Wednesday, February 10, 2016

Fat acceptance: still stupid, still dangerous

I've been very critical in the last few years of fat shaming, the practice of berating overweight people into a healthier lifestyle and a slimmer waistline. What I find equally troubling, however, is the recent effort to ignore or downplay the risks posed by obesity for the sake of people's feelings, often referred to as fat acceptance.

There are dozens of excellent reasons why the fat acceptance movement ought to disappear forever, but I want to focus here on the negative influence it exerts on science. As a society, we're letting our preconceived ideas about discrimination against fat people influence our interpretation of public health research. The dishonesty alone should discourage us from this practice, but there are more important consequences. Most importantly, we're encouraging people to make poor choices in order to spare their feelings, and making their lives worse in the process.

Let's start with the example that prompted this blog post to illustrate the point. A study published last week in the International Journal of Obesity suggests that the BMI is incorrectly labeling fat people as unhealthy based solely on how much they weigh. Most of the news reports on the paper, NPR's for example, highlighted the paradox presented by the study: a lot of fat people are healthy, while many slim people are not.

The news outlet pointed out that "47 percent of people with an overweight BMI, 30 percent of those considered obese, and 16 percent of those labeled extremely obese" were just as healthy as 70 percent of people in the normal weight range, based on metabolic health markers like blood pressure and insulin resistance.

 Data like that makes for a provocative headline. If it's accurate, though, it means that 70 percent of obese people are metabolically unhealthy based on the same markers, and that 84 percent of extremely obese people are also in the same category.

The trend, should you have missed it, tells us very clearly that excess body weight is correlated nicely with poor metabolic health. The dividing line between an unhealthy and a healthy weight has been poorly defined over the years, no doubt. But the fact that we have trouble pinpointing exactly when someone's weight becomes a risk to their health doesn't mean that weighing 300 pounds is perfectly healthy.

It may sound like I'm creating a straw man, but this is precisely what fat acceptance advocates preach, and their message has gained a wide audience thanks to feminists who have wrongly taken up the argument that anti-fat bias is part of a patriarchal assault on women.

Their arguments may not seem entirely baseless; there is some research that can be used to support the notion that you can be fat but fit. This assertion ultimately misses the mark, unfortunately, because it ignores a fundamental fact about human metabolism: weight gain is one of the body's responses to a poor diet. Or as science writer Gary Taubes is fond of pointing out, eating junk food spikes your blood sugar to dangerously high levels, which would kill you absent the intervening factor of excess fat accumulation. Taubes hypothesis is based on basic biochemistry, and it's only grown more convincing thanks to a whole bunch of research published in the last decade.

But beyond politically-motivated denial of science, what's so dangerous about fat acceptance? As outlets like NPR are wont to point out, obesity disproportionately affects racial minorities in the United States. This means that a significant and ever-growing portion of the population is at risk for serious diseases like type 2 diabetes, and they're being told that their weight isn't a factor in the equation, when it's actually the most important factor.

We should look at this issue on an individual level as well, though. Being fat is a miserable experience. The social isolation and resulting anxiety it causes are enough to drive people into depression. Popular TV shows like The Biggest loser and the endless bestseller list of fad diet books are ample evidence that people despise being fat, or even looking at fat people.

Had I been told as an overweight teenager that I shouldn't lose weight, I would have been worse off in every measurable way today, because we live in a world where people evolved to judge each other based on physical appearance. Bitch all you want, mother nature doesn't care. What matters is that there are millions of people, young and old, in the same position I was a few years ago. And they're being told by their teachers, journalists and celebrities that weight loss is not only unnecessary but undesirable, that they can't improve their lives by losing weight. And that is far worse than any amount of fat shaming.