The Stigma of Obesity

In Group, Out GroupOne 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.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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216 thoughts on “The Stigma of Obesity”

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  1. Thank you. I was always a thin person. I actually felt virtuous about that. I don’t thik I was mean to anyone. But I did think that being thin meant something good about me.

    A few years ago I was diagnosed with a life threatening illness. Forced immobility and steroids have left me very very heavy. The heartbreaking thing is being fat is harder for me than having a terminal illness. People don’t feel free to criticize you if you are going to die. But if you are going to die fat (even if the fat came after the sick) then it is your fault.

    I follow a paleo diet because I feel much better. I haven’t lost weight but I am not gaining. I work on functional movements like squatting and proper form when I walk. I recently improved enough to add a daily walk.

    But none of it feels like enough. Because when people look at me they see fat. And fat means lazy. They have no idea how hard I fight just to stay mobile. I will never again be worth respecting. What people will see is the weight and all the things that they think it means.

    1. Gracie – Except you know that you’re working hard and putting in the effort. You don’t need to please anybody but yourself. Who cares what strangers think anyway?

      My mom has a similar issue. She was always thin, and since she started taking some medications for her migraines a few years ago, she gained weight. She is fighting hard to stay where she is now if not lose a little bit.

      Good luck with your fight.

      1. As one who has been on medication for migraines in the past (I was diagnosed with chronic daily headaches, which were mild to moderate migraines), I know that some of them come with warnings that they can cause weight gain. My doc and I had tried a few medications, before I finally tried the herbal supplement feverfew, which worked for me. (It doesn’t work for everyone, and not all supplements are created equal.)

        I’d been doing the South Beach diet (SBD) for a while, which does a good job of stabilizing blood sugar. I had minor hypoglycemic issues, which means that I was somewhat insulin resistant, which means that my blood sugar fluctuations were a bit more dramatic than a “normal” person’s. SBD allowed me to gain control of that. I noticed that when I got a little too lax with my diet, the hypoglycemic issues would return.

        When it came to the prescriptions, I noticed that ones that came with the warning that they could cause weight gain, usually also had a warning for diabetics, stating that they may affect their blood sugar. I figured if it affected the blood sugar of diabetics, it probably affected the blood sugar of non-diabetics as well, and that was probably the reason for the weight gain, so I paid attention to see if that was the case for me. I found that on the medications with those warnings, that I had to be very strict with my diet otherwise I craved foods that were higher on the glycemic index and/or ate more than normal. This tells me that they medication probably made me slightly more insulin resistant than I was when not on it. This may or may not be what is going on with your mother. Since she “was always thin” she may have been one of the lucky ones who was able to handle sugar and carbs with no issues. If the medication is affecting her blood sugar, like some of them did mine, she may not recognize the symptoms (almost nonexistent) of mild, medication induced hypoglycemia.

        1. @Celestia, I’m not getting used to fasting yet. I’m on SCD, which is pretty close to Primal, for about 7 years now – my recent fasting experience was very difficult… I hope the next attempt will be easier 🙂

          I’d like to know if you were talking about intermittent fasting or extended fasts?

          Anyway, even though this is difficult for me to fast, I don’t want to stop: the benefits are way too important for me not to continue!

          If you’re interested, 2 days ago I shared my experience and results after a 16-day fast:

          http://nutritiongang.com/therapeutic-fasting-my-results/

        2. It’s just not possible to gain anything but water weight on 1000kCal per day, irrespective of the macronutrient ratio. It’s much less then anyone needs to be healthy and is an anorexic diet. People often underestimate their intake. Prisoners in concentration camps got around 1000kCal per day and they either died or became emaciated, not one of them left at a healthy weight, let alone overweight or obese and the Minnesota starvation experiment demonstrated emaciation on 1500kCal per day with exercise.

          I don’t judge or blame people for their weight problems though. I know it’s not possible to diet, loose weight an maintain it because a reduction in calories causes the metabolism to slow down, your appetite to increase and as soon as the diet is stopped, you’ll put the weight back on again. Trying to keep the weight off often results in disordered eating, i.e. counting calories, fat, carbs, measuring food and episodes of binge eating, as the body fights the weight loss.

          Low carb diets only work because it makes fat storage difficult for the metabolism (carbs stimulate insulin production and low levels make fat storage hard) and a low fat diet does too (converting carbs to fat is inefficient so the body prefers to burn, rather than store them). Both extremes cause you to eat fewer calories, they’re not magic. Low carb is better for some, and low fat better for others. Unfortunately for some, just changing the macronutrient ratios is ineffective or creates more problems than it solves.

          Weight gain for people who aren’t prone to obesity is difficult and impossible to maintain in the long term. The Vermont overfeeding study conducted on prisoners showed that even eating 8000kCal to 10000kCal per day for 10 weeks only caused a weight gain of 25% at most and they returned to their normal weight when eating normally.

          Medication can cause weight gain or loss, via changes in appetite or metabolism. The risks of taking vs not taking the medication need to be balanced which includes other side effects as well as weight. Quite often your body returns to its original weight when you come of the drugs so it’s not a problem.

          I’ve been overweight and anorexic before and now I’m a lean and healthy. I’ve done low fat, low carb, very low calorie (800kCal) and high calorie diets (<6000kCal) before before. It wasn't easy to overcome (still struggle now every now and then) and I understand why some people have a life long struggle with their weight, whether they be underweight or obese.

    2. I respect you and pray for you. I’ve never been that sick before but as a medical intern I see a lot of terminally ill patients who struggle a lot more psychologically than physically with coming to terms. I can’t imagine how hard it is, but at least when my time comes I’ll know many people strong like you made it through before me.

    3. hang in there, Gracie! it’s rough to be around the judgemental assholes, but rest assured a LOT of people empathize!

    4. Gracie, I understand.

      There is bias, sometimes so subtle the owner doesn’t realize. I have been both fat and normal weight. Just the way strangers interact is amazing. When I’m fat, I’m invisible. When I get past the thyroid and pcos (and stress) and lose weight, I find strangers are obviously cordial.

      I think it’s hard-wired into some of us to be Fixers, and we might think we’re helping. That can come across as “something is wrong with you and all you have to do is…(diet, exercise, sleep more, stop worrying, get a different job, etc).”

      The older I get, the better I get at not judging ANYONE about ANYTHING. 🙂

      1. “I have been both fat and normal weight. Just the way strangers interact is amazing. When I’m fat, I’m invisible.”

