We live in a culture that discriminates against people who are fat. Prejudices about individuals who are fat are nearly always unchallenged and many assumptions we hold are taken as cut-and-dry fact. This form of bigotry may stem from the widely held belief that a person ultimately has control over their size. It is interesting that we so whole-heartedly believe this when weight, body size and shape are largely attributed to genetics, and the attempts that people make to change their body weight (via dieting) is what often causes weight gain. We are taught to believe that fat people are glutinous and lazy, and those negative personality traits are the cause of their weight. Take a deeper look, and you will learn that this is a very faulty assumption and is a belief of a “fattist.” It is interesting to know that many studies have shown that fat people generally eat the same if not less than thin people. This really makes me question the belief that fat people are glutinous. As a dietetics professional involved in counseling individuals with eating disorders, disordered eating, and negative body image, I believe that it is my job as a dietitian to confront and challenge our false notions that fatness is bad and weight loss is good.
I would like to briefly comment on my choice of the word “fat.” I am purposefully choosing not to use the word “overweight,” though it may be seen as a more euphemistic word choice. The word “fat,” however is a descriptive word, just as the words “tall,” “thin,” or “brunette” are, and the word “overweight” implies that individuals who are “fat” are over or above some magic, ideal number. I often like to ask people who use the word “overweight,” “over what weight”? Furthermore, there are many individuals who fit into the “overweight” category, according to their Body Mass Index (BMI), that are muscular and therefore have a higher weight to height ratio than the BMI’s definition of “ideal” or “normal.” They are “overweight” according to BMI charts, but it would be laughable to call them “fat.” So, I will continue to use the word “fat” throughout this article to emphasize the need to neutralize the common-held negative meanings associated with this description.
“Being fat is unhealthy” is commonly touted as fact. Friends, family, and medical professionals recommend losing weight to fat persons in an attempt to promote those individuals’ health and increase their lifespan. Ironically, a number of studies have shown that the highest longevity rates are actually associated with individuals who are considered “overweight” by the medical standards of Body Mass Index (BMI). In “obese” individuals (obese being defined by BMI), mortality rates do begin to rise, but only very slowly. It is also interesting to note that individuals who are considered “morbidly obese” have a better chance of surviving to sixty-five than would someone who would be considered “underweight” by BMI standards.
Maybe it is not fatness that is unhealthy. Not only do “overweight” individuals tend to live longer lives, there is also a lot of evidence showing that many of the negative health consequences that are typically associated with fatness are really caused by weight fluctuations due to yo-yo dieting. The dieting industry has every reason to keep this information out of the eyes of the public and the media because the $40 to $50-billion-per-year industry is sustained by the high failure rates of dieting. Diets fail 95-98% of the time after a five-year period, meaning that after five years, only 2-5% of individuals are able to maintain their weight losses. The diet industry has a lot of vested interest in making sure the studies that are reported in the media show a strong connection between weight and disease, and the diet industry is often the funding source of many such studies.
It has also become evident, through various studies that are underreported in the media, that the so-called “weight-related” health problems can be reversed by change in lifestyle without weight loss. There was a study conducted by Linda Bacon, published in the Journal of the American Dietetic Association, which showed the failure rates of dieters and the success rates of a Healthy at Every Size (HAES) approach. The group of dieters was instructed to consume less, exercise more, keep a food journal, and weigh themselves. The second group was provided with the HAES approach, and they were told to eat according to internal hunger and fullness cues, notice how certain foods made them feel, consider what obstacles kept them from being physically active, and attend a support group that stressed self-acceptance. The dieting group had 58% dropout rate during the first year of the study, and only 8% of the Healthy at Every Size group dropped out. More importantly, at the two-year mark of the study, any success that was had by the dieting group within the first year vanished, including an initial 5% weight loss. The non-dieters, however, managed to maintain an increased level of activity, lower their blood pressure and cholesterol levels, and achieve higher levels of self-esteem, even though they had not lost weight. This study shows the power of lifestyle intervention versus weight loss. It is surprising to me that any doctor would prescribe weight loss, when the odds of keeping it off are slim to none and the benefits of lifestyle intervention far outweigh the costs of weight fluctuations. Work on challenging and confronting our culture’s fat biases and prejudices. Start to look at fat in a new way without the current conditioned assumptions that are so commonly held by our society.
Here are some tips to do just that:
Join anti-fattist groups, such as NAAFA, the National Association to Advance Fat Acceptance.
Appreciate the artwork of such artists as Renoir, Gauguin, Titan, and Peter Paul Rubens. Each artist appreciates the bodies of curvy women.
Research history. There have been times when fat has been in-style and promoted by the medical community.
Travel to or find information about countries that promote fatness, such as the countries in Africa.
Read the Health at Every Size journal.
Appreciate the beauty and diversity of all body shapes and sizes.
Criticize the media’s perception and image of beauty.
Question the validity, safety, and effectiveness of weight loss tools and products.
Focus on fitness instead of fatness.
Practice body acceptance.