11 Reasons Your Phony ‘Concern’ for Fat People’s Health Has Got to Stop

Person with their hand up to their ear, indicating, sarcastically, that they're listening

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“I’m just concerned about their health.”

“I’m a feminist, but I don’t think fat is a feminist issue.”

“I’m body-positive, but I don’t believe in glorifying obesity.”

“I think people of size deserve respect, but I think they’d find it easier if they were thin.”

“Studies have shown that obesity is the second leading cause of preventable death, so I can’t support that lifestyle.”

Stop.

Concern trolling – which is the act of a person participating “in a debate posing as an actual or potential ally who simply has concerns they need answered before they will ally themselves with a cause” – is something we see all too often, even on our very own Everyday Feminism Facebook page.

And most often, we get these sort of “But isn’t this freedom actually kinda dangerous for society?” comments on articles that we post about fat acceptance and body liberation.

And to be honest, it’s disheartening to see feminists – people who we generally trust to engage with content and have their status quo boundaries pushed – rush to quote sketchy research and throw oppressive ideologies around all in the name of, supposedly, “health.”

But when we live in a world that so desperately hates people of size (um, hello, “War on Obesity”), we completely understand how these prejudices turn into truths in our minds.

But because fatphobic concern trolling is oppressive (and, on a more personal note, makes us cringe), it’s time for us – all of us, but especially feminists – to stop.

And because we generally see fellow thin people making these comments, we wanted to call you all in to discuss why this behavior is so harmful.

So if you need a little bit more convincing before you give your fingers, poised and ready to go on your keyboard, a rest, here are eleven reasons why fatphobic concern trolling makes zero sense.

1. Because Stereotyped Assumptions About Someone’s Weight Are Oppressive

You claim to be worried about a fat person, and the first thing you think about is diabetes.

Okay.

What about the negative judgment that they’re subjected to from people – both from individuals and society as a whole – and the impact that has on their lives?

Think about what it must be like for larger people – that is, most people living in the United States – to confront daily in the papers, magazines, television shows, and commercials that their bodies are unattractive and constitute a horrifying public health crisis.

To hear assumptions from dietitians and other healthcare practitioners that because of a physical characteristic, their weight, they must be unhealthy and engaging in poor self-care.

To then have people on the Internet dedicating entire comment threads to berating them.

Everyone – fat or thin – is severely harmed by this message. And as social justice activists, it’s first and foremost your job to show empathy to marginalized folks – and then look inward to examine your unchallenged assumptions.

As Marilyn Wann famously says in her weight diversity talks, “The only thing anyone can accurately diagnose when looking at a fat person is their own level of weight prejudice.”

2. Because Fat Doesn’t Kill

There is a commonly quoted statistic that people allow to fuel the fat-shaming fire, and that is this: that “obesity” is the second leading cause of preventable death in the US.

Let’s burst that bubble right here: It’s not true.

And yes, of course if you Google it, a bunch of health organizations will come up, quoting it as fact. But here’s why: because a 2004 CDC-sponsored study stated that approximately 350,000 deaths per year are related to being “overweight” or “obese,” second only to smoking.

But in 2005, the same journal published a re-analysis with more scientifically accurate results, putting the number closer to 25,000 – a 94% difference.

But because it’s much easier to fear-monger by telling people they’re likely to die, the fact that it was a mistake and that you have more or less equal chances of dying in a car accident and dying from disease related to “obesity” isn’t widely publicized to the American people.

So if you used to think that fat was deadly and that’s what you were using to help “motivate” people to thinness, you can stop doing that now.

In reality, if you want to use the oft-quoted BMI scale (more on that later), scientific evidence actually indicates that people categorized as “overweight” live longer than those categorized as “normal,” and most “obese” people live similarly long lives as their “normal” counterparts.

3. Because Fat Doesn’t Cause Disease Either

Right. So if fat itself isn’t the problem, then what about diabetes and heart disease, which we’ve been socialized to believe are “obesity-related” illnesses? Don’t those lead to death?

Well, yes.

And it makes sense that people think that fat, then, is the problem. After all, there are, indeed, diseases (like diabetes and heart disease) that are more common in heavier people.

But there are also higher incidences of death by drowning in places where there are more ice cream sales.

So, let’s have a quick lesson in stats, shall we?

Correlation does not equal causation.