        My cousin had this issue–she became overweight after a bad car accident that left her with a double hip replacement at age 16. After she graduated, she moved to college and lost ~50 lbs, and everyone started to treat her differently. Whenever guys would hit on her, she’d get very depressed because she never got positive attention when she was larger and nothing about her personality changed… It was a hard time in her life, and I can only imagine the emotional pain she went through.

        Although I’m overweight (and have been all of my life), I can thankfully say that I’ve never had any of the issues Mark discussed. I have had issues where I couldn’t perform something properly due to my weight, which made me angry rather than depressed, but those issues are few and far between. I’m mostly trying to slim down because my family has a bad history with cardiovascular disease!

    5. Gracie,

      I am truly sorry for what others have put you through and I will say a prayer for you to remain strong through your struggles. I hope your illness is gone so you can focus on healing and recovering. If not, I pray for a speedy recovery.

      I won’t lie, thoughts and biases about weight have entered my mind in the past, but I have worked hard on focusing on the individual and their story because a LOT of people have stories like yours and it’s not always about them just being lazy.

      I also used to be an effortlessly skinny guy (6′ 0″ and 170#), but after I got married, I ballooned up to 220# (granted not super overweight, but still a significant increase) and was teased about my weight as well. It was then I realized how hard it can be to lose weight and what others go through.

      Thoughts and prayers are with you!

    6. I lost 60 lbs 6 years ago at the age of 20 and and have kept it off. Because I was diagnosed with Celiac Disease. But, it’s amazing how people treat you differently.

    7. “But none of it feels like enough. Because when people look at me they see fat. And fat means lazy. They have no idea how hard I fight just to stay mobile. I will never again be worth respecting. What people will see is the weight and all the things that they think it means.”

      Can I hazard that this is what YOU see in the mirror, not me? I don’t really appreciate being prejudged that all I see is your weight because I’m “thin”.

      I have been seriously overweight during my childhood and until my 30th year. My aunt and father have always been seriously overweight – my mother is in a nursing home a good 70 pounds overweight. We have family friends even bigger.

      My father doesn’t like me to take pictures of him – you know why? Because all he can see is a fat old man.

      I want to take the picture, because *I* see the man who held our family together through my Mother’s literal craziness. The man who cared enough to uproot his life after 5 decades in one place and move near to my Sister and myself. Who still tries everyday to take care of himself by playing a really lousy game of golf 3 times a week and manage his diet long after my Mother gave up on life.

      Don’t condemn me because you don’t like what you see in the mirror. I already see more than that. 🙁

      1. Actually, I am not responding to what I see in the mirror. I am responding to words that people choose to use when they talk to me. I don’t assume that people think things about me. That is a losing game. But when people suggest that scarring in my lungs could be reversed if I would “loose a little” they are responding to the fat.

        When I go to the doctor because even as a fatty I have always had low blood pressure but it is suddenly very high and he says “What do you expect” while gesturing towards my fat self he is responding to my fat. Not me. It was up to my pharmacist sister in law to figure out that I was having a problem with medication that drove up my blood pressure.

        When I have 17% lung function and have to rest in between showering and brushing my teeth and someone tells me that I will feel better if I get more exercise, they are responding to adipose tissue and not Gracie.

        When I look in the mirror I see me. I am very fat. But I am still here. And I am very happy. It is when people speak to me that I cannot pretend they still see me.

        1. Hi Gracie, my heart goes out to you, I’ve been on the end of people’s judgement too.

          From childhood I was chubby and grew into an obese adult. I accepted the judgement of others about my weight because deep down I knew that they were right; I was lazy, greedy and a failure.

          I know realise that the weight wasn’t due to my laziness or greed, the wrong foods messed up my hunger hormones and made my body store fat.

          The way that fat people are treated isn’t fair, people treat me differently now that I’m at a ‘normal’ weight, but I am still the same person, just better educated.

          One of the biggest changes in my life since going Primal is losing the guilt that I have felt since childhood about my weight; it was guilt and feeling like a failure that hurt me way more than being fat.

          You’ll never stop people judging you by the way you look but I do believe it’s possible to find inner peace.

          Good luck for the future, I’m sending my best wishes for you.

      2. I agree, sometimes when we look at others we see in them what we are hiding in ourselves, it comes out as negative judgment of them but in reality it’s a judgment of ourselves, although most don’t really know that. When we “see” it in ourself we no longer see it in others. Ahhhh, how nice it feels to allow others their own path without feeling the need to judge them.
        Funny situation, the other day I met someone who was 9 months pregnant and but I didn’t even “see” her big stomach for some reason, was totally shocked when she said how close to delivery she was. Funny to me when that happened. So, some of us do not “see” fat/skinny people but see humans when we look at different sizes. Dignity, we can all show it to others.
        Like I tell my son, do your best, some days it’s better than on other days but your best is just that your best.

    8. Don’t fall prey to this negativity–fight it like everything else you are fighting. Having watched my beloved wife fight Chronic Fatigue Syndrome for 28 long years, losing so much of what she loved in life, but remaining strong, feisty and committed to being the best she could be (and she’s great!), I know that the world-at-large doesn’t care or take the time to really get to know you and what you face. Still, there is a lot of support out here and you are doing all the right things. We are both Paleo now and she’s doing so much better…I have hope and she is starting to dare to hope (a little). Hang tough and stay the course.

    9. If people want to criticize you, they will always find a way. Don’t waste energy explaining yourself. As someone (more and less) said, your friends don’t need the extra information and your enemies won’t believe you regardless.

      About weight gain, just remember that medicine is not made of calories so, if you are putting on weight, it is coming from somewhere else. I myself find that I care less about whether my weight goes up or down than “not knowing” why. In other words, I prefer an honest, upfront, additional cheesecake/pizza/etc than a sneaky, closeted one that I don’t “count” and oftentimes don’t even enjoy.

      1. Ummm medicine is not made of calories? That’s a pretty stupid thing to say. Weight gain is not solely dependent on calorie consumption, brainiac. Medicine interferes with or alters hormone production, which is mainly what affects fat storage.

        Omg I can’t believe you even wrote that?

      2. I just held back from letting you know how moronic your comment was until Christina said pretty much exactly what I thought….That’s it from me I might enjoy an honest upfront cheesecake now.

    10. BIGHUGGRACEBIGHUG A virtual cup of nourishing bone broth to share with you this Sunday afternoon, and wishes that those who love you and know you would surround you and forget about this sickness humans have…BIGHUGGRACEBIGHUG

    1. The hardest part isn’t the weight loss, it’s adjusting to the new person and how they’re perceived/treated.

      1. Agreed. It took me months, even years, to feel like it was really me in the new body. I wonder if the different treatment by the world had something to do with it. Never considered that!

