Greg Kline, PhD, MPH
The research findings and policy recommendations regarding the benefits of an active lifestyle are as ubiquitous and nearly axiomatic as the recommendations for “weight management.” Unfortunately, the reality is that all across America, millions of women and men are deciding not to go to the beach, pool, tennis courts, or local exercise facility because their bodies don’t meet the current standards of beauty and appearance. Poor body-image and shame keep many clothed, hot, and at home instead of out experiencing the joys of life.
It is noteworthy, however, that research studies looking at exercise interventions with large people often provide a built-in mechanism for social support and emotional safety, i.e. designing and administering the program specifically for them. Unfortunately, this is often not the case outside the controlled research setting where large people more realistically must confront the social stigma and humiliation associated with being large in a public exercise facility or setting. For many large people, the social and physical barriers to exercise add to the already considerable impediments expressed by most people who do not engage in regular physical activity (e.g. lack of time, distance to facilities, cost, and so forth).
With this in mind, I realized that I might attract fewer people to my health and fitness class by stating plainly in the ad that it was intended for “fat” people. Then again, fat people were the very folks I was trying to reach, and no other word seemed to convey that as efficiently. Ms. DT signed up for the class stating, “Here I am at 53. I’m middle-aged. I don’t want to go to my grave hating my body and myself.” Her feelings are fueled by a culture that is contemptuous of, and mean-spirited toward, large people. Ms. DT tries to walk 3 miles on most days; however, she is reluctant to do any other kind of activity in public. Even walking in her neighborhood is sometimes emotionally difficult because of verbal harassment from passersby. She loves swimming but goes to a nearby lake only a few times during the summer, and then only when no one is around. “I’ve spent obsessive amounts of time trying to disguise and hide,” she says.
Many large people often don’t get enough physical activity because it is a habit they haven’t developed due to the shame and discomfort they are subjected to if they attempt it in public.
After an article about my class appeared in a local newspaper, one father wrote a letter supporting me in my efforts to provide a safe and comfortable exercise environment for large people. Mr. RR cited his 12-year-old “Rubenesque” daughter who loved swimming but would not take swim class at school because of the teasing. All the people in my class loved the water activity but had not been swimming for many years. For many large people, swimming pools are out of the question for two reasons: 1) public humiliation—getting from the locker room to the water is emotionally impossible; 2) ladders—most swimming pools are designed with vertical ladders or steps carved into the side of the pool wall. For many large people, sloping steps are the only comfortable entry into the water. I discovered this problem when the swimming pool used by the class was closed for repairs. Much to my surprise, all the other available swimming pools in the area had vertical ladders for entry and exit, but no sloping steps. This frustration occurred once again when a water aerobics instructor was invited to give a workshop at the university pool. One of the larger members of the class required assistance because the vertical ladder was not negotiable.
The members of the class also agree that the local health/fitness facilities are taboo for them. One woman joined a local health facility only to be told that she was too large for a particular piece of exercise equipment. Indeed, the manager has the right to be concerned about the weight capacity of his equipment; however, the more salient question is, “Why do most exercise facilities not provide equipment designed to accommodate people of all sizes?” The spandex-clad, lean, hard-body culture at most exercise facilities is daunting for the general unfit population and especially so for large people. In a very real sense, health/fitness facilities are “preaching to the choir” and have created an exclusive atmosphere that is uninviting to those whom the health care profession admonishes most vigorously about needing to get more exercise.
Large people don’t need to hear more about the benefits of physical activity—they know this already. Rather, they need to have access to safe, comfortable, supportive activity environments, which currently are difficult, if not impossible, to find. We need to acknowledge the double bind created for large people by the health community’s admonition to “get more exercise” without doing more to make physical activity less threatening, more accessible, and more comfortable for them. Instead of talking about why they need more activity, we need to talk about where and how. We need to create dedicated time and space where large people can feel comfortable and supported.
The April 10 airing of CBS TV’s “Inside Edition” had a piece about higher costs charged to large people wishing to join health/exercise facilities. This was billed as “undercover” investigative reporting and seemed to support the notion that some facilities actively discourage large people from joining their facilities because they don’t fit the “fit”image!
To underscore this reality, a female graduate student seeking an assistantship at her university’s fitness/exercise facilities was told to lose 15–20 pounds because she was “too fat to be a role model for health and fitness.” The tuition waiver and health benefits were substantial incentive, and the student proceeded to crash diet and purge in order to achieve the desired weight loss. Not only did size discrimination rear its ugly head, but the obvious “fit OR fat” message was clear, and this student was manipulated into bouts of disordered eating. I believe this shameful and unethical behavior is not atypical in today’s lean, hard-body fitness culture.
Health/fitness facilities must realize they are missing out on an important customer base. Large people need to become more politically active by voicing the need for time, space, and equipment that helps accommodate their needs. Health care professionals, educators, and parents need to become more insistent that these concerns be addressed in the school system and in community recreation and fitness facilities, both private and public. This can make a big impact. By no means exhaustive, a few examples might include:
1. Writing letters to editors of local newspapers addressing the need for better access
2. Writing letters to, phoning, or visiting exercise facilities to discuss marketing possibilities aimed toward large potential customers
3. Organizing as a group to create a class or group activity (e.g., swim, bike ride, tennis, yoga, etc).
4. Renting activity space and time for “large body” exercise classes
5. Talking to school physical education teachers and exercise facility instructors about providing a more supportive atmosphere
6. Creating a “fat people’s” swim time or water aerobics class with a fat-positive (or at least respectful) instructor at a pool accessible by public transportation (or with carpooling)
7. Encouraging health care providers to educate fat people about pain management, the best shoes for a fat person doing a lot of walking on sidewalks, and other medical and fitness-related information with the needs of a fat body in mind
8. Advocating for an explicit commitment by those who encourage exercise to provide education both within the health care profession and also to clients about resisting the prejudice against fat people that permeates our society. This is crucial to fat people’s health. It is an additional barrier fat folks need to overcome, one that is crucial to the health of fat people.