Fat is not the problem

We’re surrounded by headlines with the following sentiments: 

“Lose weight, be healthy!”

“Obesity linked with increased risk of heart disease”

“America has never been fatter”

Then a fat person does something amazing and instead of raving about the amazing thing, the haters come out of the woodwork and chastise him or her for her size. This in turn creates a stigma around obesity known as “fat stigma.”

Fat stigma is pervasive. I see it every.single.day at work in healthcare. Studies have found that it is rampant in the medical community, even more so that the general population. And this further drives more stigma. Fat stigma could be interchangeable with fat shaming. Some may think it is motivating, but when was the last time being shamed by everyone around you motivated you? 

Brene Brown (oh how I love her!) describes the difference between shame and guilt. Shame is a focus on self and identity, guilt is a focus on behavior or circumstance. Shame is, “I am bad.” Guilt is, “I did something bad.”

The problem is when we use an imperfect proxy to judge others. Weight should not be the judge. I do it too (remember, I live in the same world as you!). But I am mindful of my judgements and make active efforts to change them. To see the other side. To realize there is a person on the other end of that judgement that is aching to be loved and accepted just how she is. 

As many of you know, I am an advocate for health at every size. Yes, many people carry more weight than they need, but true health is not in the weight loss alone. Restricting calories and taking medications or supplements to lose weight is not sustainable and is not healthy. Weight is an imperfect proxy – if someone eats a poor diet and doesn’t exercise s/he will almost always gain weight. But not everyone who gains weight or doesn’t meet society’s standards for the ideal body is unhealthy. 

Our bodies are complex. Some people have health conditions that cause weight gain. Some people have to take medications that cause weight gain. Some people have tried to be healthy for years but the yo-yo dieting and inconsistent exercise program has left them overweight. Some people were never taught how to deal with emotions as kids and turned to food for comfort. 

Here’s the problem – let’s say that obesity alone is THE huge health problem we need to be addressing. Shaming people who are obese is NOT going to help them become less obese. We can’t support fast food or cheap, easily accessible processed foods and then chastise people for eating them. We can’t tell people to be more active, but then comment with shameful messages to posts about the fat guy exercising. We can’t tell people to go to the gym but then make them feel uncomfortable when they are just learning to use the equipment. If we truly think fat is the problem then we need to work together to make a community where fat people are accepted and support ALL PEOPLE in being the healthiest versions of themselves. 

It is a slippery slope. I get it. By giving permission it allows people to let themselves go. But who **wants** to be fat in our society? No one. There are few groups that are more discriminated against or shamed openly. 

There was a great article earlier this month in Scientific American about this very topic. Check it out here: http://bit.ly/332htxt. Don’t think you have weight bias or are affected by fat stigma? Open the link and notice your first thought when you read the headline and see the picture. 

Unfortunately, well-intentioned efforts have left us in a mess where people focus on weight instead of true health. Studies have shown that exercise alone has health benefits. Many studies that link obesity to various diseases DO NOT control for fitness level, making it difficult to know if the link is obesity alone, or if it is fitness level. No randomized controlled studies have been done to prove that obesity alone is what is killing us. 

I must add, however, that I have seen numerous health problems with those who are super obese (BMI >50) and I would argue that these people have been failed by the system. They have used unhealthy coping strategies to deal with life stresses and have been stigmatized by the world around them to feel like there is no where else for them to turn. I still think that they can lead a healthier life than they are leading now if they are offered support and treatment. 

*Fat is not a derogatory word. It is a descriptor and has been an accepted word by the HAES (health at every size) community.