Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
6 Jun

The Stigma of Obesity

ingroupoutgroupOne of the things I love about positive-focused healthy lifestyle communities (like but not limited to MDA) is the genuine support that exists for people to take charge of their well-being. It’s the collective excitement when others transform their bodies and health. It’s the willingness to offer help and advice, personal anecdotes and perspective to those beginning their journeys or struggling with the process. In the bigger framework of society, and even occasionally in these positive communities, however, weight-related stigma still holds sway. In these more subtle demonstrations, it becomes a sort of “if you’d only do X” assumption, a looking down one’s nose at someone else’s grocery cart or an unconscious judging that faintly influences impressions and interactions.

We live, of course, in a culture, obsessed by body image and weight. Celebrities are skewered on the covers of magazines for gaining (or losing) weight. Advertisements for diet products, often designed with questionable taste, are at every street corner and commercial break. For weekly entertainment, we watch obese people battle their weight on T.V., ominous music and trainers screaming in the background. Within this swirl of society jokes, cultural judgment, and media images, the obesity/overweight stigma is ubiquitous. Far beyond the intention to help, the function becomes to exploit. Outside any interest in being supportive, the focus becomes voyeuristic and, at times, self-congratulatory.

Some say the obesity/overweight stigma is the last allowable prejudice. Although I think there’s enough animosity and judgmentalism in the world to debate the statement itself, I understand the central point. Researchers have time and again measured the “anti-fat bias” (effects ranging from outright discrimination to unconscious stereotyping) at work in everything from employment to health care. Obesity/overweight stigma figures into the collective consciousness far more than we often give it credit for – lurking in places and people we’d assume would be immune to its effects.

Physicians themselves, numerous studies show, demonstrate a significant anti-fat bias. Just a few weeks ago, a published study reported 40% of medical students demonstrated an unconscious weight bias. Research has illuminated anti-fat bias in therapists and even health professionals within obesity related specialties.

With all this, research shows primary physicians are offering less weight loss counseling to their patients – particularly those with high blood pressure or diabetes. Karen Hitchcock, a physician who works in an obesity clinic with a bariatric surgeon’s group, offers a candid and surprisingly personal glimpse at the discomfort of a physician who struggles with counseling her patients: “The emotion in the room thickens; I am acutely aware of the shame my patients feel.” As critical as the need is for honest consultation, her perspective is hard to dismiss.

Finally, the kicker. Research shows that the social bias remains even after people lose weight – and can be as strong against those who were obese and lost their excess weight as as it for people who are currently obese. As someone in the health and weight loss business, this is the hardest to hear. I can’t quite imagine what it’s like for a person who actually experiences that bias.

I think it’s clear I believe in people taking personal responsibility for their health and well-being. That said, I also understand the reasons for obesity are varied and complicated. Genetics do play a role, and for some people it simply takes more effort. Thyroid, other hormonal issues, and even toxin exposure can throw a wrench in the best weight management endeavors. On a cultural level, too many people have little access to fresh food and even fewer to real nutrition education. Too many grow up with the unchallenged influence of incessant junk food marketing and perhaps poor familial modeling at home and school. As Karen Hitchcock suggests, “We live in a society that judges people for being fat, yet has in place every possible means for making them so.”

Physiology is physiology. The biological facts behind obesity are constant, yes. The personal picture of one’s weight – not to mention each person’s experience of it – however, is much more complex than any stereotype or momentary judgment can begin to tell.

When we simplify other people’s stories, I think the person we end up diminishing is ourselves. My mother used to constantly say “Worry about yourself.” Sure, it was generally in response to sibling quarrels or school yard gossip, but it gained dimension as I grew older. To this day, it’s one of the most abiding pieces of wisdom I’ve ever come across. It doesn’t mean of course, don’t appreciate other people or help where and when you can. After all, life is about connection. Happiness and health are about connection. That said, we miss the point when we bring a self-grandiosity or condescension to that engagement. We do better when our support for others comes from a place of personal humility.

If we’ve been successful in losing or managing our weight, that’s a great accomplishment. If we’re working on it, we’re worthy of respect and genuine support in our efforts. If we’re not to that point yet, we’re still worthy of the same respect. It’s been my observation people are more inclined to invest in themselves – and believe in the support of others – when they believe in their own worthiness. When we choose to question the obesity stigma, whether we’ve ever personally fit that category or not, we value – for ourselves and others – living as healthy but also “whole” people. That’s, to me, the best endeavor for thriving.

Thanks for reading today, everyone. I hope you’ll share your thoughts and comments on the obesity/overweight stigma. Have a great end to the week.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Having been fat most of my life, this stigma has permanently messed me up psychologically. Loneliness, depression, etc.. I have come to resent most people because of it, if not hate them, because everyone seemed superficial. But now I realize, can you really blame them? It’s only human nature. We are hard-wired to want the healthiest genes possible in our partners. We wouldn’t be the humans we are today if it wasn’t for this hard-wiring. Although modern ways have an impact on the body unrelated to genes (some people say fat people would be better off back in the day, for example), our brains are still not adapted to modern society. (Which may be a good thing, because then maybe it’ll motivate people to want to go BACK to the old ways).

    Brian Kozmo wrote on June 6th, 2013
  2. I have to admit I have been guilty of ” looking down one’s nose at another persons grocery cart”, especially when the person was overweight and shopping in her pajamas at my local Market Basket. When I stopped working after my second child and had to cut down on Wholefoods shopping I was shocked at what I saw at local ” regular” or non yuppie grocery stores. I now have a silent wish when I see obese or unhealthy people filling their carts with FDA approved foods; ” I wish you health and happiness”. The light within them is the same as the light within me.

    Mary wrote on June 6th, 2013
  3. Thank you for writing this!! Ten years ago I had a macro non-secreting pituitary tumour removed. Previous to this I had always been of average weight, and pretty focused on my outward appearance. Since surgery, I have just struggled with my weight, hormonal issues requiring a premature hysterectomy, Lupus and steroids/medications all of which have been hard on my sense of vanity.

    Thanks to starting the paleo lifestyle this January my Lupus is in better control and I’ve lost nearly 40lbs, while I have plateud in the last month. However I would love to lose 100lbs more!

    I have wonderful doctors who always tell me they envy my blood work, & it’s due to eating healthful as I couldn’t imagine if I work hard just to avoid weight gain what junk food would do to my weight. The reality is I have a compromised endocrine system and that has a far reaching effect.

    I have many ‘skinny’ friends who tell me they could never eat as healthy as I do. Honestly I believe it keeps life optimized as I sleep better & have much better energy. I was given the gift of getting to see my kids grow up, so I need to ensure I optimize my life even if my outward weight doesn’t reflect my lifestyle choices. Most days i hold my head high, but I’ve shed some tears with my caring physicians. They remind me if i falter how healthy I actually am in spite of a complicated health history. One doctor actually said I had changed how she looks at obese people, she admitted to some previous bias.

    I know the value of life and it has nothing to do with my size.

    Regan wrote on June 6th, 2013
  4. Thanks for this article. This is one that strikes home. I’m someone who has my entire adult life struggled with weight. I really appreciate all of the daily information and I’m motivated at this point.

    TaiChiHolly wrote on June 6th, 2013
  5. I haven’t met any one who chooses to be overweight. People don’t wake up in the morning and say to themselves “today I am determined to eat as much as I can to gain weight”. There is more sympathy if you are an alcoholic or a drug addict. Sugar is addictive and killing more people than all the other stimulants put together. I also feel we are being let down by the medical industry. I can’t think of the last time a doctor said lets try and find out why your not eating well. They just prescribe pills because their next patient is in the waiting room. Unfortunately there is more money to be made out of sickness rather than wellness.
    But I believe it is turning around. Websites like MarksDailyApple give me hope and I think there are “health practitioners” (as opposed to doctors who are sickness practitioners) who are fighting the good fight for health through diet and lifestyle advice.

    Scott wrote on June 6th, 2013
  6. Very interesting. I used to be fat, and I know what it’s like to be treated poorly. But then I lost the weight. I don’t think I was treated badly after though.

    I find myself in the situation where – on one hand, I KNOW how much it sucks to be fat and how hard it is to lose weight. On the other hand, I KNOW it can be done for most people.

    But here I am at almost 43, post a second baby, and man, this second time baby weight is a lot more stubborn that the “I’m just fat” weight and the “post first baby” weight. I hate that people judge me and I hate my tendency to judge others.

