Fat Shaming isn't Good Actually
Contra Richard Hanania's Personal Anecdote
He starts by defining a "choice" as anything that is responsive to incentives. Since all (or at least the vast majority of) fat people who were faced with a sufficiently severe, and credible incentive to lose weight would succeed in doing so, he infers that being fat is a choice. For example, if a fat person faced a very credible threat of murder at the end of each day if they exceeded a caloric intake of 500 calories they would eat under 500 calories a day regardless of how difficult it was and would eventually lose weight. I think this is obviously true, as shows like the Biggest Loser prove. While in the Biggest Loser environment, which involved constant surveillance, food control and plenty of bullying from Jillian, virtually all of the contestants were able to lose weight, often at an alarming rate. However, those contestants regained 70% of the lost weight on average over the next six years.
He correctly points out that this responsiveness differentiates obesity, often described as a disease, from undisputed diseases like cancer. Generally, regardless of the incentives faced by a cancer patient, they will not succeed in curing their cancer through personal behavior changes. I agree that calling obesity a “disease" is obfuscating. It seems more correct to describe obesity as a common symptom of diseases which involve metabolic dysfunction or as a predictor (and potential causal factor) for other diseases. But anyways, while I get what he's saying about incentives I think his conclusion is totally wrong and based mainly on his own anecdotal experience. Well, I have anecdotes too! Plus data on the effectiveness of weight loss interventions.
I agree that incentives can affect body size and that shaming is one of the incentives that could be used to motivate people to lose weight, but I think it is very obviously the wrong incentive to focus on at the margin because:
Fat people already face a lot of shame.
The fat activism movement that he's reacting to is itself a reaction to the extreme and ubiquitous shaming that fat people already experience.
We don't have a treatment plan for obesity that works for most people and leads to sustained weight loss.
This widely cited study shows that only 20% of individuals who lose more than 10% of their body weight maintain that weight loss after a year and this one shows that 5 years after a weight loss intervention 75% of the lost weight has been regained on average. Semaglutide drugs like Wegovy seem promising but we'll have to see how large the effects end up being in practice. The clinical trial data (which should be expected to be a ceiling on effectiveness) shows it producing an average body weight loss of 12%. Significant, but not enough to “end obesity”. As convincing as Richard thinks his anecdotal evidence is, my anecdotal evidence points in the opposite direction. The obese people I know have already tried a lot of things a lot of times. And the reason they're still obese isn't because they prefer to be but is simply because nothing has worked long term.
I doubt his claim that fat shaming, at the margin, will reduce average body size.
Richard notes that “there was a broad cultural change starting in the 1960s in which we started to destigmatize things like drug use and illegitimacy, and ended up getting more of those behaviors.” But the push to destigmatize fatness is super recent with Body Positivity and other related movements only really taking off since the 2010s. The 60s actually saw a shift to an increased idealization of thinner women which lasted at least until the mid-2000s. Consider Marilyn Monroe vs. Twiggy and Jane Birkin, not to mention Kate Moss, the avatar of the heroin chic ideal (yes, we actually called it that) and famous for her quote that nothing tastes as good as skinny feels). Yet, we’ve been seeing sharply increasing rates of obesity since the 1980s.
I don't think there's comprehensive data tracking the average size of models and actresses over time, but from my observation it seems like they were getting thinner for several decades until around the mid-2000s. I did find one empirical trend that makes my point: the size of Victoria’s Secret (VS) models from the mid-90s to 2018 actually mildly decreased.
Panels A:D from Figure 1 in: Maymone, Mayra Bc, et al. "Unattainable standards of beauty: temporal trends of Victoria’s Secret models from 1995 to 2018." Aesthetic surgery journal 40.2 (2020): NP72-NP76.
While not representative of all female public figures that could be said to collectively define the beauty standard, VS has (at least until very recently) been one of the most competitive fashion shows. Being an angel more or less made some of the biggest supermodels of my generation, like Adriana Lima. And in this clip you can see Gigi Hadid drop to the floor with joy when she finally “got her wings” in 2015.
And also, shame is not free!
By definition shame makes people feel bad. This is a cost. And yet he didn't bother to even attempt to account for that potential cost in his post.
He also uses the case of smoking as an example of how social stigma can incentivize behavioral change. However, I don’t think smoking is an appropriate comparison because:
Most importantly, smoking used to be considered cool.
Fatness has not been considered cool or attractive within generational memory, at least in the West. Therefore we don't need a massive campaign to convince people it's undesirable. Again, fat activism is a reactionary movement and it wouldn't exist if fat people weren't already shamed.
The downsides of smoking take a really long time to be felt.
Whereas some of the downsides of being overweight, including the social stigma, are experienced right away. Most people also find that being overweight is less comfortable in various ways, so there’s a more or less immediate internal incentive to lose weight.
The link between obesity and disease is more circular and complex than the link between smoking and lung cancer.
I'm definitely not saying that being obese doesn't have health implications, it almost certainly does. And even without considering disease, the impact of increased pressure on your joints and the likely mobility limitations are also downsides. But it's also often a symptom of existing disease and dysfunction. From what I've read obesity has a wider range of health implications vs. smoking, but the strength of those links and their causal nature is often less clear. For instance, if you look at lung cancer you'll find that almost 90% of the afflicted are smokers. Whereas if you look at heart disease, which is classically associated with obesity, heritability is also a significant causal factor.
It’s not that I don't think there are any excesses within the fat activism movement. In general, I have a problem with any social movement that insists upon dishonesty. At least some of the proponents of the Health at Every Size (HAES) movement really are saying the most batshit crazy things that people accuse them of. And I definitely don't support expressing disappointment when obese public figures lose weight (Adele talked about the criticism she faced for her significant weight loss for example). However, the original idea behind HAES was mostly really good - which was that you can engage in health promoting behaviors at any size and that self-care and self-love are better motivators for engaging in those behaviors than shame and self judgement.
While I thought Richard's recent post "A Fat Man's Guide to Being Skinny" did offer helpful tips for people who may not have experimented much yet with weight management, he seems to be intent on using his own personal story as the basis for larger social commentary. This is despite the fact that he’s heard reasonable arguments on this topic, including from other previously fat people. In my experience fat people already know that they're fat, they would like to not be fat anymore and they are trying and have tried many interventions, diets, exercise routines etc. And also, they normally already feel shame. Encouraging people to intentionally try to increase those feelings of shame for people that are already trying their best reads to me as incredibly cruel as well as likely to be ineffective.
As I've mentioned, we've always stigmatized fatness and we still do. Yet people have gotten fatter over time. I do think obesity is a real problem that we should be looking for solutions to. But I think effective solutions are more likely to be found in the medical, nutrition and social engineering realms than in a focus on telling people who are already painfully aware that they're fat and that they should lose weight.
So let me ask you this. Why do you think that advanced countries differ so much in how fat they are, even of similar ethnic backgrounds. Something cultural is going on. What is it? I don’t know. But just looking at Victoria’s Secret models doesn’t tell you everything you need to know about the culture. Anecdotally, I’ve heard that in Europe being fat is less socially acceptable, but I don’t know if it’s true.
I totally agree that fat shaming causes more damage than good. But we live in an insensitive world. There will be people all around you ready to nudge you about your imperfections - that's a given. Being a victim of shaming - fat or otherwise - shatters your self confidence and even leads to an aggravation of concomitant disorders. I must state at the cost of sounding naive or cliched that it's upto the victim to deal with it. It's his or her choice to stand up to it , take remedial action or just simply ignore, live with the spite and move on.