How should we talk about weight?

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Journalist Lindy West on her wedding day. Image from: https://www.theguardian.com/lifeandstyle/2015/jul/21/my-wedding-perfect-fat-woman#img-2

 

In a lot of ways, I’m reluctant to publish this blog post. It’s not a topic I’m an expert on, and academics are generally cautious about writing on something they haven’t researched, due to the fear of being shredded by someone with a PhD and 20 years’ experience in the field.

I’m also worried about making things worse, about saying the wrong thing and invoking the collective ire of the Internet #trolls.  This is also the kind of topic where it’s difficult not to take sides or to admit that you don’t have all the answers, because it’s so polarizing. But I’ve got a question I want to get it off my chest. How do we – as public health advocates, as a community, and as individuals – talk about weight?

This question has been bugging me for a while, but especially since I wrote an opinion piece (with Alexandra Jones) in the Medical Journal of Australia talking about the need for better nutrition policy in Australia. One of the readers of my article cautioned me about the need not to conflate nutrition and weight: people can be “overweight,” but eat well, feel good and live healthy lives.

Her comments immediately reminded me of a podcast that I’d listened to recently on This American Life, which discussed how people are starting to think differently and talk differently about body weight. Among the stories was one from Lindy West, a US journalist, feminist and fat acceptance activist on how she confronted her boss about his some of his reporting on the “obesity epidemic.” Other stories in the podcast described saddening and horrifying accounts of the discrimination, stigma, and sub-par medical care that people experience because of the way society perceives and treats people who fall outside what is considered a desirable weight range.

The reporting that Lindy West was concerned with seemed laced with personal prejudice. Yet it’s not uncommon for stigma to be considered as a tool to convince people to lose weight. The UK’s former public health minister once said that doctors should tell their patients that they are “fat” rather than “obese” to better motivate them to lose weight and to take “personal responsibility” for their lifestyles.

Stigmatizing language (and behavior) is never acceptable. A growing body of research shows that stigma tends to demotivate people to lose weight or change their eating habits. Stigma is also linked to negative health outcomes, including poor mental health and low self-esteem.

Even if it did result in public health gains, stigma can’t be justified given the negative impact it has on individuals’ health, wellbeing and self-perception.

However, the problem goes beyond stigmatizing, discriminatory, and shaming language. As Lindy West explains, it’s also about being constantly bombarded by apparently scientific or “objective” messages that obesity is a “crisis,” that having a high BMI is undesirable and unhealthy, and that people who are “fat” are a drain on the healthcare system. Many people will understand the pressure to achieve a “desirable” weight, and what it does to self-esteem, and the fat acceptance movement is, in part, a push back against this kind of messaging.

So should we talk about weight at all? Could the public health message simply be “eat well and move often?” (And when I talk about moving I mean dancing, going for a walk with friends, or whatever else takes your fancy, not boot camps and chin-ups). A lot of my research targets the food industry and focuses on how food is made and sold. I want to improve the food system, not tell people to eat less chocolate.

From a public health advocates’ perspective, the problem is that a certain amount of excess body weight is a risk factor for chronic disease, as well as being associated with a range of health conditions. One of the main reasons why we focus on promoting and facilitating healthy eating is because weight gain has effects on people’s health.

Public health advocates know that body weight isn’t simply a question of people cramming Tim Tams into their faces while simultaneously watching Netflix and drinking two litres of soft drink (or “soda” for the Americans out there). It has a lot to do with genetic and physiological make-up, as well as whether we have the kinds of social, cultural, and economic environments that make good food easy to access and affordable, where healthy eating is valued, and is possible. Public health shouldn’t be about fat shaming, but even what seems like a relatively neutral message may have that effect. The concern for public health advocates, however, is that we will lose one of the main health messages behind our work if we take the word “weight” out of the picture.

Yes, we can think about using language more carefully when we convey information about weight and health, but is that enough? Would it be more helpful if we stopped talking about weight altogether, or – as Lindy West suggests – we stop seeing it as a problem? We should keep in mind here that most people on diets fail to lose weight and keep it off, that there are difficulties in defining what a healthy weight actually is (and what tools are useful in categorizing weight), and that there are socioeconomic and ethnic differences in population weight distribution. Most of the time, fat shaming will also mean shaming poorer people and people of color (with the shaming being done by middle-class, white people).