    Marcia wrote on June 6th, 2013
  7. “In these more subtle demonstrations, it becomes a sort of ‘if you’d only do X’ assumption, a looking down one’s nose at someone else’s grocery cart”

    I have definitely been guilty of this. Coming from a place of understanding, I can stop assuming certain things simply based on what people have in their carts.

    Tom wrote on June 6th, 2013
  8. I am formerly obese. (I am now overweight by 10 pounds, according to the dubious BMI.) I know how I became obese: I ate far too much (as in, an extra meal a day and ridiculous portions) and was sedentary. I lost weight by reducing my food consumption and exercising. It really was that simple for me. I am fortunate that I was never treated badly as an adult for being obese, nor have I been treated differently since losing 90+ pounds. In fact, I have received much kindness and support throughout my weight loss journey. However, I find myself now judging the obese and, as much as it shames me to admit it, looking down on them, especially when they tell me they could never do what I did. I realize there are medical reasons that prevent people from losing weight, but for the majority of people a choice can be made.

    Nicole wrote on June 6th, 2013
    • You’re right; it is a choice, but it’s one that many obese people either can’t or won’t make. I’ve never been overweight by more than 15 or 20 pounds, but I couldn’t seem to drop those extra pounds. Then I got serious about paleo/low-carb. I dumped the sweets (including artificial and substitute sweeteners) and the grain products. The extra weight melted right off without me changing anything else, and it has stayed off. I didn’t cheat, I didn’t rationalize, and I didn’t give in to cravings, which incidentally disappeared within a week or so.

      I mentioned this to an overweight friend when she asked what my “secret” was. The response was, “Oh, I could never do that.” I said, “Sure you can”…but I know she won’t because overweight people are very good at rationalizing and lying to themselves. There are occasionally other reasons involved, but for most people being overweight is very much about choices.

      Shary wrote on June 11th, 2013
  9. One funny thing is that even though I am very fat, I am very strong. Since limited lung function makes aerobic and cardio activity unsafe I can’t do that. But I decided a few years ago that this is no excuse for being weak. So even though I am very fat and huff and puff on my very slow 1/2 mile daily walk, when I go to the feed store I throw a hundred pound bag over each shoulder and walk out. When it is branding time I don’t have to use the chute for any animal under 500 lbs.

    But I am sure all the people who are explaining physics and the importance of attitude are really strong too. My point is just if there is something that you really and truly can’t do, do let that make you feel like there is nothing you can do.

    Gracie wrote on June 6th, 2013
  10. Sorry that is 300 pounds. But 500 would be awesome.

    Gracie wrote on June 6th, 2013
  11. I’ve been both super skinny and normalish (could lose a few). Even though I dislike it, I find socially its actually easier to be 5 lbs over weight than 20 pounds under. If you are really thin, people reply with the same kind of overly simplistic logic. Just eat more! Anorexia and obesity have many similarities in that both have some kind of obsession with food. If you walk into a room people will notice your BODY right away, before they notice your clothes, smile, personality or anything else. When your skinny people have no trouble telling you “you’re too skinny” if you are slightly overweight, people tip toe around like its an elephant in the room.

    irunprimal wrote on June 6th, 2013
  12. It’s really frustrating to read some of these comments. It’s almost as if some didn’t even read the article.

    gunderson wrote on June 6th, 2013
    • +1

      Joy Beer wrote on June 11th, 2013
  13. I feel like I could write a book about this topic, and a lot of it would be based on my (short) life story. I’m only 24, but this just resonated with me so much, from the time I was first made fun of for my weight in about 4th grade (100 lbs) to being a collegiate athlete who was definitely on the heavy side in comparison to all my peers and teammates, to post-collegiate career when I put on 40 pounds. I wanted to lose weight, but could never find a balance between eating enough to fuel my grueling volleyball practices and weight room sessions and cardio training, while still eating little enough to lose weight. So no, it’s not always about a “choice” to lose weight. I made that choice, but my lean cuisines and whole grains (the things that are supposed to help you lose weight and be healthy) weren’t doing it.

    I would have completely given up if it weren’t for a program called Take Shape For Life, which in a roundabout way led me to this blog. Now I’m basically fully primal, and I’m confident in my ability to sustain this lifestyle for a long, healthy life. I’ve always wanted to lose weight/be healthy, but I just didn’t know how to do it. And unfortunately there are still a LOT of people out there that want it more than anything, but are being fed lies (intentional or not) by media, by the government, by doctors, by food companies. It’s such a shame and makes me sad. So when I see an overweight person at the grocery store, I never look smugly at their cart; but when I see them buying things like lean cuisines and whole grain cheerios and other SAD foods marketed as healthy, I feel sad. Sad that I have the knowledge of something that might help them, that might actually change their life, but am unable to share it with them at that moment.

    Thank you, Mark, for this post and everything that you have done and do on a daily basis. You’ve changed so many people’s lives, for the better. If I can even help a small handful it will be because of you and this website.

    Stacie wrote on June 7th, 2013
  14. I’ve been pretty thin my entire life no matter what I ate. Let me tell you that, unfortunately, being judgmental works both ways, and is a simple fact of being human.

    I have had obese and overweight relatives, friends, and even complete strangers, whose comments ever since I was tiny girl, is how thin I am, how I need to gain weight, and how I just need to eat more. Sometimes the comments are just downright nasty. I try not to judge and treat people no matter their weight with friendliness, but the second they comment and judge, it just takes away any sympathy for them.

    Everyone just needs to not be so judgmental, and that applies to people of all weights.

    Wafaa wrote on June 7th, 2013
    • I agree. It just blows my mind that people think it’s okay to comment about someone else’s looks, no matter what they weigh. I always thought it was sort of a “rule of society” that people don’t make rude remarks about overweight people (although, from other comments, some people don’t hold with that rule), but skinny people are fair game.

      Even regular sized people feel the need to point out my stick arms or knobby knees. I have a friend who still won’t wear shorts no matter how hot it is because she doesn’t want anyone to see how thin her legs are and make comments (she eats plenty, it’s just her body type). My friends said I should get the extra padded bra, then laughed about how disappointed my husband would be on the wedding night. Just what every girl needs, to be informed that not even someone who loves her would like her body.

      I’m glad people are realizing it’s not right to say mean things to overweight people; it’s unkind and completely unhelpful. I still don’t appreciate that in their effort to celebrate larger sizes they somehow believe it’s still okay to say skinny girls “aren’t real women” and “not attractive.” Putting someone else down is not the way to make you feel better.

      Annie12 wrote on June 7th, 2013
  15. Do I think living a healthy life is a worthy goal? Absolutely. I work hard at it. I want to make it into overtime then sudden death. Game well played. But I have a friend who is eating himself into an early grave. He’s not dumb. He’s informed, a licensed medical professional. He knows what he is doing, and enjoying it. Freedom includes the right to make lousy dietary decisions and dying from it. Ditto smoking. It is not as if there is a limited number of people and each of us must be kept alive as long as possible. If he wants to drink five Big Gulps a day and die of diabetes at 40 fine by me. It is his life to throw away as he wishes. The rub, however, is when the government wants to rob me — at gun point if necessary — to pay for his poor judgment and lifestyle. To me it is all an issue of personal responsibility. You drank the five Big Gulps daily, not me. You pay for your diabetes not me. You pay for your smoking. Not me. You pay for your obesity. Not me. Have I tried to help? Absolutely. But people have to want to change. Is there a stigma to obesity? Yes. Is it wrong? Proably. But so, too, is the attitude of “accomodate my obesisty.” Have you sat on a transcontinental flight with a person taking up 2 2/3 of the three seats leaving you 1/3 of your own seat? What is “Big And Beautiful” but accomodate my obesity? All kinds of dscrimination cases have been filed but they are for the most part “accomodate my obesity:” YOU change rather than ME lose weight. The obese person often wants someone else to be responsible for their obesity. Stigmas do not develop in isolation. They are self-helped.

    Green Deane wrote on June 7th, 2013
    • Well, Mark wrote on kindness on being nonjudgmental, and some of this is over the top. But you did touch on something that struck a nerve – one’s freedom to do what one wants ends when it impinges on someone else. I spent hundreds of dollars for a major league play-off game, then spent the five hours STANDING UP because the extremely obese man in the next seat took up 3/4 of my seat. Even turning totally sideways, we were touching (and it was a HOT day!). Not sure why someone weighing that much would buy a seat in the grandstand (at this park, they are very narrow, clearly built for people living years ago!). Also not sure why HE didn’t offer to stand in the aisle or in back.
      Mark is very right in his post, and I support it, but courtesy goes both ways.

      Huntington wrote on June 7th, 2013
  16. Mark, thanks for the beautiful and encouraging post.

