The wild notion that you can be fat and healthy.
Am I promoting obesity? Maybe.
Am I promoting useful information to support people's mental health? Definitely.
When it comes to our health, there is a lot of misinformation floating around. One of the biggest misconceptions is that weight is directly linked to health. This simply isn't true, and it's time we set the record straight. In this article, we'll take a deep dive into the facts and research behind weight and health, and explain why the link between the two is often overstated.
What is Fatphobia?
Fatphobia is a pervasive and harmful form of prejudice and discrimination that is directed towards individuals who are overweight or have a larger body size. This can include negative attitudes and beliefs, as well as discriminatory practices such as bullying, exclusion, and harassment. This often takes the form of weight stigma, where people are shamed or treated differently because of their body size. Fatphobia is not only hurtful, but it's also dangerous. Research has shown that weight stigma can actually make people more prone to health problems, such as high blood pressure and cardiovascular disease. Fatphobia is also deeply ingrained in our cultural beliefs and values, perpetuated by mainstream media and societal norms.
The Cultural Stigma of Fat
Fat has long been stigmatised in our society, with people who are considered overweight or obese often facing discrimination and prejudice. This negative attitude towards fat is rooted in cultural norms that prize thinness and view fat as a sign of laziness, lack of discipline, and poor health.
As a result, many people who are considered fat internalise these negative messages and come to believe that there is something inherently wrong with their bodies. They may feel shame, anxiety, and low self-esteem because of their size, even if they are perfectly healthy.
Fat is not an emotion
And of course this stuff gets internalised as it is what we have taught. It's important to understand that the negative feelings we associate with fat are not the same thing as physical fat. Our bodies store fat as a way to conserve energy and provide us with a source of fuel. The amount of fat we have is not necessarily a reflection of our health or our worth as individuals.
When we say we "feel fat", it is occasionally referring physical sensations such as discomfort or tightness in our clothes, but most often, people use the phrase "I feel fat" to mean regurgitate all of the prejudice and stigma faced by fat people. Life feeling lazy, or slovenly or greedy or like we take up too much space or feeling uncomfortable etc etc et bloody cetera. It's probably worth reminding yourself and those around you that fat is not a feeling, it is a result of our beliefs about what it means to be fat and the cultural stigma that surrounds it.
The Misconception of Weight and Health
One of the biggest misconceptions about weight and health is that there is a direct link between the two. This simply isn't true. In fact, there is very little scientific evidence to suggest that being overweight or obese is the cause of health problems.
Studies have shown that there is not a direct correlation between weight and health. For example, a study published in the American Journal of Public Health in 2003 found that "there is no clear evidence that weight loss improves health outcomes." Another study, published in the International Journal of Obesity in 2006, found that "people with a high body mass index (BMI) have a similar or lower risk of death than those with a normal BMI."
It is important to recognise that weight is just one factor among many that can impact health. But it is one of the most stigmatised - primarily, I believe, as people believe it is as a result of individual choices. In truth, there are numerous other factors, such as genetics, lifestyle, and access to healthcare, that play a much larger role in determining health outcomes. By focusing solely on weight, we overlook these other important factors and perpetuate harmful stereotypes about fat people.
Furthermore, the medical community has long perpetuated the idea that fatness is a sign of poor health, and this has resulted in biased and harmful treatment practices towards people with larger bodies. This includes denying people access to healthcare, assuming that all health problems are solely due to weight, and prescribing weight loss as the sole solution to all health issues, regardless of their root causes.
The Problems with BMI
BMI, or body mass index, is a commonly used measurement of body size that is often used to determine whether someone is healthy or not. However, this measurement is fundamentally flawed and does not accurately reflect the complexity of human biology.
BMI does not take into account factors such as muscle mass, bone density, and body composition, which are all important indicators of overall health. Additionally, BMI was developed in the 19th century and was never intended to be used as a diagnostic tool.
Moreover, BMI is inherently racist, as it was developed using a population of white men, and has since been shown to consistently overestimate the body fat levels of people of colour and other marginalised populations.