Also, evidence of a connection between weight and increased mortality and morbidity is not all one way. We are still untangling the complex connections between body weight and health (remember, correlation is not necessarily causation). Even within the public health community there are debates about whether body weight is the crisis that we make it out to be.

So what’s the answer here? To be honest, I don’t know. I hope we haven’t lost the opportunity to have a constructive conversation about how we talk about weight (or if we should talk about it at all).  I can’t pretend to be an expert on the topic, and while I’ve had issues related to eating and my weight, I’ve never experienced the type of discrimination that Lindy West and others describe. But listening to her, and hearing from other people with similar experiences, makes me think we could – and should – do better.

Thanks to Alex Bayley for the comments and resources she provided for this post. All the opinions expressed here are mine, as are any mistakes or misconceptions.

86 thoughts on “How should we talk about weight?

  1. It is one of the trickiest topics around and age does not enter into this subject at all as being heavy affects everyone at some time of their lives. Should we not be advising; food taken should always be less than calories consumed by exercise?

    Liked by 5 people

  2. One thing I have noticed while researching my own health issues is that body weight is not the cause of health issues, it is a symptom. I have thyroid issues, and it took years and quite a few doctors to get it diagnosed because my weight did not match my symptoms. Hypothyroid causes obesity, but I have always been underweight, so no doctor would test me for hypothyroid. I had to do all the research myself, and found that “weight loss” and “weight gain” and “obesity” and many other weight related concerns were in fact symptoms of other conditions. So while having a body fat percentage over a certain level may be an indicator that a person is unhealthy, fat is not an illness. I do not have a medical degree, and I am not a researcher, so I know that I do not have all the answers, but this has been my observation of the relationship between health and weight.

    Liked by 10 people

    • That is true. I just recently found out why I sometimes I forget words, although I know, but it doesn’t come out. I either wait or my daughter tells me. For example, I tell her, “you know, it is something we cook with on top of the stove.” She answers, “a pot?” So many of these things of weight concerns and percentages will be moot later. Fat is not an illness. True. Neither is drug addition or alcohol addition is not a disease. I feel compassion for those people who have these problems. If they think of it as an illness, the more they want the self and other’s pity–boo hoo I call it. And honey fat may not be an illness, it can bring other health problems. Best wishes

      Liked by 3 people

  3. Hello: I agree this is a subject that is hard. I’m an American woman. I’m now 47 years old. I’ve always been in the higher range of the American health chart and as an adult fit in the obese range. I do believe genetics fall into play. One side of my family was bigger and one side was smaller. As a young girl and now woman with a bigger body frame it can be really difficult. There is lots of judgement and sadly most of the judgement comes from other woman. I was put on diets at a really young age. I was always hungry and always judged for what I put in my mouth. Unfortunately this attitude of big is bad has really held me back in life. I have always felt unloved for my size. I’m a smart, active, and kind person but unfortunately I just don’t fit the mold. As I get older I work at confidence, dressing nice, and just try for moderation. We really do need to start looking at fat as a different word. Fat right now is a true prejudice for many people. I find bigger people are kinder and softer and lovely to be around. Sometimes the extra thin can be quite mean. I’m sure they’re starving. So lets embrace our surroundings and work for better understanding of a bigger body and remember we have feelings and are human just like anyone.

    Liked by 7 people

    • This does not fit my life story, but I was filled with sadness there is a lot of judgement from other women. I am not one of them. Who put you on diets? Unless you were real obese, I would not have done that. No go for outrages. I do if I can find the right clothes for the money that I have. I dress up for the occasions, but I am 73 and I do not like to dress as I “should.” I am a rebel with a cause. I am overweight. I do not like it, but I do not care what people think. I want to be outrages and fun. You can do it at home. Put some clothes together and wear sunglasses and go to 7-11 store. Floppy hat is good. I am very serious. And don’t worry about others!! If you think about them, the more you will boo hoo. Now stop it and put some extra makeup on for work. Start small. Best wishes.