    Commenters, most of you make me want to shoot myself. Just sayin’.

    Rhonda the Red wrote on June 7th, 2013
    • Yeah, I have never, ever found the intelligence of MDA readers to be anywhere near the intelligence of Mark Sisson. That difference in intellect is why Mark is the creator and they are mere readers. Many times I just read Mark’s articles and skip the comment section all together. With this post, I could not resist watching the stupid unfold. lol! So sad how silly most of these comments and people are. I am a student of Kinesiology, Exercise Science and low carb nutrition. I was an athlete and I have never been judgmental about fat people. I recognize that there are many factors, and there is no one size fits all. The simplistic answers to this post are not shocking. Ignorance abounds.

      Chase wrote on June 16th, 2013
      • Ah, but you are judgmental about people’s intellect. People are here to learn and share. Give us some slack. Obviously, not everyone is as smart as you.

        I hope in the future you can add to the conversation with your new found knowledge and help enlighten the stupid people. On the other hand, laughter is good medicine so maybe you would just rather take that route.

        Sharon wrote on June 16th, 2013
        • “So sad how silly most of these comments and people are.”

          I felt the same way on the salt thread – i WON’T list examples, as they might hurt someone’s feelings, or god forbid put them off exploring a healthy diet – and they may be obnoxious and obtuse, but who knows, maybe they have kids? Mrs Mummy Mozart probably wasn’t a genuis! :)

          What you have to remember is silly people are trying too.

          MAINLY trying our nerves, but still… ;)

          Patrick wrote on June 16th, 2013
  17. Thanks for the great post. I always learn so much here.

    Bill Pogue wrote on June 7th, 2013
  18. Thank you, Mark. I’ve been thinking a lot about this issue lately. I’ve been thinking about shame, recently. In my opinion, shame has no place in something like getting fat. Shame is something that you should only feel if you harm someone else or do something actually really bad. There’s no need for shame, and it makes things worse. Yet the feeling still creeps up. I feel ashamed and as if the fatness is just who I am. What that does is the opposite of helpful. I tend to give up on my diet (which I know works, when I do it) and exercise and escape into lala land. Which makes me depressed even more, creating a vicious cycle.

    My mother has disabilities that make it almost impossible to walk, plus chronic fatigue symptoms from fibromyalgia and other conditions. She is like me. She knows exactly how to eat but doesn’t always have the willpower. It’s like an addiction. She’s extremely overweight, which makes her disability even worse, and since I help pay her expenses as her disability/social security isn’t actually enough to live on, I get frustrated. But my sister downright blamed my mother’s problems on her weight and got angry and shaming. Unfortunately this shamed me a little bit too because I’m also overweight. I know exactly what to do to get healthier whether I lose weight or not, but I feel like a drug addict sometimes with food. Telling me to stop eating bread or sugar is like telling an alcoholic to simply stop drinking. The shame doesn’t come from my weight then, it comes from my lack of willpower. That shame just makes it worse.

    But recently I read part of a book called “Hot & Heavy: Fierce Fat Girls on Life, Love & Fashion” and something really clicked. I don’t agree with all of it, as it seems to be OK with eating things like cupcakes with abandon. That’s not good for anyone, thin or fat. But I looked in the mirror and really was OK with what I saw. A huge weight was lifted off my shoulders. There was this feeling that I am beautiful, regardless. Eating primal and getting the proper exercise stopped being about being fat and started being about feeling good, being able to walk distances, lifting my depression and energy levels and just becoming the strong badass I know I am, adipose tissue on my muscle or not.

    It’s really important to remember that we are not less of a person, less talented, less important, less valuable or have more flaws or shortcomings than someone who simply has less fat on their body for whatever reason. Fat is not who we are. It’s something we have on our bodies. I have fat on my body. Some people don’t have as much fat on their body.

    Willow wrote on June 7th, 2013
    • Imagine fat was an organ, imagine how stupid it would be to be SHAMED for having an extra kidney – fat IS an endocine organ, it secretes hormones.

      Sort it out mate, or madam, you grew some extra endocrine organ in response to environmental threats, maybe you got diet wrong based on government advice, or psychological stressors – but really, if it was JUST a hidden extra kidney, you’d cope more rationally maybe? Just a though, good luck Willow!!

      Patrick wrote on June 16th, 2013
  19. This is a very kind post and I appreciate it being written. I’ve been very fat and now very much in shape thanks to primal and paleo, so I too see both sides of views.
    In terms of fat-shaming, having lived in different countries on several countries, I would say Americans are among the LEAST fat-shaming societies in the world. Try being an obese girl in Asia, Europe, even parts of Latin America and Africa. People don’t hold their tongues at all. A lot of it is because one stands out from the crown in a very uncomfortable way, especially if one is young and female. The judgement is more covert in North America and likely it’s due to a combination of people being more prone to minding their business and also the prevalence of obesity here.
    Personally, since I’ve been fat and I know how hard it was to lose the weight using Conventional Wisdom, I tend to be very sympathetic to overweight friends and family members. The entire food, agricultural and medical industries, backed by political and economic forces, have made it so that most of us cannot lose weight and get healthy in a sustainable manner. I only recently was one of the herd myself so who am I to judge those who have not yet found out the pertinent information for themselves?

    Sophia wrote on June 7th, 2013
    • I don’t want to diminish your experience, but my experience is very different. Yes, in other countries people will talk about your fat more, but it is because the moral stigma is less.

      For example, in the USA when I was obese, if I went to a spa I was given like a regular size large robe instead of the largest men’s robe, which might fit. A friend called it “right sizing” me, lol. When I asked for a larger robe, or said I was just going to wear my clothes since their robe didn’t fit me, spa workers would look like they wanted to fall into the floor. In China if I went to a spa, I could just say, “Awe, your robe doesn’t fit I need a towel to hold in front of it.” and it was nothing.

      When I was mugged in an Asian country, a bystander said, “Why didn’t you hit him, you are big enough.” Because being big enough was just a thing, not a Thing.

      Mary wrote on June 8th, 2013
  20. Try being skinny. Try being laughed at every time you walk down the street and people calling you anorexic and telling you to eat a cheeseburger. If your body doesn’t absorb food properly or function properly in other ways, you are subject to the same humiliating treatment as obese people. In fact, I can’t tell you how many times it is heavier people making the cruel comments. The world is not a friendly place. You have to stop expecting it to be. Thankfully, going paleo has helped me put on a few pounds, but I’ll never be “average”. Woody Allen and Audrey Hepburn were never meant to look like Swartzenegger and Marilyn Monroe….All I know is,in my next life, I’m coming back with a gorgeous body or I’m not coming back at all. LOL

    jaa wrote on June 7th, 2013
  21. Thank you so much for this article. I gained weight after a bad accident, which coincided with a new job where there is a constant emphasis on one’s appearance. We call it “executive presence,” and, in practice, is a sanctioned way to discriminate based on one’s appearance.

    It is heartbreaking to know I am qualified for things and not be given the chance to do work for which I am trained. As I lose weight, people are nicer to me. And stare.

    Get another job? Why bother … I guess the best thing about where I work is that people are honest about it.

    Julie wrote on June 8th, 2013
  22. This was an interesting article that generated even more interesting replies. I’ve been obese-but-healthy (meaning all of my “numbers” and blood work have always been in the normal range) for much of my adult life. The primary fat stigma I have faced has come from myself.

    No one has made snide comments to my face about my weight (except my mom once or twice, but as when she told me I was the most beautiful girl in school, she’s Mom so it didn’t count. Sorry, Mom.) No one has ever shouted nasty comments at me as I waddled around the neighborhood, not even the snarky teenagers who congregate at the path that leads to the local high school. I have never been turned down for a job for which I was strongly qualified. And yet….

    I felt less worthy of respect when fatter. Reading the comments from folks who said that they were treated much differently after losing weight “even though I was the same person,” made me wonder: Am I really the same?

    Since easing into a more paleo way of eating and exercising, I’ve noticed benefits – I have more energy, generally better moods, am stronger and have more confidence. As my maximum squat weight increases I feel – dare I say it – downright badass. (My best so far was 135# for 3 reps – not too bad for a 45-year old fat chick. I like to think of it as 235# since I have about 100# of fat to lose). Given the changes in my attitude, is surprising that people are treating me differently?

    More people are willing to include me in conversations – now that I am more willing to join them. People respond more positively to me – now that I am in a good mood. I have been promoted at work – now that I have the confidence to pursue more responsibility.

    In other words, I am behaving in ways that in the past I have only done when my weight was closer to my ideal – when I “deserved” to feel happy and confident. Thus, I have to conclude that no, I wasn’t the same when fat as when normal weight.

