What To Know About Fat Stigma, BMI, and Diet Culture

Published on: Aug 16, 2021fb-roundtwitter-roundemail-round
fat stigmaDesign: theSkimm | Photo: Pexels
The Story

"Fat" is not a bad word. Yep, you can read that again. But it’s time we talk about fatness and fat stigma.

What do you mean?

Anti-fat bias or weight stigma (stereotyping based on body size) has become a clear public health problem. Studies show that fat people are often mistreated by strangers, as well as family, friends, and doctors, who could fail to screen them for certain cancers or overlook certain diagnoses. That’s all despite the fact that being “overweight” (we put that in quotes for a reason, which we'll get into later) doesn’t necessarily mean you're unhealthy. What’s worse: Data shows that weight stigma damages mental health and, in fact, is harmful to physical health, too. 

How’d we get here?

Well, we’ve been here for a while. Sure, fuller bodies were the subjects of statues thousands of years ago. But the corset has been holding in waists for hundreds of years. Even in the early 20th century, only curves with tiny waists were prized — and that was decades before the Kardashians. The Western idealized body type has gotten smaller and smaller ever since (and is typically white...more on that in this book). Enter: the fat liberation or “fat acceptance” movement, which emerged alongside other liberation movements of the ‘60s and ‘70s as a way to celebrate big bodies and fight against weight stigma. (It would take decades before medical journals would quantify just how dangerous weight stigma is.) Today, many activists use the word “fat” to reclaim it as a neutral adjective to describe body size, and to push back against fatphobia (another word for anti-fat bias or weight stigma).

What can we do about it?

Learn about weight stigma, and understand the real meanings of relevant terms. And also confront the ways society has shaped how you think about bodies.

OK, let’s talk.

We called up experts Kimmie Singh, a registered dietitian nutritionist who identifies as a fat-positive provider, and Alissa Rumsey, a registered dietitian and nutrition therapist who wrote Unapologetic Eating, to give us theSkimm on fatness, diet culture, and weight stigma...

Fat
  • Some context…Merriam Webster defines “fat” as “notable for having an unusual amount of fat.” Some activists repeat the word to normalize it, while others avoid it because it’s long been used as an insult. Despite what a billboard may say, ‘fat’ is not a feeling.

  • Rumsey says…“Many people, especially within the fat acceptance and fat liberation movements, choose to use the word ‘fat’ as a neutral adjective to describe body size, like short or tall. It’s similar to some of the things we're seeing now with the word ‘queer.’ People in fat bodies are kind of reclaiming this word.”

  • Singh says…“Folks have used ‘heavier,’ ‘people of size,’ ‘bigger’ or ‘larger-bodied,’ but I prefer the word ‘fat.’ I think it's really important to neutralize that word. I know that can make people really uncomfortable. And I also think it's important that we listen to fat activists who have been describing themselves as fat since the [late] ‘60s.”

BMI
  • Some context…It stands for “body mass index.” BMI is meant to measure body fat based on height and weight. Doctors use it to assess whether someone is at greater risk of certain health conditions, because it’s considered a quick way to get an idea of someone’s overall health and weight status. But many people have deemed the measurement BS or even racially biased

  • Singh says…“BMI was created by a mathematician, and it wasn’t created to be a medical tool. He was using it to look at the proportion of different body sizes in a population. Research shows that using BMI leads to misdiagnosis of people as ‘unhealthy’ or even ‘fat’ according to their BMI, even if they’re metabolically healthy.”

  • Rumsey says…“The body mass index is based upon an equation from the early 1800s that was primarily used for white European men...It's not a representative sample of the general population and doesn't account for any differences in average body sizes in other ethnic groups.” 

Obesity and overweight
  • Some context…These O-words are the weight statuses that the BMI chart gives to adults who have upwards of a 25% (for “overweight”) or 30% (for “obese”) weight to height ratio. And they’re terms many people find harmful. One reason: Doctors tend to overlook certain medical conditions (and instead focus on weight loss) when treating people with these identifiers. 

  • Singh says…“‘Overweight’ and ‘obese’ are words that I consider to be terms of stigma and fatphobic slurs because they’re used to discriminate against fat people. They've historically been used from the BMI ranges of what’s considered an unhealthy body, so that's why I recommend people stay away from those words.”

  • Rumsey says...“The word ‘obese’ actually comes from a Latin word, obesus, which means ‘having eaten until fat.’ That's a super stigmatizing word, especially how it's used now, when it can be a diagnosable sort of condition. That's why you'll see quotes or some people will put asterisks (i.e. ob*sity), so they're not spelling out the whole word, to kind of signify that we don't recognize them as official terms or agree with what they signify. As for overweight, ‘over’ what? Humans, we are so binary.” 

Diet culture
  • Some context…Fad diets come and go, but the societal desire to be thin remains. Diet culture describes the forces that encourage an ongoing pursuit of thinness. Think: looking at before and after photos, focusing on eating only “good” foods as part of a strict regimen, and comparing yourself to filtered Instagram models. Many argue that diet culture is harmful and unhealthy, both because it fuels weight stigma and because data shows that dieting usually doesn’t even lead to long-term weight loss.

  • Singh says…“Diet culture is this cultural norm of pursuing thinness at all costs, pursuing fitness in the hopes that your life will become amazing. And it’s painted as ‘if you can kind of get your food and movement under control in a certain way, everything else will just fall into place.’ And I feel like it upholds these really disordered views on bodies, food, and health.”

