According to a new book, labelling all fat people as unhealthy is outdated and leads to “widespread discrimination”.
Rekha Nath, an associate professor of philosophy at the University of Alabama, says there is ample evidence to show that being fat is not always bad for one’s health and that the issue is not black and white.
She draws on a series of new studies from the past decade showing that current methods of tackling obesity are not working and that a more nuanced approach is needed if we are to create a healthier population.
Professor Nath also claims that these norms contribute to a ‘collective dislike’ of overweight people, making them more likely to gain weight and become depressed.
A 2023 study found that the distribution of a person’s fat was more important to their overall fat than just their body weight. Fat around the middle, which strains vital organs, led to an increased risk of diseases that can lead to premature death.
She argued that changing the way society views fat people will lead to better health care for them, making them more likely to lead healthy lives.
“It’s okay to be fat because there’s nothing wrong with being fat. There’s nothing wrong with being fat, of course, except that our society makes it bad to be fat,” she said.
In her new book, entitled ‘Why it’s OK To Be Fat’, Professor Nath referred to a 2010 review of 36 older studies which found that obese people who exercised, fewer are more likely to die prematurely than people who are unfit and have a ‘healthy’ body weight.
She argues that lifestyle factors, in this case exercise, may be a better predictor of health than waist size alone.
Professor Nath has published several articles on obesity and global socio-political philosophy and holds a PhD from the University of Melbourne.
That study and the American health care system use the Body Mass Index (BMI), which divides people into three categories based on their height and weight: healthy weight, overweight and obese.
For example, someone who is 5 feet 7 inches tall and weighs 150 pounds is considered overweight, while someone who is 5 feet 7 inches tall and weighs 170 pounds is considered obese.
But doctors have become increasingly critical of the measurement. Fatima Cody Stanford, an obesity doctor at Massachusetts General Hospital and Harvard Medical School in Boston, said BMI doesn’t give a complete picture of a person’s health.
Not everyone with a high BMI is in poor health. Things like fat distribution and activity level may be more important than just your weight, she says.
For example, there is a growing body of research showing that where your fat is located is more important than how much fat you have in total.
Research has shown that fat located deep in the midsection (around the stomach, liver and kidneys) contributes more to factors linked to obesity than fat located just beneath the skin of your legs and buttocks.
This is because your deep belly fat, called visceral fat, releases more molecules that inflame your body and contribute to a range of health problems than superficial, subcutaneous fat, according to Dr. Howard E. LeWineinternist at Brigham and Women’s Hospital.
This connection is so clear that a 2023 study found that people who didn’t store most of their fat in their bellies were healthy. That means 15 percent of the obese people in the study were generally healthy.
‘If we only look at height and weight, we know nothing about the health status of the individual,’ Dr. Stanford told Nature.
Some doctors will find the idea that being fat is healthy ridiculous, especially given the current situation.
Researchers from six countries, including the US and UK, found that people who were “generally obese”, and those who were taller and had more belly fat, had the highest risk of colorectal cancer.
According to the NIH, about seven out of ten Americans are obese or overweight, a number that has been steadily rising since the 1970s.
The annual cost of treating obesity and obesity-related conditions in the US likely exceeds $1.4 trillion. a report from 2020 from the Milken Institute, a nonprofit think tank.
This includes expenditures by private insurers, public insurers and individual costs for bariatric surgery, medicines, diagnostic tests, preventive services and medical treatments.
Although no one dies directly from obesity, Harvard researchers It is estimated that obesity-related conditions cause nearly 500,000 deaths in America each year.
Obesity causes type 2 diabetes, high blood pressure, stroke, heart disease, liver disease and many types of cancer.
Professor Nath’s book was published by the Taylor & Francis group, a major academic publisher
In addition, according to Harvard researchers, smoking causes people to lose an average of two to four years of their life, making smoking a greater risk of premature death than smoking.
Dr Nath acknowledged this, but said that methods to treat obesity do not always work well and actually make fat people feel worse.
Until Ozempic came along, the general advice for overweight people was to eat less and exercise more. Sometimes that works.
However, Professor Nath cited a study that found that 41 percent of people who try to lose weight through dieting end up heavier four to five years later than they originally weighed.
Although diets are not always effective, people are seen as failures if they do not see results, says Professor Nath.
“Being fat is seen as unattractive, even dirty. We see being fat as a sign of weakness, greed, laziness,” says Professor Nath.
This creates a system where being thin makes people good, and being fat makes people bad, she said, adding: “Many, if not most, of us are not sure whether it’s really OK to be fat.”
How much fat a person has depends on the number of calories he or she consumes, regardless of who that person is.
If you consistently eat more calories than your body uses to fuel itself, your body will begin to store those calories. excess calories as fat.
However, genetics, stress, medications and health conditions can all make it harder to lose fat. They can cause inflammation, slow metabolism and affect the distribution of body fat.
Regardless of the cause, it is clear that people fear getting fat and associate it with failure, says Professor Nath.
One in three students said obesity is ‘one of the worst things that can happen to a person’ a 2014 study from Dickinson College and Yale University School of Medicine found.
Nearly half of the 4,000 respondents to a global online survey said they would rather give up a year of their life than become obese, Professor Nath said.
This creates a prejudice that causes fat people to receive poorer medical care, have fewer job opportunities, and are more likely to be publicly shamed.
This makes them less likely to lose weight and more likely to develop conditions such as depression and anxiety, which are harmful to them.
‘Not only does it appear that the stigma surrounding being overweight makes fat people less likely to actually become thin, but the stigma surrounding being overweight also appears to seriously harm their physical and mental health in many ways,’ said Professor Nath.
This is most common in Western cultures such as the United States, the United Kingdom and Australia, says Professor Nath. But other cultures prefer being fat over being thin.
For example, in communities in the southeastern Nigerian state of Cross River, being fat is seen as a sign of beauty.
The solution to the problem is not to ignore someone’s weight when they go to the doctor, Dr. Stanford said. BMI still gives health care providers “an idea of how much weight you’re carrying around,” Dr. Stanford said.
The key is that you have to look at all the other factors in someone’s life, besides their weight, to determine their health, she said.
