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gloomwitchwrites · 1 month ago

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Dog with No Teeth // Chapter Nine

Simon "Ghost" Riley x Female Reader

Chapter Specific Warnings (MDNI): post-apocalypse au, swearing, mild angst, mild fluff

Word Count: 6k

The mandate becomes clearer. You start your first day at the archive. Ghost shares information.

Chapter Eight // Chapter Ten

ao3 // main masterlist // dog with no teeth masterlist

United Nations Preservation of Humanity Charter (UN Mandate I)

Pillar I: Genetic Continuity: All citizens capable of reproduction must contribute to the gene pool unless medically exempt.

Pillar II: Historical Memory: Each Safe Zone and its civilians must preserve human history, language, and art, ensuring no generation forgets humanity’s origins.

Pillar III: Weapons Compact: All Safe Zones are forbidden from producing, obtaining, or trading weapons of mass destruction without prior UN Council approval. Military force may be used only under UN mandate to prevent genocide or extinction-level threats. The production or attainment of firearms, explosives, projectiles, blades, or any instrument of war by civilians is prohibited.

Pillar IV: Bioethics: Non-consensual testing on humans is prohibited. Artificial intelligence, cloning, and biotechnology is outlawed unless authorized by UN Council and must prioritize long-term human well-being.

Pillar V: Reintegration: No persons may be denied sanctuary in a Safe Zone on the basis of origin, gender, or religious belief. All survivors have the right to seek safety and sustenance.

Pillar VI: Equity of Resources: Vital resources, such as water, food, medicine, and power, must be shared across Safe Zones under UN allocation protocols, and redistributed in times of shortage.

Pillar VII: Rewilding: Each Safe Zone and the citizens therein must preserve or restore a percentage of surrounding ecosystems to maintain biodiversity and prevent ecological collapse.

Pillar VIII: Cultural Sovereignty: Safe Zones and the citizens therein retain cultural autonomy, as long as that autonomy does not propagate ideologies that promote extinction, discrimination, or historical erasure. Minority cultures, languages, and traditions must be legally protected.

Pillar IX: Equal Dignity: All individuals, regardless of origin, ethnicity, religious belief, sexual orientation, or country of birth, are equal under the law and entitled to equal protection and opportunity.

Pillar X: Anti-Extremism: All Safe Zones and the citizens therein must report, identify, or otherwise notify the respective authoritative bodies of any organizations, groups, collectives, or movements advocating genocide, supremacy, or systemic subjugation.

You close the pamphlet, shutting out what you didn’t want to know but need to understand. The Preservation of Humanity Charter. Mandate I. Specific and yet entirely vague—open to interpretation. On the surface, nothing appears nefarious, yet you detect hypocrisy in it, that as you dig deeper and ask more questions, fractures will appear.

Your gaze shifts to the collection of reading materials the transitional advisor and family planner handed you when you departed. They stare back, mocking. With a sigh, you set the pamphlet down and reach for another. This one is black with white lettering. “Bill of Rights” is embossed on the front near the top of the thin booklet. In the middle is the emblem of the United Nations.

Opening it, you scan the introduction.

In recognition of the fragility of civilization and the enduring worth of all persons, the United Nations affirms the following rights and protections as universal and mandatory for all Safe Zones, Neutral Zones, governing bodies, and military authorities. These rights are preserved under The United Nations Preservation of Humanity Charter, Mandate III, in alliance with the global standards set forth by the United Nations Continuity Council.

You pause in your reading, mind drifting toward all that’s been lost. There was so much chaos when the structures in place began to collapse—when everything destabilized and devolved. No one believed that any of this would happen. When world leaders threatened one another and preached for isolationism, nothing seemed to come of it. People went to work, lived their lives, spent time with their friends and families.

Then came the trade wars, the tariffs, and sanctions. Even then, people only complained about rising prices and the cost of living. Land and border disputes followed. More empty threats where nothing happened, and the news cycle carried on. But one country put boots on the ground. Another did the same in retaliation. Like a faucet being slowly turned on, the droplets became a stream and then a current.

Article I – Right to Existence and Liberty.

All citizens have the right to life, dignity, liberty, and autonomy. No persons shall be subject to enslavement, forced labor, or arbitrary detention.

All “citizens.” You’re not a citizen—not yet. Where does that leave you? Will they grant you full status when probation is lifted?

Article II – Equality Under Law.

A loud, repeated thudding fills the room, coming from the front door. Clutching the thin black booklet, you head for the door, yanking it open, only to find Lieutenant Riley on the other side holding a cardboard box.

“You’re here early,” you blurt.

“Brought you something,” he replies, voice raspy but gentle.

Behind the balaclava, all you can see are his gorgeous brown eyes. There is no crease in his brow—nothing that indicates any emotion. Yet his shoulders are a tad slumped, almost as if he’s exhausted and would rather be in bed.

You step to the side, holding the door open enough for Lieutenant Riley to enter. Shutting the door, you follow behind him as he makes his way into the bedroom. Placing the cardboard box on the bed, Lieutenant Riley rests his hands atop it, silently observing you as you approach the box.

“You brought me something?” you ask with a hint of excitement.

Neutrality becomes softness. A flush of pink blooms at the edges of the balaclava. Ghost taps the top of the box and takes a step back, extending an arm in open invitation.

“Go on,” he urges.

Placing the thin, black booklet on the bed, you reach for the box with eager, itching fingers. Anticipation flowers in your stomach. Only days ago, Lieutenant Riley dumped you out of his lap and left, hardly giving you a glance as he walked out the door. Now, here he is, bringing you a gift.

You open the box and find an array of colors.

“Is this…” you trail off, reaching into the box, fingers gliding along soft fabric.

Lifting it from its home, you unfurl it. A sweater. Deep maroon by the color. The fit looks almost perfect. Holding the sweater off to the side, you peer down into the box.

“Have you brought me clothes?” you ask, almost choking on your words.

On your release from quarantine, you were given a single outfit. You’ve been rotating through two shirts and two pants the last two weeks. Placing the sweater on the bed, you start removing more items. There are tank tops, dress pants, and cardigans. There’s even a sundress. A wave of joy washes over you, drowning you in rapt glee as you retrieve more clothing items out of the cardboard box.

“I guessed on your size,” says Ghost as a mountain of clothes begins to form on the thin duvet. “Wasn’t sure about color. Or style.”

While the clothes are clearly second-hand, all of it is in good condition. You’ll have more than two shirts to wear. More than two pants. Ghost has brought you an entire wardrobe.

Gratitude explodes within you, bringing you to the brink of tears.

“I can exchange what you don’t like,” he continues, rambling on like he’s suddenly nervous. “If something is too big, can always have it resized.”

“Lieutenant,” you whisper, clutching a pair of black slacks to your chest.

“Do you like it?” he asks, taking a step toward you.

He sounds so eager—so hopeful.

Words form and then promptly leave your head, escaping into the air. So, you don’t speak. You walk around the corner of the bed, and push into Lieutenant Riley’s space. Placing your hand on his arm for support, you go up on your toes, pressing your lips to his balaclava-covered cheek.

“Thank you,” you murmur, squeezing his arm. “For thinking of me.”

Lieutenant Riley’s brow is soft and delicate. He leans in your direction, pure affection in his gaze. It’s startling, sending a rush of heat up your neck and a little flip of your stomach. You quickly drop your hand, backing up.

