Body Liberation Fits in Public Health, Reason #3

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 #3: Focus on Equity

In recent years, public health has focused increasing attention on the impacts of injustice and inequities in our society on health. Rightfully so, many schools of public health, public health departments and non-profits working on public health issues have dedicated significant effort and resources to impacting the social determinants of equity (Jones, 2018).

People in larger bodies face bias and discrimination in many areas of their lives, including workplaces (Kinzel, 2014), health care (Mercedes, 2022) and even graduate school admissions (Burmeister et al., 2013).

Weight/height discrimination is highly prevalent in American society and increasing at disturbing rates. Its prevalence is relatively close to reported rates of race and age discrimination, but virtually no legal or social sanctions against weight discrimination exist. (Andreyeva et al., 2008)

Ethical issues with public health campaigns aimed at people in larger bodies have been raised (Pause’, 2017). Human rights violations by the “war on obesity” have been outlined (O’Hara & Gregg, 2012), more accurately described as the war on people in larger bodies. In an excerpt from their book, Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness, Da’Shaun Harrison makes insightful comparisons between the racist origins of both the “war on drugs” and the “war on obesity” (Harrison, 2021). As you cannot war on an inanimate object, in practice these become wars on people who use drugs and who have larger bodies.

Beyond our commitment to health equity, research also shows that weight stigma can contribute to poor health and weight gain (Hunger et al., 2015; Tomiyama et al., 2018), so even those who want to continue to insist on weight loss as critical to health will have to contend with weight stigma (Puhl & Heuer, 2010). There are some who argue that we can simultaneously advocate for weight loss while reducing stigma for people in larger bodies. From the perspective of people in larger bodies, this is logically inconsistent and harmful. (For excellent insights on this, see Chapter 4 “On Concern and Choice” in What We Don’t Talk About When We Talk About Fat by Aubrey Gordon, 2020.)

Including weight stigma in our anti-oppression work allows us to take a more inclusive and expansive approach to equity. Body liberation adds an important piece to our liberatory, health-enhancing work.

ALLY ACTION

Connect the dots between inequity, injustice and body size. For example, include anti-fat bias, fatmisia or weight stigma as examples of oppression and social determinants of health when these topics are discussed. When people treat weight-health correlations as causal, raise the issue of weight stigma and seek to clarify correlational/causal relationships.

CURIOUS TO LEARN MORE?

Andreyeva, T., Puhl, R. M., & Brownell, K. D. (2008). Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006. Obesity, 16(5), 1129–1134.
Burmeister, J. M., Kiefner, A. E., Carels, R. A., & Musher-Eizenman, D. R. (2013). Weight bias in graduate school admissions. Obesity, 21(5), 918–920.
Gordon, A. (2020). What We Don’t Talk About When We Talk About Fat. Beacon Press
Harrison, D. (2021). The War on Drugs and The War on Obesity. In Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness. North Atlantic Books.
Hunger, J. M., Major, B., Blodorn, A., & Miller, C. T. (2015). Weighed down by stigma: How weight-based social identity threat contributes to weight gain and poor health. Social and Personality Psychology Compass, 9(6), 255–268.
Jones, C. (2018, April 18). Dr. Camara Jones Explains the Cliff of Good Health.
Kinzel, L. (2014, November 28). New Study Finds That Weight Discrimination in the Workplace is Just as Horrible and Depressing as Ever. Time.
Mercedes, M. (2022, Spring). No Health, No Care: The Big Fat Loophole in the Hippocratic Oath. Pipe Wrench.
O’Hara, L., & Gregg, J. (2012). Human Rights Casualties from the “War on Obesity”: Why Focusing on Body Weight Is Inconsistent with a Human Rights Approach to Health. Fat Studies, 1(1), 32–46.
Pause’, C. (2017). Borderline: The Ethics of Fat Stigma in Public Health. The Journal of Law, Medicine & Ethics, 45(4), 510–517.
Puhl, R. M., & Heuer, C. A. (2010). Obesity Stigma: Important Considerations for Public Health. American Journal of Public Health, 100(6), 1019–1028.
Tomiyama, A. J., Carr, D., Granberg, E. M., Major, B., Robinson, E., Sutin, A. R., & Brewis, A. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Medicine, 16, 123.