On hearing the news this morning about NICE and WLS

I woke to the news that the National Institute for Health and Care Excellence, part of the British government's Department of Health, wants thousands of people to have gastric bands in order to prevent the National Health Service paying for diabetes treatment.

Dear NICE,

It is 6.30 in the morning and I am burning when I should be dozing.

You are slime.

I just want to call you names because I am so angry.

Let's talk about treating fat people with diabetes but let's not pretend that you have found a risk-free, health-enhancing way of enabling people to lose weight, or that weight loss is The Answer to Everything.

Instead let's talk about your treatment of fat people as guinea pigs and scapegoats.

Or the conflation of fat and diabetic.

Or pre-diabetes.

Or the obesity epidemic.

Or how fat people "cause climate chaos".

Or food addiction.

Or how fat people are responsible for The Deficit.

Or the need to tax sugary things.

Or The Children.

Or obesogenic environments.

Or the thousand other bullshit ways that hatred is leveraged to reconstitute and dehumanise fat people in the public eye through fatphobia, and how this affects a population's health.

You have no idea how difficult it is to access adequate healthcare if you are fat. That fat people's lives – probably including mine – are shortened by fatphobic 'care,' aka iatrogenesis, is the real scandal here. It is really hard to be healthy in a culture whose major institutions and centres of medical excellence want to obliterate you.

Now you have made it a lot worse.

A gastric band is a surveillance device. You throw up what the band decides is superfluous. Your body then eats itself because you are really really hungry. This is how you lose weight.

This government loves surveillance.

But like all surveillance, people inevitably find a way around it. It is a faulty surveillance device. It doesn't make diseased fat people into healthy thin people, it makes people have really fucked-up relationships with food and it causes the kinds of problems you would imagine would be caused if a major organ was messed with. Surgery is a relatively recent intervention and it is hard to know long-term outcomes. It's a gamble. It doesn't keep people thin. People still regain weight after a band has been installed. Diabetic people too. What then?

Gastric bands further medicalise people, including those with diabetes, for the rest of their lives. How does this save the NHS money?

I cannot believe that you would mandate more weight loss surgery. You want to invest in something that is entirely duff and requires expensive and risky procedures to install.

You want to invest in this rubbish instead of no-risk, cheap, community-based health promotion rooted in Heath At Every Size. Models that have success records, that fat people are happy to engage with because they/we are seen as agentic authors of our own lives with lived expertise to offer.

It makes no sense at all. Whose sponsorship is behind this decision? Who is making money out of this? What further crap will this recommendation inspire?

With horror,

Disgusted of E15

PS. Insert Headless Fatty here.

Fat activism and tattoos

On Saturday around noon my girlfriend and I went and got tattoos.

It wasn't my first, that one was in 1996. I'm hardly covered but every now and then I'll go under the needle. I like it, the pain feels good, I enjoy the rush afterwards as well as having a picture on my skin. I have one tattoo that I might do differently with hindsight but I've never regretted them, they remind me of things that I don't want to forget.

We got matching tattoos, which is really lezzie, but the subject matter has other stuff going on. In 2004 someone who will be known here as Yeti, unless they want me to name them, and someone else known as Big Blu designed a symbol for a fictitious girl gang project that I was stirring up called The Chubsters. This symbol became known as the Screaming C: a fat letter C, with fangs dripping blood. To me it symbolised the fat person who bites back; a refusal; a snarl. The Screaming C has been deployed in various ways over the years, as graffiti, as embroidery, as doodles, even as stonemasonry. It's a fantastic symbol. As a project The Chubsters is more or less played-out, though a web archive is on the way. But that symbol endures, I think about it often.

Alice works on my skin
We got Screaming Cs tattooed on our hips. I'd been hemming and hawing about it for a while. I'm aware that my tattoos further position me as a marginal person in many people's eyes. I've been reading news stories lately by tattoo haters about how getting tattooed is akin to self-harm. Nice girls don't get tattooed. This is precisely the reason why I went ahead: I'm not and don't want to be a nice girl.

We didn't pretty-up the artwork, we used the original drawings as source material and our tattooist, Alice at Divine Canvas, was faithful to it. It looks like someone has taken a biro and scratched it onto us, which is not so far from what actually happened. The blood droplets are red.

I realised on the day that so much of today's tattoo aesthetic is about prettiness, 'a work of art on your skin,' an inflated idea of art, or 'good art,' taste, which of course is all about class and cultural capital (knowing what the 'right' art is, for example). I like bad art, cruddiness, things that are bodged together. I don't care so much about prettiness. It's one of those things that I conflate with being nice: "nice and pretty". This is not what I'm looking for in life.

My favourite tattoos on other people are ones that would be deemed crap: the group of friends who got a banana tattooed because it was only a tenner; a wonky Siouxsie Sioux; dots made with a sewing needle and ink; a friend who has a cartoon penis and fanny tattooed on her ankles; a pal who has a devil with the words 'Not sorry' underneath, and so on. It's no coincidence that these tattoos are always the cheapest ones in the shop, or homemade, they don't cost the equivalent of a small car.

Having a Screaming C tattoo feels like part of the work of feeling at home in my body as a fat person; it's playful, silly, has meaning and is nothing more than what it is. It felt freeing committing to a tattoo that is not about high-minded aesthetics but is connected to something more basic.

Anyway, getting our tattoos was a lot of fun, not very expensive, and now they are healing nicely and I'm looking forwards to flashing mine from time to time. Some people said that they also wanted to get Screaming C tattoos. I'd rather they went for something more original than copying my tattoo, but it's up to them what they do. The experience has made me think of other fat activists and their tattoos, and it's led me to wonder about fat activist tattoo aesthetics.

I hope commenters will chip in with their own thoughts and pictures, but at the moment it seems to me that a fat activist tattoo often has one or more of the following qualities: cute renditions of junk food; slogans, especially Riots not Diets, inspirational quotes; vintage-cute renditions of fat figures, maybe cartoons, or traditional Western tattoo culture figures (they might have names that I don't know); fat animals, pigs, whales, cows, manatees and so on. Fat activist tattoos are placed on parts of the body that are coded as problematic in the rhetoric of weight loss: bellies, thighs, fat rolls are popular. A theme emerges where fat and tattoos converge where bodies are embellished by flowers, the natural world, sea creatures; these symbols beautify bodies that are reclaimed from, for example, medicalisation and fatphobia, with love that has been hard-fought in many cases, they say to me something like: "My fat body is beautiful and worth beautifying."

Obligatory dodgy tattoo selfie with added flowery knickers
So where might this go? I don't want to yuck anybody's yum, I wish power to all fat people and their beloved tattoos, but what happens if a tattoo is not necessarily about being beautiful? What happens if tattoos undermine discourses of beauty? What might happen if fat activists question the trend towards cuteness? What's that cuteness about anyway? What might a fat activist tattoo - or aesthetic more generally - develop into? A tattoo of a raised fat fist? A trashed set of scales? A broken chair? The cover of Shadow on a Tightrope? I want to see more of this stuff! Fat activists, unleash your imaginations, it's only skin after all.