Fat-acceptance advocates say medical terms like "obesity" and "overweight" stigmatize fat people and should be eliminated from our vocabulary. They're putting public health at risk to promote a misguided ideology.
Once the social justice movement began its rampage through our culture, it was only a matter of time before it came for the sciences, replacing well-established ideas with postmodern gobbledygook. Examples abound. Charles Darwin wasn't a pioneering scientist but a racist, sexist white man whose problematic views “undermined” his work and legacy. Biotech crops aren't a yield-boosting innovation; they're a tool of Western “colonizers” looking to exploit the developing world. Women aren't the female sex of our species; they're “bodies with vaginas.”
I could go on, but you get the idea: political activism that openly rejects our ability to gather objective facts about the world has jeopardized scientific discourse. The case I want to focus on here comes to us from a well-known repository of medical wisdom—Buzzfeed.
As the headline suggests, the article is a critique of the language often used to describe overweight and obese people. These aren't medically appropriate terms, the argument goes, they're hurtful and oppressive rhetoric:
There’s nothing wrong with 'fat.' The word itself is just a descriptor, but a society that praises and elevates thinness has tried to make 'fat' so negative that people opt for terms they believe are based in medicine, like 'overweight' or 'obese.' But they fail to take a step further and question what’s really behind those words and what stigmas they perpetuate.
Basic decency requires us to treat our neighbors with respect, whatever their physical features, and most physicians seem to share this sentiment. That said, obesity can be a very serious health condition and doctors must be free to respectfully communicate this undeniable fact to their patients. Buzzfeed and other progressive media outlets aren't fighting stigma; they're lying to their readers at the expense of their health. Let's dissect a few of the story's specific claims to illustrate our point.
“'Overweight' implies that there is some objective standard weight by which we can assess the health of every body. And 'obese' comes from the Latin 'obesus,' which means 'having eaten oneself fat,' a definition that activist and writer Aubrey Gordon describes as 'inherently blaming fat people for their bodies' ...”
This thinking originated in a field known as “fat studies,” which maintains that the mainstream definition of "obesity" was socially constructed to oppress overweight people. Besides the fact that someone named Aubrey Gordon says so, Buzzfeed didn't explain why we have to accept this conclusion. Appeals to authority don't work in science, unless that authority has evidence to justify their views.
But even if we assume Gordon is correct for the sake of argument, it cannot be denied that the risk for serious disease increases with BMI. There isn't an ideal weight we should all strive to achieve, but weight clearly influences our long-term health outcomes. Buzzfeed has set up a false dichotomy here.
BMI doesn’t measure anything about an individual’s health — it simply looks at height and weight and is based on a Belgian scientist’s idea of “the average man” 200 years ago. It’s racist and served as a steppingstone to the creation of eugenics. And both 'obesity' and 'overweight' have contributed to weight stigma that leads to employment discrimination and physical and mental health issues.
BMI is an imperfect instrument for measuring metabolic health. Some researchers have noted that individuals who are considered overweight actually have a lower risk of all-cause mortality than their normal-weight peers. But even these intrepid scientists have acknowledged the risks of obesity. After reviewing 97 studies involving almost three million individuals and more than 270,000 deaths, the authors of a 2013 meta-analysis concluded that:
"Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality."
For all its faults, BMI points toward a well-documented relationship between obesity and adverse health outcomes. This isn't a mere association either. We know, for example, that overeating can expand the size of our fat cells and contribute to insulin resistance, which often leads to Type 2 diabetes if not properly treated. The fact that medical terminology like “obesity” has been misused for nefarious ends over the years doesn't refute these basic scientific observations.
“'Fat justice'” is how Gordon describes the goal of her work. 'I yearn for more than neutrality, acceptance, and tolerance … all of which strike me as meek pleas to simply stop harming us.' As with any movement for justice, language is only a small part of it, but it matters.”
Social Justice advocates emphasize lived experience as a source of knowledge about oppression in society, so I'll use some of my own here. After being obese for most of my life, I committed to losing weight in my early 20s. Much of my motivation to do so came from friends and family, who explained why I needed to slim down in no uncertain terms. “Look at what your lifestyle is doing to you,” my dad once told me. “You need to make a change.”
Gordon would no doubt accuse my father of perpetuating fat injustice, but he was right. Now that I have a little boy who I want to teach how to fish and watch grow up, I'm glad my dad said something. The same is true of my doctor. Though professional and respectful, she wouldn't hesitate to point out behaviors I need to change to improve my health. And that's the way it should be.
Pressuring physicians into ignoring the risks their patients face under the guise of promoting “equity” is foolish and dangerous. If we care about people, we'll tell them when they're in harm's way.