Just because some factors, on the surface, seem related doesn’t mean that they have a causal relationship. It’s not an easy cause-and-effect equation, where situation A results in situation B.

Take the drowning-and-ice-cream scenario. People aren’t drowning because of ice cream, although it might seem that way on the surface. Rather, both drowning and the sale of ice cream are more likely to happen at the beach. The beach, in this case, is what we might call a confounding factor.

Similarly, there are confounding factors that complicate the relationship between fat and disease.

For example, one hugely important factor is that of dieting. And not that those who diet are more likely to be healthy – quite the opposite, actually.

Both dieting and weight cycling – that is, the process of going on a diet, losing weight, regaining the weight (and sometimes more), then going on another diet, losing weight, regaining the weight, and on and on and on – increase inflammation.

And inflammation itself is actually a risk factor for many diseases that are typically blamed on “obesity,” like diabetes and heart disease.

And who do you think is more likely to have lived a life of constant dieting and weight cycling? People of size.

Correlation. But no causation.

That is to say, it’s not as simple as it seems on the surface. And just because both fat and disease are present does not mean that the former caused the latter.

4. Because, If Anything, Fatphobia Causes Adverse Health Effects

Point-blank-period: It’s hard to be a fat person in our society. And if you’re a thin person, consider this: All other things in your life remaining unchanged, would you rather be fat?

Probably not – considering over half of people report they’d rather be dead than fat.

And in a world where weight discrimination is as prevalent as sexism and racism, it’s easy to understand that being of size is a stressful experience.

And that’s simply because we live in a society that hates fat people – as evidenced by the simple fact that fat-shaming (and the defense of it) exists.

And the stress level associated with this kind of discrimination – living your daily life ridiculed by people and with less access to resources and happiness – is also associated with cardiovascular disease and diabetes.

Here’s one way to look at this: Researchers have found that the gap between a person’s actual and idealized weight (that is, the extent to which they experience body dissatisfaction) is a better indicator of mental and physical health than the BMI scale (which is total bullshit anyway).

So the way that you feel about your body (and in a fatphobic society, no one feels good about their body, least of all folks whose bodies are seen as worst case scenarios) has a much more significant impact on your overall wellness than the actual shape and size of your body itself.

In fact, even the CDC reports that our day-to-day health behaviors, like diet and exercise, only account for less than a quarter of differences in health outcomes.

What matters the most, actually, is what’s called “social determinants of health,” and those include stuff like early childhood development, level of education, employment, food security, and access to housing and healthcare.

That is, what’s most likely to cause ill health is how oppressed a person is – not which behaviors they engage in.

So if you really, truly care about someone’s health, maybe instead of suggesting that they diet, you just lay off the fatphobia instead.

Better yet, as much we hate the term “keyboard warrior,” maybe instead of falling into that trope by angrily typing away at comment sections (a la Kermit), you focus your energies on social determinants of health by pushing for policy change that addresses inequities.

5. Because Mental Health Is Also Health

I’m pretty sure no one’s health has ever been improved by being ridiculed. In fact, there’s research to back up exactly the opposite.

Because when you ridicule someone, or a group of people, based on their social disadvantages, especially wherein you hold power, what we call that is bullying.

And beyond the aforementioned social problem of fatphobia, there’s also the individual, one-on-one kind, wherein people take their socially constructed implicit anti-fat bias and actively use it to tear down another person’s self-esteem.

This, of course, may take the shape of tossing slurs toward a person of size who’s out for a jog. It might be whispers and giggles in response to someone walking down the halls at school. It might be hanging up pictures of people you deem unattractive in their fatness to serve as your “thinspiration.”

Or it might take the shape of leaving comments on fat-positive threads, pounding into the ears and eyes of everyone who comes across them the same old BS rhetoric being espoused by the public at large.

But mental health is just as important as physical health. And if you’re really, truly concerned about someone’s wellbeing, it matters to not deteriorate their emotional and spiritual health.

6. Because ‘Glorifying Obesity’ Isn’t a Bad Thing

We do a lot of work in the eating disorder field – a place where we’re all too familiar with the notion of glorifying, of romanticizing illness.

The idea that you can take something that’s harmful and twist it into something that’s beautiful or, in the words of Blythe Baird, “the most interesting thing about me” is one that we concern ourselves with day in and day out in our work trying to rid the world forever of the hashtags #proana and #promia – or at least the damage that they can cause.