    I don’t mean this post to any way belittle the struggles that others experience. Size-bias, like all biases, of course does exist and some people enjoy hurting others for whatever excuse they can find. The callous ignorance that doctors can display is truly astonishing. My life seems to have included few sadists and I fired the one doctor who kept trying to refer me for stomach stapling so I count my blessings in that respect.

    I mean that in my own case, clearly the feelings of unworthiness I have felt were self-imposed. Is it possible that people still treat me differently than they would if I were a normal weight and I am too dense (ha ha – see what I did there?) to notice? Of course, but so what? I can’t think of any friend, family member, coworker, or stranger who has ever treated me worse than I have treated myself – not even that jerk in 6th grade who I once clobbered with a Scooby Doo lunchbox. (Don’t look at me like that. He totally deserved it.)

    It would be easy to blame the media or advertisers or societal pressure for my self-hating attitudes but nope, I’m not going to do that anymore. I chose my mindset then and I am choosing a new one now.

    “When we are 20, we worry about what everybody thinks about us. When we are 40, we decide we don’t care what anybody thinks about us. And when we are 60, we realize that nobody was EVER thinking about us.”

    If anyone knows who said that, please let me know as it is my new favorite saying.

    Badger wrote on June 8th, 2013
  23. Stereotyping all fat people as lazy, gluttons, fraught with disease that they have brought on themselves is discriminatory and stigmatizing. You cannot tell by a person’s body size what their fitness levels are, how hard they work, how intelligent they are, or how disciplined they are. To do so, is overly simplistic.

    Stigma and discrimination of people based on their physical appearance or body size is resulting in physiological reactions to this stress. The pressure to reduce their body size in not only extremely difficult, if not impossible, it is BAD FOR THEIR HEALTH.

    Shifting our focus to behaviors that bring us health is laudable, I struggle with that resulting in changing the way that society sees us. If I do not exercise 30-minutes daily, am I any less deserving of my civil rights? If I eat a larger portion than might be considered “enough”, am I deserving of shame as a result?

    Does shifting the focus of the public from a weight-centered paradigm to a health-centered one make the public any more accepting of me as a fat person? When they look at me, will they see anything but my fat and the “billions” of dollars I am costing them? Since John Q. Public doesn’t see what I do in my daily life, I have my doubts. I also doubt that they would care if they could. I suppose I’m idealistic in my desire for society to accept ME, who I am, as I am, and not demand that I change to fit what they want me to be.

    Before making a judgment about a person based solely on the size of their body, ask yourself: if you were to gain weight, would you want to be treated the way you are treating fat people right now? And which of your civil rights should be taken away from you because you are fat?

    Join the fight for Equality At Every Size. http://www.naafaonline.com/dev2/

    Darliene Howell wrote on June 8th, 2013
  24. I work in an environment where my coworkers are constantly talking about how fat other people are. Their other two favorite topics are other peoples clothes and how other people smell. I am a bit on the heavy side for myself right now at 160 pounds. The way my coworkers talk bothers me, not just because I’m a little heavy, but because it shows how much of an insult it is to call someone fat. I have struggled working in this environment but it has also opened my eyes to something; if the worst thing you can say about someone is that they are fat then that person is a better person than you because at best you are merely rude.

    I hope everyone keeps on their own personal journey with compassion toward others and good health.

    Jill wrote on June 8th, 2013
  25. It seems that you are asking us all to avoid being a part of the “stigma of obesity”, but I’m not sure what that would look like. You never used a word for the attitude that we should hold regarding obesity, so perhaps this is more about clarification than a rebuttal.

    I am a health educator who could stand side-by-side with you on a conference stage and most in the audience would never detect any difference in our philosophies on the subject of human health, yet in my teaching I never use the word “obesity” because I believe it is misleading. It invites a distinction, and in that distinction is an opening for accommodation that would not exist if it were referred to by it’s actual meaning: disability.

    Obesity – in and of itself – is never the core issue. Obesity is merely the most obvious symptom of a much bigger problem caused by – and only by – inactivity and malnutrition; both are lifestyle choices. Of course, food-like-substances are the cause – even among those who are genetically or hormonally challenged – but the result is no different than the self-imposed injuries by any number of means: like drug addiction, for example. Or, utter inactivity. Anything that causes the human body to fall below a minimum threshold of functional capacity (which obesity clearly does by virtue of fat alone) all results in the same basic problem: disability.

    Disabilities do come in several varieties, but they all have the same basic characteristic: a human’s inability to function normally and with no assistance from others in performing the acts of survival. It is true that some disabilities are caused by accident and other un-preventable means, and there should be another word for those (that is a distinction that does matter), but we can agree that even a cursory examination of common disabilities shows the vast majority of them to be caused by simple neglect – neglect of human health by a failure to do what we already know we should, and that which can only be done on an individual level. I honestly don’t see the “struggle” that you speak of in this. The path is known and the methods are well-documented, and yours are among the best; available freely and proven effective.

    Therefore what we know of as obesity is a choice, not a “struggle”. And it is a choice with a significant impact on society (that’s you and me), but even more so on those closest to the person disabled by their own hand. As their disabilities increase and their ability to function normally decreases, the activities in which they can participate diminish, and those who seek their company and care about their comfort must accommodate or leave them behind. When you love someone, leaving them behind is not an option.

    I do not engage in or support discrimination in the way that it is typically understood, but no one refers to our societal attitudes about drug addiction or refusal to move one’s body as a “stigma”. Nor should they about obesity. How is it shaming to reveal to someone that their choices are unhealthy, and if they continue on the path that they’re on there is a cost to themselves, their family , and the rest of society? What I want most out of this discourse is to shine a light of reality on the subject of self-initiated disabilities such as obesity so that everyone will recognize the power they possess to have full control over these issues. The only truth around obesity, and so many of the disabilities that are only known in modern times, is that they are the direct result over a failure to create an environment that supports a thriving human body. No one can do that for anyone else; it must always be done at the individual level. If it is discriminatory for me to hold that attitude, then maybe it is the concept of discrimination that we should be looking at – not obesity.

    Dave Young wrote on June 8th, 2013
    • Dave Young wrote: “How is it shaming to reveal to someone that their choices are unhealthy, and if they continue on the path that they’re on there is a cost to themselves, their family , and the rest of society?”

      Oh yeah. NOBODY KNOWS. Be sure you run across the street and tell them! I know they will be so grateful for your pointing it out.

      If you are looking at someone’s shopping cart filled with cereals then perhaps you can bother having an opinion (assuming they are shopping only for themselves which is an assumption).

      Otherwise, you’re merely patronizing. You make the unfounded assumption that just because someone is fat that in fact they are every day making choices that “help them continue” on the path” to not only ruining their health but being a vampire even to society — oh but your altruism is so touching. It’s only for the good of society and the children, I’mm sure.

      Many people I know are fat, even VERY fat, and in fact eat better and live better than nearly every lean person I know. Usually it was being fat and trying to get UNfat that taught them to eat whole-foods well eventually, but the fact remains that after “some” fat loss — a little or a lot, but leaving them still fat or even VERY fat! — that stopped, and now they are much healthier but still, people like you will “assume.”

      The idea that if people would “just quit eating all them damn bon-bons” or something, that their fat would magically disappear and they’d be lean! is such a ridiculous, horrible, utterly gigantic LIE. If it were even micro-fractionally true the diet industry would not be a 60+ billion dollar industry (if not more by now).

      I know fat people with bad habits but I know as many or more thin or moderate people with bad habits. It’s just assumed that since they aren’t fat, their habits must not be so bad, their eating when they’re emotional must not be the same, their eating enough for two people must be rare or balanced by ‘healthy exercise’, in short their moral superiority about how they deal with food is evident solely by the size of their ass. THAT is what prejudice is: basing one’s opinion of matters they know zip about, on some physical feature of a person.

      Your discrimination is not that you choose to call it disability rather than obesity. It’s that you assume, merely based on someone’s looks, that you know something about their life, their private habits, and so on, and that today, and yesterday, that person in line who is fat “is making bad choices! every day!” — and OMG all of society will pay — and you don’t know anything about them at all.

      PJ (RightNOW) wrote on June 2nd, 2014
  26. Mark, thank you for raising this issue. I am not going to try to attempt to respond to the diversity of comments above but I do consider this issue deeply personally and professionally. Some thoughts:

    -The original post addresses our culture’s obsession with appearance. This affects all of us. I read a lovely blog post the other day about how to talk with young girls and how to engage them in topics like what they like to read v. starting out by saying how cute they are. We would all do well to direct our attention to qualities other than appearance.