“You start at the archive today,” states Ghost that soft gaze following your every step.

“I do,” you exhale, smiling in his direction as you delicately fold a pair of jeans. “I’m excited to be around books again.”

“Should pick something out,” nods Ghost. “Look your best for the big day.”

“You’re right,” you grin. “I should.”

After a long deliberation and several spins for Lieutenant Riley’s viewing pleasure, you select a simple black dress with a forest green cardigan. It’s plain and comfortable but professional.

Ghost lightly tugs on the hem of the cardigan. “Fit all right?”

“It’s lovely,” you beam, shying away from how intensely Lieutenant Riley watches you.

It’s hunger but not lecherous in nature. Like dark water, you cannot see into his depths—you cannot begin to guess what he might be thinking. Yet you like the attention, and whatever animosity that lingered between the two of you from the other night is gone. Lieutenant Riley’s body language is relaxed and intimate. The man is in a good mood, and that contentment only heightens your own happiness.

You should enjoy this day. It’s a fresh start. A new beginning in the face of all that you’ve lost.

Ghost releases the cardigan, his arm returning to his side. “Ready?”

You nod. “Ready.”

Out on the street, Ghost escorts you toward a black SUV.

You come to a dead stop. “Is this yours?” you ask in disbelief. “People own cars?”

Ghost opens the front passenger door. “No,” he answers, stepping to the side to indicate that you should get in.

“No this isn’t yours? Or no people don’t own cars?”

“Yes.”

You poke him in the chest, but you’re grinning. “Don’t you dare,” you laugh.

“Dare what?” he replies in mock confusion.

You shake your head good-naturedly, sliding into the passenger seat. Ghost shuts the door, circling around the front of the vehicle to hop into the driver side.

You arch an eyebrow. “Why are you taking me to work in a non-military vehicle?”

“How do you know that?” counters Ghost, draping his arm across the steering wheel.

“So it’s a civilian vehicle?”

“Didn’t say that,” he says casually, leaning back in the seat, reaching into his pocket as he digs around for something.

You open your mouth. Shut it. Ghost chuckles, and you playfully smack his bicep with the back of your hand. Withdrawing a pack of cigarettes and a lighter, Ghost sets both in the middle console. The SUV roars to life, the floor gently rattling beneath your feet. Ghost checks the side mirror and shifts gears. The vehicle rolls forward, cruising slowly down the street.

Two weeks behind the wall and all you’ve seen is the inside of your temporary apartment, and a few surrounding streets. This is furtherment—a consolidation of what was and the exploration of possibilities. Home is behind you, though it dwells in your heart, and for now, you must make peace with your new reality. You must navigate this to your advantage, happiness, and well-being.

That is the core of survival after all. To carry on.

“Where is the archive?” you ask, peering upward through the windshield at the towering buildings.

“It’s inside the library,” answers Ghost, turning on his blinker as he rolls up to a stop sign. “In the civilian zone.”

“We’re going to the civilian zone?” Your voice is laced with excitement.

All you’ve known is grim-faced men and a militarized looming presence. This might just be your first real sense of normalcy in almost a month.

“We are,” replies Ghost.

You can’t sit still as the SUV shepherds the two of you along. Beneath your skin is a buzzing adrenaline. It pushes you to twist and turn, to try and absorb everything around you. The neutral greyness of the militarized zone starts to change, shifting toward greenery. Where there were only sidewalk, road, and buildings, trees and plants begin to appear at even intervals, adding a touch of color.

Ghost slows the vehicle at a small guard gate. The barrier lifts, and a guard waves the SUV through. The transition to the civilian zone is almost instantaneous—a whiplash. While there are several vehicles on the road, the majority are buses, and beside those in designated lanes are bicyclists and motorized scooters. No one walks around in uniform. It’s so…ordinary, and yet so strange, like you’ve been transported back to a time before the collapse or shoved into a parallel reality.

There is a communal quality to the way people move in groups or pairs. No one appears to be any hurry. Lieutenant Riley turns, and you nearly tell him to stop the car. You press your face to the glass, mouth agape as he drives by an open market.

As he takes another turn, you whirl around in your seat. “What was that? Can we stop there?”

Behind the balaclava, the skin around Lieutenant Riley’s eyes wrinkle, hinting at a hidden smile. “Another time,” he murmurs. “Promise. Don’t want to be late on your first day.”

You press yourself against the seat, head tilted in the direction of the window. While everything appears clean—utopian even—there is an underlying rawness, a wear and tear that can only come from age and lack of sufficient resources. Questions fire off in your head. There is so much you want to ask Ghost. If he weren’t so goddamn stubborn, you’d talk his ear off for hours. Instead, you sit still, toying with the hem of your dress as Lieutenant Riley guides the vehicle along.

A few more turns, and then you’re solidified, staring up in shock at the building before you.

“Oh my God,” you say aloud.

Lieutenant Riley snorts at your outburst.

The library’s front façade are book spines in various colors and titles. This is not a structure built in the collapse but from the time before, when libraries were receiving adequate funding, the government cared about knowledge, and learning was publicly free institution. The very center of the building, where the stone stairs meet the entrance doors, is a wall of glass, splitting the book spines into two sections.

“This is—This is amazing,” you gasp.

Ghost grunts in what must be an agreement. Either way, you don’t particularly care. This is a library, a place you never thought you’d see in all its glory again.

“Are you crying?” asks Lieutenant Riley, reaching across the center counsel to place his hand on your shoulder.

“Yes,” you hiccup, wiping away a wayward tear.

“What’s upset you?” He sounds genuinely worried, and that only makes you cry harder.

“I’m happy. I promise,” you say through a shaky breath.

The crease in the middle of Lieutenant Riley’s brow doesn’t abate. “Need to take a minute?”

You nod, sniffling, using the sleeve of the cardigan to absorb the remaining tears. “Just a bit overwhelmed.” Ghost nods but remains the quiet companion as you gather your composure. “I’m ready,” you murmur after a minute.

Lieutenant Riley leans away from you, fingers pressing against the door lock buttons. You hear the audible transition of the locks disengaging. Reaching for the handle, you take a deep breath, readying yourself for what’s to come.

The car door opens. Crisp, cool air rushes in. You inhale sharply, slipping from the seat, landing on solid ground. Glancing over your shoulder, you lock gazes with Lieutenant Riley. He gives a little nod, an encouraging inclination to go.

You raise your hand in the smallest goodbye, slamming the SUV door. Through the window tint, you watch him watching you. Backward step. A turn of your heel. Forward step by forward step. Stairs.

At the top, just before the glass doors, you turn one last time. Ghost is still parked at the curb. Waiting. This is a different version of him, a patient and caring Lieutenant Riley you haven’t seen before. He’s certainly flirted, found ways to comfort you, but there has always been distance—a separation. You consider this change as you enter the library, questioning whether Lieutenant Riley’s motivations are pure.

Who did they assign to you?

Why does it matter?

It matters to me.

The bit of joy that’s made a nest in you fractures. Small cracks. Tiny fissures. Not enough to notice but just wide enough to allow bitterness in.

I was offended they didn’t make me an offer.

Perhaps Lieutenant Riley’s motivations aren’t pure. It’s clear that he wants you to himself, but why? Why you when he could probably have anyone?

