The Nuance

Our Obsession With Body Size Is a Threat to Public Health

Anti-fat bias and weight-loss fixation — including among doctors — is a problem that must be remedied

Markham Heid
Elemental
Published in
5 min readMar 26, 2021

--

Kieran Blakey for Elemental

The study’s findings were surprising, even to its organizers.

Led by researchers at the CDC and the National Cancer Institute, the study examined roughly 30 years of data collected from tens of thousands of Americans. Its purpose was to identify associations between body mass index (BMI) and excess mortality. Its findings, which were published in JAMA in 2005, revealed that adults who were overweight were at no greater risk of death than those who fell into the “normal” BMI range. People with BMIs in the obese range were at increased risk of death, but so too — albeit to a lesser extent — were people categorized as underweight.

“Being overweight was associated with lower mortality than being underweight, which we didn’t expect to find,” says Katherine Flegal, PhD, first author of that study and a former senior scientist at the CDC. “Later we did this whole meta-analysis, and we found that this was actually a very common finding” — that being overweight was not associated with any kind of increased health risk — “but that researchers tended to tuck this away so that it was hard to find.”

Too often, heavy bodies are reflexively labeled as sick bodies, and people are led to believe that the only way to be healthy is to be slim.

The association between large bodies and poor health is deeply enmeshed in American culture. This association is not baseless; there is a lot of evidence linking obesity, and especially severe obesity, with an increased risk for a variety of medical problems. But experts say that, too often, heavy bodies are reflexively labeled as sick bodies, and people are led to believe that the only way to be healthy is to be slim.

“This fixation on BMI and weight loss is overemphasized, and I think it contributes to fat-shaming and stigma and misperceptions,” says Flegal, who is now a consulting professor at Stanford University. She explains that BMI is a blunt and often misleading…

--

--

Markham Heid
Elemental

I’m a long-time contributor at TIME and other media orgs. I write mostly about health. I grew up in Michigan, but these days I live in southwest Germany.