Is fighting obesity 'fat shaming'?

Is it reasonable to campaign for the right to be obese when the health and economic arguments don't weigh up?

A couple of years ago, on billboards throughout London’s tube network, a trim, bikini-clad woman and a buff, shirtless man asked commuters, “Are you beach body ready?”
 
The ads were vandalised with messages like, “Stop encouraging women to starve themselves”, “Don’t worry about it. You look gorgeous just the way you are” and “If my body is on a beach, then it is ready”.

The billboards were taken down. 

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 The Biggest Loser triggered fad diets across the world. But most of the US contestants regained the weight they lost on the show. Why? And what does this mean for the rest of us? 

The fat acceptance movement, also known as size acceptance, fat liberation, fat activism or 'fativism', emerged back in the 1960s with the rise of identity politics, but only really gained traction over the last two decades—in step with climbing obesity rates. In an interview with David Shankbone, American fat activist Kira Nerusskaya says, “We are always looked at as sub-human or second-class citizens because of our size. Ironically enough, we outnumber everyone else. Over 60% of the population in America is overweight in some capacity”.

Human Development lecturer and activist Dr Cat Pausè says, “I find that people accuse me of promoting fatness when I present myself as happy or successful or not performing the shame they expect and demand of me as a fat person." She's reminded of a quote from British author Dame Rebecca West: “I myself have never been able to find out precisely what feminism is—I only know that people call me a feminist whenever I express sentiments that differentiate me from a doormat.”

We calibrate our sense of normal against those around us; in underprivileged communities this distorts how we see weight gain.

But what seems to set fat activism apart from movements like feminism and racial equality is the idea that being overweight is a ‘lifestyle choice’. You can’t help what sex or ethnicity you’re born into, but the common perception is that even if you can't help what genetic makeup you're born with, you can control your diet and exercise to offset an unfortunate genetic predisposition. Gender Studies lecturer and activist Dr Jenny Lee says, “Being thin at all costs is what is promoted by our culture.” In this way, Lee thinks fat shaming is the reflex action of our obsessive efforts to stay thin. 
 
However, weight is more accurately a social issue. Poorer communities tend to be fatter. Education about and access to healthy foods is harder to find in disadvantaged settings. And given we calibrate our sense of normal against those around us; in underprivileged communities this distorts how we see weight gain.  
 
Health researcher and anti-obesity advocate Dr Lareen Newman is acutely aware of this. “Governments are well placed to make healthier foods more affordable and available, and to reduce the supply and promotion of unhealthy food,” she writes. “They can also provide environments that encourage physical activity and make other policy changes so it’s easier for people to be healthy. In other words, governments have the potential to change the social determinants of obesity.” Newman  contributed to a Health in All Policies initiative in South Australia. This novel approach emerged out of Finland and builds healthy living into different departments like environment, housing, transport, further education and prisons.

But fat activists say weight-loss should not be a goal. And many deny that the obesity epidemic is even real.
 
The leading argument made by fat activists is that dieting is ineffective and counterproductive. “It’s a well-known fact that most diets don't work,” says activist Jes Baker. “We all know this, and there is a ridiculous amount of research to back it up. This ‘yo-yo dieting’ (and all diets are yo-yo diets) is also called Weight Cycling and has physical ramifications.”

You don’t have to be fat to be unhealthy ... You could be skinny and smoke three packs a day.

Health professionals tend to agree dieting is not the answer. Only, where health professionals advocate for a long-term balanced diet, many fat activists say eat what you want and love however it makes you look. Saying we shouldn’t pressure people to look like billboard models seems uncontroversial. Saying obesity with its associated health risks is okay, feels problematic.

Activist Kate Harding says, “you don’t have to be fat to be unhealthy.” What she means is: thin people can have many of the same health problems as fat people like diabetes, high cholesterol or high blood pressure. From a passing glance in the street, there’s no way of knowing that a thin person is unhealthy. Nerussakya makes the point that, “you could be skinny and smoke three packs a day, which is just as unhealthy.” Fat people aren’t glanced over. They’re noticed. And judged.
 
The essential difference here is that smoking and promoting cigarettes is increasingly restricted. But if obesity also kills, should it be acceptable to celebrate significantly overweight bodies? Canadian obesity specialist Dr. Arya Sharma has accused fat activists of downplaying the risks associated with being overweight. He argues fat activists have relied on misleading research much like the tobacco industry did to deny the risks of smoking.

In Australia, the public healthcare system is buckling under the strain of lifestyle diseases associated with obesity. Fat activists are quick to point out that they pay taxes so therefore they are entitled to public services. But this is one of the movement’s less compelling arguments. Spending on obesity in Australia far exceeds the tax revenue collected from obese people. 

Of course, good health is more than a BMI reading between 18 and 30. Anxiety and depression are contributing to another health crisis in Australia. An overweight person might be happier loving the skin they’re in rather than feeling anxious about maintaining a desired weight.
 
Perhaps interventions like gastric bypasses and lap band surgeries will become as shameful a memory as conversion therapy. LGBT people are no longer considered 'medically defective' and we can see how traumatic and effective ‘treating’ them was. 
 
However, unlike conversion therapy, these kind of surgeries do tend to be effective. So, if a person can lose weight by surgical intervention, should they? Well, surgery can be risky, painful and expensive. And despite the fact that men are more likely to be obese than womenfour times as many Australian women had lap band surgery at the peak of its popularity in 2007-08.
 
Discrimination is bad. Dieting is bad. Pressure from friends, employers and crass advertisements to conform to an unrealistic body ideal is bad. But undermining innovative health policies and trumpeting fringe science to dismiss obesity concerns as moral panic is also bad. It’s perfectly fine for someone to be happy and healthy in their own skin—even if they are technically overweight. Being fit and somewhat overweight isn't necessarily an oxymoron. But many obese people do want to be thinner and would be healthier as a result. So how do we support them? Fat shaming is totally indecent and tends to result in weight gain. But learning to love a body that that might kill you seems like a dangerous delusion.

FAT PRIDE: CHANGING THE WAY PEOPLE THINK ABOUT FATNESS

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Source The Ethics Centre