In American culture, it’s bad to be fat. Rarely is this more apparent than at the start of the New Year, when diet culture, fatphobia and capitalism converge. Exploiting body shame and people’s desire for renewal, weight loss companies ramp up ads, gyms reduce rates and diet companies promise to help people realize the elusive goal of weight loss that lasts.
Sociologists and medical professionals who treat patients using a model of health at every size say this yearly cycle underscores society’s obsession with thinness and fuels dangerous misperceptions about the relationship between weight and health.
January’s anti-fatness may be cloaked in wellness and body positivity, but its core message to potential customers is the same it’s always been: their body is not good enough and they have not been disciplined enough to lose weight. Sociologists say this message also suggests weight and health are solely the product of individual choices, rather than the result of sexist, racist and classist systems.
“People are doing this to avoid the social stigma, the economic stigma, the moral stigma of being fat or just not being as thin as they could be,” said Natalie Boero, a sociology professor at San Jose State University and author of “Killer Fat: Media, Medicine and Morals in the American Obesity Epidemic.” “If it were about health, we would be talking about access to healthcare. We would be talking about the toll of discrimination against fat people in medical settings, as well as in social settings. We would be talking about access to food and activity and education and economic security. We certainly wouldn’t just be talking about people above or approaching a certain weight.”
An anti-fat society
Implicit in the barrage of New Year’s weight-loss ads is the belief that thinner is healthier. Fatness is threatening, and as some scholars such as Sabrina Strings have found, also linked to anti-Blackness.
“By the early twentieth century, slenderness was increasingly promoted in the popular media as the correct embodiment for white Anglo-Saxon Protestant women. Not until after these associations were already in place did the medical establishment begin its concerted effort to combat ‘excess’ fat tissue as a major public health initiative,” Strings wrote in her book “Fearing the Black Body: The Racial Origins of Fat Phobia. “In this way, the phobia about fatness and the preferences for thinness have not, principally or historically, been about health. Instead, they have been one way the body has been used to craft and legitimate race, sex, and class hierarchies.”
Natalie Ingraham, a sociology professor at California State University whose research focuses on the intersections of body size, gender, sexuality and health, said when health is defined and measured by medical professionals who tend to be white and male, that can lead to discrimination against certain bodies. The same is true of wellness and nutrition spaces led by white women.
Dr. Gregory Dodell of Central Park Endocrinology in New York City said some medical professionals are questioning body mass index (BMI) as a marker of health. Rather than focusing on the scale, Dodell takes a holistic approach by assessing his patients’ overall health and related behaviors, including exercise and nutrition.
“We know that people can be healthy across the size spectrum,” he said. “I have patients that are ‘normal BMI’ that have type two diabetes. And I have patients that are well above ‘normal BMI’ that don’t have any health problems. If you hide their weight, if you just compared their labs to each other, you’d think the person with the poorer labs was the heavier person. It’s not always true.”
95% of people who diet gain back their weight
Goal-setting around health in the New Year isn’t inherently problematic, Ingraham said, but goal setting toward weight loss, in particular, is setting people up for failure. Ingraham said research shows 95% of people who diet will gain back their weight.
Dodell said people in larger bodies are the ones most likely to have dieted in their lives.
“The most likely outcome of dieting is weight regain, which metabolically is shown to be worse for people because you go into this restrictive state, which gets you into this January — lose 30 pounds in 30 days. What happens in February?” he said. “This weight cycling increases inflammatory markers, it increases stress response. It actually may even reset our set point so people not only gain the weight back that they lost, but more. And what does that do to your body? Your body just throws up its hand and is like, ‘what am I supposed to do now?’”
Ingraham said not every body can or should be thin, and people have less control over their weight than diet culture would have them believe.
Individual choices not the sole driver of health
While everyone can strive to make healthy choices, sociologists say weight and health are not determined by individual choices alone.
“That message ignores food deserts and poverty, which is such a huge driver of health issues, because what choices do people really even have to make if they can’t access good food and there aren’t safe places for them to do outdoor physical activity, or if they will never have the money to join a gym, or they’re working 60, 70 hours a week,” Ingraham said. “The structural pieces make health really challenging because so much of health status is tied to this intersection of race and class.”
Boero said the weight loss industry needs people to believe in the myth of self-discipline. Structural realities are not profitable.
‘Who benefits from us feeling terrible about ourselves?’
At the start of the New Year, experts say people who want to renew their focus on health should take time to examine what health means to them.
“Brace for what’s coming, know that there’s going to be this onslaught of messages in January that you need to reinvent yourself, that there is something wrong with you that needs fixing with a New Year’s resolution,” Ingraham said. “You can push back on that mentality to say, ‘I’m doing OK actually.’ Or maybe there is something you’re wanting to change about your lifestyle that is in your control, and I think it’s OK to set that goal. Just don’t let a corporation set it for you.”
Read more at usatoday.com
