Toxic Fat Activism

The other side of the story

I wrote a post a couple of weeks ago explaining why I disagree with the take from

Richard Hanania

that we need more fat shaming. Basically, I think people already feel more than enough shame around their body size, and so piling on additional shame is not an effective way of incentivizing behavior change (plus it makes people feel shitty which I think is bad!). That said, I agree that there are toxic elements within the body positivity and fat activism movements that deserve a call out. But first, I wanted to add some numbers and nuance to why I think a lack of shame doesn’t explain American obesity.

There’s something about America, I just don’t think it’s Fat Positivity

The causes of rising obesity in the US over the past 50 years are complex and still poorly understood. There are obviously cultural and systemic factors that have contributed, as evidenced by this study which shows that immigrants start out thinner than Americans but close ~50% of the BMI gap after living here for >10 years. So I don’t doubt that there’s something particularly American about the problem, I just don’t think body positivity bears much responsibility, especially given it took off so recently.

The below plot shows the % of people falling into normal, overweight and obese categories for native born Americans relative to more recent (<10 years) and long-term (>10 years) immigrants:

Figure 4 from: Hao, Lingxin, and Julie JH Kim. "Immigration and the American obesity epidemic." International Migration Review 43.2 (2009): 237-262.

I think we need more research into what’s driving obesity. But I think the relative focus of that research should be on understanding the systemic issues at play rather than focusing only on individual behaviors that promote weight loss. Obviously there are things that individuals can do to help maintain their weight, and I thought Richard’s advice in his more recent post was pretty good. But there’s been a massive amount of time, effort and money dedicated to researching diet and promoting various eating regimens. And it has failed to arrest the rising obesity rates.

Despite the very recent mainstreaming of body positivity, Americans really want to lose weight and they reveal that desire through their spending patterns. We spend way more per capita than skinny Europeans on “Healthy Eating, Nutrition & Weight Loss”, which suggests we do care about our health and weight.

Figure 2.3 from: “2024 Global Wellness Economy Monitor (2019-2022 Data).” Global Wellness Institute.

Of course high spending doesn’t imply effective spending. Most of the “Healthy Eating, Nutrition & Weight Loss” category is comprised of foods that are simply labeled “healthy” or marketed as such. Americans desire health and wellness but they don’t seem to be going about it the “right” way. I expect that Europeans consume relatively less processed and more whole foods than Americans but I also think they benefit from stronger food cultures. Here in the US we’re all eating everything from everywhere and trying to figure out what’s normal on our own - hence the desire to reach for anything marketed as “healthy”.

American sedentariness is very likely part of the problem. But I think Americans suffer more from a lack of accessible and easy opportunities for movement than from a lack of desire to get fit. While we get less physical activity we spend more money on it with American’s per capita spending on fitness second only to Monaco. Many of our communities are structured in ways that make a sedentary lifestyle the default. This increases the effort and willpower needed to exercise rather than having movement be a part of regular life, something that doesn’t feel like hard work.

Of course Americans are fatter because we eat more and move less. But the question is why do we eat more and why do we move less? And I don’t think the answer is that we don’t stigmatize fatness enough or that Americans are especially lacking in willpower (which wouldn’t explain the data on immigrants).

The goal we should be aiming for is understanding what we can do to reduce the amount of effort the average individual has to put into weight maintenance. The rate of obesity in New York, about 27%, is much lower than the over 40% rate in America overall. Manhattanites are particularly skinny, with only a 20% obesity rate, comparable to European countries like the Netherlands. And I think part of what explains this is that it’s much harder to be sedentary here relative to a life in the suburbs where there are no sidewalks let alone bike paths and every family member over 16 has a car.

Is glorification of obesity a real problem?

Ok so now that I’ve said all of that I’ll finally get to the promised critique of “body positivity”. The extremes of the fat activism movement are very problematic and sometimes truly mind boggling. And while I stand by my claim that these movements aren’t responsible for the level of obesity in America today, I do think they have the potential to have a more negative impact if they continue to gain cultural capital.