      Liked by 5 people

  4. Great post! It is a touchy subject. I can’t speak for everyone in the U.S. but there seems to be a lot of emotional eating. I live in the most obese state in the U.S. and while I believe you have the right to eat what ever you wish, I also don’t think Obesity should be used as a disability. You chose to eat your way to 400 pounds and you can just as easily choose not to.
    After a massive heart attack at age 32, my husband was the food Nazi. But after a few years he was back with his friends eating burgers and fries and a gallon of sweet tea a day. I tried the nagging, being a good example and none of it worked so I just bought more life insurance on him and just worried about my own eating habits. I am a plant based eater. I think for future generations we have to fight the junk food industry. We eat food for fuel for our bodies, not to please our mouths.
    I don’t care about the trolls or anyone else’s opinion, this is just mine.

    Liked by 7 people

  5. The link you have given on the fat acceptance movementemphasize deeply on the subject of being overweight. People tend to forget that there are many aspects in the process of becoming overweight.

    But among all of these, health problems and mental problems remain the main priorities to be debated. Smooth approach concerning this sensible topic should be taught.

    Though there are many people out there who are comfortable with their corpulence, there are also many of us that find it difficult to live with an overweight condition.

    You have written a very interesting post here which brings up a subject that is still considered as taboo in our modern society.

    Liked by 6 people

  6. I have been fat, obese, skinny, and finally healthy. I think you’re spot on in calling out the food industry. My parents were aware that I was too large as a child and at an unhealthy weight, but with limited resources, they bought the groceries they could afford to feed our family of six.
    Fifty years ago nobody ever talked about “dieting” or “working out.” Our food industry, consumption, and over all attitude toward food was totally different too.
    Only as I have grown older and more successful have I been able to afford to feed my family and myself better, more nutritious foods. Hence, virtually eliminating the need for the “weight talk” in our house.
    I once had a doctor tell me “it’s not like you’ll ever loose 150lbs and wear a bikini anyways.” I was nine months pregnant and carrying a 10lb baby. I went on to deliver a big, strong, healthy baby via c-section, get a new OBGYN, and loose 200+ pounds.
    Well done piece.

    Liked by 9 people

  7. Well’ it’s a delicate and yet cruel subject matter’ first and foremost’ humor must not be applied’ if we look at most popular improve comedians they sling Pain for achievement of laughter by the inebriated and or ignorant’ or High’. I can tell you how ill society is’ and how gross’ cruel’ hateful’ and repulsive many famous comedians are today in our modern society. And then there are the ‘Just mean’ and cruel people in our daily life’. There are many medical reasons why people are obese’ Hell I stopped breathing last Friday and put myself in the Hospital’ when I went to my Doctor who has been treating me he states most of all my medical condition are secondary as a result of my being overweight’ to include sleep disorders which cause weight gain’, hell I even considered kicking off my black boots and bribing the nurse with cash before stepping onto the weight scale’ at my Doctors visit. My grandfather dropped dead at age 40’ of a massive heart attack’ because many decades ago as in many states presently of the families of the farmlands and Bible Belt region’ here in the United States have daily evening means of heaped starches packed Mashed potatoes and Pies and not to mention the consumer food industry selling sugar sweetened sugar sweetened boxed dry cereals fortified with sugars and salt’.

    And every one that is ignorant about their need for ‘Organic vegetables and healthy meals’ is chewing down deep fired everything from grossly raised consumer foods of abused farm animals, to bottom feeding trash fish battered in beer and fried up with starches and Okra. And they chase it down with beers’ or their fifth Aspartame tainted canned carbonated’ diet Syrup soda. So what do we wish to be entitled as’ whatever it be’ it has to addressed with respect based conscious effort. ‘Unhealthy folks’ is about as far as I would go’. But finger’! …to the comedian on stage that use other people’ painful health issues as a target / means for their fame, laughs and fortune. I was once in a polite conversation with an older aged woman who was suffering from serious headaches. When I don’t her it was due to her ingesting diet sodas. She attacked me for attacking her poison of choice of which she was addicted to. And when people are tossing back four five or more tins of Diet soda’s a day’ they are far from Diet sodas. If you have type 2 diabetes and ingest aspartame’ it very well may attack your body with severe physical pain.

