How to talk about bodyweight
Whenever I tackle any issue related to obesity/overweight I find myself needing to define what I am and what I am not talking about.
The truth is - although the issue has its basis in scientific and medical research - in reality it is a complex mix of science, medicine, culture, fashion and personal experience that can stop us from being able to talk about the issue objectively. This is understandable and, as such, it is important to imbue honest discussions about weight management with empathy.
My goal is to get to a point where we have shed unhelpful cultural stigmas attached to bodyweight that will allow honest discussions to continue that will improve the health of individuals and populations without getting bogged down by unnecessary baggage.
This article defines the principles that guide my research and writing when talking about this potentially volatile and emotional issue.
1 – What constitutes a healthy weight is defined by medical/scientific consensus.
Cultural & social expectations and fashion trends need to be separated from health in this context. Conflating them leads to confusion and misinformation.
Obesity is a complex and multifaceted illness with multiple, inextricable causes. The nature of our understanding of the disease is constantly evolving with new and better research. The fact that we do not yet fully understand obesity means we need more and better research. Social movements can have significant value, but they lose their merit when they deny scientific consensus.
On the other side of the debate, we should not allow what is considered healthy to be defined by what is currently fashionable - the two are often unrelated.
2 – What constitutes a healthy weight will vary both inter and intra individual.
This is why medical guidelines give healthy weight ranges with substantial room for inter-individual variance. Further to this it is well recognised that no single measure of weight gives an entirely accurate measure of individual health. For example, the body mass index (BMI) NHS guidelines are for a BMI of 18.5-24.9 - a significant range - that is often measured in conjunction with blood pressure, resting heart rate and waist circumference to give a more complete and accurate picture of overall health.
Further, what constitutes a healthy weight will differ for an individual in their own lifetime. The healthy body fat percentage of a woman post pregnancy will likely be different to her pre-pregnancy healthy body fat percentage. This seems obvious, but is often overlooked.
It is possible to be larger or smaller than someone else and be just as healthy - it will depend on various factors. Of course this has a natural limit, which is why the guidelines are in place. The same principles that dictate why being severely underweight is unhealthy dictate why being severely overweight is unhealthy.
3 – A person’s weight is the result of a complex interaction of behavioural, genetic and environmental factors.
To say bodyweight/bodyfat is a modifiable physical characteristic is accurate – but only to a certain extent. We can control our behaviour, yes. But we cannot control our genes and can only influence our environment to a limited degree - sometimes not at all.
As with many aspects of life, to assume we are all on an equal footing with regards to bodyweight displays a lack of understanding of the scientific evidence and nature of the disease. This is why fat shaming or any blame/guilt associated with over/underweight is ignorant and generally unhelpful.
4 – The obesity epidemic is a very real, very significant issue.
I won’t go into grim detail about the significance of the obesity epidemic here, save to say it is now recognised as the world’s leading cause of preventable death. With much suffering, disability, pain and financial cost flowing from this reality.
The fact that this issue is increasing in number and significance suggests that it must be dealt with at a macro level – with significant changes to policy and industry. Yes, personal choice and responsibility are major contributing factors. However, those who are living in environmental conditions that easily facilitate obesity/overweight need to be assisted through external means.
All research and discussion in relation to obesity/overweight must be had in the context of knowledge of the tremendous and devastating impact of the global obesity epidemic.
I respect and recognise the value of social movements such as body positivity that recognise the foolishness of fat shaming and emphasise right to be happy and confident in any body size. But they are not always entirely beneficial. Concurrently with these benefits follows an unhelpful trend where some adherents fail to acknowledge the magnitude of the obesity epidemic or deny it outright. This is dangerous, irresponsible and unethical.
5 – The value of a person is not intrinsically linked to their weight.
I feel this, in some ways, is the major issue. If we can untie the perception of overweight individuals being at fault, lazy, greedy etc – all of which are generally untrue – we would be able to talk about obesity more honestly and from scientific principles without the conversation becoming over personal and distorted by emotion and anecdote. (I only say ‘generally' untrue as opposed to ‘completely’ untrue as a concession that it is, of course, possible to become overweight through a combination of greed and laziness. But I clarify that this is rarely the case).
I believe many people get stuck at a certain weight by becoming bound to it socially. The jolly, fun, fat guy has to stay that way - he couldn’t still be jolly and fun if he lost weight, right? The same is noticeable for those that advocate for fat acceptance. A cause with some merit, but one that can easily bind someone to a bodyweight that is medically unhealthy; lest they be labelled a traitor to the cause.
If you develop a personality, or indeed a career, around the fact that you are overweight how open can you really be to the reality of the significance of the disease? When research emerges that reveals obesity as major risk factor for Covid-19, are you likely to integrate the new information or simply dismiss it and continue beating the drum for health at any size? When the time comes that this impacts your health (not definite, but likely) what will your reaction be to the diagnosis?
Of course you have the right to be ‘fat and happy’ - just as you have the right to have any disease or illness and be happy - but you don’t need to be tied to it. Your weight is an unimportant and not particularly interesting part of who you are.
We attach too much significance to bodyweight culturally. In reality it tells you nothing about a person, their personality or their worth.
You are the same person, with the same value, regardless of the number on the scale. Yes, your weight and general health are linked. But being bigger doesn’t make you any ‘worse’ than being smaller makes you any ‘better.’ We don’t think this about any other disease - we should treat obesity/overweight the same way. It is an illness that should be addressed and treated, not a character flaw to be judged.
Feed the life you want to lead,
Duncan