Julia Klein contributed this guest post. She has a bachelor’s degree in Nutrition Science and is working on her master’s degree in Applied Nutrition to become a Registered Dietitian. She also wrote “7 Tips for Holiday Eating,” which is a handy reference for any time of the year.
Note: the word “fat” in this post refers to a neutral, descriptive term of bodies. It is not used in a judgmental or disparaging way.
It’s estimated the U.S. spends upwards of $100 billion each year on medical care costs of obesity. The idea that we need to lose weight to be healthy and happy, and that being fat means a person is unhealthy, are deeply entrenched in our society. We learn that being fat is the cause of diabetes, heart disease, stroke, and more. While there’s no denying these associations exist, the relationship between fatness and health is a more nuanced topic than it’s made out to be.
Furthermore, placing the focus on an individual’s weight as the main indicator of health status discounts the social, economic, and environmental factors that contribute to “lifestyle” diseases.
So, is obesity really a condition that needs to be treated?
Most people have a set-point weight range where their body functions best. While this range can change throughout our life, genetics largely drives what a person’s set-point weight range will be. The set-point range for many people naturally falls in the “overweight” or “obese” BMI categories. Just as we’re not all meant to have the same height or hair color, we’re not all meant to have the same body size.
Frequent yo-yo dieting has been shown to raise a person’s set-point range, as well as lead to other negative health outcomes. Most people who diet gain the weight back, and then some. And guess who is constantly being told to diet? Fat people. But why are fat people always being told to go on a diet? Is being fat really so detrimental to our health?
Studies have shown that being classified as “overweight” or having “mild obesity” are not associated with a reduction in life expectancy. Particularly as we age, it’s better for one’s health to be overweight than it is to be at an underweight BMI, or a BMI in the low range of normal. It prevents us from becoming frail. Having some extra fat reserves helps to maintain muscle mass and provides energy reserves that the body can tap into in times of illness or injury. It also reduces the risk of life-threatening fractures from falls.
Research about the associations between negative health outcomes and higher body weights often fail to control for the fact that there is a greater prevalence of fat people in lower socioeconomic conditions. People of low socioeconomic status are more likely to have a lower life expectancy, are less likely to have insurance, and have higher rates of chronic conditions. So how can we say for sure that all the negative associations seen between fatness and health are solely caused by a person’s weight?
We also cannot discount the role that anti-fat bias plays in the health of fat people. Many healthcare providers believe that fat people neglect their health, are lazy and unmotivated, and are non-compliant with health recommendations. Because of this, fat people are less likely to seek healthcare, and they receive poorer quality care when they do. It’s not uncommon that fat people are denied treatment or that their health complaints are not taken seriously; they’re dismissed and told to come back when they lose weight. These unethical healthcare practices may account for a large portion of the health disparities seen in fat people.
Weight-loss studies tend to be short-term. Thus, the studies report that people on “insert any diet name here” lost weight. Most diets “work” in the short term. But these weight loss practices usually are not sustainable. If the results of a diet can’t be maintained in the long-term, how well is it really working?
Instead of putting all our efforts toward weight loss, it’s much more beneficial to focus on building healthy habits. Regardless of a person’s weight, health-promoting behaviors have been shown to reduce the risk of mortality. These include eating a wide variety of foods, engaging in regular movement, having meaningful relationships, taking care of one’s mental health, and more. The definition of healthy is different for everyone and it is important to remember that the size of someone’s body does not tell you how healthy they are.