We need to change the conversation around obesity and health

obesity

In 2015, 93.3 million US adults were obese, a 39.8 percent prevalence of obesity for the US population. Statistics from 2013-14 show that this figure stands at 40% for women.

Adjacent to this rise in obesity is a 66% increase in weight discrimination over the past decade, a discrimination that is clearly, then, doing little to reduce obesity levels.

While it cannot be denied that the facts about obesity and health conditions are there, with obesity being linked, for example, to thirteen types of cancer, being obese does not mean you are automatically unhealthy.

The term ‘obesity epidemic’ is bandied about by studies, health advocates, and news articles all over the world. The myth of obesity spreading like a terrible contagious disease is only aggravated by the wave of media attention the term has garnered as of late, resulting in a wave of panic-ridden hyperbole that does little except fat-shame.

Desperately trying to counter this sensationalisation are members of the body positive and HAES (Health at Every Size) communities, especially women who are also bombarded with constant messages that their self-worth is purely dependent on their weight. These groups are getting increasingly tired of being treated like social pariahs due to the false assumption that their fat is a definite indication of poor health, and not only that, but that they have actively chosen to make themselves ill.

“I have come to view physicians as an oppressor class for people in larger bodies. This in itself makes many fat people unwilling to seek care because they feel ignored.”

But where is the middle ground? How do you reconcile the ever-increasing rates of diabetes, obesity, and weight-related metabolic disorders with a movement that is advocating health at every size?
The key is finding a way to engage in discussions about these issues that allows people complete autonomy and agency over their bodies, while understanding external factors. It must be understood, for such a discussion to take place, that fat does not immediately equal sick.

Sadly, however, nightly news features, and a weight loss industry worth 66 billion dollars, have made this a near impossibility, and that’s before you even take into account the difficulties that overweight and obese patients face when trying to seek quality care. Doctors will, whether consciously or not, invariably relate any symptoms or injuries to your BMI.

Dr. Jennifer Gaudiani, eating disorder expert and founder of the Gaudiani Clinic, knows firsthand the difficulties that people face when seeking quality care, and it’s this that motivated her to start her clinic.

“I have come to view physicians as an oppressor class for people in larger bodies,” says Dr. Gaudiani, describing how doctors are expected to prescribe cutting calories and increasing exercise as a fix-all for obesity. “This in itself makes many fat people unwilling to seek care because they feel ignored.”

Jennifer McKnight is a travel blogger and advocate for body positivity who understands all too well the problems of living with “the societal expectations of a fat-phobic society”. For Jennifer, the negative attitudes aimed at people in larger bodies are what motivated her to start her travel blog, Travel with Curves, where she also provides a platform for women to share how they found solace and self-love during their own travels.

“There is an inherent problem in assuming obesity automatically equals health risks,” she says. “It’s difficult to have a conversation about obesity-related risks if everyone assumes you’re unhealthy because you’re fat. Fat doesn’t necessarily mean a person is inactive or lazy.”

“I’ve heard heard people say ‘few medical conditions lead to weight gain’ and they use that line to justify fat shaming. But how can someone truly know whether a fat person has a condition or takes medication that causes weight gain?”

Turning obesity into a horror story and comparing it to disease outbreaks doesn’t demonise being fat any less, and this is where so many problems with sizeism come into play. It’s all too easy for the media to point to weight and discuss health problems when, in reality, the link between obesity and health risks is a complex one.

“I’ve heard heard people say ‘few medical conditions lead to weight gain’ and they use that line to justify fat shaming,” says Jennifer. “But how can someone truly know whether a fat person has a condition or takes medication that causes weight gain? They can’t, yet they still pass blanket judgements on everyone who is obese.”

She continues, explaining that while it is important to stay informed of the health risks of certain conditions, society’s tendency to stay hyper-focused on obesity is more divisive than it is helpful. “Equating certain health conditions with obesity seems to give those in smaller bodies a free pass, which does them a disservice,” she adds.

Unfortunately, there is no easy solution. For many body positive advocates every day is a constant battle against the expectations of a fat phobic society.

“Look around you and chances are you’ll see that more than two adults in three are overweight or obese…A subtle form of peer pressure has convinced many, consciously or otherwise, that it’s acceptable to be significantly heavier than the “normal” weight ranges listed on a body mass index (B.M.I.) or doctor’s height-weight chart,” reads one article in the New York Times.

This presents us with yet another common misconception of the body positive movement: that body positive influencers are ‘normalising’ obesity and putting many in danger because of denial of health risks. It’s misconceptions like these that put body positive advocates on the defensive. Not all fat people are unhealthy just like not all skinny people are healthy. Instead of allowing a person agency over their own body and health, people in larger bodies are clumped together.

For obesity, rarely do campaigns and health initiatives work to target the problem rather than the person.

If you compare smoking and drinking campaigns with obesity campaigns, you begin to see just how warped our understanding of obesity is. National efforts to reduce smoking rates have been hugely successful, and a major tagline that is still seen today is the simple but effective “smoking kills”. Crucially, campaigns that aim to educate about the health risks of smoking do not target smokers.

For obesity, rarely do campaigns and health initiatives work to target the problem rather than the person. Instead of regulating the food industry en masse and making healthy eating affordable and accessible, we order the regulation of an entire group of people without consideration of their own personal health histories.

There are a lot of complicated knots when it comes to reshaping the conversation about health and obesity that need to be unraveled. “Until society quits equating obesity with words like “lazy,” “slob,” “glutton,” and other hurtful assumptions, it’s difficult to have any kind of conversation that doesn’t come across as targeting or shameful,” Jennifer says.

Dr. Gaudiani agrees that there has to be major societal shift in the way people approach obesity, and any associative health risks, adding that until we find a way to have a more accepting outlook, we continue to set negative patterns for the generations after us.

“If we could change, not to focus on the size of the body, then we might get down to meeting the emotional needs and systemic needs of children and young adults and be able to intervene in ways that alter behavior and relationship to body and acknowledge bodies will be diverse, she says. “Even if a higher body weight is linked to cancer, targeting people with higher body weight is not a solution.”

Kay Vandette

Kay Vandette is a writer, blogger, and fat positive advocate. She has been involved in body positivity to some degree since her early years, but it wasn’t until working as a science writer and reading study after study about the obesity “epidemic” that Kay realised there was a major discord between the missions body positivity, and the media coverage dealing with obesity and its health risks. When Kay isn’t unraveling the myths tied to stigmatising obesity, she is writing about other topics such as climate change and the plastic pollution crisis.

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