    2. The scar on my finger where I cut myself in the 8th grade will never “properly” heal and yet it as much a part of me as my finger. “Scars” from use on sturdy, lasting furniture are generally called character. I tend to think of them as the same in people.

  2. EXCELLENT article, Mark!!! i find that some of the athletic people EVEN HERE make disparaging comments about those of us who have to struggle to make progress….

    1. 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 be assholes no matter what community they are in.

      1. This is very true, but I can tell you for a fact that the weightlifting sites I use are full of assholes that put those here to shame. I just figure it’s good practice to learn to filter that crap out and keep fightin’! Most people are cool and want you to succeed. The rest…well, life’s too short.

  3. I’ve always been pretty lean myself, but strive to be healthy and lower my body fat percentage for aesthetic reasons. Thus, it was not until this article that I thought about the extra hurdle that people who are overweight have when trying to follow the primal diet. I imagine a whole slew of extra judgement for all the meat and fat consumption over ‘healthy’ iceberg lettuce and HFCS dressing.

    There’s been numerous posts about the shock and awe of people when observing primal eating habits. Adding to that a hefty serving of self-righteous judgement because that person might be overweight sounds terrible. I hope anyone who experiences that has the pleasure of reaching their goal weight as proof to people who are quick to judge.

  4. I’ve been on both ends of the spectrum so yes, I’ve walked a mile…yada yada.. but my motto has always been don’t look down on someone unless you are helping them up. You don’t know anyone’s story. If you are fortunate enough to be of good help then celebrate your good fortune and share that positive energy with others who aren’t so fortunate. Great post Mark!

    1. Don’t look down on someone unless you’re helping them up…I love that!

      Stealing…hope you don’t mind. 🙂

        1. I also love that. How wonderful. I’m also going to steal that….

    2. “Don’t look down on someone unless you are helping them up.” Well, I won’t be “stealing” this because it was on a poster in my college dorm in the 70’s, and was the topic of a workshop I attended in the 80s, and I read it in a newspaper article in the 90’s……so not original, but still awesome! Thanks for reminding us of it!

  5. Interesting article. Luckily I have avoided the stigma associated with large weight loss and I haven’t seen the prejudice continue, but mainly the prejudice was from the opposite sex (which I never was upset about) and not as much from society. Perhaps this is because I am in the technical field and/or because I have in Ohio, where obesity is rampant.

    I do have some issues, however, that are frustrating; There are quite a few people that what to know “how I did it”, but than they will debate you as either incorrect or as folly. They judge it as unsustainable, yet I’ve been doing it for almost 3 years and thus they assume that I will fall off the wagon and gain the weight back. Lastly, most people just want to lose weight. If I don’t hear “I want to get healthy”, I usually don’t bother wasting my time. People waiting for you to gain weight back for self gratification (wanting you to fail) is kind of offensive.

    However, forgetting what you used to be like and seeing the looks on peoples faces that haven’t seen you in a year or two is priceless. That and your uncle asking people who that was in the wedding and them tell them is was you. What I have found, however, is that after a while people just forget you were ever fat (including myself). It’s to the point now that I’m surprised when someone is surprised to see me now.

    The most frustrating part is that I am still, technically, overweight. I am still over 20% body fat, yet people think I am too skinny now. I look different than the guy with the same weight/height because I don’t have that belly. The fat is just stored in harder to notice places. Those parts are being massively stubborn to get rid of.

  6. The stigma is difficult. I have always been chubby and even after a couple years on primal I’m still chubby and nobody will look at me with envy or use me as an example of success. I can say though that doing the primal fitness is a huge contributor to making me feel awesome and happy with my body. I lift weights now and measure my progress by the weight on the bar, not the scale. I have been working on adding in sprinting (it’s hard because I pee myself if I run and otherwise it’s very exhausting and I’m 48 years old and need recovery time for lifting.) It’s invigorating. The more of this primal (as opposed to the ordinary, slow, “heart healthy” aerobic) fitness I gain the better I feel and the better I feel about my body. I walk with confidence these days that I didn’t have before. The result thus far is that even though I’m the same size, wearing the same clothes, people keep telling me how fit I look.

    1. Diane, I’d say your doing just fine then. If you feel great and happy about where you are then more power to you.

      I personally can’t say I experience the same issue with sprinting that you do, but sprinting is such a great exercise…don’t give up on it! Find a private place to perform your sprints then you don’t have to worry about it. 🙂

      Best of luck!

      1. When I was a kid I would wait so long before going to the bathroom that I would be crossing my legs and holding myself to avoid peeing. I took a cue from that and use the exercise bike for my sprints. Works great and no need to wear maxi pads or diapers!

        1. maybe try Kegel exercises too. You can do them wherever, whenever. No one can tell. (and they help with more than just incontinenece 😉 but yeh, I’ve had that problem in intense boot camp classes! And you pray it’s just mostly sweat but you just don’t know…

    2. LOL Diane. I know what you mean! I can’t run at all since my daughter was born (21 years ago)! If I do any type of bouncing or jarring activity, that’s all she wrote. Thank God for Bikes!

    3. With the stress induced incontinence, wetting yourself when you run (or sneeze or cough hard), I have found, that in my case, doing planks religiously helps a great deal, though it takes a few months to see real results. It’s not completely gone, but is back to very minor inconvenience it was after the birth of my first child, rather than the major problem it was after my second (who weighed 10 lbs 3 oz). I know it’s the planks because I’d let them go by the wayside when things got really hectic, and had the problem return to “major problem” levels and go back to “minor inconvenience” within a few weeks of adding planks back in. So if you’re not doing planks regularly, you might want to work on them a bit more, it could help. I hope you get the same results as me, if not better.

      1. I’m going to hold onto that tidbit of information in case my wife experiences the same issue. We’ve already had one girl and she’s near the end of our second pregnancy with twin girls no less! So I imagine things might be a little beaten up in there by the time it’s all over.

      2. Thanks for the plank suggestion. I swear, when my daughter was born, that whole system of my body was just never the same!

    4. Regarding stress incontinence. I agree with the plank suggestion. Core strengthening will tighten up the pelvic floor too. Also, try using a tampon when working out. I can jump and sprint with no problem if one is in, but without it (like in a pick up soccer game with the kids) the problem returns.

  7. This is so true. I’ve lost three long term friends AFTER I lost 100lbs and have kept it off for going on four years now. It gives me a little relief to see this fact stated in writing. Hell, I thought there was something wrong with me.

