What Cis-Male Pattern Baldness Can Teach Us About Weight Science

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One of the most common arguments for the weight-loss paradigm is that being higher weight is corelated with many health issues, and so body size must be the problem and weight loss must be the answer.

We can learn how wrong that thinking can be by looking at “male” pattern baldness (with a note that diagnoses created on the gender binary create issues for trans and nonbinary folks in terms of healthcare exclusion, stigma, diagnoses, treatments)

“Male” pattern baldness is highly correlated with increased risk of cardiac incidents. Appropriately, research has been undertaken to determine what factor(s) may causes both outcomes.

But imagine for a moment if science and healthcare had stopped before doing that research and simply determined that since the primary risk factor was baldness, the solution was for those folks to grow hair so that they could have the same health outcomes as those who had never been bald.

Imagine that the hair growth industry realized the profit potential of claiming that growing hair was, in fact, necessary for heart health. They might fund studies (perhaps with pretty dubious methods) that would show how much bald people cost the healthcare industry and society. They would foment blaming and shaming of anyone who didn’t pay them to try to grow hair. And if their products failed the majority of the time, they would sell progressively more dangerous and expensive products, all the while claiming that bald people have a “personal responsibility” to grow hair so that they their healthcare doesn’t cost so much.

Soon there might be a government-sponsored “War on Baldness” and billions of dollars would be earmarked for “public heath” campaigns that shamed bald people for their health issues, and billions more would be earmarked only for research that studies hair growth (and not research that, for example, studies how to lower the rates of cardiac incidents in people who are bald.)

Let’s say it turns out that the stress of the stigma they experience (a stigma that I want to note is real in the world outside of this hypothetical due to stereotypes of beauty), the side effects of the treatments, and the lack of healthcare they get (because doctors are only focused on helping them grow hair,) are all shown to actually increase their rates of cardiac incidents.

But this idea that growing hair is the solution has become an accepted belief, and there is an industry making, oh, let’s say $70 Billion a year selling hair regrowth that almost never works long-term, and they have wheedled their way onto healthcare organization boards, and they created a Board Certification around “Baldness Medicine” that is predicated on that idea that it is worth risking the lives and quality of lives of bald people in an effort to get them to grow hair. So instead of admitting that they’ve gone a long way down a bad road and harmed a lot of people, they claim that the failure to grow hair, and the subsequent health issues, are actually bald people’s fault because they don’t try hard enough and/or aren’t willing to risk their lives and quality of life. Doctors believe it, the general public believes it, and pretty soon bald people themselves begin to believe it.

Welcome to the current situation of healthcare for fat people. A huge part of what is considered “healthcare” is based on the completely unproven, but staggeringly profitable, belief that if you make fat people look like thin people, they will have the same health outcomes. The rest of the “anti-ob*sity” fruit grows from that poison tree.

The fact that correlation cannot be substituted for causation is one of the most basic principles of research (which has been all but abandoned in weight science.)

Research since at least the 1950’s has shown that weight loss attempts fail the vast majority of the time, and up to 66% of the time result in long-term weight increase! (There’s nothing wrong with being fat or fatter, there is something wrong with a so-called “healthcare intervention” that fails about 95% of the time and has the opposite of the intended effect that majority of the time.)

You know what’s more effective than weight loss attempts for improving fat people’s health? Pretty much anything, or nothing. Seriously, the weight cycling that is the most common outcome of two or more weight loss attempts has been linked to significant harm to health, so doing nothing could actually be better. But there are things we can do - like bringing down barriers to health (including stigma and oppression, creating greater access, improving social determinants of health, and shifting the focus from manipulating fat people’s bodies to supporting their actual health, while understanding that health is an amorphous concept and is not an obligation, barometer of worthiness, or entirely within our control.)

The harm that is done to fat people in the name of “healthcare” is indefensible and unforgivable. It must stop. It is time to admit that we’ve gone a long way down a bad road and we must, must, must, turn back immediately.

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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.