A lot of people talk about the “glorification of obesity” but I find actual instances of that quite rare - often when you click through to a post someone is angry at for “glorifying obesity” it’s actually just a fat woman who dared to post a pic of herself in a bikini, not anyone claiming obesity is better (which is implied in the term glorifying).

The two biggest issues I see within the fat activism community are (1) doubting or obscuring the link between obesity and health and (2) leaning in to obesity as an important part of your personal identity. I find the identification issue particularly troubling.

“What so you’re a DOCTOR now and you can diagnose someone with your EYES?”

In case there are doubters I wanted to establish that some people really do deny or obscure any link between health and obesity. The Health at Every Size (HAES) principles from the Association for Size Diversity and Health are largely positive and encourage a wide range of health promoting behaviors regardless of your body size. But they also include:

Which takes things too far. While we don’t all need to be thin, at some level additional weight should be pathologized. You’ll often see figures in the fat activism community “correct the record” in response to comments that their weight is unhealthy by saying that they feel good and all of their blood tests are normal. And sure, especially when you’re young it’s not that surprising to see someone who’s obese, physically active and generally healthy. Lizzo has shown endurance and energy levels as a performer that many thin women would envy. But being obese for decades is a strong predictor of a variety of future health problems, and while I don’t doubt Jillian Michaels is overly invested in diet culture, I think she’s right that we shouldn’t praise Lizzo for her body but for her music (as we do with male artists!)

In some communities simply talking about health at all can be interpreted as stealth fat phobia. Tess Holiday once educated a fan on why it’s best that she avoid using the word “healthy” while complimenting her.

Snipped from Michelle McDaniel’s YouTube video.

Body positivity and beauty

I’ve written about the downsides of overweighting beauty in your self-worth here, and why you should be thoughtful about how much time and money you spend on it here. And I think the insistence that we include obesity within the beauty ideal actually reflects an uncritical acceptance of beauty’s importance. From my first ever post:

Now women who flaunt their large bodies, with Lizzo being the favorite example, are praised for “being brave” and quasi-compulsively referred to as beautiful. Through repetition, the statement that “Lizzo is SO gorgeous”, takes on the role of a mantra - if we all keep calling her beautiful maybe we’ll eventually believe it and then maybe we can feel beautiful too.

The “scary skinny” beauty ideal I grew up with was pathological and I’m happy that the demand for thinness has lessened and that there’s at least a slightly wider range in what’s considered an acceptable body. As surgically enhanced and unrealistic as they are, the post-Kardashian beauty standard somehow feels a little more accessible (and attractive to men) than the “heroin chic” ideals I grew up with.

I think some ideals are worse than others… but at the end of the day, outside of some artsy films, we mostly want to watch attractive performers. People that have talent, but also nicer faces and sexier bodies than most people do. And weirdly no one really pushes back on the nicer faces part - there’s no major campaign to include more people with skin problems or weird nostrils.

The insistence that you should love yourself and your body can also become it’s own source of shame. One more quote from my piece “Escaping the Beauty Myth”:

the demand on women to “LOVE YOURSELF” and eschew unrealistic standards in solidarity with other women, while on the one hand liberatory, can also create another way to fail, another source of shame and personal blame. Now, you can not only hate your body but you can hate yourself for hating your body. 

So, while I think it can be great to find things to feel good about yourself for, including physical attributes, I think pushing back on the importance of looking good can be even better. And I think we only reify the central importance of looks to a woman’s value by insisting that every woman is actually super hot.

Fatness and identity (finally)

The element within the extreme fat activism movement that I find most concerning is the encouragement to identify with being fat. I think this can be understood as a reaction to being fat shamed, and being made to feel less than as a result of your body size. Given that sort of history I can understand why someone might want to flip the script by accepting and intentionally identifying with their fatness, an identification that had previously been forcibly pushed on them.