    1. I am not at all surprised. Some people like it when you’re a “mess” and when you make changes to improve yourself, they change towards you. Personally I think it’s because they no longer feel superior and they are uncomfortable when you are in a good place. These are people you do not need in your life so be happy that they are gone. Congratulations on losing 100 lbs. AMAZING accomplishment!

      1. Sadly, you’re right. I had to let go of some lifetime friendships because they needed to feel superior to others regardless of how petty it was. Life is a lot less stressful now and I can focus on bettering myself and encouraging others without the distraction of them trying to make it into a competition of who does what better.

    2. Same thing often happens when you quit drinking– people accuse you of being “no fun any more”. If you can’t be like them, or won’t be the way you “used to be,” then they can’t deal with it. Sad.

      1. Done that one too. The three friends I lost were all in recovery as well.

        1. Lost family as a result of getting sober. They dont like who i have become?
          I think they are intimidated.

  8. I have to admit that I have been judgemental of obese people and smokers in the past. Since becoming Primal I have become much gentler and try to help as many people as I can without the judgements or being attached to wether or not they are interested. Both my brothers are doing fantastic on Primal and all our talk is positive. Grok on!

  9. What makes the stigma harder to cope with is when it’s in your own home. After my 3rd baby I held on to 60 extra pounds, and when I would tell my husband about my “extreme” plans he would tell me, “you don’t need to do that, just eat less and exercise more” I tried and tried and tried to follow that advice with very little results. But apparently I just wasn’t trying hard enough (according to him) It wasn’t until I found MDA that I learned the truth. I am now down 54 pounds and counting 🙂
    Now it’s my husbands turn, the last two years he’s gained about 50 pounds. He’s always been super thin while living on pizza and hamburgers, and still doesn’t think he needs to chage his diet (mostly from stubborness). He finally admitted to me he never realized what it was like to be overweight, and thought people were just being lazy and eating too much. However he still refuses to read “The Primal Blueprint” because it crazy hippie sh*#. One day he will see!
    I have to admit that, I too have found myself looking at an obese person and thinking they should really try harder, but I have to remind myself that maybe they don’t know how. There was a time when I didn’t. So I pass on my new found knowledge direct them to MDA and let them decide to make the change. Sometimes that’s all I can do, but at least it’s something!

    1. +1

      My husband has been lean all his life and eats like a horse, I have to remind him sometimes that he has no idea what it’s like to be fat, and that the advice to “just eat less” is hopeless and impossibly hard to implement.

  10. Good for you Diane. Keep the effort up. You’re doing awesome by showing the love and attention to your body and mind first and foremost. And don’t get hung up on the running thing. I’ve found walking or riding my 25 year old bike fun and not so exhausting. (Yay…it still worked after all these years.)

  11. I have struggled with weight for most of my life. I was always friends with lots of people, pretty active and thought i was happy. I worked hard and lost 100# through diet and exercise (mainly playing racketball everyday). I noticed that people that i knew before the weight loss treated me differently after i lost the weight. some were supportive, others became “more friendly”. it was definately interesting. I got pregnant, put on bed rest and gained all of the weight back with that combo and some post pardum depression issues. it has take me several years to work the weight off. i have recently started crossfit (in april) and LOVE it! everyone there was talking Paleo this and Paleo that. i have decided to give it a go, now on day 4 without any sugar, dairy, grain or refined carbs. I can already tell a difference, just in my sleep pattern alone. in regards to being judged for my weight, yes, that happens. i too have lost people that i thought were my friends. but i have to remember that i’m not doing this for friends. i’m doing it for me, and if they can’t support that, then good riddance.
    🙂

  12. Conventional Wisdom is that people become fat because they’re lazy and gluttonous. In Good Calories, Bad Calories, Gary Taubes suggests causality should be turned around in the other direction, people become lazy (dysregulation of effort and activity) and gluttonous (dysregulation of appetite) as a result of becoming obese. I have some hot-off-the-press data from a rat study that seems to confirm the premise that obesity is a cause of laziness (willingness to make an effort to obtain a reward). I’ll be presenting these data at the Ancestral Health Symposium (AHS13) in Hotlanta this year.

    “Worry about yourself”. Hah! That’s what I keep telling my 7-year old for the past year whenever conflict arises between her and her little sister. Must be a gene that’s expressed when parenthood ensues.

  13. What happens when someone doesn’t want to lose weight, and is healthy and happy being a bigger person?

    1. Exactly! I love all the “well at least you are trying” responses to people. THAT IS EXACTLY THE STIGMA!!! It takes a lot of effort to manage the illness of obesity, an illness that no one picked to have. If someone decides their life energy needs to go to other activities, that is a reasonable and valid choice for them. They don’t need to fight their obesity just to make the people looking at them happy. I say this as someone who has lost 80 lbs. and it is a battle every day and will be a battle every day of my life, and that energy DOES come out of my career, my family, etc.

      The other place I see the stigma is in medical claims that are flat out false, and are impacting things like decisions about health insurance structures. Being thin might make others happier to look at you, but losing weight over age 40 does almost nothing to your life expectancy, or example. Yet in serious healthcare decisions and in everyday conversation people say to me “oh you’ll live longer!” No, statistically, I will live exactly the same length of time.

      1. “Being thin might make others happier to look at you, but losing weight over age 40 does almost nothing to your life expectancy, or example. Yet in serious healthcare decisions and in everyday conversation people say to me “oh you’ll live longer!” No, statistically, I will live exactly the same length of time.”

        Maybe. That time might seriously suck, though, if you’re seriously overweight.

        It isn’t a theoretical for me. Most of my family and their friends are overweight to seriously obese. They do have the same life expectancy, but they are on cabinets full of drugs. One, at the tender age of 51 has already back surgery and knee replacements. My Mother, already weak from non-exercise, has increasing mobility problems directly related to the extra weight.

        Stigma aside – don’t fool yourself about the health consequences of ignoring a serious weight problem, especially later in life. It’s worth the effort to lose the weight.

        1. And thanks for proving the point. I already said I had lost weight, but you get to give me the snotty lecture because you are better than me for being thin? And you get to ignore a scientific fact to justify your snottiness? You think I don’t know what it feels like to be 80 pounds lighter? And not to have to deal with the likes of you? I do, and I do.

          And you have NO IDEA if it is worth the effort. No idea. I am fortunate that I am rich and white collar and have no particular demands on my time and energy. So not quite putting in that extra effort in the office or in life because I’ve spent my cognitive energy on the food battle doesn’t do anything to me. But if I were in an exhausting job, or hovering on the edge of being laid off, or had a child at all, much less a demanding one… I could not do what I do. And I’m doing it every day, so I do know what it takes and I don’t judge anyone who makes a different decision.