As you enter the library, you’re greeted by a warmly lit space, the interior all dark wood and polished stone. Overhead, you notice a balcony of a second story. All you can see of it are the tops of the shelves, but that isn’t what captures your attention. As you approach the front desk, you notice the lack of books on the shelves. Some are completely empty, others full. Most are partially stocked with sections of barren shelving, dust collecting in the corners.

You give your name at the desk, and the receptionist smiles.

“Follow me,” she says, voice soft and lyrical.

As the two of you head toward the back of the building, your awe becomes worry. Most of the lights are turned off back here. The bit of light it does receive comes from the main windows up front and a few skylights that cut through the middle of the second-story ceiling. Rope barricades close off endless rows of empty shelves. Destruction has not touched them. They are simply empty. Bones and broken skulls that once held neural gore.

“Through this door, dear,” says the receptionist, indicating a door that says, “Archival Department” and below that “Employees Only.”

“Thank you,” you reply, but she’s already off, shoes clacking against the marble.

You press your hand to the door, standing there in the muted shadows. Instinct is rising, whispering to run, to seek shelter in more familiar places. But there is nowhere for you to go. Even if you were to walk out the front door, Lieutenant Riley might not be out front, and you don’t know how to return to your apartment.

“Fuck,” you whisper, pressing your forehead to the door with the other hand on the handle. “Fuck.”

You have to do this.

You have to—

Turning the handle, you shove it open, barreling through without looking where you’re going. You nearly take a tumble, righting yourself at the last moment. The door slam shuts behind you, and three pairs of eyes stare back.

“That’s certainly an entrance,” comes a masculine voice with a thick Irish accent.

A tall, lanky man with wire-thin glasses sits behind a plain wood desk covered in stacks of paper and various office supplies. His auburn hair has a touch of grey in it—messy too like he’s only just rolled out of bed. In his hand is a white mug with black lettering that says Yes, I really do need all these books.

“Hi,” you manage, raising your hand in greeting.

When he smiles, there is a fatherly touch to it. You instantly gravitate toward it. “I’m Arthur,” he says, rising from his chair and circling around the front of his desk, arm extended, hand offered in a handshake.

You give your own name, clasping his hand. “It’s nice to meet you.”

“You’re me new archivist.”

“I am,” you nod.

Arthur beams. “Welcome.” He turns to the other two people in the room. Both are women around your age give or take a year or two. “This is Hannah.” He nods toward a blonde with a head of tight curls. “And that is Eloise.”

“Hello,” they greet in unison, all smiles.

The room itself is a quaint office space. Along the far wall are large windows that let in natural light. There are four desks in total, three clearly belong to Arthur, Hannah, and Eloise. The fourth sits empty and must be yours. Beneath your shoes is worn, dark wood and the walls are an off beige with one accent wall in dark green. Pushed up against the three walls without windows are rows and rows of shelving, all of it packed and overflowing. A few of the wood shelves sag inward, threatening to collapse at any moment.

“Charles mentioned your experience,” says Arthur. He takes a drink from his mug. “We’re happy to have you. Too much work for three.” He chuckles. “Not that four will be much better.”

“I noticed all the empty shelves,” you reply, taking a leap in what he might be referring to.

He nods solemnly. “This library services the entire Safe Zone. You’d think they’d assign more staff.” Arthur shakes his head. “We can’t process all this material fast enough. Demand is high but we’re only three.” He lifts his coffee mug in your direction. “Four.”

“Staying busy sounds nice,” you reply, because it’s true. You need out of your fucking head. You need to be away from Ghost and from that apartment for a bit. “And books make me happy.”

Arthur nods. “Hopefully you’ll still love them as time goes on.” He clears his throat. “Now, about the job.”

An endless sea of information rushes at you. Eloise and Hannah float about the office, the two of them chatting in French as they rifle through paperwork. Arthur leaves them to it, taking you on a full tour of the office space and then into the library itself. You stay politely silent through most of it, asking questions when there are lulls. Meandering through the library, Arthur circles back to the office, bringing you to another door.

“Behind here,” he begins. “Is everything we have yet to duplicate.”

While walking through the library, Arthur explained the only books on the shelves were ones they already had duplicates of. There are plenty more where there are only singular copies. Some in pristine condition, others needing a reprint. But it’s not all physical. There are digital versions too that are sitting, waiting to be processed.

“It’s a maze in there.”

“I’m ready,” you smile.

Arthur opens the door, the two of you stepping inside. The quality of the air is immediately different. On the wall next to the door are several panels indicating temperature, air quality, and humidity. It’s all being monitored. But that’s not what shocks you.

Arthur wasn’t joking. The place is a fucking maze.

“What—what is all this?” you ask, turning toward him, gesturing at what can only be called a mess.

Arthur sighs, adjusting his glasses. “That is too much work for four people.”

There is no organization. To order in the chaos. It’s just rows of shelving, stacks of cardboard boxes and storage bins. There are even stacked books pressed up against the wall. A home was found, even that means home is on the goddamn floor.

“No kidding,” you whisper.

Just as Arthur opens his mouth, the door swings open.

“It’s lunch,” says Hannah.

Arthur checks his watch. “Look at that.”

“And someone is here for you,” adds Hannah, smiling in your direction.

“Me?” You point at yourself as if there might be another of you lurking in the stacks.

Hannah’s smile shifts, becoming a knowing smirk like she’s holding on to a little secret.

Arthur claps and pats his stomach. “Lunch is an hour. A full hour.” He winks. “We take that seriously around here.”

At the library reception desk, you find an unexpected visitor.

“Lieutenant,” you breathe, approaching Ghost slowly. “Are we leaving?”

You don’t want to go. Only a few hours in and you’re eager to stay, to idle amongst the shelves.

In one hand, Ghost carries a soft-sided insulated cooler bag. Tucked under that arm is large blanket. The receptionists gaze lingers on the two of you, observing with abject curiosity. Ghost is in his all-black fatigues and balaclava.

“Thought I’d bring lunch,” he states.

“That’s kind of you,” you murmur, reaching for the blanket.

Ghost surrenders it without protest. “There’s a park across the street.”

You nod, clutching the blanket to your chest. “I’d like that.”

A few minutes later and you’re sitting on the blanket, soaking up the sun as Lieutenant Riley opens the cooler bag. He retrieves a glass bottle of water along with sandwiches, fresh fruit, and some cut raw veggies.

“Eat as much as you want,” sighs Ghost as he settles onto his back, arms tucked behind his head.

Unwrapping one of the sandwiches, you take a bite, chewing slowly. “Thank you.”

Lieutenant Riley glances at you. “You didn’t pack a lunch. Knew you’d be hungry.”

“Looking after me?” you tease.

“That’s my job.”

You snort and take another bite. As you chew, you pour yourself some water. It’s cold and crisp. Refreshing. “Didn’t work today?” you venture to ask.

“Work every day,” sighs Ghost. “Price doesn’t mind if I slip away for an hour or two.”

“Must be nice,” you murmur.

“First day treating you well?”

You nod, still chewing. Swallowing, you answer him. “It’s a good fit. Keep me busy.”

“Good.”

“Arthur is the Lead Archivist. And Irish. Hannah and Eloise speak French, but their accents are different.” You take another bite. “Pretty sure Hannah’s Canadian and Eloise is from France,” you muse. After a few seconds of silence, you continue. “Is that normal for all the Safe Zones?”

