What's Wrong with Fat?

Photo Courtesy of Oxford University Press

I was fortunate enough today to attend a lecture with Abigail Saguy, PhD discussing her new book, "What's Wrong with Fat?"  It was a very interesting discussion and I'm excited to read the book to learn more about what she has to say about "fatness" and our society.

The major point of her discussion today was to help us question whether our society's emphasis on the "Obesity Epidemic" is really helping or are we stigmatizing those individuals who are overweight or obese.  By the way, Dr. Saguy used the word fat so I'll use that here instead of the former terms.

Her talk was very interesting and I'm not going list each point but the the highlight was learning about how we "frame" the obesity or fat issue has an effect on how we address it.  Most of my fellow employees in healthcare see fatness as a medical issue.  Something that can be cured or fixed with the right treatment.  Some of my fellow RDs see it as a public health issue where numbers are reaching epidemic proportions.  But lastly, there are some who would see fatness as a social justice issue, where fat is just a diversity issue and we must learn to accept people no matter what their size without bias or stereotypes.

She also discussed how no matter what perspective we use, there is research that would suggest that weight alone is not a good predictor of mortality.  One study she highlighted was Flegal KM, et al., 293[15]: 1861-7, 20 April 2005 in which the authors found this notion of an "obesity paradox" where people with BMIs between 26 and 29 (overweight) actually had a decreased risk of death compared to those in the normal weight category.

As we concluded she closed by questioning why our perception of fat changed over that last 100 years.  It used to be that being fat was a desirable trait but that is no longer the case.  But today, being fat is quite negative.  When you see someone who is fat, what do you think?  "They're lazy and weak. They're slobs and how could they do this to themselves?"  One interesting point that Dr. Saguy made was by explaining that a disproportionate number of minorities and lower income people are fat compared to other groups.  Fatness aside, these groups are also ones that are often discriminated against for other reasons so are we just adding another by making obesity such an issue?

As a dietitian, this topic is extremely important in the work that I do.  Many of my colleagues and other health-care providers will not agree with me, but I agree with Dr. Saguy and I feel that if we can take weight out of the equation we can focus on the behaviors that really matter.  Why should we force our clients to lose weight when 1) most will likely gain weight and 2) losing weight might not improve their health unless they change their behaviors?

As a individual, this topic hits home with me.  I am fat!  I have a belly but that does not limit me in my health.  I can run, I can play sports, I can bike and I am healthy.  I know that some of my clients and some of my fellow employees look at me and say to themselves, "Why is this guy teaching a class on losing weight! He should take some of his own advice."   Well to those folks I say this: my weight is just one part of me. From what I learned today and what I continue to learn, it does not mean I have five years less to live than you.

So what do you think, does Dr. Saguy make you change the way you think about how we frame the question of obesity/fatness?