Fatphobia, Capitalism, Professional Ethics & Community Acupuncture: An Introduction

Recently the punks at GCA wrote a blog post about weight loss and community acupuncture which got some interesting feedback from around the internet. Inspired by this, we (Lisa R and Lisa B) are working on a series of posts exploring issues around weight loss, fatphobia, capitalism, and acupuncture. We’re going to include some material in The Mighty CA Wiki. If these ideas are new to you, that’s ok. We’re not trying to jump down anybody’s throat.

That being said, we need to start with a couple of basics:

A heavier body does not necessarily mean worse health. Fat ≠ unhealthy. Thin ≠ healthy. Kate Harding does a beautiful job of explaining this; if you are already confused, please read her post before continuing. You could also watch this video. People are deserving of respect, dignity and quality healthcare, regardless of their state of health.

When the question of weight loss comes up in the community acupuncture clinic, the ethical approach is to be honest with our patients. Acupuncture can help with pain, depression, anxiety, addiction, stress, hormonal balance, sleep, appetite, digestion & relationship with food. A shift in any of these things could have an impact on someone’s weight. Or not. Our job is to focus on what we know acupuncture can do for our patients. Maybe weight loss will be a side effect of acupuncture; maybe it won’t.

There is a strange disconnect within the approaches of some acupuncturists who assure their patients that acupuncture (by tonifying the Spleen, building Kidney fire, seeping pathogenic dampness and/or phlegm, blah blah blah you get the picture) will make the pounds melt away and stay off – while simultaneously also saying “I can’t help you if you don’t help yourself” and coaching them in healthy eating, movement, social engagement and other lifestyle interventions (which, let’s remember, aren’t a part of community acupuncture - not if you want to be treating 6/hour, anyway).

Repeat after us: THERE ARE NO MAGIC METABOLISM POINTS. If there were, the acupuncture profession wouldn’t be circling the economic drain. Any acupuncturist with patients who consistently lose significant amounts of weight and keep it off would have a year-long wait list.

There is a growing body of evidence strongly pointing to the fact that for many people, long term weight loss is a biological impossibility, that our bodies know the weight they want to be at, and will strongly resist our efforts to change that. We think it’s important to look at this research, but at the same time, we’re not here to step on anyone’s bodily autonomy. It’s not really our business whether someone’s on a diet or trying to lose weight, and we want to carefully avoid the “social justice shaming” angle. When someone says weight loss is a goal for them, we don’t suggest that you say “That’s probably never going to happen, don’t waste your time” or “Will you please raise your damn consciousness, my feminist feelings are in an uproar”. We have bitten our tongues before when our patients enthuse to us about extreme diets, and we will again.

It is entirely possible to engage with our patients honestly about what acupuncture can and cannot do, while avoiding shaming them about a) their weight or b) their level of rad body-positivity & self-acceptance.

Now that we’ve debunked acupuncture as a weight loss tool, let’s notice that weight loss is a multi-billion dollar industry worldwide. Let’s notice the emotional and psychological and physical harm done by fatphobia

Part of why community acupuncture works is that we pay attention to context; we don’t reduce everything down to what individuals do or don’t do. In talking about weight loss, it’s worth looking hard at the larger context that we and our patients all live in -- and that context is a culture that allows capitalist businesses to make huge profits from fatphobia. And so if we market acupuncture as a tool for weight loss, we join that attempt to profit from body shaming while feeding into it. Even if that wasn’t what we consciously set out to do. With fatphobia being such a pernicious part of the culture, any time we try to sell anything as a weight loss tool, we are fueling fat shaming whether that is our intention or not. Our marketing does not happen in a void. It happens in a viciously fat-shaming world.

POCA has developed a clear ethos about how community acupuncture works. It’s about breaking down isolation, relaxing into yourself, recognizing your body’s own wisdom. When weight loss is a shame-fueled project, it is the polar opposite of that.

The weight loss industry is an example of capitalism at its worst: profiting from people’s pain. POCA clinics should stand in opposition to this.

To be continued.

This story was posted on March 10 2016 by Lisa B..

Comments

  • March 10 2016 at 5:09 PM
    melissa writes:

    “In talking about weight loss, it’s worth looking hard at the larger context that we and our patients all live in—and that context is a culture that allows capitalist businesses to make huge profits from fatphobia. And so if we market acupuncture as a tool for weight loss, we join that attempt to profit from body shaming while feeding into it. Even if that wasn’t what we consciously set out to do. With fatphobia being such a pernicious part of the culture, any time we try to sell anything as a weight loss tool, we are fueling fat shaming whether that is our intention or not. Our marketing does not happen in a void. It happens in a viciously fat-shaming world.”

    This reeealy helps articulate why I always feel queasy when patients want us to be part of this or I see CA clinics advertising this way. I like the parts about being honest about what acu CAN do and helping open the door to the idea of body positivity without shaming anyone’s goals. Thanks for this post!

      8 likes
    • Lisafer
    • suzzanne.lohr
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  • March 11 2016 at 5:56 PM
    andy wegman writes:

    One of the clear messages I like send to people asking about weight loss in clinic, is my hope that part of what acupuncture provides is a change in perspective, allowing us to not be so hard on ourselves.

    Thanks for starting to write on a very practical and obviously important topic.

      3 likes
    • bottley
    • Bob W
    • jokerpoker
  • March 25 2016 at 3:43 PM
    ceramae writes:

    I love, love, love this topic. Hand in hand with fat shaming comes a lot of “food shaming.” It is a big reason I am a fan of not giving out lifestyle (aka dietary) advice in clinic.

    It reminds me of this article, which addresses correlation between childhood poverty and weight gain:

    https://www.washingtonpost.com/news/wonk/wp/2016/02/12/the-crippling-thing-about-growing-up-poor-that-stays-with-you-forever/

      1 likes
  • February 17 2017 at 6:10 PM
    teatree writes:

    I just had a patient call in asking about a. our price and b. acu for weight loss and by the time we got down talking about lots of questions that came up she didn’t ask again about the weight loss question. I didn’t know what to say as someone representing WCA ( i knew what *I* thought which is basically what you just outlined about, that healthy bodies come in all sorts of sizes and that the shame and extreme behaviors around trying to change so great harm). It’s so great that these forums exist so when i have a question I can see what the sages of CA say. (and its great to be part of a coop that refuse to fat shame)

      0 likes
  • January 21 2018 at 7:16 PM
    sissy writes:

    Thanks for this. It clarifies how I think but was unable to put to words. Really helpful.

      0 likes

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