Ghost adjusts, stretching. “Is what normal?”

“Is it normal for people from different countries to all live in a Safe Zone together?”

Lieutenant Riley stares up into the sky. “It’s on purpose.” You start to formulate a follow-up question, but he carries on. “To dispel supremacy movements. Can’t gather support if the remaining population is scattered across hundreds of Safe Zones.”

“There are hundreds of Safe Zones?” Ghost nods but doesn’t elaborate. “How many exactly?” you probe.

“Just over two hundred.”

Two hundred? There aren’t even two hundred countries. You recall the map in Commander Graves’ office, of the different colored stars that dotted the unlabeled land masses. Of the stars, there were eight different colors, but now that you consider it, they easily could have been two hundred of them on it.

“Are they all large like this one?”

“No,” snorts Lieutenant Riley. “Most are small. Only a few dozen are the size of this one. Ten that are even larger.”

This is the most information Ghost has given you. He appears more open than before. Relaxed. You take another bite of your sandwich, knowing that you need to take advantage of this opportunity.

“Is that why the country flags are black on your uniforms?”

Like a sudden breeze that chills the bones, Lieutenant Riley’s demeanor shifts to a somber note. “Partially,” he answers, voice raspy. “Black flags used to mean something different. Now it’s a statement of grief and remembrance.”

“I don’t entirely understand,” you say softly, shifting closer to him. “There’s so much I don’t know. And no one is willing to talk to me about it. They just…stare at me like I’m dumb.”

You recall Commander Graves’ disgusted expression, and the aloofness you received from Charles. Joann didn’t acknowledge your lack of understanding either.

Ghost still stares into the sky. “Countries exist by law and not land. Borders don’t bloody matter when half a continent is devasted by warfare.”

A sourness blooms in your stomach, the food sitting heavy. “What about your home?”

“Habitable. But destroyed. The infrastructure is gone. All the major cities are craters.”

You reach out, placing your hand on his arm. “I’m so sorry.”

Lieutenant Riley finally looks at you, a sadness settling in his brow. “I’ll be fine, dove. Everyone I care about is here.”

You give his arm a little squeeze before retreating, fiddling with the paper wrapper your sandwich sits in. While you’d like more answers, it’s clear that this topic upsets him. Lieutenant Riley’s home is gone—obliterated. It’s not a pleasant topic for idle conversation.

“With the school attached, I might be asked to lead a writing or reading class. Maybe sub if someone is sick. Arthur mentioned that they try to go there once a week to help those students who are behind reading level.”

It’s an attempt to turn the conversation around, to divert Lieutenant Riley’s thoughts elsewhere. He takes it, some of that sadness receding.

“You interested in that?” he inquires.

You incline your head. “Yes. Did it all the time in my previous community.” Taking another bite of your sandwich, you chew thoughtfully. “But I wouldn’t call what we had a ‘school.’ Did our best though.”

Lieutenant Riley’s gaze is soft. There is a lightness to it, an affectionate edge that reminds you of this morning. You fluster under that stare, staring down at your lap.

“You’ll be brilliant,” he states with such confidence that you believe it too. A smile forms on your lips, spreading wide until your cheeks hurt. Lieutenant Riley rolls onto his side. “Can I kiss you?”

Startled, you blink rapidly. “I—” You giggle. “Yes.”

As you lean toward him, Ghost reaches out, grasping the back of your neck to draw you closer. With one hand on his chest, and the other pushing up his balaclava to reveal his lips, you don’t care if anyone is watching. The sweet connection is instant sunshine—a flowering of a season. Low in your core, a heat stirs.

Soft and slow, Ghost restrains himself, and that only fuels the desire swirling inside you. This is the Lieutenant Riley you like. The one you want to know. Even though you’ve been ripped from your home, you could make a new one here, with him, if only it were always like this.

“Dove,” he breathes against your lips.

That name he calls you. An endearment. You pretend to hate it, but the way he always says it with a husky tone sends you over the edge every time. It drives into your skull. Burrows in your bone.

“Need to take you back,” he whispers, nuzzling your cheek. You linger here, eyes closing as his thumb traces the underside of your bottom lip.

The walk back is silent but not awkward. You stand close to him, arms occasionally brushing against each other with the sway of your body. The urge to hold his hand is suffocating, but you resist. There is no relationship here—only a terrible back-and-forth that you cannot wrap your head around.

The rest of your workday is a blur. It’s combing the library catalog and organizing stacks of paperwork Eloise places on your desk. There is no clear organization. Most of the paperwork are inquiries from other Safe Zones, wanting to know if they have extra copies of certain materials. You do not touch anything in the storage room, but neither do Arthur, Hannah, or Eloise. It dawns on you then, that the work happening requires far more people than what’s been staffed.

When Lieutenant Riley comes to pick you up, you’re almost thankful. Exhaustion settles over you, and you don’t realize you’ve fallen asleep in the passenger seat until Ghost awakens you. Every step is a drag, and all you want is your bed.

With a groan, you flop onto the duvet. Beside you, the bed dips as Ghost sits.

“Are you staying?” you ask into the bedding.

“No.” Silence. Then, “I have to take you to the family planner at the end of the week.”

Your eyes pop open, the tiredness vanishing. Pushing up, you turn toward Lieutenant Riley. “Did they say why?”

He shakes his head. “Just that they want to see you.”

This is it.

The push.

“You’re being pushy.”

“I’m sorry if I’m coming across that way.” Joann folds her hands in front of her on the desk. She has this superior look about her, as if to say, I know more than you. “I’m simply thinking ahead. Better to start the search now than wait until you’re ready.”

“I’m not ready,” you scoff, still in complete belief at Joann’s audacity to hurl this at you. “I haven’t even been assigned my new home after probation. I just started my job a few days ago.” You shake your head. “This is all very sudden.”

Joann puts on an air of false sympathy. “I completely understand. It’s a difficult transition. But if you put this off, you’ll find yourself rushing later.”

I fucking doubt that, you think even as the words threaten to leave your mouth.

She raises her hands in a placating gesture. “Don’t think of it in the way you’re thinking. You don’t need to make a decision tomorrow.” Joann shrugs. “Think of it as shopping.”

“You’re asking me to shop around for a potential spouse?”

“Or sperm donor,” interjects Joann. “We are inclusive here.”

You wince, wanting to be done with this conversation. It’s not as easy as saying no and moving on. Joann isn’t here speaking with you just for you to throw a no in her face. Not that she gave you the option. I put you down for single’s social, she had said with a bright smile, as if that’s something you wanted to hear today.

“Do I need to wear anything specific?” you ask. “Is this a casual event? Or…”

“It’s casual, but I’d recommend something that compliments you.” She laughs. “No one is going to be in a suit if that’s what you’re asking.”

“Didn’t know those still existed,” you mutter.

Joann ignores your comment. “Look at this as an opportunity. I’ve already received a few inquiries about your eligibility.”

“I’m sorry,” you blurt. “You’ve received what?”

Joann continues like she didn’t hear you. “All of them will be there. And I’ll likely receive more after you attend.” She sighs dreamily. “Especially from those military boys. They see what they want and go after it.”

No. Fucking no.

“This will overwhelm me,” you chuckle nervously. “I shouldn’t go.”