    -As many above have reported, I’ve been on both ends of the spectrum. Just an N =1 but the person who judged me worst when I was heavier was me. The people who judge me the worst now are others. It’s apparently ok to openly attack someone with a normal BMI.

    -Epigenetics. I have had the benefit of getting to know the research on both maternal and child health and individual health as affected by both obesity and high-glycemic foods. Do not for a second think that the children in our country today are operating with the benefit of 100% choice about how fat they get. The weight status of their parents will inform their weight. We need to get out of our heads about this as a moral choice and get into the science.

    -Surrounded by bad choices and bad information. I have the benefit of some of the best information on the planet, supposedly, about food choice, weight, and health. I followed it after the classic dying thyroid diagnosis and it was a disaster. I found Taubes et al and that saved me, but seriously, that took a lot of work and I can afford a subscription to the New York Times.

    We have an entire culture funded by a food industry built on an ag policy that makes poor food choices imperative. We have an energy policy that makes poor transportation choices imperative.

    Rather than getting down on each other, we need to get down on the vast policy and financial incentive systems that have made it so easy for people to wreck themselves (and I would include alcohol in this, absent from this conversation) and so difficult to make good choices.

    Watch TV. I dare you. It is the land of 100% mixed messages with thin beautiful people eating garbage.

    -Don’t get me started on clothes sizing

    In conclusion, I really think we need to just leave each other alone and work on the systems and policies that have fundamentally changed the health of our society. Yes, individual choice is about creating new markets and I’m all for that but we need to invest in evidence-based work to countervail these huge trends we are pushing against.

    The real challenge to our community is to organize around local, state, and national food policy that makes education and healthy food choices easier and more affordable. School lunch program anyone?

    Juli wrote on June 9th, 2013
  27. Thank you for this post! I know I was completely unaware of this until a few years ago when I became friends with a wonderful and morbidly obese woman. I will never forget the nasty stares she got when we went out to eat at a restaurant the first time. It wasn’t just one person. Nearly everyone seemed to stare at her. It made my skin crawl.
    She has tried many things to lose weight with varying success, but every time she has to grocery shop or do anything in public, she has to deal with harsh looks of strangers. Talk about discouraging!
    I have never been more than 20 pounds overweight, so I never personally experienced this. It breaks my heart to know there are people everywhere dealing with this in addition to the aches, pains, and health problems that come with being quite overweight.

    Susan wrote on June 9th, 2013
  28. “Be kind, for everyone you meet is fighting a harder battle.”
    ― Plato

    We just don’t know one another’s stories; we don’t know where someone is on their personal journey through life….

    Wishing you all kindness and compassion!

    Maybeme wrote on June 10th, 2013
  29. AMEN.

    “The personal picture of one’s weight – not to mention each person’s experience of it – however, is much more complex than any stereotype or momentary judgment can begin to tell.”

    This is so true, and sometimes the people we want to look like (the thin, the bodybuilders), got that way through starvation, or harm to themselves. :(

    Kait wrote on June 10th, 2013
  30. Yes, people keep thumbing the side effects of obesity, repeating the age old clichés and attributing some characteristics to them. Anti-fat bias can be seen in different facets of life even some medical professionals have the same bias. Overweight patients often report weight discrimination in health care settings but it doesn’t mean that there aren’t any nice doctors.
    As far as obesity is concerned, it may be genetic or the result of our own life style but we should change our behaviour towards obese people so that they don’t have the feeling of being degraded and discriminated.

    SamreenM wrote on June 11th, 2013
  31. Yes, people keep thumbing the side effects of obesity, repeating the age old cliches and attributing some characteristics to them. Anti-fat bias can be seen in different facets of life even some medical professionals have the same bias. Overweight patients often report weight discrimination in health care settings but it doesn’t mean that there aren’t any nice doctors.
    As far as obesity is concerned, it may be genetic or the result of our own life style but we should change our behaviour towards obese people so that they don’t have the feeling of being degraded and discriminated.

    SamreenM wrote on June 11th, 2013
  32. It’s important to remember that not everyone is psychologically ready to change. One friend of mine constantly complains about her weight and how she “needs to do something,” to the point that her five-year-old daughter now tells her the same thing. But she’s so dragged down by depression that making a lasting change is impossible until she deals with the emotional issues. So instead she drinks more wine, and gains more weight, and gets more depressed…going on several years now. For some of us, effecting change is as simple as making a decision and following through with it, but for others like my friend there are far greater roadblocks to overcome.

    KevvyB wrote on June 13th, 2013
  33. Thank you for this post–even though reading the comments has been a mixed bag. One of the things that’s difficult for me when I attempt to eat in a healthier manner and lose weight is that hen I go to forums looking to read things that will be supportive/inspiring I find so many unkind comments about fat people that it makes me feel like I don’t belong there, that I’m not wanted. The same thing happens in gyms and even health food stores and such, and it makes something that’s incredibly difficult so much harder than it needs to be. Self-righteous anti-fat people do so much damage to fat people who are really trying to do better.

    I have been fat my whole life–pudgy as a child, truly fat since my mid-teens. I’ve been “morbidly obese” since around 1990. Doing a better job of taking care of my body is a tremendous struggle against depression, pain, addiction and entropy. OTOH, despite my weight my cholesterol, blood sugar, blood pressure, etc. are all within healthy ranges. Health problems I have (allergies, thyroid, depression) may be related to diet, which is why I’ve gone mostly primal at this point, but plenty of slender people have the same problems. About the only thing I can blame solely on my weight is crankiness in my feet, ankles and wrists, and I don’t take anything other than advil for those.

    What makes me sick is that should I do the massive amount of work involved in losing half my body weight, I’ll still be overweight enough that the ignorant jerks who judge fat people will still look down at me. I’ll have great strength and endurance, and I’ll be eating incredibly healthy food, and these people will look at me and think, “Oh, look at that lazy fat slob.”

    Elizabeth wrote on June 13th, 2013
  34. As always from MDA, this article is superb. How Mark hits all these important angles, I have no idea, but I thank God for this website.

    I’m the guy who has been fat and thin his entire life. I’ve lost and regained over 200 pounds during my 42 years and I am so tired of it all. I’m 5’11″ and weighed 286 pounds this morning. I suffer from it all: Low T, high blood pressure, lethargy, headaches, joint and muscle pain…I was at 250 last summer, losing weight, eating primal, and doing Crossfit. I just can’t stay with it because I suppose I no longer care. I’m done. I’m invisible to most of society now that I’m really fat again. People just look right through me or avert their glances quickly.

    Thin people do not understand. You can be the thinnest person in the world, even downright skinny, and there is a preconceived notion that a thin person is fit, which is totally wrong. When I am in the gym, I often outperform people much less obese than me. I know two physical education coaches who are in wonderful condition. During our lunches together, they talk and make fun of fat people incessantly. It’s all they talk about. It’s so elitist and judgmental that it has made me less likely to want to exercise or eat primal. They’ve even covertly snapped pictures of fat people in the gym and laughed about it while sharing them with one another, and these coaches are both adults. It doesn’t matter that the fat person is in the gym trying to improve. It doesn’t matter that the fat person has totally changed their diet. All that matters is that they’re fat.

    It’s astonishing how much differently I’m treated when I’m thin. A few years ago, I lost a lot of weight, hit the weight pile and gained some lean muscle mass, and had more attention from the ladies than I’d ever had in my life. My male friends all wanted to “know my secret.” There was no secret. I worked my ass off in the gym and swore off junk food and empty carbs. I resented the ladies who wouldn’t give me the time of day when I was fat and I resented my male friends who just the year before would call me “big boy” or “big fella” during conversations. Light-hearted fun, I know, but I didn’t need to be reminded that I was a porker. I already knew.

    C.C. Deville, the famous guitar player from Poison said it best, “When I was in Poison [80's], I was a cocaine addict. When I left Poison [90's], I quit cocaine and got fat. It was more socially acceptable for me to be a junkie than be fat.”

    C.C. Deville gets it.

    jbourneidentity wrote on June 16th, 2013
  35. This was a great post. As someone who is on her way down from 250lbs, I get people who congratulate me, but still roll their eyes when I take the bun off of my burger, or who just down right tell me I look sickly (at 5’3 and 180lbs, I don’t think so) to deter me from doing whatever crazy diet they think I’m doing. It’s frustrating, because I feel like I’ll never really shake the obesity stigma. My family and close friends and amazingly supportive, it’s the aunts and uncles and people who didn’t watch the transformation over time (I just showed up weighing 60 pounds less one day) who are the least supportive.