    2. That’s good too! I really don’t feel better at a lower weight. There is a little vanity involved, but mostly I like being at the lower weight because people can’t question my choices as much if my weight is socially appropriate.

  14. I have dealt with weight and the stigma of it, my whole life. Always be labeled as ‘plus sized’ despite participating in athletics in high school and college. I walked away from an abusive relationship after 3 years where my ex would use the word “fat” like a weapon in his words and deeds. He was blessed with skinny genes, and I inherited the fat genes which have plagued my mother’s side of the family. Even my thinner siblings have fallen into unconsciously saying things about my weight, even as I currently participate in marathons and triathlons.

    I have watched what I ate my entire life, and started the Paleo diet a few months ago. While I am feeling healthier, I still struggle to lose any significant amount of weight (despite testing for hormonal abnormalities).

    I totally agree with your observations about society’s perceptions of obesity and how we look down on fat people, but fail to understand the complex issue of how people become fat or remain fat.

    I long to live in a world, where my dress size is not something that is used to describe who I am.

    1. Exactly. As long as my size doesn’t interfere with what I want to do I don’t care. I doubt I will ever be a thin person because of hormonal abnormalities. I do know I have more energy and feel better living in a more primal/paleo way so that is what I do.

    2. “I long to live in a world, where my dress size is not something that is used to describe who I am.”

      I hovered on size 16-18 for the first half of my adult life, overweight even as a child. I know what’s like to be called fat and ugly in middle school, in small town with no friends.

      It hurt like h?ll. But you know what, I stopped being mentally fat when I left that world and stopped worrying about it. (Which was well before I lost the weight.) Some of that stigma is about being overly sensitive to what you think others think of you. I’ve found the overweight and obese to be much harder on themselves than any outsider might have been, especially adults.

  15. EXCELLENT post! I am very cognizant of “fat-shaming,” both in regular society and, sadly, in the paleo community as well, and work to avoid it as much as possible.

  16. I have lost 160 pounds following a not very strict but mostly paleo diet. I absolutely know that people treat me differently. And when I tell a stranger about my weight loss it really baffles them, I think it’s hard for them to imagine me as being obese, when I am still getting used to being thin.

  17. I have always been heavier than normal and never been a yo-yo dieter. I thought I had a pretty good body image but I was an emotional eater. And I had lots of triggers. Other than being overweight I was fairly healthy until about 10 years ago when I went through a terrible 18 month period of time and gained about 65 lbs on top of already being about 65 lbs overweight. My blood pressure went up and thanks to starting the change of life I also got depressed and lethargic. My doctor at the time definitely had a prejudice and just made the assumption when he first saw me that I would be unhealthy. He was actually surprised when – other than the BP – all my blood work numbers were good. Anyway, I struggled for years trying to lose that extra weight and get back to feeling good – I joked that I lost 150 pounds but it was the same 10 pounds 13 times (I did actually lose 30 but it was hard)! Bad relationships, unemployment, and that emotional eating made everything very difficult. Inside I was miserable.

    I discovered primal in March this year; I was already off most processed food due to chemical allergies and I quit dairy last year. I’m not even following the lifestyle 100% and I’ve already lost 25 lbs. I feel better than I have in years, I’m riding my bike again after a 30 year hiatus, and I’m healthier at 52 than I was at 44. That said, if I had not finally figured out what the cause was behind my emotional eating and worked very hard to fix it, I don’t know if I would be having success now.

    1. Oh Adriana – I hear you! I too am an emotional eater. It’s taken me about 1 year of CBT to work out why I do such things to myself (cause, if you think about it logically – you won’t eat tons of stuff that will make you fat). One of the main things I realised is that I probably will always comfort eat, because emotions are much stronger than logic. What I can do is limit the worst of the damage, and not beat myself up when I do have a slip.

      When I stick with the programme, I also lose plenty of weight (I lost about 10 pounds in 7-8 weeks last year). But I’ve just finished my final exams, so my eating has been a bit all over the place. But I’m picking myself up and carrying on because I know that I’m going to be happy when I’m healthier.

      Good luck to you!

  18. I still remember this from college over 20 years ago. I was jogging and someone yelled out their window, “You know you have to eat less too.” Even heavy people trying to do something about it are judged.

    1. I too had something like that happen whiile I was riding my bike. I just couldn’t beleive someone would yell out their window like that, like how rude! It affected me for hours, days afterwards.

      1. So they judge you for being fat, and terrorize you when you want to do something about that. So not supportive actually. How would Grok and his mates have reacted in their society.

        I hope living Primal also reflects on living to make your community solid.

        1. Had Grok witnessed someone shouting at you like that, he would shun and/or shame the person doing the shouting. From what little I’ve read of tribal communities, the social emphasis is on building and maintaining the community ties. Mocking a person for putting in their best effort does not build or maintain community ties in a healthy way. Shunning and shamming disruptive influences are presently considered to be disruptive in and of themselves and therefore undesirable but they do have the effect of immediately and distinctively isolating someone who does not help the community.

  19. This article resonated with me, maybe moreso than any other I’ve read. I am morbidly obese, and strangely, I feel the largest bias coming from my doctors. I’m constantly pushed toward bariatric surgery and I’ve had more than one doctor question my lab results because they don’t line up with what a fat person’s health should be. I’m mostly healthy, despite my weight, and I owe a lot of this to a primal way of eating. It’s a harsh world out there, but my faith that I am cared for by my Creator coupled with the new lifestyle changes I’ve put to work keep me focused and encouraged.

    1. When I went to the doctor years ago, having lost 170# (!!) on low-carb (and mostly whole-foods LC at the end), all the (obese!) nurses wanted to talk about was their expectation that I would be having gastric bypass and their shock and dismay that no, I wouldn’t even dream of doing that, given that (a) it won’t change lipedema which is where nearly all my fat is, and (b) screwing up my nutritional absorption is the worst thing I can imagine for my health, and (c) as I kept repeating, but if I am on an eating plan that is doing so well for me, why would I want to do surgery? Why not just eat well??

      That these women were nearly all 30-60# overweight themselves and yet, since I was more overweight, felt entitled to the whole attitude toward me, just boggled my mind. Mind you, all my blood readings were fine (to never-ending surprise).

      (This reminds me of eating in restaurants, where anyone at the table no matter how fat, if they are even 10# obviously less fat than you, will feel perfectly entitled to spout their eating philosophy as ‘advice’ even if they have never dieted successfully in their life.)