One of the biggest issues with the link between weight and health is the use of BMI (body mass index) as an indicator of health. BMI is a measure of body fat based on height and weight, but it doesn't take into account factors like muscle mass or body composition. This means that it can be misleading, especially for athletes or people with a lot of muscle mass.
Additionally, BMI has been criticised for being racially biased. Studies have shown that Black people, who have a higher muscle mass, have a higher BMI compared to white people with the same body fat percentage. This means that Black people are often classified as overweight or obese when they are actually healthy.
Why Fatphobia is Ableist
Fatphobia is also ableist because it reinforces the harmful idea that people with disabilities or chronic illnesses who have larger bodies are not only unhealthy but also lazy or irresponsible. This reinforces harmful stereotypes about people with disabilities and contributes to a toxic environment for those who are already marginalised.
The Dangers of Fatphobia
Fatphobia, or the fear and hatred of fatness, is a form of prejudice that has widespread and damaging effects on individuals and society as a whole. Fatphobia reinforces harmful stereotypes and stigmas about fat people, leading to discrimination and mistreatment. It also perpetuates the false idea that weight is a measure of a person's worth, and that fat people are somehow inferior to their thin counterparts.
This type of prejudice is not only harmful, but it is also ableist. Fatphobia assumes that fat people are inherently unhealthy and that they are responsible for their own health problems, ignoring the role of poverty and the systemic barriers which are often in place. This includes discriminatory healthcare practices, limited access to healthy food options, and social stigma that makes it difficult for fat people to engage in physical activity. Let alone the negative impacts of stress on the body (spoiler: when you are stressed, your cells are designed to store more fat to protect you). I know you may not think it is fair, but you brain does not care how many "diet lollipops" the Kardashians promote on instagram, your body is only concerned with keeping you alive, and if it needs to change your cell structure to do that, it damn well will.
Fatphobia is not only harmful to individuals, but it also contributes to a larger societal issue. When we equate weight with health, we perpetuate the notion that there is a "right" and "wrong" way to be healthy. This reinforces the idea that people who are overweight or obese are somehow "less than" or "unhealthy."
Not only is this harmful and untrue, but it also discourages people from seeking out care and supports the need to be healthy. When people are shamed or stigmatised because of their weight, they may avoid going to the doctor or seeking out help for fear of being judged or discriminated against.
Fatphobia also has harmful effects on mental health. A study published in the International Journal of Obesity in 2018 found that weight stigma and discrimination was associated with increased symptoms of depression, anxiety, and decreased self-esteem.
The Importance of Intersectional Feminism in Promoting Health Justice
Fatphobia intersects with other forms of oppression, such as ableism, racism, and classism. This means that people who are marginalised in other ways are more likely to experience weight stigma and fatphobia.
As an intersectional feminist, I believe it is important to understand the ways in which social justice issues, such as fatphobia, intersect with health. Fatphobia reinforces patriarchal systems of oppression that prioritise thinness and punish those who do not conform to these unrealistic and harmful standards.
This is just not good enough and not something I am willing to partake in. I invite you to consider if these are systems you wish to contribute to upholding.
Correlation vs. Causation
It's important to understand the difference between correlation and causality. Correlation means that two things are related, but it doesn't necessarily mean that one thing is causing the other. Causality, on the other hand, means that one thing is causing another. The link between weight and health is often described as a correlation, but there is little evidence to suggest that it is a causal relationship.
One of the biggest misconceptions about weight and health is that being overweight automatically leads to poor health. However, this is simply not true. The relationship between weight and health is complex and multi-faceted. In fact, research has shown that there is not a correlation between weight and health.
A study conducted by the World Health Organization (WHO) in 2016 found that the majority of people categorised as overweight or obese actually had a lower risk of mortality than those considered normal weight. This evidence challenges the long-held belief that being overweight automatically leads to poor health.
Another study published in the Journal of the American Medical Association (JAMA) in 2006 found that being overweight or even moderately obese was not associated with an increased risk of death from any cause. This study further supports the idea that weight and health are not directly related.
