Diet culture has no place in blood donation campaigns
Illustration by Marlee Jennings
As the Omicron surge took the world by storm last winter, the Red Cross declared a historic blood shortage in the U.S., and the internet was filled with pleas for donations. While donating blood is a great way communities can come together to save lives, the information available for people planning to donate is influenced by a culture that moralizes body size and food consumption. For example, blood donation campaigns encourage donors to eat cookies after donating because they’ve “earned it,” rather than because of the physiological importance of eating after losing blood. Other organizations list burning calories as a benefit of donating. On top of that, there are even fitness blogs (1) that specifically list blood donation as a weight loss strategy.
Posts like these not only assign moral value to body size and eating habits, but also associate this moralizing language with the undeniable benefits of saving lives and serving the community. Thinness is not a moral obligation, and it is not superior to fatness. An individual’s food choices do not have moral value. There are issues of morality in our food systems (eg., worker exploitation, child labour, the mistreatment of animals, environmental degradation, corporate monopolies and food gentrification) but these are structural issues beyond the control of the individual, and they have nothing to do with a food’s nutritional content or the size and shape of a person’s body. There is nothing wrong with being fat.
The fatphobia in blood donation campaigns is reflective of fatphobia within public health as a whole. Marquisele Mercedes has written about how fatphobia, as well as other systems of oppression, shows up in the conversation around food insecurity. Our culture pretends that thinness is equivalent to health, but the relationship between weight and health is not causal. It is complicated, and is influenced by a lot more than food and exercise. Ragen Chastain describes how correlations between weight and health do not control for the negative impacts of weight cycling, weight stigma and healthcare inequalities. Dr. Asher Larmie has also discussed the myths around weight and health, as well as the impacts of weight stigma.
Regardless, health is not a moral obligation. Individuals do not have a responsibility to themselves or others to be healthy (they do, however, have a responsibility to avoid contributing to the spread of infectious diseases). Healthcare and public health professionals have a responsibility to care for individuals and treat them with respect, regardless of their assumptions about the person’s lifestyle. The core principles of healthcare ethics –– autonomy, beneficence (doing good for a patient), non-maleficence (doing no harm) and justice –– require supporting fat liberation. This is a justice issue, both in how fatphobia impacts health and well-being and in the racist origins of fatphobia. Weight stigma worsens healthcare outcomes, including by harming mental health and allowing serious conditions to be overlooked. Fat patients are often denied care based on their weight, including gender affirming care for trans individuals. Emergency contraceptives are less effective for fat bodies, and fat patients may be charged more for abortion care. Equating the moral good of lifesaving blood donations to weight loss further contributes to this rhetoric, harming individual and public health.
Donating blood has undeniable benefits for society and the individuals who receive blood donations. There’s no need to use fatphobia and diet culture to justify blood donation. In fact, it’s antithetical to public health. Pursuing intentional weight loss is harmful to mental health, with 20-25 percent of people who go on a diet developing an eating disorder, the second most deadly form of mental illness. The vast majority of people with eating disorders are not considered underweight. Moreover, fat patients often delay care out of fear of stigma, and when accessing care, do not receive high-quality, evidence-based care. In fact, there often isn’t adequate evidence about what care is most effective for fat patients. For instance, in light of the U.S. rolling back abortion rights, some people have been deeply concerned by the lack of evidence about whether emergency contraception will work for people of all weights. This is clearly harmful to the goals of reducing illness and death. So when we’re talking about the value of blood donations, suggesting that it can burn calories or lead to weight loss should be left out.
(1) MaxWorkouts lists that blood donation can be part of an intentional weight loss plan.
About the author: Katherine Gladhart-Hayes (she/her) is an occupational therapy and public health graduate student with a background in bioethics and history of science. She is interested in the relationship between science and society, history of medicine, reproductive justice, and climate justice.