The diet/wellness industry made over $5 billion dollars in 2022 by telling us that our bodies were not good enough, then shilling the elixirs that would magically fix the problem. Of course, none of the solutions are truly sustainable, because then they would lose their revenue streams. They took an obscure actuarial concept and extrapolated it far beyond its original design: BMI (Body Mass Index), validated only on the bodies of white European men, now gets to determine the “health” and perceived goodness of all bodies. The anti-fatness crusade has its origins as an anti-Blackness movement to keep melaninated people small (read docile and not taking up too much space).
And it invaded the medical sphere, where ostensibly all bodies deserve appropriate treatment and all doctors have vowed to “do no harm.” And yet, we all too often perpetrate harm by stigmatizing people in larger bodies, sometimes even denying them appropriate medical care. Too often the panacea for any concern (even a simple desire for birth control) is “lose weight.” But we also ignore warning signs of eating disorders in those who do actually lose weight – praising them for “getting healthy” even as they present with all the classic signs of a malnourished body.
The biased actuarial statistic, BMI, is now used to define specific disease categories. It would be nice if “disease” truly corresponded to worse outcomes, but people in the “overweight” BMI category actually live longer than those in the “normal” category. And those in the highest weight categories do not show long-term negative health effects until they also develop co-occurring conditions like diabetes or hypertension. But, by medicalizing the biased statistic, the diet industry legitimizes consumers’ need for their products. Despite studies showing the above as well as ones that suggest the negative health impact is more derived from the body’s chronic stress from fatphobic microaggressions being directed at it nearly constantly.
Enter Health at Every Size. Lindo Bacon, PhD collated the studies in their groundbreaking book of the same name. They propose a radical concept: treat people without regard for their body size. Treat their medical conditions like diabetes and hypertension, certainly. Stop denying them needed medical care (such as surgery or medication) until they lose weight. Stop encouraging weight loss, since studies have shown repeatedly that diets don’t work. And recognize that we all deserve to take up space in this world – no one expects a Great Dane to look like or fit into a carrier intended for a chihuahua. Stop asking people to change their natural body characteristics because it makes others more comfortable. Start treating people as human beings worthy of genuine care. Because we all are.