Anti-Diet
I take an anti-diet approach, which recognises that weight is just one aspect of a person's health and that it is not a reliable indicator of overall health. This approach prioritises health and well-being rather than weight loss, and encourages individuals to focus on habits and behaviours that promote health, such as eating a balanced diet, engaging in physical activity, and managing stress. But I am extremely aware of my privilege to be able to make these choices.
Shifting Your Thinking About Fat
So how can you begin to shift your thinking about fat and cultivate a more positive relationship with your body? Here are a few practical tips:
Practice self-compassion: It's important to be kind and gentle with yourself, especially when it comes to your body. Try to speak to yourself with the same kindness and understanding that you would offer to a friend.
Challenge negative thoughts: When negative thoughts about your body arise, take a moment to examine them and ask yourself where they come from. Are they rooted in cultural norms or personal beliefs? Once you've identified the source, try to reframe the thought in a more positive and empowering way.
Focus on health, not size: Rather than fixating on the number on the scale or your dress size, focus on cultivating a healthy relationship with your body. This means listening to your body's needs, engaging in physical activity that feels good to you, and nourishing your body with healthy food.
Surround yourself with supportive people: Seek out friends, family members, and community members who support and celebrate bodies of all shapes and sizes. I also have a free workbook on body image, if you'd like to work more on what is coming up for you.
Notice when you find yourself judging someone for their size, you can make a conscious decision to rewire your brain. Deliberate practice a suffix like "I have no idea what their arteries look like." or "They have a heart and lungs" or "I do not know their blood group". Actively train your brain to humanise people.
The Big Arse Bottom Line
In conclusion, it's time to challenge the myths and misconceptions about weight and health. The reality is, weight and health are not synonymous, and there is very little factual, scientific evidence that being overweight directly leads to poor health.
TLDR Key Quotes
Journal of the American Medical Association "Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories"
"The conventional paradigm of weight management, which focuses on weight loss as the primary goal, may be outdated, potentially harmful, and not universally effective."
"Overweight and obesity are not synonymous with poor health outcomes, and their elimination should not be a primary goal in public health."
"There is a growing body of evidence that indicates that health risks are not necessarily proportional to BMI and that individuals with 'high' BMIs can be perfectly healthy."
"It is becoming increasingly clear that BMI alone is not a reliable indicator of health and that the focus on weight loss as the primary goal of health interventions may be misguided."
"Weight is only one aspect of health, and BMI is not an accurate measure of overall health status."
"The relationship between BMI and health is complex and not fully understood, and BMI should not be used as the sole criterion for determining health status."
"The emphasis on weight loss as the primary goal of health interventions may have unintended negative consequences, including stigma and discrimination against individuals who are overweight or obese."
"Rather than focusing on weight loss, health interventions should aim to improve overall health behaviors, such as healthy eating and physical activity, regardless of weight status."
"Efforts to improve health should be based on an individual's overall health status, not just their weight or BMI."
"It is important to recognize that there is no 'one size fits all' approach to health and that interventions should be tailored to the individual's unique health needs and goals."
From The New England Journal of Medicine "Health Effects of Overweight and Obesity in 195 Countries over 25 Years":
"The association between body-mass index (BMI) and mortality is complex and varies with age, sex, and race-ethnicity."
"Mortality rates were higher for underweight and obese men and women than for those with a normal BMI."
"The relationship between BMI and mortality was strongly influenced by smoking status, physical activity, and the presence or absence of preexisting disease."
"Individuals who were overweight or obese did not have a higher mortality risk than those with a normal BMI after adjustment for these and other factors."
"The link between BMI and mortality is not a straightforward one and needs to be considered in the context of other factors."
"A focus on weight loss as the primary goal of health interventions may be misguided and should be replaced by a focus on overall health behaviors and risk reduction."
"The relationship between BMI and health outcomes is complex and cannot be reduced to a single number."
"Efforts to improve health should be based on an individual's overall health status, not just their weight or BMI."
"BMI should not be used as the sole criterion for determining health status or guiding clinical decision-making."
"The association between BMI and mortality is not as clear-cut as previously thought, and a more nuanced approach is needed to understand the relationship between weight and health."
