The Other Side of the Obesity Epidemic

This article is written by Erec Smith, assistant professor of English and director of Ursinus College’s Center for Writing. He is a co-editor and contributor to the forthcoming book, The Making of Barack Obama: The Politics of Persuasion. His recent essay, “Making Room for Fat Studies in Writing Center Theory and Practice,” can be read in the journal Praxis: A Writing Center Journal. His interests lie in writing pedagogy and rhetorics of diversity.


In the Fall of 2012, Ursinus Magazine took on the very timely topic of childhood obesity. The magazine’s cover story, “Keep Moving: Ursinus Alumni and Faculty Work to Bring Attention to Childhood Obesity” presented the noble goal of creating healthier lifestyles for America’s youth.

Erec Smith

Erec Smith, assistant professor of English and director of Ursinus College’s Center for Writing

Correlating children’s appearances with their probable lifestyles, the article equated size with health. However, it did not take into consideration movements that counter the more moralistic and aesthetic implications of initiatives like Michelle Obama’s “Let’s Move” Campaign or those movements that expose research on weight/health correlations as inconclusive, at best.  There is even an academic field, Fat Studies, which explores these issues. In this piece, I want to draw attention to the other side of the obesity epidemic to let people know that there is, indeed, another side. I hope you will explore this side for yourself and come to your own conclusions.

Fat Studies is an interdisciplinary field of scholarship dedicated to the critique of the information and common beliefs about fat and fat people. This field is growing rapidly and seems as important from an activist’s perspective as it is from a scholar’s. Organizations like the National Association for the Advancement of Fat Acceptance (NAAFA) combine scholarship and activism to support fat people in all aspects of their lives, from living healthily to dealing with an anti-fat society. Scholarly texts like the Fat Studies journal and The Fat Studies Reader are working to promote awareness and solidify the place of fat studies in academia. Books like Paul Campos’ The Obesity Epidemic, Peter Stearns’ Fat History, and Amy Farrell’s Fat Shame are just a few of the texts that discuss the nature and rhetoric of fat stigmatization and the connection to other modes of discrimination.

I am sure that many people involved in the “Keep Moving” article do not condone the mistreatment of fat people, but they may still insist that a certain amount of weight is simply unhealthy. However, there are health care professionals who insist certain weight and health correlations do not have the strict cause and effect relationship we are told to believe. What’s more, there is little clarity about the definition of “fat.”  Both professionals and laypeople rarely provide a clear definition of a healthy weight and the Body Mass Index used to determine who is and who is not fat has been questioned, if not completely debunked, by medical professionals.

In Health at Every Size: The Surprising Truth About Your Weight, nutritionist and physiologist Linda Bacon concludes that there is no real proof that losing weight automatically prolongs life. She writes “While it is clear that research indicates a short-term improvement in health risk factors with weight loss, no randomized clinical studies have observed the long-term effects of weight loss.” Bacon even finds fallacious cause and effect relationships between weight and conditions like type-2 diabetes. (High levels of insulin may be a cause of weight gain, not its effect.) Bacon concludes that a Health at Every Size (HAES) approach is best, citing research that classifies fat people as fit based on performance in standard fitness tests. In collaboration with The Association of Size Diversity and Health, Bacon has created a HAES fact sheet, available online at https://www.sizediversityandhealth.org/content.asp?id=161.

The hot topic at the moment among “fat activists,” as it is in the “Keep Moving” article, is the issue of childhood obesity. The First Lady’s “Let’s Move” campaign, along with the fact that children are now featured on the television show The Biggest Loser, has put fat children in the spotlight. I see no definite stigmatization from Ursinus Magazine’s authors and contributors. However, I still think it imperative for us all to be careful about how we word our preferment of childhood health. The article features children of all sizes and encourages fitness for all. This is good. However, the focus on childhood obesity, seen in the article’s full title as well as the cover of the magazine, suggests that only the kids deemed overweight are the problem, while kids of a “healthy weight” need not worry so much. From a HAES point of view, fitness, itself, is the goal. Losing weight is a possible byproduct of this, but not a definite marker. In fact, a child who isn’t considered fat can still be out of shape due to an unhealthy lifestyle. As activist Marilyn Wann says in the preface to The Fat Studies Reader, “The only thing that anyone can diagnose, with any certainty, by looking at a fat person, is their own level of stereotype and prejudice toward fat people.”