Joann blinks. “Course you should. It’ll do you good to get out. Talk with people other than Lieutenant Riley. I know he’s mysterious and has a bit of a bad boy reputation, but he’s not the only option.” She smooths her hand over the small stack of papers in front of her. “It’s also an excellent opportunity to make some connections. Maybe find friends.”

You could use some friends, but your coworkers are starting to fill that gap. Eloise brought you some croissants she made, and Hannah presented you with your very own coffee mug with “Book Sniffer” on it because she caught you smelling a particularly beautiful copy of War & Peace.

Gathering up the papers, Joann gently taps them against the top of the table. “Lieutenant Riley will be there but I recommend you branch out. I know that he’s probably a place of safety for you right now but lingering at his side all night isn’t the best idea.”

“Why is that?” you snap.

While you’re genuinely interested in knowing, you’re also a bit pissed off that Joann called you out. Ghost is your safety net, and if he’s attending, why would you leave his side to speak with anyone else.

“It’s not fair to others,” answers Joann simply. “Stick by Lieutenant Riley’s side during the whole social and people will think you’re spoken for. They’ll complain.” She looks at you pointedly. “And we don’t want that.”

Fuck.

Causing problems. It’s the exact thing you don’t want to do while you’re on your probationary period. Once you’re past it, things might be different. Charles hasn’t discussed what comes after. He didn’t say whether or not you receive immediate citizenship or if there’s an additional process.

No one is giving you clear direction. No one wants to fully explain. It’s expected submission, to look down and follow along. Pushing back or questioning too much seems to aggravate everyone.

“No,” you agree. “We don’t want that.”

Joann’s face lights up, and you immediately want to slap it off her face. “Brilliant,” she sighs. “Here’s the information. Can’t wait to hear all about it when I see you next.”

Fucking doubtful.

With a half-hearted smile, you make your exit, meeting Ghost in the lobby of the building. When he notices you, he immediately turns in your direction, walking toward you with purpose in every step.

“Everything good?” he asks, grasping your arm to pull you in.

You hand him the information instead of speaking. Ghost takes it, gaze roaming over the piece of paper rapidly.

“You’re fucking joking,” he growls.

441 notes · View notes

fatliberation · 3 months ago

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Anti-Obesity Drugs in Sociopolitical Context

Abstract

This literature review critically examines the use of Body Mass Index (BMI) as a diagnostic tool for obesity, highlighting its historical and scientific flaws. The diagnosis and treatment of obesity is heavily stigmatized and reflects deeper socio-economic and racial biases. Fatphobia, or anti-fatness, is deeply rooted in white supremacy and colonial history. I argue that anti-fatness and weight-based discrimination significantly impact health outcomes, rather than body fat percentage alone. The way that the medical system focuses on body size rather than the overall health of patients perpetuates harm and yields even poorer health outcomes. To genuinely improve the lives of fat individuals, we must dismantle anti-fat systems and remove barriers to healthcare, job equity, and basic infrastructure by implementing legal protections, rather than simply promoting weight loss. This review emphasizes the need for a holistic approach to health that considers socio-economic factors and systemic discrimination.

Journal Summary

Recently, two anti-obesity medications, Ozempic and Wegovy, which are primarily prescribed for type 2 diabetes mellitus (T2DM), have shown promise in causing weight loss. The 2022 scientific journal “Ozempic and Wegovy for Weight Loss, Pharmacological Component and Effect” by Abdullah Mohammed, et al explores the pharmacological components and effects of these medications on weight reduction, summarizing findings from existing clinical studies.

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist primarily used to manage T2DM. Clinical studies indicate that semaglutide can also promote significant weight loss. Ozempic's mechanism involves binding to GLP-1 receptors in the brain, reducing food intake and increasing feelings of fullness. This leads to a decrease in body weight and improvement in glycemic control. Wegovy, also a GLP-1 receptor agonist, is the same drug as Ozempic but two times the dose, specifically approved for weight loss for fat people even without T2DM. Administered as a weekly injection, Wegovy has shown effectiveness in inducing sustained weight loss. The STEP trials demonstrated that participants using Wegovy experienced an average weight loss of 15.8% over 68 weeks. Wegovy's pharmacokinetics involve prolonged activation of GLP-1 receptors, enhancing satiety and reducing hunger. GLP-1 receptor agonists like semaglutide mimic the action of the natural hormone GLP-1, which regulates appetite and blood sugar levels. By slowing gastric emptying and promoting a feeling of fullness, these medications reduce caloric intake. Clinical trials have shown that GLP-1RAs, including semaglutide, can result in weight loss from 5% or up to 10-15% of body weight. However, sustained weight loss requires ongoing lifestyle modifications, as discontinuation of the medication leads to weight regain. Common side effects of GLP-1 receptor agonists include gastrointestinal issues such as nausea, vomiting, diarrhea, and constipation. Other potential side effects include increased heart rate, fatigue, headaches, and changes in thyroid function.

Obesity as a Disease

How does one get an obesity diagnosis? There is one single criterion used for diagnosing someone with this disease: The Body Mass Index (BMI). A person’s BMI is their weight in kilograms divided by the square of their height in meters, rounded to one decimal place. It does not account for muscle mass versus body fat. For these reasons, the BMI has been widely proven to be an ineffective health measure. The BMI was also never intended to be a measure of health in the first place.

The BMI was created in the 1800s by a statistician named Adolphe Quetelet, who did not study medicine, to gather statistics of the average height and weight of specifically white, European, upper-middle-class men to assist the government in allocating resources. It was never intended as a measure of individual body fat, build, or health (Karasu, 2016). Quetelet is also credited with founding the field of anthropometry, including the racist pseudoscience of phrenology. Quetelet’s L’homme Moyen would be used as a measurement of fitness to inspire, and as a scientific justification, for eugenics (Eugenics archive).

Studies have observed that about 30% of "normal” weight people are “unhealthy," whereas about 50% of "overweight" people are “healthy” (Rey-López, et al, 2014). Thus, using the BMI as an indicator of health misclassifies 75 million people in the United States alone. “Healthy*” lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index (Matheson, et al, 2012).

*I put “healthy” in quotation marks here because the definition of an individual’s health is oversimplified and depends on many socioeconomic factors.

While epidemiologists use BMI to calculate national obesity rates, the distinctions between weight classes can be arbitrary. Ever notice that the weight classes on the BMI are nearly intervals of five? In 1998, the National Institutes of Health lowered the overweight threshold from 27.8 to 25—making roughly 29 million Americans "overweight" overnight—to match international guidelines (Butler, 2014). Critics have also noted that those guidelines were drafted in part by the International Obesity Task Force, whose two principal funders were companies making weight loss drugs.

Jackie Scully, Senior Research Fellow at the Unit for Ethics in the Biosciences, University of Basel, in her scientific journal titled “What is a Disease?” states the following: “As the business literature shows, new clinical diagnoses are often welcomed primarily as opportunities for market growth (Moynihan et al, 2002). One recent example of this is female sexual dysfunction (FSD). The huge commercial success of sildenafil (Viagra) for erectile dysfunction in men provides a strong motivation for drug companies to identify an equivalent market (that is, condition) in women. And some ethicists feel that drug companies were, to put it mildly, over-involved in the medical consensus meetings held between 1997 and 1999 that effectively drew up very inclusive clinical criteria for the definition of FSD (Moynihan, 2003)."