    Liked by 7 people

  8. I’m right with you. I think anyone can be beautiful at any weight. I am also one that has struggled with weight since I was 12. As an adult I’ve had to push doctors to help me figure out why, because they were essentially assuming I was being lazy. Ultimately, I finally found a doctor that works with me and helps me to manage both “sub-clinical hypothyroid” and massive food allergies. It’s taken 20 years of my hard work to get a partial answer, and I know that I am not alone. Fat doesn’t mean you’re not already doing your best to be healthy, and often people need more than “eat healthy and exercise” to solve the problem.

    Liked by 7 people

  9. An absolutely necessary topic of conversation- great post. Doctors have told me I was overweight my entire life, although I didn’t feel or look overweight at all. Just because I didn’t fall within their parameters didn’t mean I wasn’t healthy. I felt great. When I did actually gain weight however, comments about it or innocent jokes were very hurtful and often discouraged me. People who haven’t struggled with weight can fail to realize what their words do to those who do. It didn’t motivate me- it made me hate myself. Many people don’t understand that.

    Liked by 6 people

  10. well written and quite insightful. There is no easy answer. I’ve run into a few contradictory things about this over the years and there is one simple thing. If you find that you are suffering physically and find that you are spending a lot of time at the doctor and are ill often what is the issue? Are you willing to do something about it? Surgery should be the last line to cross but it is often the first. When confronted with the realities that their bodies are failing and that there is an option the individuals become a victim and you are attacking them though the reality is quite different. Their bodies are telling them something and as they age it gets louder – with more issues, diseases, etc – and the question becomes will they listen to themselves? I’d like to see a P.S.A. revolves around that. The stories that are told by our bodies…

    Liked by 5 people

  11. I enjoyed reading your blog. I don’t have an answer either. Weight can be a very sensitive subject for many people. I don’t believe anyone has the right to assume anything about someones weight. I think it is a subject that should be talked about, however not in the way many think. Some think that it as simple as change of diet and exercise. I think there are any other factors involved, some that include body makeup and heredity, the way food is processed and packaged, culture, marketing,behavior,and society. Everyone wants to blame, but there are few who would be willing to change the way food is processed and sold. It’s all about the almighty dollar. Until we become less greedy, I don’t think we can ever resolve the problem.

    Liked by 9 people

  12. Hey, thanks for a great post and it’s an interesting question you’re making.

    Personally I think people can have any body shape they’re comfortable with and sometimes it’s the genes that dictate our shape and weight.

    What I do care about is the food industry that has created a lifestyle for us that makes us fat, have diabetes, die from cardiovascular disease, and search on Google “why am I fatigued all the time?”.

    Food industry is the one who is mass producing food that we should not be eating on a daily basis. Maybe that’s why this funny Paleo diet is so popular these days, slowly people realise they don’t want to eat “laboratory food”.

    After researching on the topic of health, I realised the main culprit is fructose in sugar. To my own surprise I didn’t need much to feel convinced. I read a short book the topic and felt especially convinced after listenin to lecture by a doctor that explained what does fructose exactly do to our bodies. Not to scare, but the stuff is poison and creates this mess with the health of our body. It’s a time bomb.

    I highly recommend watching Jamie Oliver’s documentay Sugar Rush. It’s an easy start to the topic.

    The main issue should not be our extra curves, rather we should think if we treat our body right. We should love our body and give only the most nutritious food for it.

    Liked by 6 people

  13. Any crisis needs to be looked at in terms of who benefits. The obesity epidemic is good for business; the medical (medication) and the junk food industries, (and others I’m overlooking at the moment) are billion dollar entities. There is no money in prevention. The unsustainable goal of capitalism is ever-increasing profits, and once the markets have become saturated the only way to keep profits in an upward vertical is to increase consumption. I find it obscene that junk foods like candy bars, ice cream and soft drinks are all permissible to buy with food stamps here in the US. Sugary foods should be taxed at the same rate that alcohol and other luxury goods are taxed; with the proceeds going to pay for free universal healthcare like civilized countries have.

    Liked by 7 people

  14. I think what makes this a difficult topic is the fact that there is still so much discrimination and hatred towards obese people. We have come a long way to recognize people’s rights when it comes to race, gender and sexuality but body appearance is still something that people feel they can comment on by calling people lazy, stupid etc. at the end of the day, I, not sure why someone being overweight or underweight is someone else’s problem.