Let me reiterate that my main purpose is to inform people that alternative approaches to what is called “the obesity epidemic” exist and are thriving. I am no scientist or medical professional. My goal is to see that all sides of this issue are voiced. Please look into Fat Studies, fat activism and HAES on your own and come to your own conclusions.

18 thoughts on “The Other Side of the Obesity Epidemic

  1. Thank you for bringing another view to the topic of obesity. It is certainly more complex than many people realize.

  2. Well said. It is time for some sanity on this issue. Institutions like Ursinus should jump OFF the fat panic bandwagon and support the work of scholars like Dr. Smith!

  3. Excellent points you raise, Erec. Thanks for speaking out and raising the level of discourse. I’d also like to give people a heads to an article that provides an academic review of the weight/health issues and makes a strong argument for the ethical need to switch our emphasis from weight to health. It’s called Weight Science: Evaluating the Evidence for a Paradigm Shift and can be found here: http://www.nutritionj.com/content/10/1/9. Thanks again for such a thoughtful article.

  4. I am a novelist, not an academic, but I am saddened by the cultural implications that arise when fat people are stereotyped and then disrespected and dismissed simply on the basis of appearance.

    The viciousness of the stigma attached to fat and the many negative traits attributed to fat people are prejudice plain and simple. Arguments taken for granted that “fat is per se unhealthy” rarely have any connection with actual scientific research. I see this as a clear example of the famous “Big Lie” which takes on a fake reality based on repetition.

    Worst of all is the victimization of the most innocent of us all. Rather than being given supportive encouragement and empowerment. our current culture chooses to make self esteem for fat children conditional upon their losing weight–an endeavor that has a 98% failure rate for people of any age. The sanctioning and promotion of bullying children “for their own good” makes me angriest of all. Thank you, Erec Smith, for speaking out in favor of actual rational thought on these matters and for encouraging others to do so.

  5. Great rebuttal, Erec, and I agree with you wholeheartedly.
    Focusing on the “obesity epidemic” does a disservice to all people. Trying to come up with programs that will turn fat people into thin people ignores thinner people who are sedentary and don’t eat a healthy range of foods. Concentrating on trying to make fat people thinner ignores health and focuses instead on aesthetics. What these programs should be focusing on is all people, no matter what their size happens to be. Reach out to everyone with the message that adding movement to your life, movement that you enjoy doing and will continue to do for the rest of your life will not only make you feel better, but may also improve all of those metabolic markers that doctors like to look at and say “This means you’re healthy.” Reach out to everyone and say that eating as wide a variety of foods as you can afford, can cook, and will continue to eat, in moderation, may also help improve those same metabolic markers.
    There are fat people who are fit and healthy, there are fat people who are not, but you can’t tell just by looking at a fat person into which category they fall. There are also thinner people who are unfit and unhealthy, and thinner people who are fit and healthy, but again, you cannot tell just by looking at them into which category they fall. And shaming or blaming, or bullying is not the way to motivate people to make healthy changes to their lives. Campaigns that target only fat people aren’t about improving health, they’re about telling fat people they aren’t “good” enough, that they need to change in order to be accepted as “normal” instead of some aberration. If it’s really all about “health”, then put the focus on improving health for everyone and leave weight out of the equation.

  6. Thank you, Erec for presenting “the other side” for people to consider. I would like to recommend the free NAAFA Child Advocacy ToolkitSM (CATK) to anyone that has contact with kids of all sizes.

