The Obesity Epidemic: The Bigger Picture

As an eating disorder survivor, the body positivity movement saved my life. After years of only seeing thin, white models walking down the runway, the movement showed my 16-year-old self that bodies have fat, curves, and come in all shapes and sizes.

However, not everyone feels the same way about the movement. After the release of a documentary titled “Speaking Frankly: Fat Shaming” as shared by CBS News, critics argue that the body positivity movement contributes to the obesity epidemic.1 In the documentary, one woman suggests that obesity is a result of individual behavior, stating, “I don’t celebrate anybody doing anything that compromises their health”.1 This reductionist view equates individual action with one’s health; in reality, a multitude of factors impact one’s weight that is beyond an individual’s control. The obesity epidemic’s hyper focus on willpower and decision-making creates a weight stigma that actually perpetuates the epidemic itself.2 Research has shown that fat-shaming is ineffective and actually leads to poorer physical health outcomes.3 If we are to combat the rise of obesity in America, the body positivity movement opens the gates to explore multiple levels of influence on weight: interpersonal, intrapersonal, organizational, community, and policy.4

Currently, the idea that an individual is solely responsible for their weight only explores interpersonal and intrapersonal factors of weight gain. Obesity is a valid concern to public health: obesity rates have increased steadily over the past several decades.5 Further, there is some control a person exhibits on their decision-making which is often influenced by their own self-efficacy and the social support of the people around them. However, that doesn’t tell us the full story: examining the community level highlights how the built environment promotes healthy eating and exercise. At this level, celebrating one’s body allows us to break down social norms. As described by the woman who defended body positivity, engaging in healthy behaviors can be an “alienating” experience for fat people; in her case, the yoga space rarely ever had other fat women who were practicing yoga.1 This social norm can deter people in larger bodies from engaging in this healthy behavior.3 Without a call for body positivity, how can we deconstruct this norm?

The exclusion of larger bodies continues beyond the fitness space. Patients who are overweight and obese are less likely to be taken seriously when receiving healthcare.2 Many of their ailments are attributed to excess weight which deters them from getting the medical care that they need. Shaming people and reducing them to their weight status is not conducive to combating the obesity epidemic; in fact, it’s discriminatory. This leads to the most macro-level lens of an ecological perspective: do the policies we currently have in place promote a healthy lifestyle? From subsidies for processed foods to an abundance of fast-food restaurants, I argue that the current American environment is obesogenic. If the environment we create sets people up for failure, then we cannot blame the individual for their choices.

Instead, I urge readers to practice Health at Every Size (HAES). While taking both principles of the body positivity movement and obesity concerns into account, HAES considers a weight-neutral approach to health.6 Unlike the body positivity movement whose basis is not explicitly in health, HAES argues that health can belong to any body. Consequently, acts of practicing health intend to improve the outcomes of the individual while decentering weight. Weight loss may be a byproduct of a healthy lifestyle, but it is not the focus.

Eliminating weight stigma improves the livelihoods of all people, regardless of body size. Not only does stigma deter overweight people from making a healthy behavior change, but it can also perpetuate fear around gaining weight in the existing healthy-weight population. Using weight as a proxy for health makes too many assumptions about one individual; to improve obesity in America, we must take an ecological approach for effective interventions.

Reference List

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1.        CBS News. The debate about body positivity during America’s ongoing obesity epidemic. Published online 2020.

2.        Tomiyama AJ, Carr D, Granberg EM, et al. How and why weight stigma drives the obesity “epidemic” and harms health. BMC Med. 2018;16(1):1-6. doi:10.1186/s12916-018-1116-5

3.        Hunger JM, Major B, Blodorn A, Miller CT. Weighed Down by Stigma: How Weight-Based Social Identity Threat Contributes to Weight Gain and Poor Health. Soc Personal Psychol Compass. 2015;9(6):255-268. doi:10.1111/spc3.12172

4.        Mcleroy KR, Bibeau D, Steckler A, Glanz K. An Ecological Perspective on Health Promotion Programs. Heal Educ Behav. 1988;15(4):351-377. doi:10.1177/109019818801500401

5.        Hales CM, Carroll MD, Fryar CD, Ogden CL, Ph D. Prevalence of Obesity and Severe Obesity among Adults :; 2020. https://www.cdc.gov/nchs/products/index.htm.

6.        Penney TL, Kirk SFL. The Health at Every Size paradigm and obesity: Missing empirical evidence may help push the reframing obesity debate forward. Am J Public Health. 2015;105(5):e38-e42. doi:10.2105/AJPH.2015.302552

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