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The Complexities of Fat Activism: Rights, Risks, and Realities

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Understanding Fat Activism

In today's society, the conversation around obesity and fat activism has gained significant traction. While everyone deserves the right to exist in their own body without facing judgment, promoting obesity as a positive lifestyle can be seen as irresponsible.

To begin, I must disclose that I do not identify as overweight. In fact, the last time I checked my BMI—likely over a decade ago—I was on the verge of being medically classified as underweight. Standing at 187 cm and weighing in the 70s, I could only afford to lose a few pounds before entering the underweight category, along with its associated health risks. My struggle has always been the opposite of what many face.

During my formative years, friends often teased me about being too thin. Occasionally, family members would also offer unsolicited comments about my stature. I was that lanky guy—cool enough not to face outright ridicule, but often the subject of quiet comments. Thankfully, I was confident in myself, and these remarks did not deeply affect me, even though I heard them.

After completing medical school, I decided to intentionally gain weight. During the transitional period between finishing my studies and deciding on my next steps, I had the opportunity to indulge in bad dietary choices. I ate excessively, allowing myself to indulge in all my cravings. After several months, I grew concerned. There were no visible changes in my body, which was disheartening. I thought, "Perhaps I’m being too critical. The scale will surely reflect a difference."

After three months, the scale showed just a 3-pound increase. Five months later—still only an additional 3 pounds. This experience led me to abandon my goal.

My narrative is not representative of the majority. Globally, there are far more individuals classified as obese than those who are underweight. Statistics reveal that in the United States, 31.6% of adults are overweight, 39.6% are obese, and 7.7% are severely obese. On an international scale, the World Health Organization (WHO) has reported that over 1 billion individuals are living with obesity. Alarmingly, childhood obesity rates have quadrupled since 1990, indicating a public health crisis of monumental proportions.

The Rise of Online Communities

The internet has facilitated connections among individuals who share similar beliefs, creating communities around shared characteristics like obesity. In various online spaces, those who identify as obese openly advocate for their right to exist in any body size they choose. Blame is often directed at society for shaming individuals, researchers for disseminating negative studies about fat individuals, and healthcare professionals for incessantly urging weight loss.

In 2018, when Cancer Research UK launched a campaign highlighting obesity as a leading preventable cause of cancer, comedian Sofie Hagen accused the charity of promoting fat shaming. Over the last decade, a burgeoning industry has emerged around fat activism, including books, podcasts, and merchandise that celebrate obesity in a manner akin to racial pride. In 2023, FatCon—a convention dedicated to individuals who identify as fat—was held for the first time and has continued annually since.

My stance on this issue is unequivocal: I fully support everyone's right to be themselves, to look however they choose, and to dress as they wish, including the choice to be as fat or thin as they desire. Fat activists argue that individuals who are fat often face discrimination across various sectors, including employment, healthcare, media, and education. I firmly oppose any form of discrimination. Having faced weight shaming and racial discrimination, I understand the detrimental impact such biases can have on individuals. Stigmatization often leads to lower self-esteem and increased anxiety among those affected.

However, advocating against stigma should not equate to endorsing obesity as a norm. It is essential to acknowledge the public health campaigns that have emerged due to scientific findings regarding obesity over the decades. While some studies indicate that stigma may exacerbate mental health issues, numerous others establish a clear link between obesity and a range of serious health conditions.

Health Risks Associated with Obesity

Obesity has been associated with cardiovascular diseases and a heightened risk of various cancers, including breast, colorectal, and kidney cancers, among others. It is also linked to diabetes and even conditions like infertility. While anyone can fall ill, research indicates that individuals with a healthy weight generally have better recovery odds than those who are obese.

Let me clarify: the correlation between obesity and these diseases does not imply causation. Yet, it is unlikely to be coincidental that obesity stands as a significant risk factor for these ailments. Given the alarming rise in obesity rates, it is justifiable for scientists, healthcare professionals, and public health advocates to express concern. A small increase in weight among a few individuals is acceptable, but when obesity rates have tripled or quadrupled over the last few decades, it becomes evident that we face a serious challenge.

The pivotal question is whether we can simultaneously affirm that people have the right to be fat without facing discrimination while also responsibly communicating the health risks associated with obesity. The answer is a resounding yes, much like the way society recognizes the right to smoke, paired with health warnings on cigarette packages.

Addressing the Challenges

I do not equate smoking with obesity; numerous factors—stress, genetics, social status, and more—contribute to weight gain, some of which are beyond an individual's control. Losing weight through diet and exercise requires immense effort and sacrifice, and even those who succeed often struggle to maintain their weight loss. Nevertheless, many factors contributing to obesity are controllable.

Historically, only a small segment of the population was overweight. Our rapidly evolving lifestyles over recent decades have led to the current surge in obesity rates. Factors such as the rise of fast food, a consumption-driven culture, and technological advancements have reduced physical activity and labor. These influences have seeped into our daily lives, making weight loss a challenging endeavor.

While everyone should have the right to choose not to engage in the demanding work of losing weight, that choice should not preclude health advocates from reminding the public of the associated risks of obesity. Critics may argue that public health campaigns foster feelings of inadequacy among obese individuals. However, the intent of these campaigns is to awaken us to potential health threats rather than to flatter our self-esteem.

A Non-Conclusive Perspective

Several influential fat activists have emerged through their online presence. These activists can be categorized into two distinct schools. One group, represented by Virginia Sole-Smith, promotes the idea that being overweight should be embraced without concern for health implications. Sole-Smith's stance—that individuals should eat freely without worrying about weight—may seem benign but can lead to unchecked weight gain and dangerous health outcomes.

Conversely, the second school, exemplified by Roxane Gay, acknowledges the importance of body acceptance while also considering the health risks of being overweight. Gay openly discussed her gastric sleeve surgery for weight loss, illustrating that individuals should be free to pursue weight loss goals without facing judgment from the fat activism community.

Both groups of activists have garnered significant followings online, leveraging their platforms to promote body positivity. However, they face a dilemma when they decide to lose weight after building their identities around body acceptance. The conflict arises from the fear of disappointing their followers and the potential financial implications tied to their brand.

Final Thoughts

My motivation for writing this essay stemmed from reading the interview with Virginia Sole-Smith in the New York Times. Throughout this discussion, I have emphasized the importance of not discriminating against individuals based on their body size. As a medical professional, I find Sole-Smith's messages troubling, as they appear to dismiss the health risks associated with being overweight.

My hope is to foster an environment where individuals can be accepted for who they are while remaining informed about the health implications linked to body size. If I can persuade even one person to consider this perspective, I will deem this piece a success.

This video explores the complexities of fat activism and its implications on health, featuring insights on the cultural narrative surrounding obesity.

In this video, a personal journey is shared about living with obesity, highlighting the challenges and societal perceptions tied to the fat acceptance movement.

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