How can one diagnose a person with a disease and sell them medications solely based upon an outdated measure that was never meant to indicate health in the first place, especially when obesity has no proven causative role in the onset of any chronic condition? (Kahn, et. al., 2000), (Cofield, et al, 2010).

This is why the term “obese” is recognized as a slur by fat communities. It's a stigmatizing term that medicalizes fat bodies even in the absence of disease. The word directly translates to "having eaten oneself fat" in Latin. Obesity, as a medical diagnosis, doesn’t have much ground to stand on. Aside from being overtly incorrect as a medical tool, the BMI is used to deny certain medical treatments and gender-affirming care, as well as insurance coverage. Employers still often offer bonuses to workers who lower their BMI. Although science recognizes the BMI as deeply flawed, it's going to be tough to get rid of. It has been a long-standing and effective tool for the oppression of fat people and the profit of the weight loss industry.

To treat obesity, patients must eat less. Making someone smaller still means they will be healthier, right?

Fatness and Mortality

The idea that obesity is unhealthy and can cause or exacerbate illnesses is a biased misrepresentation of the scientific literature that is informed more by bigotry than credible science (Medvedyuk, et al, 2017). Fatphobia existed long before fatness became medicalized. Yes, obesity is correlated with conditions such as cardiovascular disease, hypertension, and diabetes, but some scientists are looking into possibilities that don't equate correlation with causation. Obesity has no proven causative role in the onset of any chronic condition (Kahn, et al, 2000), (Cofield, et al, 2010) and its appearance may be a protective response to the onset of numerous chronic conditions generated from currently unknown causes (Lavie, et al, 2009), (Uretsky et al, 2007), (Mullen, et al, 2013), (Tseng, 2013). A portion of these correlated conditions are likely brought on by the stress of being part of one or more marginalized groups with little to no support or basic access in society. Weight stigma itself is deadly. Research shows that weight-based discrimination increases risk of death by 60% (Sutin, et al, 2014).

Dieting also poses serious health risks. The reason that these weight loss drugs are so successful by comparison is that dieting is unsustainable and does not lead to prolonged weight loss. Over 50 years of research conclusively demonstrates that virtually everyone who intentionally loses weight by manipulating their eating and exercise habits will regain the weight they lost within 3-5 years, and 75% will regain more weight than they lost (Mann, et al, 2007). Evidence suggests that repeatedly losing and gaining weight is linked to cardiovascular disease, stroke, diabetes, and altered immune function (Tomiyama, et al, 2017). If most fat people have historically tried to lose weight their whole lives through dieting, this has major implications on overall health. Prescribed weight loss is also the leading predictor of eating disorders (Patton, et al, 1999).

Another factor that may be impacting fat people’s rate of mortality is that they are being mistreated at the doctor’s office. I have personally heard dozens of stories about doctors refusing to treat or investigate a problem that a fat person came in for until they lost a certain amount of weight, only to discover years later that the problem was unrelated to their weight and has progressed severely because it went untreated. Fat people are often mistreated and looked at with disgust and disdain in medical settings, leading them to avoid going to the doctor in shame or fear of abuse. This can seriously worsen health issues. Fat stigma in the medical establishment (Puhl, et al, 2012) and society at large arguably (Engber, 2009) kills more fat people than fat does (Teachman, et al, 2003), (Chastain, et al, 2009), (Sutin, et al, 2015). This impact is too significant not to be taken under consideration.

Anti-Fatness as Anti-Blackness

The issue of anti-fat bias is directly rooted in white supremacy. The ideal thin body was constructed as a marker of whiteness and “purity” before any of this was ever made to be about health. Dr. Sabrina Strings has spent her career studying this history. In her book, Fearing the Black Body: The Racial Origins of Fat Phobia, Dr. Strings discusses how constructions of race led to the thin ideal. “Over the decades, the rise in biracial children would break down the way that slave owners saw Blackness and whiteness. To combat the hypocrisy they created, owners invented new ways to dehumanize the enslaved population. They made a calculated decision to start putting more value on white physiques versus Black ones. In her research, Strings found that Black women’s bodies were otherized even more than Black males. For colonizers who hadn’t seen diverse body types before, they quickly categorized the Black female figure as ‘deviant,’ ‘greedy,’ and ‘overtly sexual.’ The fact that we still use these terms to describe fat bodies today is all the evidence we need to understand that fatphobia is directly linked to racism, not health. This mindset was also strengthened by Protestantism. Slave owners looked for any way to prove their power over the enslaved people, and they frequently used religion as ‘proof’ of their racist superiority. Additionally, Protestant belief encouraged various ways to become closer to God, which included eating as little as possible. This would resonate the most with white women. They had as much to do with perpetuating fatphobia as their husbands. White women were desperate to show their own power against Black women on the plantation, and the difference between their bodies was the perfect rift. And so began the centuries-old belief that thinness is beautiful, and fatness is ugly” (Sassenrath, 2023).

Revisiting the Journal with Context

Thinness has been an important value throughout history in the United States. Our positive associations with thinness and negative associations with fatness have led to a collective schema that is black and white, good versus bad, beautiful versus ugly, healthy versus unhealthy, and life versus death. This has led the FDA to approve Wegovy as a weight loss drug with haste, after just sixteen months of testing. It is known that going off the drug will result in rapid weight regain, so patients are expected to be on it for the rest of their lives when there have been no long-term studies. We do not yet know if the drug will have long-term effects, yet it has been approved for kids as young as twelve (FDA, 2021). As of July 2024, Novo Nordisk has a market cap of $633.01 billion (Marketcap).

Wegovy is prescribed along with diet and exercise, which has been proven to lead to weight regain and eating disorders. Patients are being prescribed Wegovy and Ozempic when they are fat, but otherwise metabolically healthy. If this drug is truly a game changer for public health, we should be measuring how patients' health improves over the long-term rather than how much weight they lose. For example, if these drugs improve heart health, they should be prescribed as a heart health medication for patients with heart disease, rather than prescribed as a weight loss fix based on body size alone. With the evidence we have, we know it is possible to be fat and healthy, so these drugs may be solely cosmetic in many cases.

Future

If we want to improve the lives of fat people, we will remove barriers to care, not try as hard as we can to make all fat people disappear. That will never happen. If we truly cared about the well-being of fat people and not their disappearance, we would work to dismantle the systems that oppress them and abolish anti-fatness.

Currently, fat people have next to no legal protections for being discriminated against (NAAFA, 2023). Fat people are denied housing, (Kariss, 1977) jobs, and receive less pay and promotions legally because of their size (The Economist). They are denied access to clothing, seating, transportation, and other human rights because infrastructure has been designed to exclude them. Fat people have less likelihood of receiving a fair trial (Beely, 2013), and are denied necessary surgeries (Barrett, 2022) ––but not weight loss surgery that amputates the digestive tract. Fat people are denied gender-affirming care (Conley, 2023), in vitro fertilization and reproductive healthcare (Muir, 2024), even adopting children (Carter, 2009). Fat children have been removed from their loving parents because when their diets failed, it was seen as neglect (Badshah, 2021). Fat people have disproportionately high suicide rates (Wagner, et al, 2013), and are facing medical malpractice and mistreatment (Kolata, 2016).

