University of Alabama researcher calls for systemic shift in fatness mindset

08 Jul 2024 --- In a revolutionary new approach to how people perceive fatness, University of Alabama, US, researcher Rekha Nath purports that it should be approached through the lens of social inequality, addressing the systematic ways in which society penalizes people for their body size.

“Our collective aversion to fatness translates into an aversion to fat people. Fat people are bullied and harassed. They receive worse healthcare, frequently at the hands of doctors and nurses who endorse harmful anti-fat stereotypes,” says Rekha Nath, associate professor, philosophy at the University of Alabama.

“Fat students are ridiculed and teased by classmates and even teachers. In the workplace, fat people experience rampant discrimination, which is legal in most jurisdictions.”

In her book “Why it’s ok to be fat,” Nath argues for a paradigm shift in how society approaches fatness. Her research shows that global obesity rates tripled in the last 50 years and the World Health Organisation refers to it as the most severe public health challenge of the 21st century. However, she goes on to show that the advice given to people to lose weight, eat less and move more is not effective and even harmful. 

Damage caused by weight stigma
Obesity rates among children and adolescents worldwide have increased four times in 33 years, while among adults, this rate has more than doubled, according to a global analysis of data for the period 1990 to 2022, published in The Lancet. Currently, more than one billion people worldwide, or one in seven, are grappling with obesity. The escalating obesity rates can be seen in almost every country worldwide.

Nath’s research demonstrates how many public health campaigns that aim to help people lose weight can make the situation worse by inadvertently stigmatizing fatness. The study shows that stigmatized people are less likely to lose weight. 

One study tracked more than 6,000 individuals for four years, and those who reported experiencing weight discrimination were more likely to become obese or remain obese than those who did not.

“The consensus view in the literature on weight stigma is that it doesn’t help. Actually, it’s worse than that. Not only does subjecting fat people to weight stigma seem to make it less likely that they will become thin but weight stigma appears to seriously harm their physical and mental health in many ways,” Nath explains.The author calls for a complete mindset shift around obesity as a viable solution to improve the adverse health effects that currently exist as a result of being overweight.  

“Numerous studies indicate that people who experience weight stigma are more likely to suffer depression and low self-esteem.” She notes that prejudice against fat people is endemic in society and public health initiatives to reduce it have exacerbated the problem.

She recommends that society not approach fatness as a trait to weed out of the population but as a consequence of social inequality by dealing with the root systemic issues.

Meanwhile, China unveiled a three-year campaign to enhance weight management to control the growing obesity problem among its population. The National Health Commission, the Ministry of Education and Civil Affairs and 13 other departments have issued a document highlighting the measures that will become effective this year.

New research from Brazil and Mexico explores the cause behind the obesity boom in Latin America, which may have broad implications beyond the region. The review article asserts that socioeconomic, cultural and epigenetic causes of obesity can be just as, if not more, significant as personal lifestyle choices.

Poor advice
Obesity is linked to lower life expectancy and is associated with a heightened risk of diabetes and heart disease. Still, Nath shows that the benefits of improved diet and fitness affect more health than weight alone. For example, a 2010 systematic review of 36 studies found that fit, obese individuals were less likely to die prematurely than unfit normal-weight individuals.

According to another rigorous review cited in the book, many people who try to lose weight through dieting end up heavier in the long run. Forty-one percent of dieters weigh more four to five years after dieting than they had before starting their diets.

Nath paints a picture in her book of a world where fat people enjoy equitable healthcare, equitable inclusion in the workforce and the ability to appear in public without shame. “It is ok to be fat because there’s nothing wrong with being fat. There’s nothing wrong with being fat, of course, except for all that our society does to make it bad to be fat. Oppressing fat people for their body size by imposing on them the gross injustice of sizeism,” she concludes.

In other industry developments, UK-based researchers call for clearer messaging on obesity to help the public and policymakers understand it and improve prevention and treatment. They highlight that the disease centers on mechanisms that regulate dietary intake, not on body weight or body mass index, which is how people generally define obesity.

Moreover, new studies underscore the importance of obesity care, linking treatments to lowered weights and other health benefits, such as reducing inflammation and cardiometabolic risk. 

However, research also suggests that most people with obesity do not receive weight-related care from their usual healthcare source.

By Inga de Jong