But there’s a line that we’ve had to learn to respect.

In the pro-eating disorder movement, there are two ways that the “promotion” can occur. The first is by advocating for restricting or purging as lifestyle choices and twisting the disordered thought and behavior patterns into active decisions being made by those suffering in order to feel more beautiful, healthy, or worthy.

The second is in spreading the message that eating disorders aren’t something that we need to hide, but rather, parts of ourselves that are equally worthy of respect as the rest of ourselves, thereby fighting against mental health stigma.

The first is what we might refer to as “glorifying” or “romanticizing.” The second, we’d just call “normalizing.”

But when it comes to “obesity” – which is not an illness (contrary to what the AMA might think!) or purported as a lifestyle choice, but rather, simply a state of being – what folks are calling “glorifying” can only be, in reality, normalization.

And if people of size want to take back the notion of glorifying obesity by saying “Fuck yeah, I am,” we’re all for that.

What we’re not for is concern trolls using the phrase to demean and discredit folks – and especially women – who, in a harshly patriarchal world, are accepting and owning (and even loving) their bodies, whether they fit into narrow beauty standards or not.

7. Because One-Size-Fits-All Definitions of ‘Health’ Are Ableist and Perpetuate Heathism

When people say that they’re worried about the health of others, we believe that they really do think that. After all, it makes sense, right?

If evolutionary psychology is your jam, then you probably subscribe to the belief that deep down, our survival instinct-driven mid-brain fuels the cultural universal of species propagation. And it’s hard to keep a species going if we’re dying all over the place from ill health!

And this foundation pushes the idea that of course we should care about one another’s health!

And okay. Sure. Let’s entertain that for a second (although, please let the record show that we are not of the evolutionary psychology camp – and don’t roll with feminists who are).

There are still a million questions that we have for you.

Like how the fuck do you define “health” in the first place? And who gets to decide what that is? And how is there any possible way to judge health based on a person’s size?

And is it even really appropriate to value health? Sure, again, from an evolutionary psychology lens, it makes sense. But evolutionary psychologists also believe in gender essentialism – and we threw that shit out because it’s sexist, cissexist, and transphobic!

And when we prioritize health as a quantifiable value that all people should strive toward, we’re being ableist. Because we’re implying that there’s a one-size-fits-all version of health and that anyone who falls outside of those parameters is unworthy of respect.

8. Because Weight Loss Doesn’t Actually Improve Health Anyway

Does eating well and engaging in exercise improve health? Sure. To an extent. But it hasn’t been proven that weight loss does.

For example: You could visit the great Google machine right now and probably pull up a million and a half studies showing that short-term weight-reduction interventions show short-term health improvements.

However, we have two problems with that. One is that they’re short-term studies, which don’t do much to show us anything substantial. Two is that in all of these cases, people are altering their behaviors in some way to achieve said weight loss. Those changes alone could account for improved health results, whether or not weight was lost.

So the studies don’t prove that weight loss itself is improving health. What they may be showing is something we agree with: that lifestyle changes – like eating more nutritious foods and getting regular physical activity – lead to better health.

And what happens if you omit behavioral changes from the results?

A liposuction study that controlled for behavioral change found absolutely no improvement in obesity-associated metabolic abnormalities, despite the weight loss that occurred.

In other words, no one’s health got better from weight loss alone.

Other liposuction studies, though they don’t explicitly control for behavioral change, support that weight loss doesn’t lead to metabolic improvements. While this isn’t conclusive, certainly, the war’s spoils – that is, the health payoff – are in question.

We actually don’t have any evidence to suggest that weight loss improves health long-term. To the contrary, most long-term studies actually suggest that weight loss increases the risk of premature death.

And even if you wanted to continue to buy into the myth that weight loss improves health, it would still be true that exercise and dietary restriction are not effective weight-loss techniques. Because you’re quite literally biologically wired not to lose weight past what your body has deemed your set-point.

So no matter what a person does, they won’t be able to keep substantial weight off long-term – unless they engage in dangerously disordered eating and exercise patterns, which kind of defeats the purpose of “doing it for health,” huh?

9. Because No, Being Fat Is Not At All Like Being a Smoker

Often, when people are called out for fat-shaming, their response is something to the effect of “But we shamed smokers until they stopped smoking! And that’s good for public health!”

