A Diet By Any Other Name

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You may have noticed that I paused publication at the end of last week. I know that many of us are still processing the US election and what it means in the US and abroad. Many of us are still working through what can be done and what we will do moving forward. I’m back on my regular publishing schedule today because one of the things that I’m going to do is to keep using this newsletter to fight against weight stigma, to elucidate and push back against the harm done by the weight loss industry, and to fight for weight-neutral healthcare options and research that includes and affirms higher-weight people, particularly those with multiple marginalized identities. The people and communities who are the most harmed by our weight-centric healthcare and public health systems are people and communities that are already marginalized and vulnerable. I’m one of many people fighting this fight and I’m glad and honored to be part of this community. Thank you for reading.

I received the following question from reader Jin,

I’m a pharmacist and one of the things I’ve learned from following you over the years is the importance of language. I wanted to ask you about language like “anti-ob*sity” medication and “ob*sity treatment.” I notice that you still use terms like weight loss drugs and I imagine that is on purpose. I’d love to understand more about this. Feel free to make it a Substack post if you’d like.

Thanks for noticing and thanks for asking Jin!  

For the last century, research has repeatedly shown that intentional weight loss interventions fail the vast majority of the time. The weight loss industry is desperately trying to rebrand in order to dodge this truth. So now it’s not a weight loss clinic, it’s medically supervised weight management or “ob*sity” treatment.  It’s not a diet drug it’s “anti-ob*sity medication.” It’s not weight loss surgery, it’s “bariatric surgery” or “metabolic surgery.”  This is essentially part 2 of my last post about person-first language for higher-weight people.

At the end of the day, it’s all still the same old thing. There is absolutely no research to suggest that any current intervention will be different than any past intervention (which is to say that there is no reason to believe that they will do anything except create short-term weight loss followed by weight regain for almost everyone and/or include dangerous, potentially life-altering or even life-ending side effects.) A failed weight loss intervention by any other name will still be a failed weight loss intervention.

The particular marketing spin that Jin mentions rests on their other nonsensical marketing claim that “ob*sity” is a “chronic disease.” This bit of spin has allowed them to lean heavily on the “hate the sin, love the sinner” concept of anti-stigma that they use to claim an anti-stigma stance while profiting off the attempted eradication of higher-weight people - like claiming to be against weight stigma while selling “anti-ob*sity medication.” (If you replace “ob*sity” with “higher-weight people existing” the stigma becomes very clear.)

Another piece of this is the claim that it’s not about size, but about health. If that were true, they wouldn’t be studying and reporting on weight loss. If the interventions treat hypertension or type 2 diabetes, they  should  be called hypertension or type 2 diabetes interventions - not “weight management" or “anti-ob*sity” interventions.

Jin is exactly right that I continue to use terms like diet drugs and weight loss surgery intentionally. The weight loss industry is so good at marketing and spin that they’ve created exponential profit increases, now up to now $90 billion dollars in 2023 (and that’s just in the US!) with a product that doesn’t work to create long-term, significant weight loss and never has. I want to do what I can in my corner of the world to push back against that marketing and spin by, at the very least, not repeating it.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.