      I don’t visit docs much and I only had one doctor that ever did jack for me — he ‘prescribed’ me a book on lowcarb. Although I don’t eat that way any more (it did well for me but after my VLC ‘success’ I’ve had years of seemingly massive fatigue-etc. problems, but I’m coming out of that, eating generally primal) it probably saved my life at the time. Every other medical opinion I ever got when visiting a doc has ranged from useless to actually harmful.

  20. Hmm. I’ve been thin my whole life, but for the majority of it, I was fat, on the inside. Just because someone doesn’t physically have fat, doesn’t mean that that’s not how they look on the inside; I believe that I’ve had to work just as hard to become physically/mentally fit. I think the whole “fat genes” and slow metabolism thing is just an excuse. Some people have to work harder than others, that’s a fact of life. I understand if someone was hit with an illness, and gained weight, but after recovering there is clear things on what to do to get where you want to be, if you really want it. I see too many people who treat their diet carelessly, and exercise as a foreign movement. Our health is wealth, our health is life, and most just don’t want to acknowledge that. I hope for desire and commitment to you all. One love.

    1. While I can appreciate where you are coming from, but I’d have to disagree with your assertion that there are “clear things on what to do to get where you want to be.” Mark shows us time and time again that conventional wisdom is anything but clear, and even those of us who wanted more than anything to be healthy and slim were unable to be so because of all the mixed messages being sent on what is healthy and what is not. This post is trying to point out those subtle assumptions like the ones you’re expressing here, that those who are overweight are that way because they’re basically not trying hard enough. It’s definitely more complex than that.

      I’m not trying to undermine your feelings, because the whole fat on the inside feeling is also a very complex thing. What a blessing that you’ve been able to become physically and mentally fit; you understand the struggle it takes. So I hope you can also empathize with those who just aren’t there yet. Their physical weight is no less difficult than the mental weight you carried for years.

  21. Over the last year and a half I have lost over 80 lbs, quit smoking, and begun a strength training program. I still have 30 lbs to lose, but the number on the scale will not budge. It’s depressing and a little humiliating. Yet I’m unwilling to reduce my caloric intake below 1400–1600/day or increase my exercise to more than an hour/day. People can judge me all they want. I’m not going to torture myself to take off the last 30. My efforts may not be Herculean, but they are sustainable.

    1. And why kill yourself for something you can’t sustain? I think you’re on the right track. Keep it up!

      1. Thanks for the encouragement! I’ve been reading the comments and I think it’s remarkable that two Marys who each lost 80 lbs are posting on this same post. (She sounds a little angrier.) I should start using an initial.

    2. That’s pretty amazing progress! I like how Mark put it in an interview, that for some people weight loss slows because the brain (i.e., metabolic level) looks at the body and says, “I like what you’ve done with the place.” And just because the number on the scale isn’t changing as much lately, doesn’t mean body composition isn’t improving in other ways.

      It may also be worth looking at whether anything has changed to slow your progress. In my case, I was trending nicely for like 6 months, but then suddenly found that I’d plateaued. So after a few frustrating months of fasting more, I stepped back and realized that I’d made two little changes at the time weight loss slowed: 1) started putting heavy cream in my coffee, and 2) stopped going to a weekly 2-hour session of Reformer and then yoga–probably a 2k net weekly Calorie increase just from that. Sure enough, a few weeks ago I dropped the cream and picked up the yoga mat, and now I’m seeing changes again.

      Regardless, you should be proud of your achievements thus far. 🙂

  22. I went on a field trip with my daughter’s class, a group of 7-year olds. One of her classmates asked me if I was pregnant. I very calmly replied I wasn’t pregnant, that I was overweight. She looked at me and said, “Are you saying you’re fat?” My daughter hugged me and told that girl that I was, “Just the right size. She’s my mom.”

    I go back and forth between being proud of my daughter, and ashamed because she shouldn’t have to defend me. Ouch.

    And yes, I can fully attest to the “being lazy came AFTER being obese” statement. I didn’t used to be so inactive, but it’s so much more difficult to get the energy, effort, and *motivation* now, even though I know it would be good for me.

  23. As someone who’s been battling excess weight for a long time now, the article really strikes me as true. As I said to someone the other say on the 21DSD; if you wouldn’t say it of someone else, why do we say it of ourselves? I regularly call myself fat (often followed by “weak” and “lazy”). I should not, since I probably restrict my own successes…. Hey ho.

    One thing missing from the evaluation of the “causes” of obesity is psychology. Many people “comfort eat”; either because they are lonely, sad, upset, bored, stressed etc etc (those are my personal triggers). The obesity issue cannot be properly tackled without tackling those issues. I’ve been to see a CBT therapist who has helped me immensely; it has, to an extent, changed my view of food, but most importantly given me an understanding of how my thought processes were stopping me from succeeding. It was a shock, and was really, really difficult at times. Doctors (in the UK we’d be dealing with “general practitioners” – local family doctors) are not qualified, generally to deal with all the complexities which lie behind excess weight.

    1. “if you wouldn’t say it of someone else, why do we say it of ourselves?” I read essentially the same advice, almost 30 years ago, in an article called “How to stop being your own worst enemy.” I have done my best to follow it ever since. I also pass it on to others on a semi-regular basis. I beleive I recently said it here too. 🙂 I love it when I hear/see someone else passing on that advice.

    2. Thin people often eat when emotional also. Fat people are so terrorized into Stockholm Syndrome culture-wide that psychology will find any reason to dig out to “explain” why it must be so. They become sure that if, when they have a fight with their SO/parent, they eat too much or eat carby foods, that this explains why they are fat. Actually, plenty of thin people do that too. It doesn’t actually explain why anybody is fat. It might however be worth recognizing since it can put a real crimp in getting healthier, obviously. Not saying it isn’t real, it isn’t. Just saying that this idea that people get fat because they eat when emotional is probably, at least most of the time, not really so, since plenty of thin people are just the same way.

  24. My natural state is scrawny. I’ve never put on weight that wasn’t hard-gained muscle except for 2 months after I quit smoking, when I gained an absolutely insane 30 pounds in that little bit of time. I’m saying that because I have never been obese, and have very little personal experience in that realm. I have no desire to be self righteous. (By the way, I always ate pretty close to primal without even knowing there was such a thing. Personal taste preference.)

    My question is how to respond to society that increasingly wants rather than to get healthy, to simply tell each other they are beautiful no matter how big they are. The people may indeed be beautiful. But there is nothing beautiful about increased rates of cancer, heart disease and atherosclerosis, Type II diabetes, arthritis, dementia, and all the other ills associated with obesity. Some one earlier wrote that life expectancy for someone who loses weight after 40 is pretty much unaltered, and with all our modern medications, they are right. We’ve kept quantity up there, but quality goes straight down the tubes. Decreased mobility, handfuls of pills, aches and pains galore, reliance on other people to get by.