International Journal of Obesity study, 2006
"The association between BMI and mortality is complex and influenced by a variety of factors, including age, sex, and smoking status."
"The link between BMI and health outcomes is not straightforward and needs to be considered in the context of other factors, such as physical activity and overall health behaviors."
"Individuals who are overweight or obese may not have a higher mortality risk than those with a normal BMI."
"The focus on weight loss as the primary goal of health interventions may be misguided and should be replaced by a focus on overall health behaviors and risk reduction."
"BMI is not a perfect indicator of health and should be interpreted with caution."
"A more nuanced approach is needed to understand the relationship between BMI and mortality risk."
"The use of BMI as a sole criterion for determining health status or guiding clinical decision-making may be inadequate."
"Efforts to improve health should be based on an individual's overall health status and behaviors, rather than their weight or BMI."
"The relationship between BMI and mortality risk varies with age, sex, and race-ethnicity."
"It is important to recognize that BMI is only one aspect of health and should not be used as the sole indicator of overall health status."
International Journal of Obesity, 2018:
"Weight stigma and discrimination are pervasive in our society and have negative consequences for the mental health and well-being of individuals who are overweight or obese."
"The negative effects of weight stigma and discrimination are not limited to physical health outcomes and can also impact psychological well-being."
"Experiencing weight stigma and discrimination can lead to increased symptoms of depression, anxiety, and decreased self-esteem."
"Weight stigma and discrimination can be experienced in a variety of settings, including healthcare, education, and the workplace."
"Individuals who experience weight stigma and discrimination may be less likely to seek out healthcare services, which can lead to poorer health outcomes over time."
"Efforts to combat weight stigma and discrimination are needed to improve the mental health and well-being of individuals who are overweight or obese."
"Healthcare providers and other professionals should be trained to recognize and address weight stigma and discrimination in their practice."
"A focus on weight loss as the primary goal of health interventions may perpetuate weight stigma and discrimination and should be replaced by a focus on overall health behaviors and risk reduction."
"The promotion of body positivity and acceptance can help to combat weight stigma and discrimination and improve the mental health and well-being of individuals who are overweight or obese."
"It is important to recognize that weight stigma and discrimination are complex issues that require multifaceted solutions, including changes at the societal, institutional, and individual levels."
WHO, 2016
"The relationship between body weight and health outcomes is complex and varies with age, sex, and other factors."
"Being overweight or obese does not necessarily mean that an individual is unhealthy or at a higher risk of mortality."
"The focus on weight loss as the primary goal of health interventions may be misguided and should be replaced by a focus on overall health behaviors and risk reduction."
"BMI is not a perfect indicator of health and should be interpreted with caution."
"The use of BMI as a sole criterion for determining health status or guiding clinical decision-making may be inadequate."
"Efforts to improve health should be based on an individual's overall health status and behaviors, rather than their weight or BMI."
"The relationship between body weight and mortality risk is not straightforward and needs to be considered in the context of other factors, such as physical activity and overall health behaviors."
"Individuals who are overweight or obese may not have a higher mortality risk than those with a normal BMI."
"The link between body weight and health outcomes should be interpreted with caution and should not be used to stigmatize individuals based on their size."
"A more nuanced approach is needed to understand the relationship between body weight and mortality risk, taking into account a variety of factors that may influence health outcomes."
Resources to back up the things
Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories
Dr Katherine M. Flegal, PhD, Dr Brian K. Kit, MD, Dr Heather Orpana, PhD, and Dr Barry I. Graubard, PhD
www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/
Health Effects of Overweight and Obesity in 195 Countries over 25 Years The GBD 2015 Obesity Collaborators
https://www.nejm.org/doi/full/10.1056/nejmoa1614362
World Health Organization (WHO), 2016
· Bacon, L., & Aphramor, L. (2011). Body respect: What conventional health books get wrong, leave out, and just plain fail to understand about weight. Dallas, TX: BenBella Books.
· Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17(5), 941-964.
· Hsieh, C. H., Satcher, D. S., & Kizer, K. W. (2015). Improving health equity through action on the social determinants of health. Public Health Reports, 130(2_suppl), 1-4.