit in, but children are especially vulnerable.

These things stick with you, long after you become an adult. A fat child who becomes a fat adult is always going to remember childhood torment, and will remember that some of that torment came from doctors and other ‘well-meaning’ people, and that much of it was considered appropriate and legitimate. These government fat-shaming programmes intended to ‘tackle the childhood obesity epidemic’ are just another reminder to fat children that they are terrible human beings who shouldn’t exist, and they act as a blank cheque for bullies, who know they can torment with impunity because they’re on the side of righteousness.

After all, fat children need to be told they’re fat, otherwise how would they know? And since being fat is obviously a bad thing, fat children should be pushed into ‘treatment’ to get unfat. Even if it kills.