    Everyone has a right to live their life how they want. But what’s the correct way to fight the disinformation out there (big is beautiful, now scoop up more whole grains onto your plate) without appearing sanctimonious or hateful? Or is there not one?

    1. I personally have much more respect for someone who is making an effort to be healthy, as opposed to how much they weigh! Telling someone they are beautiful no matter what size they are is not doing anyone any justice, if they refuse to take their health into their own hands!
      I know some people who are overweight and healthy and beautiful, and I say “more power to them”. I also know many thin people who don’t think they need to worry about their health because they aren’t “fat”. I think the biggest stigma out there is weight=health. That is a huge problem!

      1. Sorry that should say “the biggest misconception out there is weight=health”. Wrong choice of words…….my bad!

    2. This is something I go back and forth on as well. I think if we can slowly start changing our focus from weight to health, we can achieve a happy medium? Growing up I was always bigger, but active…yet I still wanted to be skinny because I thought it would make people (ahem, “boys”) like me more. This is something I wrote about in my journal, prayed about, and cried myself to sleep over. I just wanted to be skinny. It never crossed my mind that I wasn’t healthy, and I only came to that realization when I saw my dad stick a needle in his leg for insulin. That’s when it hit me….I need to change something or I’ll be doing the same thing in 30 years, probably less. That was about a year and a half ago, and now down 35 pounds, I feel confident that I am extremely healthy even though I have about 20-30 more pounds to lose. So yes, I am beautiful, even though I’m still bigger. But I’m also healthy, and building a lifestyle that will let me sustain and even improve my health.

      I try to fight the disinformation by sending people to this blog and telling them to sign up for the newsletter. Even if it helps one person, I think that’s amazing.

  25. I have so much more compassion for anyone trying to lose weight – be it a few pounds or 100 – now that I’ve learned so much about the food industry. Processed food is addicting! Anyone who is educated about how the food industry has manipulated food and caused the obesity epidemic can only have compassion for others. I wish everything I’ve learned at MDA could be taught in the workplace, in schools and published widely.

  26. I was always about average growing up, but I put on 60 lbs when I got pregnant and continued to gain for years after that, reaching 290 at my highest. All in all, I spent about 10 years being obese. I’ve been eating paleo for almost a year now, and have lost ~70 lbs, but am still technically obese. Still, I notice how people treat me different now. Random strangers will make eye contact with me and smile. It’s a real subtle difference, but I can feel it. People don’t realize how invisible you feel when you’re fat.

  27. It is super frustrating to know someone who’s obese, and not be able to help them. But I have found that you have to wait until someone asks. If you offer advice, no matter how gently you do it, you’re either foolish or offensive. My mom’s health issues have made her gain a good 100 lbs, maybe more. She makes self-deprecating comments about it all the time. She’s embarrassed, she’s unhappy. But she’s not ready to fix it yet. When she is–unless she dies first–I’ll send her here.

    1. You’re so right. My mum, who’s hardly a paragon of virtue as far as weight is concerned (was severely underweight as a girl in the 1950s and blames having me at 37 for her increased weight once she hit 40), is always going on and on about how fat I am, and how that’s not how she brought me up, and how much weight I need to lose (and then tells me that I’m doomed to fail in losing weight because she hasn’t – very supportive). I have restrained myself from actually physically assaulting her. Just. But I have threatened to never speak to her or darken the door of the family home again (this is a BIG threat – I’m an only child and mum always wanted lots of children) unless she shut up about it. Losing weight and being healthy is something, like it or not, that people have to make their own decisions about. I took a decision one day to lose weight – over the next 18 months or so lost 63 pounds. It’s gone back on, but it’s my decision about losing again. You can’t go about telling people that being fat is unhealthy etc etc. People won’t listen to other people telling them negative things. But once they make that decision, and even better, if they decide on a course of action, support them in that.

  28. I have noticed a big change in the way I am treated by both strangers and people who knew me before I lost over 100Lbs.
    At first I was flattered by the way I was being treated. Women started hitting on me again and men treated me with more respect. Then I started to get annoyed because I thought I was still the same person with all the same internal qualities that I always had. When I was fat, I wanted to be valued for my personal qualities rather than my physical attributes. Then as a healthy, primal, athletic person I was being judged for my physical attributes again instead of my personal qualities.
    It hit me like a ton of bricks one day. Most people have no clue how they are treating me (and everyone else). Our primary purpose on this planet is to reproduce. We are hardwired to be attracted to people who might help us pass on our genes, in other words, people who look healthy. We subconsciously pre-judge others based on how healthy they appear to us. Perceptions become reality and we then act according to our perceptions.
    Some of the perception that others have of us may in fact come subconsciously from us. While there are many reasons why people get fat the truth is that most of us (myself definitely included) get fat because we didn’t do what our bodies needed us to do. When we begin doing what we need to do and stop doing what is harming us, we start liking ourselves more. I have always been a happy, friendly outgoing person. However, when I like myself I’m even more happy, friendly and outgoing. Misery loves company and happiness spreads happiness. If I don’t like myself, you’re not likely to like me either. Again, this is largely subconscious but face it, we are not normally attracted to unhappy people.
    We do have the ability to cognitively override some of what we perceive. I believe that it is my responsibility to do my best to not allow these prejudices to affect my actions but, I also need to cut people some slack when they treat me differently based on what they perceive about me subconsciously. They may not know that they’re doing anything differently and if they do, they may not know why.
    I do know that I like myself better now and if others like me, well that’s ok too.

  29. Some mixed emotions about this. Being snarky, petty and judgmental is never a good way to go, people should be treated with respect regardless of race, religion, color, age, gender, weight, disabilities. The other side of the coin is the skyrocketing cost of health care for all of us could be cut in half if people would keep their weight in line. Approximately 64% of people in the US are overweight or obese I think I read the other day. I sometimes get the question “how do you stay so thin and fit, you must have good genes right?” After I give them the “diet / exercise / sleep / stress reduction” elevator speech the response is typically “No, that can’t be the reason, grains are GOOD for you” or “Wow, I could NEVER give up pasta and bread”. Education, determination and resolve are the keys I think. I realize there are some factors and viable situations that make weight loss very challenging for some.