Can a drug fix that?

References

Karasu, Sylvia. Adolphe Quetelet and the Evolution of Body Mass Index (BMI). Psychology Today. https://www.psychologytoday.com/us/blog/the-gravity-of-weight/201603/adolphe-quetelet-and-the-evolution-of-body-mass-index-bmi 2016, March 8.

“Quetelet, Adolphe.” Eugenics Archive, www.eugenicsarchive.ca/connections? id=5233cb0f5c2ec5000000009c. Accessed 5 July 2024.

Rey-López JP, de Rezende LF, Pastor-Valero M, Tess BH. The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used. ObesRev.2014 Oct;15(10):781-90. doi: 10.1111/obr.12198. Epub 2014 Jul 16. PMID: 25040597.

Matheson EM, King DE, Everett CJ. Healthy lifestyle habits and mortality in overweight and obese individuals. J Am Board Fam Med. 2012 Jan-Feb;25(1):9-15. doi: 10.3122/jabfm.2012.01.110164. PMID: 22218619.

Butler, Kiera. “Why BMI Is a Big Fat Scam.” Mother Jones, 25 Aug. 2014, www.motherjones.com/politics/2014/08/why-bmi-big-fat-scam/.

Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000 Aug;106(4):473-81. doi: 10.1172/JCI10842. PMID: 10953022; PMCID: PMC380258.

Cofield SS, Corona RV, Allison DB. Use of causal language in observational studies of obesity and nutrition. Obes Facts. 2010 Dec;3(6):353-6. doi: 10.1159/000322940. Epub 2010 Dec 10. PMID: 21196788; PMCID: PMC3280017.

Medvedyuk, S., Ali, A., & Raphael, D. (2017). Ideology, obesity and the social determinants of health: a critical analysis of the obesity and health relationship. Critical Public Health, 28(5), 573–585. https://doi.org/10.1080/09581596.2017.1356910

Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000 Aug;106(4):473-81. doi: 10.1172/JCI10842. PMID: 10953022; PMCID: PMC380258.

Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009 May 26;53(21):1925-32. doi: 10.1016/ j.jacc.2008.12.068. PMID: 19460605.

Uretsky S, Messerli FH, Bangalore S, Champion A, Cooper-Dehoff RM, Zhou Q, Pepine CJ. Obesity paradox in patients with hypertension and coronary artery disease. Am J Med. 2007 Oct;120(10):863-70. doi: 10.1016/j.amjmed.2007.05.011. PMID: 17904457.

Mullen JT, Moorman DW, Davenport DL. The obesity paradox: body mass index and outcomes in patients undergoing nonbariatric general surgery. Ann Surg. 2009 Jul;250(1):166-72. doi: 10.1097/SLA.0b013e3181ad8935. PMID: 19561456.

Tseng CH. Obesity paradox: differential effects on cancer and noncancer mortality in patients with type 2 diabetes mellitus. Atherosclerosis. 2013 Jan;226(1):186-92. doi: 10.1016/ j.atherosclerosis.2012.09.004. Epub 2012 Sep 21. PMID: 23040832.

Sutin, A. R., Stephan, Y., & Terracciano, A. (2015). Weight Discrimination and Risk of Mortality. Psychological Science, 26(11), 1803-1811. https://doi.org/10.1177/0956797615601103

Tomiyama, A Janet, et al. “Long‐term Effects of Dieting: Is Weight Loss Related to Health. Socialand Personality Psychology Compass, 6 July 2017, escholarship.org/uc/item/0tv27311.

Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. doi: 10.1037/0003-066X.62.3.220. PMID: 17469900.

Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1999 Mar 20;318(7186):765-8. doi: 10.1136/bmj.318.7186.765. PMID: 10082698; PMCID: PMC27789.

Puhl, Rebecca, and Kelly D. Bronwell. “Bias, Discrimination, and Obesity.” Obesity Research, 6 Sept. 2012. doi.org/10.1038/oby.2001.108

Engber, Daniel. “Glutton Intolerance: What If a War on Obesity Only Makes the Problem Worse?” Slate, https://slate.com/technology/2009/10/the-health-effects-of-discrimination-against-fat-people.html 5 Oct. 2009.

Teachman, B. A., Gapinski, K. D., Brownell, K. D., Rawlins, M., & Jeyaram, S. (2003). Demonstrations of implicit anti-fat bias: The impact of providing causal information and evoking empathy. Health Psychology, 22(1), 68–78.

Chastain, Ragen. “So My Doctor Tried to Kill Me.” Dances With Fat, https://danceswithfat.org/2009/12/15/so-my-doctor-tried-to-kill-me/ 15 Dec. 2009.

Sutin AR, Stephan Y, Terracciano A. Weight Discrimination and Risk of Mortality. Psychol Sci. 2015 Nov;26(11):1803-11. doi: 10.1177/0956797615601103. Epub 2015 Sep 29. PMID: 26420442; PMCID: PMC4636946.

Sassenrath, Jenna. “Anti-Blackness Is Anti-Fatness in ‘Fearing the Black Body.’” Bookstr, bookstr.com/article/anti-blackness-is-anti-fatness-in-fearing-the-black-body/ 26 July 2023.

“Novo Nordisk (NVO) - Market Capitalization.” CompaniesMarketCap.Com - Companies Ranked by Market Capitalization, companiesmarketcap.com/novo-nordisk/marketcap/ 2024.

Commissioner, Office of the. “FDA Approves New Drug Treatment for Chronic Weight Management, First since 2014.” U.S. Food and Drug Administration, FDA, www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014. 5 July 2024.

Karris, L. (1977). Prejudice against Obese Renters. The Journal of Social Psychology, 101(1), 159–160. https://doi.org/10.1080/00224545.1977.9924002

“Campaign for Size Freedom.” NAAFA, 2023,

naafa.org/sizefreedom. 5 July 2024.

“The Obesity Pay Gap Is Worse than Previously Thought.” The Economist, The Economist Newspaper, www.economist.com/finance-and-economics/2023/11/23/the-obesity-pay-gap-is-worse-than-previously-thought. 5 July 2024.

Elizabeth Beety, Valena (2013) "Criminality and Corpulence: Weight Bias in the Courtroom," Seattle Journal for Social Justice: Vol. 11: Iss. 2, Article 4. https:// digitalcommons.law.seattleu.edu/sjsj/vol11/iss2/4

Berrett, Martyn. “More Obesity Discrimination: The NHS Will Deny Non-Urgent Surgery to Obese Patients.” Healthier Weight, 24 Nov. 2022, www.healthierweight.co.uk/blog/more-obesity-discrimination-the-nhs-will-deny-non-urgent-surgery-to-obese-patients/.

LaRosa, John. “U.S. Weight Loss Industry Grows to $90 Billion, Fueled by Obesity Drugs Demand.” Market Research Blog, The Freedonia Group, Inc., 2 May 2024, blog.marketresearch.com/u.s.-weight-loss-industry-grows-to-90-billion-fueled-by-obesity-drugs-demand.

Conley, H. “Studies Show Top Surgery Is Safe for FAT Patients, but Some Surgeons Still Mandate Weight Loss.” STAT, 25 July 2023, www.statnews.com/2023/06/02/top-surgery-safe-fat-patients/.

