Has body positivity hurt healthcare?

Photo by Arnaldo Fragozo

Maybe we need some nuance in our definition of fatphobia
By Matthew Fraser, Opinions Editor

Not that long ago someone told me that they had been having terrible back pain for years that doctors couldn’t seem to fix; they had tried drugs, daily stretching, and yoga yet nothing could properly combat their pain. During COVID however, they had lost a bit of weight and their back pain miraculously disappeared. They wondered why an earlier doctor didn’t suggest a diet change or other weight reducing measures. If it works in practice and seems intuitive, why is it no longer part of the arsenal of suggestions doctors make? If anything, this should be something that we all learn in our school days and carry on throughout our lives. But as the body positivity movement has gained prominence, I suspect a doctor’s job of combating excessive weight has gotten harder.

The body positivity movement isn’t a bad thing, but like any good idea it can be taken too far or even warped into something less desirable. Originally, the movement was started for and by black women to extoll the truth that beauty is not confined narrowly to one size and skin tone. It was also meant to share power with trans and disabled folk whose silhouettes were seldom represented as beautiful in the media. Good things can blossom, but they can also wither, so it was not long before the body positivity movement produced champions like Ragen Chastain. In one post on her “Dances With Fat” blog, Chastain outlines how best to counter a doctor who insists on prescribing weight loss as a method to alleviating illness. This same post includes a series of cards to be printed and referenced during checkups to combat doctors “weight bias.”

The concept of weight bias in the medical system has recently come to light and is facing intense scrutiny. An article from Buzzfeed showcased several people’s experience with fatphobia in the healthcare system and the way that doctors misdiagnosed, mistreated, or even shamed people for what they look like. Even Business Insider and Psychology Today have published articles discussing the perils of fatphobia and weight bias in the medical profession. Clearly, it is no longer acceptable for doctors to see weight loss as the proper response to ailments and common maladies—and they may even be accused of malpractice for saying so. It’s no surprise then that someone today may be prescribed drugs long before a change in diet. But that invites the question: is medication is always better than attempting a lifestyle change? Does it really make sense to run the risk of having an overmedicated society as opposed to addressing the very real health issue that plagues millions?

Excess weight can have extreme negative consequences to the quality and longevity of one’s life. Case in point, the African-American community—who created the body positivity movement—has dangerously high rates of diabetes and hypertension. Two things closely associated with excess weight and diminished life expectancy. It certainly is possible for there to be a more nuanced and combined view of health wherein people are not required to look a certain way to be deemed attractive, but that shouldn’t preclude doctors from acknowledging some of the problems with poor diet and exercise habits.

Maybe this is a question of balance and we have not figured out when it is and isn’t appropriate to suggest weight loss as a potential health benefit. People should love themselves and be happy with their own bodies—but at the same time, we should still be able to have frank and truthful conversations about the realities of health. However, for much of the body positivity movement, even that stance is considered fatphobic and bigoted. Maybe, like the person I mentioned above, people will just have to sample prescriptions until they stumble on weight loss and hope for the best.