But in general I think it’s unhealthy to lean in to a self-definition based on surface level identity characteristics (

Vaish

and I discussed this in our second podcast episode). And in the case where the characteristic in question is an objectively negative one this is even more true! This isn’t confined to obesity, you also see this impulse in people identifying with their mental health disorders. Of course this tends to be limited to the mild and manageable versions of these conditions as

Freddie deBoer

discussed in “The Gentrification of Disability” and as Louise Perry and Freya India analyzed in a recent podcast where I learned the term “hot girl pills”.

This clip I tweeted of Aubrey Gordon from her podcast Maintenance phase, which she hosts with Michael Hobbes, perfectly highlights the issue of identifying with your body size. In the clip, from a podcast where they discuss Ozempic, Aubrey has the following response to people who express hope that the drug could significantly lower rates of obesity: “that’s you saying plainly, everything will be better when I’m gone… that’s horrible.” Um… no! We want a world where obese people are able to exert more control and choice around their body size, not a world without the people who are currently obese!

But let’s not throw the body positivity baby out with the Ozempic commentary

While these elements are certainly deserving of criticism, I don’t think we need to lump the entire movement in with its most extreme members because there’s also a lot of value there. There are real problems that arise as a result of the stigmatization of fatness which the fat activism movement has helped bring to light. This includes how obese people experience the health care system as Matt Yglesias discussed in his piece about losing 70 pounds:

One thing that really resonates with me is the experience of being a fat person who suffers from some specific medical ailment and wants medical advice about that ailment, but instead receives a lecture about how it would help to lose weight. This is not helpful advice, because it’s not always medically relevant and when it is, most people don’t have a good option to lose weight. But the knowledge that this is what doctors are going to talk to you about sometimes makes you want to avoid seeing a doctor. That makes your health problems worse. So rather than helping people with obesity-related medical ailments, our culture of fat-shaming is generating worse health outcomes for heavy people. This is also true indirectly — stress and isolation are unhealthy, and in people with a tendency to overeat, those factors promote additional overeating. Trying to make people who are overweight feel bad about themselves is a strategy America has been trying for a couple of generations, and it just doesn’t work.

As he says, not only is it not always medically relevant but the doctor also rarely has much to suggest (the new Wegovy option does change this a bit). For example, I know someone who’s doctor suggested they work on weight loss, and when they said “yes, I’d like to do that, do you have any suggestions I’ve struggled a lot with this” the doctor suggested they consult the Canada food guide - groundbreaking stuff. 

I’ve never been overweight and I know a lot of people find it insufferable to hear about how “body positivity” helps straight size, upper-middle class white women. But, whatever, I got a lot of value out of so-called “body positivity”, particularly from the intuitive eating philosophy. I was someone who fully and uncritically bought into diet culture for most of my life from ~12-28 years old. And because I had always monitored my food and because obesity is common in my family I had come to believe that if I didn’t maintain hyper focus on diet I would gain a lot of weight. 

Intuitive eating encourages you to resist the urge to judge what and how much you’re eating while making an effort to tune in to when you’re hungry, when you’re full and how things make you feel when you eat them. For some people, years of constant dieting cycles and experiments with restrictive fads that don’t lead to lasting positive change can weaken their connection to their hunger and satiety cues. And encouraging a sense of mindfulness can help make the connection between what you eat to how you feel more salient in a way that can lead to better choices over time. Intuitive eating principles also encourage a focus on feeling healthy and nourished rather than a focus on a particular “goal weight”. In my case these ideas helped me break out of cyclical dieting, and now allow me to maintain my (~7 pounds higher) weight with minimal cognitive burden. A very worthwhile trade for me.

To conclude…

I don’t think the body positivity/fat activism movements share much if any blame for the long-term rise in obesity. They arose as a result of fat-shaming and are not on their own a reason to support more fat-shaming. I think there are both good ideas and good activism coming out of the moderate parts of those movements. But there’s also undoubtedly extreme elements that are spreading a harmful and dishonest message. Demanding that people affirm obviously untrue statements about the (lack of a)link between obesity and health can be used as another version of woke purity testing. And while I support much within these movements, it’s a purity test that I won’t pass.

Also - good pod on beauty and aging