The Vague Future Health Threat Mistake

Avoid the VFHT

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The Vague Future Health Threat (VFHT) is something I originally wrote about more than a decade ago. But it came up on my Instagram feed today and so I decided to write about it here.

The VFHT sounds something like this: “Well, you might not have [health condition that someone associates with being fat*] now, but being fat will catch up to you someday”.  This can come from anyone, from internet trolls, to friends and family, to healthcare practitioners. Many people believe this is a rock-solid argument against weight-neutral health.

Those people are wrong. The VFHT is problematic, logically-challenged, scientifically unsupported, and annoying for the following reasons:

1. Adding healthism to fatphobia does not make it a better look. People of all sizes have and get health issues. Health issues are common with aging. The fact that a fat person gets a health issue doesn’t mean that it was caused by their body size, or that they wouldn’t have developed it if they were thin. Most importantly, health issues should never be used to threaten, taunt, or insult someone.

2. I have a rule – if you’re going to act like you’re psychic, cough up some lottery number or leave me alone.

3.  Everyone is going to die. There is a 100% chance. Many people, of all sizes, will get health issues along the way. We live in a culture where, for fat people, anything and everything gets blamed on our body size, even though thin people get the same health issues. Were I to die because a piano being carried through the air by a flock of flying alien flamingos was dropped on my head, the coroner’s report would call me “morbidly” fat, and some researcher would come along, count my death as “death by fat,” charge all of my crush injury medical expenses to my fatness and include it in a paper about the high medical cost of fat people existing.

That doesn’t make it true.  This “it will catch up to you” claim is not supported by the science, but it does support the diet industry’s mission of selling their wares and covering up the fact that research makes it clear that (understanding that health is not an obligation, barometer of worthiness, or entirely within our control,) health-supporting behaviors are a much better predictor of current and future health than body size, and create far less risk.

And, again, healthism is wrong on its own and is not a valid justification for fatphobia.

4.  Speaking of the lottery. What if I changed the rules of the lottery so that if you lost, in addition to the original cost of the ticket, you had to pay money to the lottery as a penalty?  Now not only is your chance of winning infinitesimally small, but there is a near 100% chance that you’ll end up with LESS money than you had after you bought the ticket.  Would you play?

Now imagine that this isn’t your money we’re talking about – it’s your long-term health.  There is not a single study that proves that any intentional weight loss method is effective long-term at making people thinner or healthier (which are two different things,) but many studies indicate that the weight cycling (yo-yo dieting) that is the most common outcome of intentional weight loss attempts harms our health. Since diets have such an abysmal failure rate, with almost everyone losing weight in the beginning and then gaining it all back within 2-5 years, and up to 2/3 of people gaining back more than they lost (and, as always, there’s nothing wrong with being fat or getting fatter, there is something wrong with health-shaming fat people into a “healthcare intervention” that has the opposite of the intended effect the majority of the time.)

So if the VFHT has its intended effect and someone responds to it with an attempt at intentional weight loss, the almost certain outcome is weight cycling (again) which puts their health at risk. Or if they turn to weight loss surgery or diet drugs, they risk their life and quality of life. All on the healthcare equivalent of a Powerball ticket that was obviously a losing bet from the beginning. Adding insult to all of this injury, wielders of the VFHT will then blame any health issues that the weight cycling, drugs and/or surgeries create on their body size.

The person VFHTing us is asking that we do something they can’t prove is possible, for a reason they can’t prove is valid, with a very high percentage that we’ll end up less healthy in the end.  Hard pass.

People of all sizes have health issues now, and will develop them in the future. Those people deserve ethical, evidence-based, blame-free, shame-free care. In the present everyone deserves access to health-supporting things (including thriving wage, social connection, sleep, food, movement options etc.) without barriers (including socioeconomic factors as well as shame, stigma, bullying, or oppression.) Nobody needs a VFHT.

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More Research

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