But there are a few things wrong with that assertion.

First, purely historically speaking, it’s inaccurate.

In reality, in the late 1940s and early 1950s, an epidemiologist named Richard Doll published research suggesting first that smoking could cause serious health damage and second that there was a close link between smoking and lung cancer, which was repeatedly confirmed.

When the US jumped on board in 1964, this led to bans on particular tobacco advertising and warning labels on tobacco products, all of which eventually led to a decrease in the prevalence of tobacco use.

While it could be argued that the “War on Obesity” is, indeed, then, similar to the “War on Tobacco,” there are very major differences:

First, being fat is a physical characteristic, not a behavior.

Second, smoking has been proven to cause death and disease. Being fat, on the other hand, has not.

Third, the idea that pushing guilt and shame on people is effective in health behavior change has been proven wrong again and again and again.

So, while it’s likely true that people have used shaming tactics in both the “War on Tobacco” and the “War on Obesity,” it’s also true that the shaming itself is not what creates change.

So even if you hold onto the flawed notion that “obesity” is similarly dangerous to smoking and should somehow be eradicated by using similar strategies, shame will not work.

10. Because You’re Subscribing to a Harmful Bootstraps Myth Mentality

Popular belief would have you convinced that being fat – like living in poverty – is a choice. And if one just works hard enough to pull oneself out of their desperate situation, then they, too, can enjoy the privilege brought on by being thin.

And this idea fuels what Jes Baker has coined “body currency” – the idea that “we are taught as a society that if we achieve the ideal body that we see in traditional media…we will then obtain love, worthiness, success, and ultimately, happiness” and that our bodies, therefore, act as currency.

This is a societal promise that, as Sonya Renee Taylor explains in the upcoming documentary Fattitude, “one day I really can cash in my thin privilege.”

And this fantasy – that the possibility of achieving thinness will then lead to happiness – is what motivates us all to participate in diet culture. It also fuels some people’s desire to, apparently, help people of size live their best lives.

But just like we don’t have much choice about our economic status, we don’t have much choice about our body types either. And while we can try to change both, we will undoubtedly encounter more obstacles and impossibilities than opportunities and successes.

So when we perpetuate the narrative that we all have a choice in whether our bodies are fat or thin, we push the idea that everyone should be striving toward thinness all the time – and that is something that actually harms us all.

In the meantime, we also push along the notion that since fat is unhealthy and therefore bad, the “choices” we make about our bodies also speak to our moralities and the extent to which we “deserve” good health and respect.

Instead, we should recognize that none of us has control over the hand we’re dealt in life, and that we’re all deserving of respect, regardless.

11. Because, Straight Up, Fat-Shaming Just Makes You a Jerk

Let’s just come out and say it: If you’re a concern troller, you’re a fat-shamer. And if you’re a fat shamer, you’re being mean. You may have the best intentions, but what you’re really doing is kicking people when society is already holding them down. Enough already.

Concern trolling does not make you a hero. You’re not saving anyone’s life.

You’re not motivating anyone toward health. You’re not helping someone cope with oppression. You’re hurting people. All concern trolling does is hurt people – both individually and socially.

And if that isn’t a good enough reason to reevaluate your actions, then what is?

Melissa A. Fabello, Co-Managing Editor of Everyday Feminism, is a body acceptance activist and sexuality scholar living in Philadelphia. She enjoys rainy days, tattoos, yin yoga, and Jurassic Park. She holds a B.S. in English Education from Boston University and an M.Ed. in Human Sexuality from Widener University. She is currently working on her PhD. She can be reached on Twitter @fyeahmfabello.

Dr. Linda Bacon is an internationally recognized authority on weight and health. Well known for her provocative political and social commentary, Dr. Bacon has generated a large following on social media platforms like Twitter and Facebook, health and nutrition listservs and specialty blogs, and the international lecture circuit. She has published her work in top scientific journals as well as the highly acclaimed bestseller, Health at Every Size: The Surprising Truth about Your Weight. Her more recently released book, Body Respect: What Conventional Health Books Get Wrong, Leave Out, or Just Fail to Understand about Weight, co-authored with Dr. Lucy Aphramor, challenges mainstream assumptions and is transforming the weight discourse.