What public health worsens by focusing on weight

on nutrition

As I was pursuing my master’s degree in public health a decade ago, I observed a certain level of hypocrisy. On the one hand, our eyes were open to the social determinants of health – which The Centers for Disease Control and Prevention defines “Conditions in the places where people live, learn, work and play that affect a wide range of risks and consequences for health and quality of life.” On the other hand, we were lectured on the “obesity epidemic” and encouraging obese people to eat less and move more would make them thinner and healthier. (I’m using fat as a neutral descriptor, like short, tall, or skinny).

Never mind that this form of “personal responsibility” rhetoric is suspect at best. For example, A panel of experts convened by the National Institutes of Health in 1992 It has been determined that when people intentionally lose weight, “one-third to two-thirds of the weight regains within one year, and nearly all is regained within five years.” 2007 review by UCLA researchers found that one to two-thirds of dieters gain more weight than they lose, and “there is little support for the notion that the diet leads to permanent weight loss or health benefits.”

I’ve heard more than one public health expert admit it all, then say something like, “Well, we still need to encourage people to keep trying.” Perhaps the case for CDC researcher Katherine Flegel, who in 2005 found herself on the receiving end of an aggressive smear campaign by a prestigious school of public health after publishing research, concluded that there are fewer additional deaths than being “overweight.” was linked to “Normal Weight. She details these attacks in her 2021 article,”The obesity war and a researcher’s education: a personal account,

Over the years, governments and public health departments have created “anti-obesity” task forces and public health campaigns. Unfortunately, these efforts have been more harmful than helpful, as the stigmatized messaging used in many of these campaigns has fueled anti-fat bias – or weight stigma – in all corners of society.

In their 2018 paper, “What’s Wrong with the ‘War on Obesity’?Public health researchers Lily O’Hara and Jane Taylor wrote, “In a bitter twist of irony, there is evidence of a direct causal pathway from stigma to weight gain, with or without a change in eating behavior as a mediator. , which shows that … an atmosphere of fat hatred makes people fat.”

Experiencing an anti-fat bias elevates levels of the stress hormone cortisol, which contributes to weight gain but directly harms health. Whereas the “War on Obesity” Can Affect Everyone by Encouraging Shame being fat or scared becoming Fat, the greatest harm comes to those who are already fat and experience hostility, discrimination, and harassment while navigating a physical environment designed for thin people. If you identify as a woman, as low-income, as disabled, or as a member of another marginalized group, these effects are magnified, resulting in greater inequalities in health.

Fortunately, there are signs of change. There is a brief description of a policy titled “Public health needs to reduce weight and healthfrom the University of Illinois Chicago School of Public Health Collaborative for Health Justice, which states, “If the goal is to find the most ethical and effective strategies for achieving optimal public health, there should be an alternative to ‘obesity’ and a weight-focused approach.” and a change in the understanding of weight stigma as a social justice issue.”

That’s right. Weight stigma, or anti-obesity, is a social justice issue. full stop.

Leave a Comment

%d bloggers like this: