In what light does society view a binge-drinker? What about a Juul user? A tanning booth user? Someone who doesn’t use a seatbelt, or use sunscreen? Most notably – what about a “fat” person?
Binge-drinking, Juuling, tanning, and other unhealthy behaviors are arguably normalized (and perhaps even culturally praised). People put their health at risk in several ways, but society is particularly hostile toward those who do so through overeating. Why?
Fat Shaming is Pervasive
The results of the Harvard Implicit Project, a two-decade-long (and ongoing) study evaluating implicit bias, evidences society’s prejudices against those who are overweight:
Another study found that 40% of Americans have faced weight-based teasing, unfair treatment, or discrimination – including in job applications and, unfortunately, Ph.D. program applications:
Why is fat-shaming so prevalent if Juul-shaming, no-sunscreen-shaming, binge-drink-shaming, and tanning-booth-shaming, to name a few, exist only minimally if at all? Why are we so focused on shaming one particular health risk – obesity – but not others? Unless fat-shamers are immaculately healthy themselves, judgements made are hypocritical. How do we combat weight-based discrimination and social stigma? One movement aiming to do so is called “Health at Every Size.”
Let’s break down Ms. Poretsky’s main arguments. Is what she’s saying valid? Do fat and thin truly “not matter?”
Combatting Fat-Shaming Through Health at Any Size
Ms. Poretsky discusses the fat-shaming she has battled since childhood, which she explains caused her self-esteem to become “scale-dependent.” These experiences understandably threatened her mental health. She explains that the Health at Every Size movement has helped her to “create mental health and peace… and to let go of judgments” through three primary initiatives: eat “intuitively” according to hunger and satiation cues, find pleasurable body movement (enjoyable workouts), and intend to love and accept your body. These three initiatives are both medically healthy and mentally uplifting – rendering them a fantastic way to combat weight stigma.
Her Claims About Health: Correct?
Though the initiatives Ms. Poretsky describes above are valuable, she makes some questionable health claims. She says that the following is a myth: “fat is unhealthy, weight loss is healthy.” She also says “yo-yo dieting,” or “weight cycling,” is unhealthy, particularly because the majority of people regain weight after dieting. Though partially valid, there are problems with the evidence she supplies to support her claims.
Although “weight-cycling” isn’t proven to be physiologically harmful, long, repeated periods of especially restrictive diets can result in nutrient deficiencies (if you’re not getting enough food in the first place, you’re likely to be lacking in vitamins as well). This may be avoided through proper supplementation. Ms. Poretsky could be referring to non-supplemented restrictive diets, and to the potentially adverse mental health effects of a restrictive attitude toward food – which would partially validate her claim. She says that the statement “weight loss is healthy” is a myth. It can be unhealthy. It is not inherently unhealthy, however, so long as one does not engage in dangerously restrictive dieting. Weight loss can mitigate the negative effects of obesity, which can render it a healthy decision if gone about properly.
Her claim that fat is not unhealthy is partially flawed. To evidence this claim, she discusses the obesity paradox – the hypothesis that excess fat can sometimes have a medically beneficial effect. She names a few of the scenarios in which the obesity paradox is valid – for example, Intensive Care Unit patients and elderly people with higher body fat percentages have higher survival rates. If one falls ill, having excess reserves of energy in the form of fat can have a protective effect. The problem with Ms. Poretsky’s argument is that she fails to mention that the obesity paradox, as defined by medical professionals, does not apply to everyone. Instead, she uses the specific scenarios that the obesity paradox applies to to conclude that “fat and thin don’t matter” across the board. In reality, unless one is at risk for becoming dangerously sick or is elderly, the benefits of excess body fat does not apply.
Ms. Poretsky pinpoints a few studies that support the obesity paradox to support her argument without considering any studies that suggest obesity is dangerous – of which there is an abundance. Excess fat, especially when reaching levels of obesity, is proven to be risky time and time again throughout scientific literature (see links at the bottom of the article to view several). Obesity is related to heart disease, stroke, type two diabetes, joint weakness or failure, some cancers, gallbladder, liver, and kidney diseases, and increased risk of mortality. Obesity-related diseases cost the United States $190.2 billion per year – 21% of annual medical spending. The argument that fat is not unhealthy is flawed – it does not specify that fat can most definitely be unhealthy, depending on the amount that exists in excess.
It’s important to note that the unhealthiness of excess fat does not render thin people inherently healthy. Those who are lean may also be putting their health at risk through their diet.
Implications – Is Health at Any Size Valid?
The claim that “fat and thin don’t matter” is only partially invalid; “fat” and “thin” do matter physiologically, according to scientific literature (and the National Institute of Health). However, “fat” and “thin” shouldn’t matter when it comes to how we treat each other as humans. If one experiences scale related self-esteem issues, like Ms. Poretsky for example, one may choose to prioritize his or her mental health by avoiding dieting or deliberate weight loss. The choice to sacrifice one’s own physical health, unless it harms others, is personal and should not constitute cause for discrimination.
Let’s eradicate fat-shaming and promote body positivity through the scientifically valid portion of the Health at Any Size movement – the three initiatives that Ms. Poretsky suggests. Because most of us engage in at least some form of unhealthy activity, shaming those who are overweight is hypocritical. No one deserves discrimination due to the size of their body. But as we work to eliminate weight stigma, let’s remember to prevent the spread of misinformation.