Anti-obesity vs. Fat Acceptance - Weighing Both Sides,
A few months ago, Sylvia Moore, Director of the
WWAMI Medical Education Program at the University of Wyoming, alerted me to an
article from last year that did a masterful job of sorting out the two major
approaches for addressing obesity. I’ve now read the article three different
times and want to share with you some of the points I found to be the most
insightful for me.
- The authors conclude that morality as much as mortality plays a central
role in the controversy over how obesity is perceived. Those in the
anti-obesity camp see body weight as something that is under personal
control and therefore they argue people have a responsibility to manage
their weight. Those embracing the fat acceptance approach view fatness as
natural, and largely inevitable for some people, and therefore they argue
that large body sizes are one type of human diversity.
have documented that higher body weights are more common among lower
socioeconomic groups with African American and Mexican American women among
the most likely to be obese. Fat acceptance promoters argue that blaming fat
people for their weight serves to reinforce social inequities. It is
difficult to be physically active when one lives in a high-crime area and
can not afford a gym membership.
Many obesity expert panels (National Institutes
of Health, Food and Drug Administration, World Health Organization, etc.) are
dominated by anti-obesity researchers suggesting that much of the current
research on obesity may have a bias against a diversity of hypotheses being
- To understand how the anti-obesity and fat
acceptance approaches view the same findings differently, the authors offer the
often cited 75-95% failure rate for people attempting to lose weight. The fat
acceptance approach argues the high failure rate is proof body weight is outside
of personal control for most people. On the other hand, the anti-obesity
approach argues that a 5-25% success rate proves that weight loss is possible,
- The national debate continues over whether or not
obesity should be considered a disease. If considered a disease, weight-loss
treatments such as surgeries could be covered by medical insurance and Medicare.
On the other hand, some fear that labeling obesity as a disease suggests fat
people should always seek medical treatment, even if it is risky and has a low
probability of success.
- Since the 1990's, obesity is the U.S. has been labeled an epidemic,
with a large number of people reaching a body mass index (BMI) of 30 or
higher. Some researchers are now suggesting that the term epidemic
does not truly represent what occurred with changes in BMI over time. These
researchers point out that the average person gained only seven to ten
pounds over a ten year period. Over the years, more and more people were
inching ever closer to the arbitrary BMI of 30. Thus, the current rise in
obesity is seen less as an epidemic and more as a steady but constant
rise in body weight over time for most people.
- Some individuals promoting the fat acceptance approach fear a focus on
body weight can be counterproductive to promoting healthy lifestyles. Body
size is not a reliable indicator of a person’s healthy eating habits or
level of physical activity. People who improve their diet and become more
active do not always lose weight. There is also fear that a focus on weight
will not only lead many to pursue dangerous weight loss treatments, but will
also increase eating disorders and rates of smoking as people try to achieve
- Anti-obesity promoters don’t buy the argument that anti-obesity
approaches will cause a dramatic increase in eating disorders. They argue
that eating disorders are mainly concerns of upper-middle class women, and
most of the targeted information about obesity should be directed to the
Source: Saguy AC,
Riley KW. Weighing both sides: morality, mortality, and framing contests
over obesity. Journal of Health Politics, Policy and Law,
Compiled by Betty Holmes, MS, RD
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