Body size, health and fatphobia

With the health-care reform debate gearing up in the states, there has been a great deal of controversy over the current system of health insurance. Last month, a four-month old baby in Denver was refused health insurance because he was considered too fat. Despite being breast-fed and healthy in all respects, Rocky Mountain Health Plans deemed the boy, who is in the 99th percentile for height and weight, too great a risk to insure. According to current U.S. health insurance system, companies can refuse to insure individuals with a pre-existing condition — including obesity. Babies above the 95th percentile and adults with a body mass index (BMI) over 30 are almost always denied health insurance.

Here is where the line between what is acceptable and what is outright discrimination gets fuzzy. Up until a few years ago, refusing a pudgy baby health insurance might have seemed outrageous. But the “obesity epidemic” has many people convinced that our weight is our problem. A large percentage of Canadians take as fact that weight is wholly determined by what we eat and how much exercise we get.

Too bad it’s not nearly that simple.

One problem with the obesity epidemic is that many people fail to question how obesity is measured. Yes, an increasing proportion of the population is now “obese,” but by what standards? The standard measure of obesity is the BMI, which is calculated using a person’s height and weight. Nothing else is measured — not your muscle mass, not your cholesterol, not even your age. For anyone who is above or below average height, or who has an above or below average muscle mass, the BMI is utterly useless. According to the BMI, Lebron James is overweight and Dwayne “The Rock” Johnson is morbidly obese. How can anyone put their faith in a scale that would classify Dwayne Johnson as morbidly obese?

Putting aside the inaccuracy in the measurement of obesity, there is still a real problem with indiscriminately labelling every fat person as unhealthy. Several alternate theories to the obesity epidemic have come out, including the notion that we are simply a fatter generation. The increase in obesity-related death could simply be a result of humans living longer. Instead of dying from pneumonia and scarlet fever, we are living long enough to die of heart disease. The health risks associated with being overweight and obese have also been exaggerated. A 2008 study found that about half of overweight individuals are metabolically healthy. Moreover, a study in September found that exercise can significantly diminish the risks associated with obesity, irrespective of weight loss. This means that even if obesity is linked to health risks, many of these risks can be overcome through regular exercise.

So, why are people so quick to hop on the “fat is bad” bandwagon? Why is the obesity epidemic such big news? Maybe they’ve provided a convincing argument, or maybe we just wanted some excuse for the negative associations we have with fat.

Fatphobia is one of the last remaining socially acceptable forms of prejudice. In fact, fatphobia is so ingrained in society that even young children characterize their plump classmates as lazy and mean. Studies have shown that fat people are less likely to be admitted to elite colleges and to less likely to be hired. One U.S. study found that for every pound they are “overweight,” professionals sacrifice US$1,000 in salary. A survey asked 47 previously fat men and women if they would rather be blind or gain back their lost weight; 89 per cent of the respondents said they would rather be blind. At least when you are blind, people want to help you.

Weight-based discrimination has gotten so bad that fat people must now fear for their safety. Last week a woman in the UK was attacked and beaten because of her size. Her assailant called the woman a “big fat pig” before kicking her in the face and torso.

The notion that anyone can be thin makes fatphobia even more pervasive. Not only are you prey to your obsessive mothers and the media’s obsession with all things thin, now the obesity epidemic has given any jerk the right to criticize the way you look. Even doctors are jumping on the fatphobic bandwagon. Many doctors refuse to treat obese patients, and prescribe “losing weight” as a solution to anything from knee pain to headaches. Despite a wealth of evidence to the contrary, even doctors believe obesity is a lifestyle choice rather than a genetic disposition.

Fat people are not a drain on the health care system, nor are they necessarily lazy, mean or selfish. A fat person is not a source for ridicule and judgement. They are not a forecast of what you could become if you eat that last piece of cake. Fat people are just like everyone else. Some are healthy; some are not. You do not have the right to pass judgement on someone based on the way they look, and you know it.