Reed Piernock
Dr. Leticia Bode
CCTP-631
26 April 2021
As Hobbs writes, "weight and health are not perfect synonyms." Anyone can be healthy at any size; conversely, sickness and disease know no weight.
Health can be measured holistically, meaning it accounts for emotional and mental health as well as physical. The Association for Size Diversity and Health defines health as existing "on a continuum that varies with time and circumstance for each individual"; that is, weight is not an indicator of health, and health does not have a one-size-fits-all approach ("The Health at Every Size® (HAES®) Approach").
The Centers for Disease Control and Prevention (CDC) state that the prevalence of obesity for adults aged 20 and over in the United States is approximately 42% (Hale, et al.), and approximately 9% for severe obesity. The CDC's data defines obesity as a BMI of 30 or higher, and severe obesity as 40 or higher.
Body mass index (BMI) calculates a person's weight (kilograms) divided by their height (meters) squared; although it is often used to place people into easy categories of underweight, normal, overweight, and obese, it measures appearance, not health (Bacon and Severson; Nuttall).
Further, it was formulated for statistical analysis of populations of groups by life insurance companies, and was never intended for individual purposes (Bacon and Severson; Hobbs; Nuttall).
BMI is a math formula, and does not take into consideration muscle mass, lean mass, or fat mass, let alone a person's health (Nuttall 120). Additionally, Stoll highlights that the definition of overweight and obese, according to BMI, has changed over time (425), while Nuttall notes that in addition to weight increase, the average height of men in the US also increased between 1960 and 2002 (121).
In 2013, the American Medical Association formally recognized obesity as a disease; however, it did so after ignoring the recommendation of its own committee specifically put together to research obesity (Bacon and Severson; Brown; Pollack; Stoll 426). The committee voiced convern that labelling obesity "a disease" would cause more prejudice against fat people.
Overall, doctors tend to disregard the concerns of their fat patients, and instead prescribe weight loss for anything from a stuffy nose to a broken arm. With fat patients, providers have shorter appointments, harsher words, and less patience (Hebl and Xu; Hobbs).
Hebl and Xu find that doctors consider their fat patients "less healthy... less self-disciplined... [and] more annoying" (1250), and would most likely be less compliant in their advice and prescriptions.
Due to this, fat patients are less likely to visit their healthcare providers when they are sick or have other health concerns (Bacon and Aphramor 5; Hobbs; Stoll 428).
Although not updated since 2014, the blog First, Do No Harm offers hundreds of user-submitted stories of their experiences of being fat at the doctor's office. The site also links to a 2009 study on physician respect for patients with obesity, finding that higher patient BMI is correlated with lower provider respect.
A common mantra in fat acceptance is "diets don't work", and studies have provided little to no evidence in support of the theory that dieting will lead to long-term weight loss or health benefits; more often than not, studies have shown either no long-term change, or harmful negative consequences of intentional weight loss (Bacon and Aphramor 5; Hobbs; Mann, et al.; Miller). Some effects include...
Dieting can lead to a severe focus on weight loss, leading to disordered eating (Bacon and Aphramor 5); correspondingly, adolescents with a history of dieting and disordered eating are at greater risk to carry those habits into adulthood (Nuemark-Sztainer, et al. 1004).
Unhealthy disordered eating behaviors include "skipping meals, vomitting / using laxatives, smoking to lose weight, taking prescription diet pills, or taking nonprescription diet pills" (Chaitoff, et al. 242).
In an interview with Hobbs, Corissa Enneking discusses her disordered eating and its effect on her mood, behavior, menstrual cycle, and panic attacks; however, when she attempted to talk to her doctor about her issues, he told her to keep up the good work.
As Bacon and Severson exclaim, "fat is not the problem — fat stigma is." One argument for fighting "the obesity epidemic" and to adding more stigma is to say that it's all "for your own good" (Hobbs).
However, fat people who feel the stress of weight discrimination, stigma, and bullying have risk of increased mortality, and many of the health conditions and diseases often thought as being caused by obesity may actually be caused by weight stigma (Bacon and Aphramor 6; Sutin 1-2).
Bacon and Severson assert that "you cannot wage war on obesity without waging war on the people who live in those 'obese' bodies".
Social and systemic injustices also play a large role in the health and welfare of our society, yet weight is often seen as a moral failing and an individual problem (Bacon and Severson; Hobbs). This removes responsibility from systems of oppression that allow fat and weight discrimination in employment, education, the media, politics, relationships, and healthcare (Stoll 423), in addition to intersection issues of race, class, and economics (Hobbs; Stoll 430).
Size has nothing to do with health; what are more important are healthy habits and behaviors (Hobbs), in addition to a culture of support regarding those habits regardless of size (Bacon and Severson). Many of the programs designed to address weight are actually more health interventions than weight interventions, such as campaigns to eat more vegetables, exercise more, quit smoking, reduce alcohol consumption, or limit sodium intake (Bacon and Aphramor 6; Hobbs; Mann, et al. 224).
Exercise itself has shown many health benefits, even without weight loss, and research has found that encouraging everyone of all sizes to add movement to their routines results in greater physical and mental health (Hobbs; Miller 14; Stoll 427; Tomiyama 203).
Bacon and Aphramor suggest the name "health promotion" instead of "weight intervention" (9), as any program to encourage health should take the focus off weight and onto universal strategies that would benefit anyone, regardless of weight (Miller 14).
This is a static website, generated using several node.js packages, including light templating with gulp-html-partial, and writing and compiling CSS using Dart Sass. For quick turnaround within the scope of this project, design is simple, yet still responsive. Fonts are courtesy Google Fonts, and icons courtesy FontAwesome.
The code for this website is available in a Github repository. If you find an issue or bug, please open a ticket.
This topic was influenced by the work of Lindo Bacon, Aubrey Gordon, Michelle Allison, and many in the Health at Every Size and fat acceptance movements.
A full list of Works Cited is also available.