No, We Shouldn't "Try Anything For The Obesity Epidemic”

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I was tagged into a conversation on LinkedIn wherein someone who identified himself as a “Senior Strategist, Direct-to-Employer (D2E); On-Site Direct Primary Care; MEDai Population Health Predictive Modeling Analyst” responded to a discussion about how a weight loss study was devoid of good science or sound research methods by saying (content note in the ensuing quote for anti-fat diet talk):

“I get it…but all ideas on the table at this point. The swelling of America continues. Intermittent fasting, Mediterranean diet, veg head diet, portion control, eat the rainbow, food as medicine, restricted eating, whatever works for someone when they're ready. Try something, anything!”

First of all, if you refer to fat people existing as “the swelling of America” then I would suggest that your voice is absolutely not needed in this conversation at all. Fat people existing is simply not an epidemic, and the only people helped by this manufactured concept are those profiting from it. Still, the argument this guy is making is at the center of the trend, both in commercial diet programs and in much of the healthcare industry, to foist interventions on fat people with little (or no) research on their long-term efficacy or harm.

The weight loss industry (including within healthcare) has long been involved in a process of churning out research (often of dubious merit) “linking” being higher-weight to health issues, and then taking advantage of people’s ignorance (or lack of care) for the difference between correlation vs causation to make the case that being fat is “linked” to so many health issues that there should be an incredibly low evidence threshold for interventions to “treat” fatness.  

Despite the fact that the research doesn’t show that weight actually causes these health issues or that weight loss would solve them, they successfully created a narrative that being fat is so terrible that any intervention, however unlikely to succeed, however miserable, however potentially harmful, is worth trying. This has driven massive profit to the weight loss industry (again, including within healthcare, especially so-called “ob*sity medicine”) and massive suffering and harm to fat patients. And now dudes like this one on LinkedIn parrot it back and use it as an excuse to insist that anyone who has an idea should get to experiment on fat people (often without their consent.)

This is particularly frustrating because the people making this “try anything” argument typically refuse to even engage with all of the evidence that shows that a weight-neutral health paradigm offers greater benefits with fewer risks. So, it’s not even really trying “everything,” and some of them seem downright eager for ideas that come with the most suffering. Starve us, mutilate our digestive systems, give us drugs with dangerous side effects and no long-term data etc.  Some of these people may be well-meaning, but at some point I have to wonder if they just think fat people deserve to be punished for being fat. It’s the “Biggest Loser” approach that fat people deserve to be physically and mentally abused.

What this argument boils down to is “Fat people don’t deserve ethical, evidence-based healthcare. Fat people should have their lives and quality of life put at risk with any and all interventions, with or without evidence, unless or until they become thin, or die trying.” This is not an ethically defensible position, but it’s a horrifyingly common one.

Fat people deserve better than being unwitting subjects in (highly profitable) medical experiments. Fat people deserve compassionate, ethical, evidence-based healthcare that is focused on supporting our bodies, not eradicating them. There is no “ob*sity epidemic” but there are weight stigma, weight cycling, and healthcare inequality epidemics and those actually do harm and kill fat people.

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*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’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.