    The NAAFA Child Advocacy Toolkit shows how Health At Every Size® takes the focus off weight and directs it to healthful eating and enjoyable movement. It addresses bullying, building positive self-image and eliminating stigmatization of large children. Additionally, the CATK lists resources available to parents and educators or caregivers for educational materials, curriculum and programming that is beneficial for all children. It can be found at:
    http://issuu.com/naafa/docs/naafa_childadvocacy2011combined_v04?viewMode=magazine&mode=embed

  7. It is easy to stigmatize large children, or those of larger stature who are older. However, to merely look at an individual and make negative judgements, says less about those who are attacked than those who are deeming them unacceptable. Moving and using our bodies to enjoy being physical beings can be a lovely experience. But when it is seen as an imperative, it takes the joy out of it. When we can accept that there are people of all sizes and that is an acceptable norm, then we have more room to be ourselves at any size,

  8. Dr. Smith’s article is filled with good information and I was glad to read it. And I congratulate Ursinus Magazine for publishing it. I have read so much evidence across the intellectual disciplines that question and/or overturn the commonly accepted opinions about the dangers of obesity that it is long past due time for the “other side” to be publicized with at least as much prominence as the “obesity is bad” information. Since the anti-obesity or bariatric or diet megaindustry is so incredibly financially rewarding (latest figures posit something like $66 billion profit in 2010) and since that industry finances so much of the research that concludes that what is called obesity is bad, unhealthy, etc. it is difficult to take seriously the meme. I hope Dr. Smith’s article opens some minds.

  9. Thank you, Professor Smith, for calling attention to the other ways of thinking about weight and health. I recently read sociologist Abigail Saguy’s new book, “What’s Wrong with Fat?” and found it really helpful in laying out the different arguments and stakeholders. I hope the community accepts your invitation to explore the topic!

  10. Excellent article! Thank you for writing about HAES and size acceptance. I’ve been a member of NAAFA for 35 years. I still hope that the fact that weight loss is usually temporary and leads to longterm weight gain will someday be accepted in the mainstream. The $66 billion weight loss industry doesn’t want us to know that body size isn’t as changeable as we think it is. For most fat people, being fat is not a choice. We can eat right and exercise and still be fat. What fat people need is not more shame or efforts to change us. What we need is acceptance and health at every size. Thank you for writing about our side of the story.

  11. Great reply article, Erec. I appreciate your work. I have read Linda Bacon’s book and have found it to be right on. I took 30 years to research ‘why am I fat when I dont eat much’. I wrote a book about it, Fatology 101, (you can find it on amazon) and came to the same conclusions as others who have written books and articles about obesity. Although I come from it at a different angle that fat activists, I feel it is very important to understand why we are fat. My hope is that if science and society understands it, then maybe being fat wont be considered a “sin” and we will be treated with the respect we deserve.

  12. This is so important. To say how epidemic this is cannot be stressed enough. I spoke on my own stigma around this from childhood to present at http://www.TEDxWomen.org/2012. I still found myself playing old tapes from fat phobia messages in my mind while reading this even though I know this is truth. Keep educating please children’s hearts and minds are at stake.

  13. This is a very thought-provoking article, Erec, and you might be interested to know that there is currently a bit of an academic tug of war taking place between one historian writing about England’s 17th-century Queen Anne — known for her “largeness” in contemporary and historical myth and documentation — in the context of Fat Studies and others who contest the context. So even dusty old history is having to consider multiple sides of the issue…!

  14. I’m glad that more people are open to the idea that weight is a number and not a diagnostic tool. As a small child, I had dangerously bad triglyceride levels. I was skinny, so my doctor never investigated. Now, I have full-blown liver disease and am fat. I had to get fat before anybody would take my triglyceride problem seriously. Focus on that one arbitrary number wrecked my health.

