Body Liberation Fits in Public Health, Reason #1

Working in a more weight-inclusive way aligns well with basic public health principles and goals. In many cases, a body liberation approach enables us to be truer to the values that underlie our work. In this series of posts, we will examine ways we can improve our public health work by becoming more weight-inclusive.

Reason #1: Correlation ≠ Causation

When it comes to body size, it seems that we have lost our way with this important rule of statistics: correlation does not equal causation. In both medicine and public health, we are quick to go straight to solutions that involve attempting weight loss without consideration of reverse causation (Erion & Corkey, 2017) or a third variable, such as stigma (Gordon, 2019). While there are certainly many correlations between various health issues and weight, reducing the solution or “cure” to weight loss is overly simplistic and discounts the impacts of the social determinants of health (Bacon & Aphramor, 2011). Even the relationship between poverty, weight and health is multi-directional and complex (Ernsberger, 2009).

Acknowledging the complexities of both weight and health, and the uncertain relationship between them provides us with opportunities to discuss the interplay between genetics, social determinants, behaviors and just plain luck. We can discuss health in a more holistic way – the role of social connections, mental and emotional health, stress levels, etc. and is more inclusive of a variety of definitions of health, as well as respectful of a diversity of people. It allows us to keep our focus on the social determinants of health, and away from stigmatizing individual people in larger bodies.

EDUCATOR'S TIP

Discussing the complex relationship between weight and health (and a definition beyond physical health) is a great opportunity for students to deepen their understanding social determinants and of the “correlation does not equal causation” principle, including what epidemiology does or does not tell us about individuals. There are correlations between health and weight, diet, physical activity, and stress. What links are strongest? What other factors might be at play? Important Note: Even if a person’s health issue is related to their weight, they still deserve to receive the same quality, attentive health care that a thinner person would. Broadening the lens about potential contributors to a health issue is meant to expand the options for improving health beyond “just lose weight,” which is often the only option given to a person in a larger body.

CURIOUS TO LEARN MORE?

Bacon, L., & Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal, 10(1), 9.
Erion, K. A., & Corkey, B. E. (2017). Hyperinsulinemia: A Cause of Obesity? Current Obesity Reports, 6(2), 178–186.
Ernsberger, P. (2009). Does Social Class Explain the Connection Between Weight and Health? In E. Rothblum & S. Solovay (Eds.), The Fat Studies Reader (pp. 25–36). New York University Press.
Gordon, A. (2019, December 16). Weight Stigma Is a Dangerous Threat to Health. Elemental.