Fat Bubble: Ragen Chastain
Hi friends, welcome back to the Fat Bubble where each week I share resources and leaders within our fat community that support an affirmed and empowered sense of fat culture.
This week I'm sharing someone who has inspired my work for a long time, and was very likely one of the first fat affirming voices I found out in the internet many years ago - it's Ragen Chastain.
As I write this, I'm thinking back to what I might have been searching for when I found Ragen's work. I had joined Fat Positive London - an early fat positive Facebook group - and might have found her through a shared link in there. Or, perhaps, I might have searched 'fat respectful doctor care' or something similar - that sounds like a combo of words I would have strung together, searching for some kind of... something, that would support and advocate for my right to receive respectful treatment.
I'm no different to any other fat person who has had to navigate the doctor's office, in that I have had to deal with doctors peddling weight stigma for as long as I can remember. I can also remember, as far back as possible, that I have sought to be as independent of doctors as possible - like many fat people, desperately trying not to put myself in the path of weight stigma. Fat people are so tediously familiar with going to the GP surgery for tonsillitis and being told to lose weight and I was heartbreakingly familiar with being prescribed weight loss for any ailment I experienced, and also generically 'for my joints'. [As a side note, fatness was such a distraction to doctors that no doctor has ever been interested in joint health in relation to the hypermobility I have, and all my learning on this has been community led and supported - thanks community!].
So I don't remember exactly how I found Ragen, and particularly her resource on how to advocate for respectful care at the doctor's office, but I do know that I would have fallen upon it like a parched person; which, in many ways, I was. Thirsting for respect, validation, actual health insights, actual care. I knew, deep within myself, that I was a person who was worthy of respect and deserved courteous care. I knew it was antithetical to medical ethics to treat people with disdain and disinterest, for the size of the body they were in, and yet it was intimidating and kinda far out to imagine pushing back to this kind of treatment. So finding Ragen's cards for the doctor was truly a lifechanger, because having a script to work from was like having an advocate right there in the room with me.
In the doctor's office, perhaps already feeling nervous and worried about potential health outcomes, we're not ideally positioned to be able to thoughtfully and rationally advocate for ourselves. But what I've found from Ragen's cards was that we can practice a mantra - bypassing the need to think of a response, and instead having one rehearsed and ready. The one I chose was, 'what do you suggest for a thin person that presents with this issue? OK, let's start with that info please', or something along those lines. I've had that script in my head for ten years and I still find it comforting when I have to go to the docs. And, whilst my current GP actually is pretty respectful and doesn't directly suggest weight loss interventions, it's still up my sleeve for the time where I might have to use it, or where I might have to see someone else. I'm under no illusion that the healthcare system is becoming less systemically weight stigmatising; something we saw during lockdowns, when people in higher weights were vulnerable to being declined ventilator support, seen as more disposable by a system that made it's body hierarchies clearer than ever during a deadly pandemic. My future is fat, and there are plenty of advocacy battles that may come my way, and Ragen's tireless work reinforces my commitment to my entitlement to affirming care.
I've lost count of how many times I've shared these resources with clients and connections over the years - they're invaluable. Ragen has, just last week, shared an updated version of these cards on her Substack, and there are French, German and Spanish translations here on her website. I highly recommend you sign up for her newsletter so it arrived in your inbox each week! Ragen continues to offer extremely well researched and robust support to all those in bigger bodies, and her work focuses on the intersections of weight stigma, weight science, health and healthcare. Other oft recommended pieces of work by Ragen are her four part series on fat people and joint pain, and her much needed work on the prescription of Wegovy/semaglutides for weight loss, and it's side effects.
To finish out, I also want to share this lovely video. Ragen's blog is called Dances With Fat - a nod to her experiences in coupled dancing competitions, and this video just makes me smile from ear to ear, and might be exactly the kind of fat joy you need to see today.
Want to read more on moving from apology to entitlement? Head to my blog to read this article from the archives.
Until next time, friends, wishing you safety and joy.
Vicky