We Know That Fat Shaming Doesn't Help People Lose Weight, So Why Is It Still Everywhere?

Maybe it's because it was never about concern for people's wellbeing to begin with.

Fat shaming is not an effective method of encouraging people to lose weight. We know this – studies have shown it to be true. So why is it still so common?

Everyone from a stranger on the internet to older relatives feels entitled to comment on your body and your health if you’re fat, offering advice they must think you’ve never heard before (eat well? exercise? you’re the first person to suggest those things!), and when questioned, their response is almost universal: “I’m doing it because I care about your health.”

Without even going into the question of why complete strangers might care so much about my health – because, no offence, I don’t care about theirs – this is a pretty transparent lie.

No. No, I can not.

This week, the Huffington Post published an article titled “Everything You Know About Obesity Is Wrong“. It basically summarises things activists have been saying for years, but provides credible, journalistic sources alongside interviews with fat people and medical professionals, and makes a strong case for the argument that we need to rethink how we approach the issue of obesity.

The writer interviews a woman, Corissa, who describes an experience at the doctor’s where her mother was concerned for her wellbeing because she wasn’t eating, and the doctor encouraged her to keep it up.

I think many fat people, particularly fat women, have a similar story. Eating habits that are seen as disordered, destructive and harmful in thin people are actively encouraged in fat people, because the end goal is to lose weight, regardless of the effect on health.

Why else would people endanger themselves by ingesting diet pills that aren’t FDA approved?

Why else would people resort to bariatric surgery when side effects can include depression and increased likelihood of alcoholism, 20% of people require further procedures because of complications, and 30% of people deal with complications related to malnutrition?

The article lists a bunch of issues relating to how doctors treat fat patients, including:

  • Doctors have shorter appointments with fat patients…
  • …and show less emotional rapport in the minutes they do have
  • Negative words (like ‘noncompliant’ and ‘overindulgent’) pop up in their medical histories more often

In addition:

“In one study, researchers presented doctors with case histories of patients suffering from migraines. With everything else being equal, the doctors reported that the patients who were also classified as fat had a worse attitude and were less likely to follow their advice.”

Maybe our attitude sucks because you mention our weight every time we come in. I saw a GP who wasn’t my regular one so I could get a referral for an x-ray for a busted ankle (that wasn’t caused by my being fat, but by a hereditary knee condition that means my knees dislocate more easily; this time, my ankle also suffered the consequences), and she informed me, unprompted, that I was too fat to be on the Pill.

Confused, I asked my GP of ten years about this, and she assured me I was fine to keep taking it. It was extremely bizarre, given the Pill doesn’t affect my ankle, as far as I know, since my reproductive system isn’t located in my foot.

Pictured: my uterus, apparently.

Despite their years of medical training, doctors aren’t infallible, nor are they immune from societal influences telling them that fat people are repulsive, lazy, and deserving of scorn. The most disturbing example of fat shaming from medical professionals in that article was this:

Emily, a counselor in Eastern Washington, went to a gynecological surgeon to have an ovarian cyst removed. The physician pointed out her body fat on the MRI, then said, “Look at that skinny woman in there trying to get out.”

It’s the sort of thing you’d expect to hear on the playground, not from a licensed physician.

Mayo Clinic researcher Sean Phelan told the author of the piece that weight was “the last area of medicine where we prescribe tough love”, which is incredibly telling.

If we can move towards treating substance abuse problems as a health issue rather than a moral failing, why can’t we do the same for fat people?

The answer is because it’s not about health. It’s never been about health. It’s about what society thinks fat people represent – sloth, gluttony, two of the seven deadly sins. Society looks at a fat person and sees someone who’s the victim of their own lack of self-control and nothing more. It’s entirely the responsibility of the fat person, and they should be punished.

Enter the technique of shaming them into submission; rather than encouraging people to lose weight, it’s more likely to discourage people from talking about their weight with anyone at all.

Stigma researchers have found that ‘just say no’ campaigns regarding substance abuse that put the onus on those using drugs or alcohol “may have actually increased substance abuse by making addicts less likely to bring up their habit with their doctors and family members”.

Fat people respond similarly to the same kind of shaming – they turn inwards, blaming themselves for their size.

The author of the Huffington Post piece talks about how being fat can isolate you from those around you, and even other fat people. A 2005 study found that fat participants looked down on other fat people, describing them as ‘gluttonous’, ‘unclean’ and ‘sluggish’. It’s not surprising that fat people would internalise these ideas and seek to distance themselves from other fat people since it’s seen as such a reprehensible thing to be.

I examined dozens of Australian women’s magazines earlier this year, and found that they were moving away from emphasising thinness and appearance in favour of emphasising health and wellness.

Weirdly, the women used to accompany these articles didn’t change – they were still thinner than average, white, and tall – they were models. The underlying assumption that health and beauty are interchangeable was rarely challenged.

People don’t like fat people because they think we’re ugly. That’s what it boils down to. They aren’t concerned about our health; if they were, they’d consider the impact their words have on our mental health, given how crucial and often overlooked aspect of health that is.

Surface-level judgements made about surface-level things are not the solution. A stranger on the internet has no way of knowing what my health is like; a stranger with no medical training has no way of substantiating their unsolicited advice. They’re commenting on my weight because they don’t want to look at it.

Nor do they want to look at underlying issues – genetics, the cost of healthy food, food deserts, the realities of the impact of being time and/or money poor on one’s ability to exercise.

Nor do they seem to focus as much of their energy on the number of Australians who smoke, binge drink, or do drugs. Because it was never about health.

The reality is that there’s no way to look at someone and instantly know how healthy or unhealthy are, but here’s another truth bomb for you: it doesn’t matter. It genuinely isn’t your business how healthy someone is, unless that person is you, your spouse or child, or your patient.

Fat people often default to defending their health in response to this concern trolling, but people shouldn’t have to prove that they’re sufficiently healthy in order to be afforded basic respect. Treating other people decently should be the default, not something you may or may not do depending on their dress size.

Peppered throughout the article are some pretty damning statistics, including one that says 0.08% of women who were formerly classified as obese manage to achieve a ‘normal’ weight. That’s from the American Journal of Public Health, which we can safely assume knows more about public health than anonymous Twitter users.

The reality is that some people are just fat. Why they’re fat shouldn’t matter to you – it might matter to them, or their doctor, but it should have no bearing on how you treat them. Making them feel bad for their weight, or reminding them that people find them repulsive, isn’t going to achieve anything. It might make you feel righteous, like you’ve done something noble and helpful, but you haven’t. You’re not telling us anything we haven’t heard a thousand times before. Your comment isn’t going to be the one to break through; the one that convinces us we need to stop being fat.

I hope this well-researched piece in the Huffington Post can somehow manage to be the one to change our approach to body issues, but I’m not that naive; I know there’ll always be people who feel the need to voice their repulsion at the sight of me.

What I do hope is that people who may feel that their concern comes from a genuine and caring place realise that their message and the way they deliver it needs work. Shaming is not an effective tool, nor is shaming dressed up as concern.

I’m tired of being made to feel ashamed of my body – can we start making people feel ashamed for their poor treatment of fat people instead?

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