Muir, Becca. “Opinion: Women with Obesity Are Often Restricted from IVF. That’s Discriminatory.” NPR, 14 Jan. 2024, www.npr.org/sections/health-shots/2024/01/14/1224546666/opinion-women-with-obesity-are-often-restricted-from-ivf-thats-discriminatory.

Carter, Helen. “Too Fat to Adopt - the Married, Teetotal Couple Rejected by Council Because of Man’s Weight.” The Guardian, Guardian News and Media, 13 Jan. 2009, www.theguardian.com/society/2009/jan/13/adoption-rejected-couple.

Badshah, Nadeem. “Two Teenagers Placed in Foster Care after Weight Loss Plan Fails.” The Guardian, Guardian News and Media, 11 Mar. 2021, amp.theguardian.com/society/2021/mar/10/two-teenagers-placed-in-foster-care-after-weight-loss-plan-fails.

Wagner B, Klinitzke G, Brähler E, Kersting A. Extreme obesity is associated with suicidal behavior and suicide attempts in adults: results of a population-based representativesample. Depress Anxiety. 2013 Oct;30(10):975-81. doi: 10.1002/da.22105. Epub 2013 Apr 10. PMID:23576272.

Kolata, Gina. “Why Do Obese Patients Get Worse Care? Many Doctors Don’t See Past the Fat.” The New York Times, The New York Times, 26 Sept. 2016, www.nytimes.com/2016/09/26/health/obese-patients-health-care.html.

#fat liberation #systemic anti fatness #systemic fatphobia #medical fatphobia #medicalized fatphobia #fat activism #fat acceptance #anti fat bias #fatphobia #essay

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memories-of-ancients · 2 months ago

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For the last 14 years, when it rains in Lowndes County, Alabama, contaminated standing water builds up around Annye Burke’s home. When the septic tank breaks down, raw sewage backs up into her toilet, she said.

Although “frustrated” by the unhealthy and inconvenient conditions, Burke said she doesn’t let it get her down. Human wastewater contaminating homes and yards in these rural parts of central Alabama “has become a way of life,” she said. The problem has existed so long and was so pervasive that a 2017 study determined 1 in every 3 adults in the county had the intestinal parasite hookworm.

The Biden administration investigated and allocated nearly $26 million to rebuild Lowndes County’s water infrastructure, with the Department of Justice declaring the majority-Black area was suffering from “environmental racism.”

But earlier this month, President Donald Trump issued an executive order to kill the deal, calling it “illegal DEI.”

The DOJ’s Harmeet K. Dhillon, the assistant attorney general for civil rights under Trump, said the agency “will no longer push ‘environmental justice’ as viewed through a distorting, DEI lens,” referring to diversity, equity and inclusion programs.

A 2023 investigation sparked by environmental activist Catherine Coleman Flowers and conducted by the DOJ found that low-income residents of the county, most of whom are Black, have lacked basic sanitation services for generations. Given the area’s especially hard, impermeable soil and the high cost of installing private wastewater systems, many residents have resorted to straight piping to deal with human wastewater. This method involves guiding human wastewater away from the home into a series of ditches and crude piping systems, according to the DOJ report. That water collects in nearby yards, open areas and woods.

In more recent years, heavier rainfall related to climate change has meant that contaminated water floods into the home, spills across open areas, and contaminates local vegetation and water, exposing residents to illness.

And so, Burke and more than 300 other families in Lowndes County — located about 40 miles southwest of Montgomery — are forced to live with a failing water infrastructure that has led to serious health concerns, including hookworm, which at one point had been thought to be eradicated from the United States, according to a 2021 study by the Baylor College of Medicine and the Alabama Center for Rural Enterprise.

Hookworms are mainly contracted by walking barefoot on soil contaminated with infected feces. It can cause abdominal pain, skin rashes, diarrhea, fever and other ailments.

“We have to be extra sanitary because people getting sick can be a problem,” Burke, 58, said. “The health concerns are real. In 2025 we shouldn’t have to deal with this, but it is what it is.”

She said she uses various disinfectants multiple times a day to clean her home and protect her family, which includes her children and grandchildren who come to visit.

This environmental quagmire has persisted for more than 20 years in this rural part of the state, where 72.4% of the population is Black and the median household income is $35,160, according to the latest census; one-third of residents live below the poverty line. Flowers said that much of the problem started back in 1866 with the passage of the Southern Homestead Act, when Black people were first allowed to purchase land there and were offered mostly places that were environmentally unsafe.

In recent decades, it’s not uncommon for untreated sewage to flow from some residents’ toilets into their yards or back up into their homes through sinks or bathtubs. Drinking water from the tap is out of the question. Some residents have dug ditches in an attempt to drain rainwater away from their homes.

Flowers, who grew up in Lowndes, has been fighting for 23 years to fix the water infrastructure in the county. Her efforts led to the Biden administration’s $26 million commitment. She said Trump’s cancelation of the agreement did not surprise her.

“There are some people who are not going to make it a priority to get this work done,” Flowers said. “That’s the way it’s always been.”

Alabama Rep. Terri Sewell, a Democrat who represents the area, said in a statement that the DOJ’s reason for abandoning the deal was weak.

“This agreement had nothing to do with DEI,” Sewell said. “It was about addressing a public health crisis that has forced generations of children and families to endure the health hazards of living in proximity to raw sewage, as the DOJ itself documented. By terminating it, the Trump Administration has put its blatant disregard for the health of my constituents on full display.”

When announcing the results of the 2023 investigation, former Assistant Attorney General Kristen Clarke said the Justice Department found evidence that suggested Alabama’s Department of Public Health showed “a consistent pattern of inaction and/or neglect concerning the health risks associated with exposure to raw sewage.”

Sewell added that the burden to “remedy this injustice” fell to the Alabama Department of Public Health. But the ADH said in a statement to NBC News that “the installation of sanitation systems and related infrastructure is outside the authority or responsibilities.”

A second statement from ADH said the department had received $1.5 million of the funds from the Biden agreement and used it in part to pay for three septic tank installations. With the remainder of that money, ADH will pay a contractor to complete more work by May 2026, according to the statement. Trump killed the agreement before any additional funds could be distributed toward fixing the water infrastructure.

Annye Burke said her daughter, who lives next door, is in a dilemma because she was hoping to receive a new septic tank when hers recently collapsed. She’s lived the last four years with her water issues.

“Being raised in the country and at one point of having to use outside facilities, I know how to make do,” Burke said. “I just take one day at a time and pray about it and keep moving on. I don’t let it get me down. But my daughter grew up differently, so I worry about how she deals with this stuff.”

Flowers, the activist, said that while she hopes the agreement will be reinstituted, she has seen communities come together to make change. Last week, she pointed out, she was in Mount Vernon, New York, where sewage issues were resolved with the combined work of the city, county and state government.

“They fixed it because they should have,” Flowers said. The problem was discovered in 2021 “and it’s fixed five years later. I’ve been working on this in Lowndes County since 2002.”

Some families have been able to afford to move away, but many cannot. Then the connection to the land is also a factor, said Flowers, who spent her childhood there and whose father was raised in Lowndes County.

“My family has been in Lowndes County since slavery,” Flowers said. “It’s home for people. Why would we want to move? That’s where our people are buried.”

Changing homes is not just about occupying another house.

“We’re talking about giving up a culture,” she said. “So, we will continue this fight.”

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