Obesity is the biggest threat to the health of our nation,” proclaims the chief of epidemiology at a major medical school on the Scientific American Observations blog. This all too common suggestion does far greater damage to public health than fat tissue itself. When the focus is on weight and body size, it’s not “obesity” that damages people. It’s fearmongering about their bodies that puts them at risk for diabetes, heart disease, discrimination, bullying, eating disorders, sedentariness, lifelong discomfort in their bodies, and even early death.
Anti-obesity campaigns are so common and normalized these days that some readers might consider our claim as the outrageous one. Yet, consider this: stigmatizing and imposing shame on bodies, whether individually or as a group of people, is hurtful both to the vilified fat people and to the thinner people who are taught size prejudice and instilled with a fear of becoming fat. (“Fat” is used here as a descriptive term stripped of pejorative connotations, reclaimed by a growing fat acceptance movement.)
When the culture and the medical world are constantly pushing the idea that “obesity” needs to be eliminated, it’s not the fat cells that are feeling that stigma—it’s the fat people. This hierarchy of bodies is nothing new, with roots in racism, slavery and every other attempt to rank bodies. We can no longer pretend that being less likely to be hired or get promotions, being paid less, receiving biased medical treatment, being socially excluded and bullied are attempts to help people “be healthier.” These are the direct consequences of living in a culture that vilifies and fears fat bodies and that treats the people living in them as morally lesser beings.
From my (Linda) decades of challenging the pervasive “fat is bad” rhetoric, I know that every time I assert that the problem for fat people isn’t their bodies, but abuse from society, bigotry fights back. It’s not just the outright haters who populate the comments section, but worse, the self-righteous who see their stance as caring. It’s all about health, their argument goes, not bias.
No, it’s not. Intent does not negate impact. You cannot wage war on obesity without waging war on the people who live in those “obese” bodies. Moreover, the dignity of a group should not be contingent on whether its members are deemed healthy, eating “right,” or exercising regularly. It should be obvious, but weight stigma does not reduce “obesity”—and health care should be about self-care and promoting the health of the person in all its forms.
“Obesity”—the word itself is a problem, pathologizing the size of a body. It is a category based on the body mass index (BMI), which is simply a mathematical equation based on height and weight. It measures physical appearance, not health. It was never intended to be used for individual health concerns, but rather for statistical analysis of a group. When the American Medical Association declared obesity a disease, it overrode a recommendation by its own expert panel, which stated that correlations between “obesity” and morbidity and mortality rates did not establish causality and there was concern that medicalizing “obesity” would lead to further stigmatization and unnecessary treatment.