    1. The problem with that line of thinking is that most thin people in the US are eating the same garbage that obese people eat and are really no more healthy. Weight does not equal health. I happen to be technically obese, but my blood numbers, energy levels, sleep, etc. are better than those of most thin people. I can lift more than any woman I personally know. On the other hand, I am surrounded by thin people with all sorts of health problems ranging from acid refulx and acne to cancer. Being judged as unhealthy just because I am larger is not only hurtful, it’s plain wrong in many cases.

      As far as health risks are concerned I’d take an overweight person following PB over a thin one eating SAD any day.

    2. Be careful of those numbers on obesity, those numbers are usually using BMI. Which is an insanely inaccurate way of measuring obesity, My boyfriend at usually over 200lbs and 5’10 or so is overweight even tho it is muscle. Lots of people are ‘overweight’ or ‘obese’ because of this.

  30. I strongly disagree with Felixs comment about fatness being caused by eating too much. I have type II diabetes and Hashimotos. I can gain weight on 1200 weighed and measured calories IF the proportion of carbs is too high. The level of insulin resistance that I have pretty much guarantees that the majority of carbs bypass my muscles and pretty much go straight to fat. Before my Hashimoto’s was diagnosed I couldn’t eat more than 700-800 calories without gaining weight. I was hungry as hell and anemic but couldn’t eat any more without gaining. So no it isn’t always eating to much, sometimes ones metabolism is just completely messed up. I am a fifth generation diabetic and was showing signs of it as a 100 lb, 5’4″, 12 year old.

    Job interviews are hell for fat people. You can have an awesome resume and the minute you walk in for the interview you can just watch their eyes shut you off and dismiss you. My husband was nearly fired from his job of eight years for being obese. He was perfectly capable of performing his job but a new regional manager came in and said that he exceeded the weight limits on the ladders in the warehouse, fire him. His store manager stepped up to bat and said that is discrimination and said that all that would be needed was to get ladders with a heavier weight limit. Which is what was done.

    1. I have been turned down for jobs because of weight, the interviewers love me, Until they meet a thin person with the same qualities and abilities. There is no doubt in my mind that calories in calories out is such a disservice to the people of the world. Whoever put that out there really screwed everyone over, because it ISN’T and never will be as simple as that. when I was twelve I was 4’9 and 125 I knew I was overweight but since I was younger it hadn’t distributed in the ugly way it has now.

  31. I use to always be “The Skinny Girl” until my 30’s, never in a million years thought I would become obese. Now, 20 years and 100 pounds later here I am…
    Three weeks ago I stumbled across MDA and made a decision to change my life. With the grace of God I have no doubt a year from now I’ll be celebrating my success with you all!

    1. That’s a great attitude to have! Way to go, and looking forward to reading your story on Friday someday in the future 🙂

  32. It is my understanding The government is making new guidelines for who and how they will treat older and other high risk patients, I’m sure with the view of saving money. Some of the things on the list were BMI, diabetic tendencies likely hood of stroke or heart problems. We will have to have to decide if we are to be treated by doctors or accountants it seems.Of course it will not apply to the polititions and likely not to the bureaucrats.

  33. I recommend Gina Kolata’s book “Rethinking Thin” to anyone interested in educating themselves further about these issues. There is a tiny percentage of people who lose a lot of weight and keep it off for more than five years. Tiny. But for the rest of the world, it looks like losing 20 pounds, gaining 15, or losing 20 pounds, gaining 25. Maybe primal eating is part of the answer. Maybe it isn’t. The guy who discovered leptin pretty much says we still have no clue about why some people weigh more than others, or what to do about it. For instance (just remembering from the book, so not promising total accuracy here), there are two times in childhood that leptin affects a person’s whole system in ways that may change that system permanently. So you cannot look at someone who is carrying a lot of weight and come up with these things about “try harder.” Given the horrible bias against fat people in our society, if one could “try harder” and succeed, a lot more people would do it.

  34. I’ve been thin and I’ve been fat, and boy do you get treated differently. One good thing about experiencing the bias: it teaches you very quickly about who is worthwhile to keep in your life.

    Good to have these conversations, good to examine our own feelings and actions.

  35. Wow, what a touchy topic! The obesity stigma works on so many levels beyond just hatin’ on fat people. From another perspective, while I love this website dearly and have been reading it for 2-3 years now, so many of the success stories focus on weight loss that it’s really just another way of saying thin=successful. I do applaud success stories that focus on being healthy regardless of weight. Especially for women, who I think are finding out that a healthy Primal woman DOESN’T necessarily mean you’re going to look like a fitness model (I know that’s what I’m finding out), how you feel, how you perform, and how you approach your day-to-day life are better indicators of success.

    I have never had the stigma of obesity, although I have been made fun of for being too skinny. Or people roll their eyes when they see me pull out a salad because “if they were my weight, they’d eat whatever they wanted!” On the other hand, I know some overweight people who are just good-natured, outgoing, and love life, and I’m thinking, wow, wouldn’t I love some of that!

    Wouldn’t it be nice if it weren’t about food and weight, but about making the best choices that align with our goals in life?

  36. Sometimes it sucks so much that you can lose any sort of momentum or desire to even try to lose weight.

  37. yeah, as a black american, i noticed this amongst white america… And I think its a terrible flaw. Blacks and Latinos are obese, but you dont get the snide looks and judging eyes. I feel that more people need to speak out. I guess the different is if you look down your nose at a black person or latino, they would speak up and defend themselves to you. I guess in white american culture, they are not talk to act out like that, so they are silently the whipping posts. Stop being so quiet, if you feel someone is being snide because of your weight, confront them on it.

  38. There is DEFINITELY a stigma against people who are overweight and sadly it is very apparent in the Paleo community. So it is great for Mark address this here.

  39. 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).

  40. 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.

  41. 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.

  42. 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.

  43. 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.

  44. 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.

  45. “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.

  46. 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.

    1. 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.

  47. 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.

  48. 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.

  49. It’s really frustrating to read some of these comments. It’s almost as if some didn’t even read the article.

  50. 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.

  51. 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.

    1. 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.

  52. 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.

    1. 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.

  53. Mark, thanks for the beautiful and encouraging post.

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

    1. 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.

      1. 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.

        1. “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… 😉

  54. 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.

    1. 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!!

  55. 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?

    1. 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.

  56. 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

  57. 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.

  58. 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.

  59. 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/

  60. 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.

  61. 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.

    1. 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.

  62. 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?

  63. 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.

  64. “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!

  65. 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. 🙁

  66. 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.

  67. 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.

  68. 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.

  69. 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.”

  70. 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.

  71. 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.

  72. 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.

  73. 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.

  74. 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.

  75. 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

  76. 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.