    Liked by 2 people

    • I think some people enjoy being able to criticize others openly and the thing with obesity is that it is easily seen on people. Whereas someone with a mental issue can conceal it more. Many don’t stop and think WHY the person they feel like insulting or judging publicly carries the weight that they do. As humans we make snap judgements about everything…EVERYTHING> that is our nature , but it is rude and classless to point it out publicly. That’s where I have issue. Whether it stems from hatred or simple ignorance, it is despicable. What I hope is that people who are obese can one day find the strength that we all have and make healthier decisions to better their lives. Not because someone made fun of them or they feel shunned by society, but because they deserve to live the best life possible.

      Liked by 2 people

      • So how would you tell someone that they overweight assuming you are a doctor??? I think there is a difference between criticizing and calling names? In healthy opinion there might be enough truth to motivate others for “living the best life possible”. I think snap judgement is different from criticism???

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      • To answer your first question – IF I was a doctor, I would tell the person ” You are overweight” “You need to lose weight” Pretty much exactly what my doctor told me. I was 300 lbs. They told me this in a private space, so it is completely different vs the harassment that some face on social media. (that’s what I meant about being called out “publicly”) Yes there is a slight difference between criticising and calling someone a name. I believe they could be done at the exact same time too. Constructive criticism is really the way to go and taking into account the type of person you are going to criticize, especially on a topic so personal like their wight should also be taken into account don’t you think? Different tactics for different people when it comes to huge lifestyle changes. Bullying isn’t always the most effective way to create change.

        Liked by 2 people

      • Agree with most of it. and here are my thoughts about criticizing people according to their personality. I think most of overweight people have low self-esteem and very often hypo sensitive. So there is not many “types” of people after all, better to say most likely those few types more likely to be overweight. And knowing that it feels like you can’t criticize them at all, because they are super sensitive. And it brings me to a thought that I support that sensitivity and silently support their self neglecting. and everyone smile guilty – all of us afraid to talk about problems…

        Like

      • Hi Hermesssagllaea and fitlifeadventure… This is an older post by now, but I just got a like on one of my comments so I came back to recall this subject… and saw your discussion. Recently, I read some people who commented on Miss Eaves “Thunder Thighs” music video and so many of them are often trolls looking to put down and laugh at overweight women and they are some of the rudest haters I’ve ever encountered. Some of them act like they are there to offer healthy advice, as if over weight people don’t already know their own issues. People are condescending to fat people as if they are stupid or ignorant. It was some of the worst bullying as if over weight people deserve to be the targets of bullies as justified by health care costs or whatever. I think the people judging are far more unhealthy… emotionally and spiritually.
        Anyhow, if you are interested… Here’s a Miss Eaves video about self love and self acceptance and self respect and sisterhood no matter a woman’s size… Miss Eaves is a feminist fully aware of the societal stigma to any weight carried by women. (it’s the comment feed that shows how prejudiced people can be. How dehumanizing while still objectifying women and while feigning to Care about other people and or their health) : https://youtu.be/fY1o9igy0a0

        Liked by 1 person

  15. I think you approached this topic with ample amounts of respect and forethought. It is a tricky subject. Truthfully, anything outside the norm people want to shame it to make it fall in line. It is possible to be technically overweight, but still be active, eat well and be generally healthy. I don’t think that is something many understand. Your desire to have a conversation about the language is admirable and greatly appreciated.

    Liked by 2 people

  16. Some can eat a ton and remain thin. Some can eat normal and store fat. Some are in the middle. Some can put on weight and lose weight quickly. Some just can’t seem to lose it once they put on weight. Weight for men and women are different. Naturally athletic men can look slim and weigh over 200 pounds, muscle carry more mass per volume. It is a complex issue indeed. 🙂

    Liked by 2 people

  17. You brought it across nicely, it is a sensitive topic. Obesity could be due to illness but for those that are due to unhealthy lifestyle and/or diet, I wish people can be more objective in facing the issue. It’s not about discriminating obesity, it’s about health. When you point at someone for smoking, it is not a discrimination. But when you point at someone for being obese, deposited being health reasons, it is deemed a discrimination.