    I’ve also gone to the doctor for anything, you name it, and 9 times out of 10, they tell me to lose weight. To be fair, when I lose the weight, my aches and pains did get better, but how frustrating is it to hear a doctor’s condescending attitude when all you want is medical help. In the end, after years of complications, I finally ASKED to be tested for Celiac’s. I was literally told to put the fork down by one doctor.

    Anna wrote on June 16th, 2013
  36. These are all great comments. I am so glad America is finally talking about obesity from a place of compassion and understanding…. although we have a long way to go.

    To help bring attention to obesity stigma (and demonstrate how it is actually counterproductive to healthy eating behaviors), I thought I would share an article that would be of interest.

    Dr. Rebecca Puhl conducted a study on the subject and published her findings in the Hastings Center Report in an article entitled, “Obesity Stigma: A Failed and Ethically Dubious Strategy.” Here is a link to an article that summarizes her findings: http://www.dugdug.com/obesity-stigma-reinforces-unhealthy-behaviors .

    Shaming people to lose weight doesn’t work..plain and simple.

    Bethany_DugDug wrote on November 25th, 2013
  37. I was lean growing up. I didn’t get fat (and I got very fat, very fast) until my early 20′s. Seeing the difference in how people treat you is so profound there aren’t even sufficient words for it. Really this is something that you’d have to BE really fat to probably see. And since I didn’t grow up that way, I didn’t expect it; I was constantly confused, not understanding, and then eventually realizing what was going on with people’s behavior.

    Ironically, my family suffers a genetically inherited, currently incurable disorder called lipedema. (A few spellings on that.) ‘Inflammation cascade’ can create a lot of fat fast and it stores in the hips to ankles (and upper arms) and never-but-never goes away. Not by diet, not by exercise, not by anorexic starvation till organs fail, not by gastric bypass surgery, nothing budges the fat which just accumulates until eventually a person is pretty well immobilized. (For ‘tiny’ stage-1 amounts, liposuction can help a bit, though it’s controversial whether it returns.) I guess at that point a bullet is the only solution.

    By stats, 11% of women in USA have lipedema. Given its diagnoses is from symptoms based on observing the fat and its behavior, let’s say that if we take that % into the number of actually overweight women we get literally 40% of overweight women are probably lipedemic. That means cutting out their guts will not solve that, it means all the diet food in the world — or even paleo — won’t solve it. (Paleo will however make them feel better in the meantime and probably reduce some water/inflammation bloat.) Not like there’s much research on that because really now we’re competing with a huge entrenched combination of industries related to being fat.

    So what, I wear a sign? “I’m not a gluttonous pig, it’s a mystery incurable genetically inherited disease?” Please. Nobody cares. Fat is just the “icon” at this point that a whole society is delighted to pour their sneering opinions into. As if people who need to lose bikini weight are really dealing with the same metabolic issues as someone who is 300# overweight. As if really fat people would all be skinny if they would just quit eating bon-bons all day for godssakes.

    Dr. Sharma’s blog over time has had a number of articles explaining how even when someone loses weight, the body can compensate a shocking number of parameters to bring it back.

    I suspect that maybe our bodies think that whatever our high weight was, that was ‘fully grown,’ and anything less is something we must have lost through illness that needs recovering.

    Anyway. The bias against obesity, believe me on this, is pretty horrifying.

    I once told my cousin, who is half black, that I didn’t really see the bias he talked about, at least most of the time. He laughed and told me that nobody who isn’t black has any clue what it’s really like living it. I suspect the same goes for obesity, especially extreme obesity.

    PJ (RightNOW) wrote on June 2nd, 2014
  38. in 2008 I was in a farming accident and had a traumatic brain injury w pituitary trauma and went from 225 to 300. Now w meds down to 195. I was totally crushed by how I was treated and still am by friends. As a fat person I was treated like crap. Like I wasnt trying although I didnt and still cant eat anything. Id watch skinny ppl eat like hogs and never gain.
    Ive learned compassion for the broken and made me a better person I think.

    steve wrote on June 3rd, 2014
  39. In addition to the factors behind obesity that Sir Grok-Sisson mentions (yes, I had him knighted here in my personal kitchen kingdom),
    I’d like to add some psychosocial aspects.

    Basically, if i makes sense to you that an experience would make weight management difficult, odds are that you’re right. In this one study, and I encourage you to look for more, 69% of patients self-reported childhood maltreatment. http://onlinelibrary.wiley.com/doi/10.1038/oby.2005.16/full

    Children die from lack of attachment and emotional nourishment. It happens in orphanages, and it happens in families. Other children survive socially and emotionally paltry environments through self-medication, such as over-eating. This creates a behavioral pattern, and a wariness of other people, that takes a lot of time and effort to change on a neuronal level.

    A lot of the obese people I meet are survivors of trauma of the drawn-out, horrific kind. I have come to view them as heroes. It is odd to me that a country that salutes its soldiers for participating in wars overseas, have so much scorn for the soldiers of childhood battle on home soil. Oftentimes, obesity is but the price a person had to pay for survival, and a heavy medal to bear for absorbing much violence and not paying it forward. In my mind, they should be saluted and supported, not isolated further.

    Obesity is lethal. I see it as a neuronal knot that takes a lot of love to untie.

    Yours,

    a soon-to-be licensed psychologist (yay!)

    Hanna

    Hanna wrote on June 4th, 2014
  40. I’m 44 and fat. Really fat. I weigh 280 pounds and I’m only 5’11″. Last year, my 38 year old wife was diagnosed with pancreatic cancer. We were blessed to be able to seek treatment at MD Anderson in Houston. Long sedentary hours there and eating in restaurants took their toll on me. I ballooned up to an unbelievable size. While my beautiful wife won her battle with her pancreatic tumor, I’ve lost my life-long battle with my weight.

    I have low T, high blood pressure, and extremely high estrogen. My very experienced endocrinologist called me an “anamoly.” Frankly, he doesn’t know what to do with me. My waistline has expanded from 36″ to 44″ and I’m now wearing 3XL shirts. I don’t recognize myself in the mirror. I know if I don’t lose weight, I’m dead in 10 years. There’s a part of me that doesn’t care. Low T has robbed me of good moods and vitality. Blood pressure meds have ruined by sex life and energy levels. How can you work out when you have no energy? I started eating Primal about 22 days ago and began Crossfit last week. It’s a minute to minute struggle. I’m a complete carb addict and I’ve been fat and thin all my life. I’ve lost and regained over 150 pounds in my 44 years.

    I’ll echo what has already been said, “When I’m thin, people flock to me. When I’m fat, no one notices me.” Truer words have never been said. I’ve watched women cast an interested glance in my direction while seating in my pickup, but when I exit the pickup, their eyes avert downward quickly and they flee as fast as possible. I’m happily married, so that isn’t important to me, but it’s the motivation behind the action that bothers me. I’m still a human being and for people who’ve never been fat, the pain is indescribable. I am in a constant state of embarrassment. I teach at a large college and sometimes, when my friends and co-workers talk to me, they say, “How are you, big ‘un?” or “What’s up, big man?” Really? Thanks for letting me know I’m fat. I had no idea until you told me.

    CC Deville, guitarist for the famous rock band Poison, put on weight after the band broke up in the mid-1990s. He said that it was more acceptable to be a junkie in LA than it was to be fat.

    Pray for me as I continue on this Primal journey and thanks for listening.

    chris wrote on June 4th, 2014
  41. You are displaying the very attitude outlined in this article. Why on earth would you presume to give (unsolicited) “advice” to this poster about her mother? You know NOTHING about the situation! I found your post incredibly arrogant.

    Sahara wrote on June 6th, 2013
  42. I agree with Sahara: it also reflects the dogmatic insistence that key to losing weight is just simply lowering calories, and fat people just need to eat less. As Taubes and many others have pointed out, that’s not the real story, and it’s based in ignorance and arrogance.

    Louise wrote on June 6th, 2013
  43. Or it could be that she is not eating enough. I began my journey through/towards menopause and found that I could eat very little and still gain weight.
    Migraines are at times a result in changing hormones that occur in women several times in our lives. With those changes in hormones come weight gain even with smaller portions or fewer meals. What helped me is eating more food along with upping my protein and fat intake. It’s been about 20 years since I started on that journey and I’ve been able to finally lose the 35 pounds I gained during those years bit by bit. Yay, I weigh now what I did when I got married 35 years ago.