  • Rumsey says…“Certainly in the US but also in a lot of other Westernized countries, diet culture equates thinness to health, to happiness, to attractiveness, to worthiness. It's this overarching system of beliefs where to be thin is to be better and morally superior, whereas to be fat is to be seen as unhealthy, as lazy, as a failure. We're taught this, not just from families, but it permeates everywhere in our culture: health care, the media, all kinds of different places.”

Body positivity
  • Some context…The term "body positivity" grew out of the fat acceptance movement and can be interpreted as honoring and embracing bigger bodies — across all genders and races — in a society that has often dismissed them. Today, some people think of it as having a generally good perception of the way they look, aka having a positive body image. 

  • Singh says…“Fat activists created body positivity to recognize the oppression that fat people experience. Now, I feel like it's something seen as having a positive body image.” 

  • Rumsey says…“As a thin person, everywhere I look — from movies to books — I see myself reflected. You can’t say the same thing for fat people. Body positivity really began as a way to center and celebrate bodies that are historically relegated to the margins of society. It was originally part of the fat liberation movement and meant for fat folks."

Body neutrality 
  • Some context…Yes, this is different from “body positivity.” It’s about accepting your body as it is. And for some people that means separating your physical body from your self-worth.

  • Singh says…“Body neutrality can be a great first step or a first goal for someone that's really struggling with not feeling so great about their body. I like to frame it as: Think of having a roommate you might not love all the time. [They] might not look or act how you want [them to], you might have some strong negative feelings toward [them], but try to coexist with this roommate.”

  • Rumsey says…“‘Body neutrality’ [could be a useful concept for] people who find that the idea of loving their body or feeling positive about their body is really out of reach. Other people find that body neutrality doesn't sit well for them, because, especially for folks who live in marginalized bodies or live in a body that is marginalized by our society, the world is not neutral with how it judges and treats them. So for some people, they find that the term ‘body neutrality’ can feel invalidating.”

HAES
  • Some context…HAES (pronounced “hays”) stands for “Health At Every Size.” It’s a registered trademark of the nonprofit Association for Size Diversity and Health, which began in 2003. But it’s the hashtag (#HAES) that you might’ve seen on your feed (especially if you follow a bunch of nutritionists). It describes a holistic approach to eating and living that doesn't focus on weight loss and thinness.

  • Singh says…“[HAES] came from folks that were really passionate about recognizing that diets don’t work and that fat people can engage in health-promoting behaviors, which research shows is more likely to have a healthier outcome than focusing on weight loss. As a HAES provider, it means that I try to work with folks to focus on ways that they can feel better in their body and improve their relationship with food, without focusing on weight loss.”

  • Rumsey says…”The tenets of the HAES framework began decades before it became a registered trademark, with the work of fat activists and the fat liberation movement that came out of the [late] 1960s. It rejects the use of weight or BMI as a proxy for health. Instead, it promotes and works to support people, no matter what their size, no matter their weight, in finding more compassionate ways to take care of themselves.” 

Intuitive eating
  • Some context…It’s the idea that you should listen to your body about what and when and how much to eat, and was coined more than 25 years ago by registered dietitians Evelyn Tribole and Elyse Resch. But it’s gotten renewed attention in the last couple years as a way to reject diet culture.

  • Rumsey says…“[Intuitive eating] is a framework that is really a non-diet, self-care approach to nutrition, health, and wellbeing. It helps people get back into their bodies and make decisions based upon their body's inner wisdom, rather than following external restrictions or outside sources, like counting calories, eating certain foods, or avoiding certain foods.” 

  • Singh says… “One of the biggest misconceptions that I hear about intuitive eating is that it encourages people to ‘just eat anything and everything.’ It's important to have permission to eat a variety of foods, but I find that people want to progress past this part of intuitive eating to learn more about eating foods that help them feel both pleasure and nourishment. It's important to mention that this part, and some other parts of intuitive eating, are only accessible to those that have the privilege of affording consistent nourishment. 

Thin privilege
  • Some context…“Thin privilege” describes how people in relatively smaller bodies may have an advantage in everyday life without realizing it, from the fact that clothing stores readily carry their size, to how strangers might not judge what they eat in public. The concept is similar to “white privilege.”

  • Singh says…“Someone can experience thin privilege and not have to worry about experiencing weight stigma, fitting in airplane seats comfortably, or being bullied explicitly because of their size. I generally remind folks that wherever there's oppression, there's also privilege. A lot of people mistake thin privilege for having positive body image. They might experience negative body image and be uncomfortable in their body, and still have thin privilege.” 

  • Rumsey says…“The term ‘privilege’ can make people bristle. I think it's important to think about the privileges that you hold as a human. They may have nothing to do with how you feel about yourself but are about how society treats you. And just because you have certain privileges does not mean that your life still hasn't been hard. It just means that you haven't been treated differently by society because of the size of your body...People don’t necessarily have to acknowledge it all the time like I do, because I'm [taking up room] in a space that was created by and for fat people. But we do really have to be cognizant of how we're talking about bodies, our own and others.” 

theSkimm 

People with fat bodies have historically been stigmatized in the US, even though studies show that weight is not necessarily a measurement of health. That’s a problem. A way to be a part of the solution: Listen and learn from fat activists, acknowledge that thin privilege is real, and know that accepting your body at any size can take time — people have been reckoning with it for centuries.

This content is for informational and educational purposes only. It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition. 

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Skimm'd by Carly Mallenbaum, Becky Murray, and Jane Ackermann


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