    Liked by 3 people

  18. I really appreciate reading all the thoughtful comments and what a great testament to acceptance that we can discuss and appreciate the complexity of these issues and the damage done by dismissive attitudes.
    Thanks so much!

    Liked by 5 people

  19. I am not sure how we should talk about weight, but I do know first hand the influence weight can play in leading to discrimination in healthcare. During my teenage years I became very sick. My symptoms, including my digestive misery was brushed aside by many doctors blamed all my problems on being an overweight hypochondriac. And still to day, even though I have been diagnosed with chronic iron deficiency anemia, fibromyalgia and CREST syndrome some doctors still only see my weight and assume that my problems are just the imaginary ills of a lazy fat person.

    Liked by 4 people

  20. In places where people have a difficult time getting enough, some extra weight is seen as desirable and attractive. Being punitive, insulting, and distressed respectful is never okay, and is never helpful. People know when they are overweight or even fat. Conveying information is

    Liked by 3 people

  21. This is an important topic, and one woven very closely with health and feminism. I agree that stigmatized language can only have an negative impact and the onus is now on the individual to remain healthy. Counting calories, idolizing swimsuit models and criticizing others is a vicious circle and not part of a society I want to encourage.

    Liked by 1 person

  22. I, personally, want anything with BMI, to be revamped. A bunch of numbers on a piece of paper does not necessarily indicate a person’s health status. It is used to judge people. For instance, when my daughter has a checkup, the doctor said, on paper she is overweight, but to see her and her proportions, she is not. There is a medical group, here in the US, that will print up your office visit. Strictly bared on weight and height, it will state if you are obese. It doesn’t take into account muscle mass, medical conditions, etc. The entire BMI needs revamping.

    Liked by 6 people

  23. I like how you’ve handled the subject. And being a formerly obese person I can’t say I have a PhD or anything, but I do have a lot of experience with weight struggles. For me the only thing that worked was changing what I ate, how I ate it and how many times I ate it. I stayed active (like you rightly said it was mostly about walking) I got a dog who gave me a sense of routine and regular activity. And most of all I distanced myself from negative people who are stressing me out and causing me to eat obsessively. I feel fatness reflects some kind of emotional or psychological inner turmoil and so it’s not about beating the fat through some rigorous physical routine but rather mastering your psychological demons. Somehow I think good mental health will always help you get fit when you need to.

    Liked by 4 people

  24. This L. West woman is ridiculous. BMI aside, because any health professional would never put much stock into those numbers – the ideas she has on being obese and the “acceptance movement”, in my opinion, is utter crap. Speaking as someone who was clinically obese and went on to lose 142 lbs naturally, I have a pretty good handle on being on both sides of the fence. While I think shaming someone into good health is insane, accepting it and perpetuating your poor health standards as some sort of crusade is just as nuts. When you are overweight there are a myriad of health risks and complications that come with that. It isn’t just about body image. At least it shouldn’t JUST be about boy image. Living a healthy lifestyle involves body mind and spirit. That is how you KEEP the weight off. To have pride in a body that is failing you and is unhealthy is wrong. That is not something you should be proud of. Don’t mistake pride for love. SELF LOVE is attainable at every size, health is not. Health is something to be proud of. It is an accomplishment. If you practice little self control, create sedentary lifestyle habits and then expect other people to only discuss it in a positive light (and if they don’t they are accused of setting unrealistic standards of beauty and fat shaming) is absolutely nuts. There is little that this woman said that is logical.

    Liked by 5 people

  25. This truly is an important subject to bring up, especially because it’s difficult to talk about. We’re getting fatter & fatter, unhealthier by the moment, which can only mean that whatever we’re doing is not working.

    Liked by 6 people

  26. Thanks for writing the post. Apparently, the topic you wrote about is very controversial, which likely will cause many different opinions. I also, myself, do not have expert background to fact check any numbers you mentioned in the post (also I don’t really mind), but I think you raising the questions people might only think about without speaking out loud, is brave and good. 🙂

    Liked by 4 people

  27. I think that people becoming too mean and too sensitive, where one use harsh words and other take everything as a insult. Obesity is a big problem, but we have to be able to have honest conversation about it, trying to solve the problem. BMI always was not reliable measurement, as we are all different.

    Liked by 2 people

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