    2Rae wrote on June 6th, 2013
  44. After menopause, I could eat as little as 1,000 calories a day and not lose weight, because I was eating the wrong foods. The old conventional wisdom about “smaller portions” was insanity. I had “dieted” (Weight Watchers etc) for years, doing the things Mark rails against – chronic cardio, eating low-fat and high-carb, and at most I lost 1.5 pounds and then gained it back. Even with a six-month “blast” of still more cardio and less food, nothing changed. Up and down by 1 or two pounds.
    Instead, I changed to primal/paleo eating, and I eat much MORE while losing weight! It’s astonishing!
    IT’S NOT HOW MUCH YOU EAT, IT’S WHAT YOU EAT.

    In addition, there ARE many medications that make people gain weight. Making them feel worse is not a kind thing to do.

    Celestia wrote on June 7th, 2013
  45. Let me qualify “it’s not how much you eat, it’s what you eat.” Obviously you won’t lose weight eating pounds of bacon every day. The thing about the primal way, though, is that you are not as hungry. I used to have to eat every three hours or I literally felt sick, like I was going to faint. I woke up starved. Eating primal, my body seems to know what it needs. (And as an aside, fasting is pretty easy now!).

    Celestia wrote on June 7th, 2013
  46. Celestia- actually, yes, you would lose pounds from eating bacon if you cut out carbs. It’s called ketosis and occurs when you consume moderate amounts of protein with high amounts of fat and low or no carbs at all. Bacon is especially preferable for this since it has a great fat to protein ratio. Obviously you would be malnourished if you didn’t include organs and even greens or occasional vegetables, but you certainly would lose weight and the amount would be significant. It would be fat loss and not muscle loss.

    Christina wrote on June 8th, 2013
  47. Actually, it’s not that simple. The Law of Thermodynamics does not apply to metabolism and weight gain/loss. A calorie is not a calorie (see http://www.huffingtonpost.com/robert-lustig-md/sugar-toxic_b_2759564.html). Please give up trying to justify your earlier comment and apologize to PotAsh.

    ARB wrote on June 6th, 2013
  48. I find this response a bit simplistic in nature.

    Focusing on the first statement only, I can safely tell you that not all calories are equal. I lost weight ingesting the same number of calories, instead changing what I ate.

    Mark had a great article on here illustrating that not all calories are the same.

    Converting calories from carbs to protein resulted in a 63 pound weight loss with no additional exercise (meaning I went from no exercise to no exercise), yet I was still eating around 3k calories a day.

    If you have not experienced the carb cycle to oblivion and how it impacts you on a physical and emotional level, I’m not sure you can relate. Carb addiction is brutal, especially when CW tells you, you are doing the right thing. How can you “change” if you don’t even know what you are supposed to change? At that point, then your statement on change from within becomes more relevant. The common theme in most of Mark’s success stories is the journey involving failed attempts at change. The cards were stacked against them.

    I didn’t even realize what I needed to change until I read a book that focused on the effects of your diet on your liver and that affects you all the way down to your metabolism, since I had fatty infiltration of the liver. At that point I finally knew what I needed to do, the recommendations made some much sense. It was paleo and primal on so many levels without even making a direct connection.

    Doug wrote on June 6th, 2013
  49. Physics may be inescapable, but we’re not just dealing with physics when it comes to an individual’s weight. We’re also dealing with biochemistry, genetics, hormones, and a few other things tossed in that all interact. Portion/calorie restriction coupled with increased exercise just does not yield anything close to consistent results under scientific research. If it did, there would not be as much debate in the medical and scientific communities as there is.

    b2curious wrote on June 6th, 2013
  50. “People who consume copious pounds of food relative to their energy needs become overweight.”

    Actually, I did the math on my weight issues, and if you use the over simplified calories in, calories out paradigm, I “over consumed” 32 extra calories a day for years, which amounted to 3 to 4 pounds a year of weight gain.

    Felix, do you actually know when you eat 32 calories more or less than you should? You must be a computer and weigh every single bite you put in your mouth. (And if I wasn’t nicer, I would now add a few of those names that you were objecting to earlier.)

    MDrake wrote on June 6th, 2013
  51. Oh well, now it’s all better. I will just change the way I feel and… nope my lungs still don’t work.

    Darn. I was so sure that would work. After all no one has ever ever told me it was all my attitude before. That was a fresh and new insight.

    Gracie wrote on June 6th, 2013
  52. No

    John wrote on June 6th, 2013
  53. Yes!

    patrick wrote on June 7th, 2013
  54. Yes. But if I judge Hitler to be a monster, is this a-holey of me to do? Judging does not equal being a jerk. But one can be a jerk by how one judges, who one chooses to be hard on.

    Joy Beer wrote on June 11th, 2013
  55. Yes.

    oxide wrote on June 6th, 2013
  56. Felix,
    I agree with you that name calling isn’t supportive, much less corrective. It is my hope that people will learn to disagree without the use of personal attacks. It makes for an open and respectful place for the exchange of ideas, opinions, and debate.

    Great article Mark. I appreciate the insight. I have been thin (by thin i mean I was “straight size.” No curves, and could have continued as a model if I were a bit taller) almost all of my life. When I turned 25, it became apparent that I could no longer survive on Doritos and Coke products and look relatively healthy. I understand the bias that one experiences in going from thin to thicker (I’m not overweight by my doctor’s charts, but I don’t carry weight well). I did not understand the psychological effects of the reverse process. I was once told that I was getting fat when I gained up to a total body weight of 100 lbs at a height of 5’4. You could see my hips and ribs sticking out for goodness sake! There wasn’t anything wrong with my weight, just my lack of muscle mass. Now I know the difference.
    Either way, I hope and pray for emotional and spiritual healing for those that have experienced the fear and pain of being ostracized for their physical appearance.

    My motto: You are separate, unique, and whole. You are never required to fit into someone else’s ideal. Even those people don’t fit into their own ideals. Realize that you are Separate – not created from the same mold as another person, Unique – different, with wonderful qualities that were meant for you and that would not be ‘right’ on anyone else, and Whole – you are complete as you are, you don’t need to model your personality, hopes, or body type after someone else to be acceptable.

    Ginny wrote on June 6th, 2013
  57. Edited:

    “Yep. I realized recently that there is no one magic community where everyone is perfectly open and nice to each other all the time. Some people are going to [needlessly belittle other people and/or their actions to somehow make themselves feel better about themselves] no matter what community they are in.”

    cTo wrote on June 6th, 2013
  58. ya know what, Felix? you’re making a lot of fuss by taking something out of context. Gracie wrote above that people treat her badly because she’s overweight due to a medical condition. those people are assholes. i replied to her comment when this article had four comments only….

    if you construed that to mean i called anyone HERE an asshole, i wonder why?

    in my second comment, not in reply to anyone else’s, i noted that EVEN HERE– where the tone is generally considerate and supportive — people who struggle with their weight are sometimes looked-down-upon. considering the size of Mark’s community, it’s a tribute to his (and his staff’s) characters that the number of unpleasant commenters is so very small.

    tess wrote on June 7th, 2013
  59. @Taco I’m obese and agree with you. Food is my drug of choice and unfortunately it’s not something I can stop cold turkey, unlike cocaine or alcohol food is needed daily.

    As far as paying more insurance for high risk behavior I also agree with you and would like to include risky sexual behavior along with the fatties, drunks & druggies.

    Lucylu wrote on June 6th, 2013
  60. Well, that’s actually not true. Does that fat 4 year old have to blame themselves, or their parents? There are many issues such as hormones or medications that affect your weight regardless of calorie balance.

    Also, once you have been fat, ESPECIALLY if you were fat as a child or teen when most of your fat cells are created, it is especially hard to lose the weight. In “Refuse to Regain” by Dr. Barbara Berkeley, she notes that people who are “formerly overweight” have a much more difficult time maintaining weight than those who are “never overweight”. This is primarily due to insulin and how the body processes carbs (also why low carb works well for people who were overweight). Meaning, we can permanently damage our bodies with what we eat.

    But I go back to the start – so if we know a fat 25 year old who was fat at age four, it’s all their fault?

    Marcia wrote on June 6th, 2013
  61. Taco, once I would have agreed with every word you wrote, and I still agree with some of it. I don’t like the rationalizing and excuse-making that’s so common among obese people, or that some of them pretend to be satisfied with their obesity. On the other hand, I’ve learned that there are many reasons for being fat and just as many reasons for why it’s sometimes very hard to lose that fat. I also realized that being judgmental and feeling smug about my thinness spoke volumes about my own flaws. I have since developed considerably more compassion regarding the difficulties fat people face.

