There’s yet another study that claims to prove that you can’t maintain a fat body and “good health” (at least by one definition of health.) There are a bunch of problems with the study and the way that it is being portrayed in the media. It uses BMI, it’s a tiny sample size, and they didn’t look at behaviors or fitness at all, the reporting about it treats correlation and causation as if they are the same thing.
The study looked at metabolic health markers over time, but didn’t look at behaviors. That’s a problem because the studies that do exist show that behaviors are a much better predictors of future health so it doesn’t make much sense to study body size and health without factoring in behaviors, but people just keep doing it – either because they don’t care since they know that it will get lots of attention without much scrutiny, or they are trying to get a specific set of results, or they’re incompetent, or who knows what.
Angela Meadows did a beautiful job of breaking down the science behind study here. What I want to talk about are the implications of doing this research, and the way that it is applied.
First let’s talk about what’s true about health. The truth is that health isn’t an obligation, a barometer of worthiness, entirely within our control, or guaranteed under any circumstances. What constitutes “healthy” has been repeatedly changed (including body size, metabolic health measures, and who is eligible for surgery etc.) after lobbying by companies who profit from those changed measurements.
Public Health should be about making true unbiased information and options available to the public, not making the individual’s health the public’s business.
In the United States “health” is a for-profit industry which means that the companies providing “healthcare” often have a primary fiduciary responsibility to their shareholders rather than the people who they are supposed to help. We also live in a society where “everybody knows” is treated as the same thing as evidence-based medicine such that true, unbiased information about health can be very difficult to find.
This kind of “you can’t be fit and fat” research and rhetoric is often used to justify “interventions” on fat people that either just don’t work, or don’t work and put our lives at risk, often by groups that pretend to be our advocates while making money hand over fist on these so-called healthcare interventions.
But perhaps the most insidious use of this so-called research about fat people and health is the way that it’s used to try to stop fat people from demanding to be treated with basic human respect. As if there’s some level of health at which people stop deserving that. (There’s not, just in case that wasn’t clear.)
The way it’s being used to insist that if it can somehow be proven that fat people are less healthy than thin people then it’s also proven that we are less worthy of basic human respect (we’re not, just in case it wasn’t clear.)
The way that it’s used to create a good fatty/bad fatty culture that tries to pit us against each other for scraps of decent treatment. The way that it’s used to promote sizeism, healthism, classism, ableism, and all of the intersections therein – like the idea that if fat people can be healthy then we should be required to be healthy to deserve to be treated well, or have the right to speak up for ourselves – that health should be a requirement for credibility in any discussion about Size Acceptance, or our right to make choices or ourselves.
From a personal perspective I’m interested in what the research says about health, from a Public Health perspective I’m interested in people having access true, unbiased information about health (and not at all interested in the choices they make). What is most important to me from a global perspective is that “health” is not used as a weapon in the ill-advised “war on obesity,” not used to try to bully fat people into accepting inappropriate treatment or forcing us to participate in experimental medicine. I want to be sure that health is not used as a barometer of worthiness or credibility.
When it comes to the treatment that we deserve – to our rights to basic human respect, life, liberty and the pursuit of happiness; to our rights to self-advocate and make our own choices, whether or not we can be fit and fat doesn’t actually matter at all.
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