  15. You make a lot of claims about current findings overturning previous findings and challenge a lot of things that I have taken to be common knowledge. I think this could be made a lot stronger by providing academic sources for your claims. I am a researcher in engineering so I don’t know what the current research is in this field, but I do know not to take claims going against commonly held believes without some form of reviewed research to back it up.

  16. Thank you to Dr. Erec Smith for his response to the Ursinus Magazine article written on Childhood Obesity. I especially appreciate his statements, which encourage the readers to “come to [their] own conclusions.” I think a point needs to be made in reference to the popular media’s stance and portrayal of these issues rather than an alumni magazine highlighting the work of dedicated professionals.
    Childhood obesity is an important issue that cannot be described with sweeping statements and sound bites that are often overused by popular media, as Dr. Smith also points out. That being said, I do want to address a few points raised in his rebuttal. In his statements, he highlights the idea that obesity in itself is not the issue, and I agree, yes you can indeed be “fat and fit,” but that is the exception to the rule. Prevention of obesity and interventions to minimize obesity in children are not futile efforts, nor do health care providers who work in this arena equate size with health. Dr. Smith points readers to various texts including the article by Bacon and Aphramor, which raises interesting points citing weak scientific evidence linking weight and mortality. The main thrust of the article is the lack of a correlation between being overweight and disease progression. There is little mention of the consequences of obesity. Also, I think it is very important to note that these articles focus on adults. There is a scarcity of literature on the prevalence of childhood obesity and the risks for lifelong chronic disease. A significant example of this is how Type 2 diabetes no longer carries the terminology adult onset diabetes, due to the younger population it now affects. The children that I see struggling with obesity suffer far more serious issues than the numbers on the scale including being bullied, succumbing to social pressures, and the development of poor lifelong eating and fitness habits. The very approaches supported by Dr. Smith are used in everyday practice; teaching children that food is nourishment to fuel the body and exercise is medicine.
    As a scientist and health care provider, I can tell you that weight loss is never my primary goal. I am most concerned with health, which was so aptly pointed out by Dr. Smith. It is well established in the literature that a sedentary lifestyle leads to chronic disease; therefore we need to develop safe and effective methods for all children to exercise, which sometimes means losing weight. Every day I see children in my practice who want to play and exercise but cannot due to the pain they experience due to excessive ligament laxity, joint malalignment, and skin friction all caused by excessive weight. I also want to alert readers to the many other measurements used besides BMI to assess health in children with obesity which include waist/hip circumference, cardiovascular fitness, insulin resistance, and muscular strength/endurance. Dr. Smith also brings to light an important point that we need to worry about kids of all sizes, which I emphatically support. The recess study I developed is for every child at the elementary school. I have high hopes that it might impact those children who do struggle with obesity, but it is geared at getting all children to engage in vigorous activity and to minimize sedentary behaviors.

    My intent is not for us to “talk past each other”. Dr. Smith’s comments help us engage in non-conventional thinking, which is needed when faced with a problem of such gravity. Instead of taking one side or the other, perhaps we should more effectively work together; this is a multi-faceted problem that requires input from stakeholders across all aspects of our community.

  17. For those of you asking for research backing up the claims in this article, I provided a link with such information at the end of paragraph five: The Health at Every Size fact sheet. I will provide it again here: https://www.sizediversityandhealth.org/content.asp?id=161.

    Also, each of the books referenced in this article provide this information. Unfortunately, I could only do so much in a rebuttal of limited space, but I invite you to visit these materials on your own time.

    Thanks.

    Thank you.

  18. Health to Michelle Obama constitutes of both internal and physical, both diet and the mental and emotional state. They are all interrelated in a way. Throughout her life, she had been privileged of making the perfect choices for herself, and she considers herself fortunatefor this. Even her husband encouraged her everytime to figure out what she actually wanted to do, as they both understood the simple fact that physical happiness is connected to all the components of a healthy lifestyle, and hence she wants to pass on these concepts to her daughters. ^..–