    Shary wrote on June 6th, 2013
  62. Hey Taco,
    It always used to irk me to have to pay medical insurance premiums month after month and never use any benefits from it. But actually, what better blessing is there? Be glad you aren’t fat.

    By your logic people with genetic diseases or just the genes for such diseases should have to pay more. Or go one further, if you partake in any risky behavior like drinking on an occassional night out, you should have to pay more because you might get in an accident.

    That said, I agree obesity is a cause of great cost to society. And education is the key. What works (from my experience is Paleo and low-carb) is not what is preached. What people are taught is exercise more, eat less. Until society changes that, you can’t blame fat people for being fat.

    You obviously pride yourself on your health and fitness. Why not take complete charge of your life and skip insurance all together?

    Suzie_B wrote on June 7th, 2013
  63. “Overweight people should have to pay more for insurance.”

    The problem with this logic is that there are a million things you can do that will wreck your health at least as much as obesity and nobody seems to suggest that they pay more. So it comes off as more ‘i hate fat people’ shaming. Not to mention that an obese 25 year old is almost ALWAYS costing less than the 60 yo, but they are forced to pay a similar premium. If you are going to start charging people because of their personal health, then go all the way and charge everyone based on their health issues. I am overweight and I guarantee my insurance company makes boatloads of money off me, whereas I have thin colleagues that cost them a bundle.

    It is surprising to me that on this site you might not have some sympathy for the fact that many people have been ill advised on what to eat for their entire lives and this is the cause of much of the obesity problem in this country.

    Lea wrote on June 10th, 2013
  64. You sound like an incredibly cruel person, and I hope I never meet you. You clearly don’t understand anything about the complexity of being a human being. We are not just machines that can adjust input and output to create the “perfect” slim body. There’s a huge mental and emotional side to all of this, and many, many people aren’t privileged enough to have a firm standing there. A lot of the emotional trauma that has contributed to me being an obese adult is related to the abuse I received from being a slightly pudgy child.

    You also have no grasp of the complexity of cause and effect. So, somebody is fat and has a medical problem–which came first? Unless you know that person’s personal health history, you have no right to judge them. In fact, that disgusting, lazy fat person you see may have recently lost 100 lbs. from months and months of hard work–physical work, mental work, emotional work. You have NO IDEA how hard it is to change your body from what you’re used to and what your body seems to want to be.

    Your attitude is toxic and cruel and only contributes to fat people staying fat, and I sincerely hope you keep it to yourself in the future.

    Elizabeth wrote on June 13th, 2013
  65. Becoming fat does create metabolism sensitives. It *is* harder to lose weight and keep it off. But the 25 year old is responsible for themselves in a way that a 4 year old is not.

    Obesity is a medical problem but like so many other issues, it just is. My parents gave me the genes that cause my dairy allergy. I can blame them or be happy to be alive and accept that a part of my life is harder because I have to deal with stuff that others don’t.

    Amy wrote on June 6th, 2013
  66. At the age of 25, I would say yes it is their fault. True their parents set them up for a harder path when the 4 year old relied solely on what their parents fed them, but there comes a point in time when you must be accountable for your own problems…25 is well past that point.

    What ChocoTaco has said has merit…albeit a bit blunt in the delivery (but I respect him for it ;) ). Obesity, by and large, is a problem based on lifestyle. There are things that make certain people more pre-disposed to be obese (genetics, stress, medications, etc), but at the end of the day, you make the choice of what you put in your body and what you do with your body (except under extreme circumstances).

    However, that doesn’t mean we should condemn or look down upon anyone that is obese (not suggesting ChocoTaco or anyone else here does that). Obesity, in my view, is just another problem that people must battle with like any other struggle. Why there’s so much stigma with this issue baffles me…and I’m guilty of it sometimes too. Human nature I suppose.

    Jacob wrote on June 7th, 2013
  67. Well Chocotaco, although you have some noteworthy points, your stance is too simplistic. Medications, injuries, hormonal imbalances also have a huge effect, and to suggest that people need to be more educated, well what’s out there? Low fat, chronic cardio, whole grain goodness and eating all day?
    My father had narcolepsy, and cataplexy possible caused by polio as a child. One of the nasty effects of this debilitating disorder is the destruction of a small, but vital part of the brain that deals with leptin. The result? Obesity, front and centre. We didn’t find this out until he was long dead, and I only found it by trawling through Jack Kruses fascinating blogs, where all the tragic puzzle pieces finally came together. Nothing is black and white, like that racey book, there are many shades of grey :)

    Heather wrote on June 10th, 2013
  68. The point is that people who feel that “people only have to blame themselves” are the same idiots who think “a calorie is a calorie” (LOT of new research that disproves this, BTW).

    It’s easy to be judgmental when you have no idea what you are talking about, or have never experienced it.

    “Just eat less”. You know, the first time I lost weight, I thought “I eat healthy, this Weight Watchers thing isn’t going to work, and IT DID.”

    After I had the baby, I went back to Weight Watchers, it worked AGAIN.

    7 years later after a second baby – now over 40 – dang, IT DOESN’T WORK ANYMORE. Now I have to try this and try that and see if anything will work. Hormonally, however, this may be it. I may be eating healthfully and getting regular exercise and just be overweight.

    “Taking responsibility for your health” doesn’t mean you’ll be thin.

    Marcia wrote on June 7th, 2013
  69. The problem with using the first law of thermodynamics as an explanation of excess body fat is that it is stating the obvious without addressing the real problem.

    I am fat. I have consumed more calories than I have expended. No, duh. Obviously my excess 100 pounds had to come from somewhere. But WHY have I consistently over-consumed? Do I love junk food more than I love life? Am I morally inferior (gluttony and sloth are deadly sins, after all)? Am I just too stupid to be allowed to leave the house unattended? Possibly all of the above are true, but that has nothing to do with my girth.

    I have gone on various diets, including “sensible,” doctor-supervised CW diets, where I consumed between 800 – 1200 calories of “healthy, low fat foods” chock full of “nutritious whole grains” to provide fiber and “appetite control” and was RAVENOUS. Why, if I was eating an amount of food that many people on the planet would be grateful to get? Yes, I lost weight, but I couldn’t maintain it because I could not cope with the incessant hunger. There was no way a healthy person in a first-world country should be that obsessed with hunger and yet there I was.

    As research has shown (and this isn’t new research, this goes back over 50 years), the cause for being overfat is not overeating and inactivity; rather, the cause of overeating and inactivity is being overfat. As Taubes puts it in /Why We Get Fat (and What to do About it)/, when the regulation of fat becomes disordered then the fat has its own agenda. Instead of food being first used for immediate energy needs, then maintenance of body tissue, and finally fat storage for future use (if any is left over), the order becomes 1. Filling fat cells 2. Building more fat cells 3. Immediate energy needs and 4. Maintaining body tissue (if any is left over). Thus the increase in appetite and reduction in energy – lean mass is starving even as fat increases. Then I need to build more lean mass to tote around the extra fat, driving me to consume more. There is more going on than thermodynamics.

    Now that I am eating foods that do not trigger a rampant insulin response I am finally losing fat consistently. It is not coming off quickly or easily, but it is coming off. I generally eat about 1200 to 1500 calories daily of fat, protein and a few veggies and keep my carb intake around 20-30 grams a day.

    The best part of eating this way isn’t even the fat loss, it is the loss of appetite. I simply do not get as hungry as I did following CW diets. Many would say that is because I am eating more nutrient-dense foods and so I don’t need to eat as much to satisfy my body’s needs. However, I do not believe that is the case. I believe it is because my body is no longer in insulin-induced fat-hoarding mode, and so the food I do eat is going to energy and lean tissue maintenance first. As it should be.

    Now, all this typing has made me hungry, so please excuse me while I go scramble a couple of eggs with a side of spinach!

    Badger wrote on June 8th, 2013
  70. Comment winner of the day:

    “Taking responsibility for your health” doesn’t mean you’ll be thin.

    Your body shape and size isn’t itself an indicator of health.

    Stephanie wrote on June 13th, 2013
  71. Exactly. I have many thin colleagues (my age or not much older) who have battled diabetes, cancer, osteoporosis, high cholesterol, etc., but I, who have always been at least a little overweight, have had no life-threatening problems, have never had major surgery, and have never been in the hospital (knock wood). I’m on thyroid medication, and that’s it. I eat paleo/low carb and work out regularly, but can’t lose the last 30 lbs. If you saw me in line at the pharmacy or had to sit next to me on an airplane, what assumptions would you make about me based on my size alone?

    Mary Mac wrote on June 13th, 2013

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