Ob*sity Is A Social Construct Not A Disease

It warms my heart to share that I’ve personally noticed (primarily through the inclusive fitness movement) an overall acknowledgment and practice of fat acceptance happening in the fitness industry. We are having more of the necessary conversations about anti-fat bias and how it causes great harm to people both on an individual and institutional level. This push to be more size affirming is directly helping to re-shape the ways we provide support to people in larger bodies and I am 100% here for it.

While its awesome that folks are committed to divesting from weight stigma in fitness, movement and wellness spaces.  Many people are unwilling or unable to separate the fact that the hyper medicalization of fat is also a form of systemic anti-fatness.

I can’t count how many times people have emailed me with some version of this statement: “I can respect people in larger bodies but I know ob*sity is simply unhealthy from a medical standpoint.”

My one sentence response is often: “Ob*sity is a social construct not a disease.”

So let’s unpack my statement.

First I’d like to define the words “Obesity”, “Obese”, “Obesity Epidemic” & “Overweight”,:

“Obesity” is defined as a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors.

“Obese” comes from the Latin obesus, or “having eaten until fat”.

“Obesity Epidemic” The definition of an obesity epidemic is the growing number of people globally, more than 1 billion adults and 22 million children under the age of five, who are overweight or obese and who often have accompanying medical illness such as chronic disease and disability.

“Overweight” implies excess; to be overweight suggests you’re over the “right” weight.

**If you are using any of the above mentioned words please refrain from using them immediately.

Secondly I’d like to define the term social construct. A social construct is something that exists not in objective reality, but as a result of human interaction. It exists because humans agree that it exists. These societal norms don't have to be accepted by every single person in order to be social constructs. They can (and often do) change over time.

The idea that pink is for girls and blue is for boys is an example of a social construct related to gender. The gender binary (the designation that only two genders exist in this world which are man/woman) itself is a social construct along with race, time, money and marriage.

 **Anti-fatness is also known as fatphobia sizeism, weight stigma, weight discrimination

Weight wasn’t considered a primary indicator of health in the United States until the early 20th century, when life insurance companies began using tables of height and weight, a.k.a. the Body Mass Index (BMI), for the purposes of determining what to charge prospective policyholders. The BMI was invented nearly 200 years ago by Adolphe Quetelet, an academic whose studies included astronomy, mathematics, statistics, and sociology. Quetelet was not a physician, nor did he study medicine. He was best known for his sociological work aimed at identifying the characteristics of l’homme moyen— the average man — whom, to Quetelet, represented a social ideal. source

Science has repeatedly demonstrated that a measure built by and for white people is even less accurate for people of color — and may even lead to misdiagnosis and mistreatment. According to studies published by the Endocrine Society, the BMI overestimates fatness and health risks for Black people. Meanwhile, according to the World Health Organization, the BMI underestimates health risks for Asian communities, which may contribute to under diagnosis of certain conditions.

As Aubrey Gordon points out in her essay The Bizarre and Racist History of the BMI, “the Body Mass Index is a product of its social context. And, even according to its biggest champions, it’s not an effective measure of fatness, much less overall health.”

Medical doctors literally made up clinically sounding words like adipose and obese to reinforce the idea that they should be the only ones treating “weight related conditions”. The term “morbid obesity” was coined by J.J.  Payne and LT DeWind in 1963 in order to persuade health insurance administrators that reimbursement for the cost of intestinal bypass surgery in higher weight patients could be justified on health grounds.

"Many researchers in the field of “obesity” studies are funded by the billion dollar weight-loss industry. “Proposals for studies in the realm of health and weight that don’t center on “obesity” have trouble getting funded. So millions are going to research combined with hatred for fat bodies which has created this moral outcry known as the obesity epidemic. There is so much evidence out there to dispel this obesity epidemic myth. As it turns out, study after study after study shows that everyone from doctors to nurses to psychologists – even those who specialize in obesity – have internalized implicit weight bias, which means that they are predisposed to associate fat bodies with ill health.” (source)

“Through annual conferences like the first International Congress on Obesity, held in Bethesda, Maryland, in 1973, doctors helped propagate the idea that dealing with weight was a job for highly trained experts. “Medical professionals intentionally made a case that fatness was a medical problem, and therefore the people best equipped to intervene and express opinions about it were people with M.D.s,” This inspired a number of new treatments for obesity, including stereotactic surgery, also known as psychosurgery, which involved burning lesions into the hypothalamuses of people with “gross obesity.” Jaw wiring was another invasive procedure that gained traction in the 1970s and 1980s. (source)

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