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    Sunday, September 13, 2015

    Fat, Fit, and on the Cover

      It’s rare for a magazine cover to make headlines, and even rarer if it’s a fitness magazine. But that’s exactly what the editors of Women’s Running did when they put plus-size model Erica Schenk on the August cover.

    Other plus-size models have landed magazine covers recently, including Tess Holliday (People) and Ashley Graham (Sports Illustrated). But putting a fat runner on the cover of Women’s Running is downright subversive. It challenges the widespread assumption that all overweight and obese people are lazy and gluttonous, and that if they’d just eat sensibly and get off the couch they wouldn’t be fat anymore. It telegraphs the idea that runners—and athletes—come in a variety of shapes and sizes. Which happens to be true.

    Compare that message, though, with the one offered by a recent satirical video on a popular social media site, which starred a character named “Ms. Fatty” who stuffed herself with fast food while begging her doctor for a diet pill. The video’s creator, who goes by the nom de plume Dr. Sorry, wrote on his Facebook page that obesity “boils down to personal responsibility.”

    Dr. Sorry is not alone in his blame game. More than half the primary care doctors in one survey described obese patients with words like awkward, ugly, lazy, sloppy, and noncompliant.[1] Two-thirds of surveyed nurses said obesity can be prevented by self-control.[2] A large sampling of British health-care providers told researchers obesity was caused by physical inactivity, overeating, food addiction, and personality traits[3]—all elements of “personal responsibility.”

    To be clear, personal responsibility is certainly part of the picture. Nutrition and physical activity play an important role in the relationship between weight and health. But that relationship is far more complex than most of us think. Some obese people are metabolically healthy; some thin people are not. And vice versa. Some thin people sit on the couch eating junk food and some don’t; ditto for fat people. Research over the last decade has found that poverty, lack of access to fresh food, exposure to persistent organic pollutants like bisphenol-A, and stigma all contribute to both obesity and poor health.

    If “personal responsibility” were all it took to make people thinner, the statistics on dieting would look different. More than 90 percent of dieters regain most or all the weight they’ve lost (and usually more) within three years. And most of those dieters, contrary to the stereotypes, go at it again and again, because to be fat in this culture is to be bullied, shamed, lectured, laughed at, and devalued.

    What we think about weight and health—and especially what health-care providers think—matters. It shapes relationships with patients, medical diagnoses and treatments, and research. Yet an awful lot of experts believe in blaming and shaming fat people. Dr. Sorry, for instance. Or Dr. Kenneth Walker, who wrote “For their own good and for the good of the country, fat people should be locked up in prison camps.”[4] Or bioethicist Daniel Callahan, who called for ramping up discrimination against fat people in a “end justifies the means” argument.[5] Or former drill sergeant John Burk, whose “your fat is repulsive” video went viral two weeks ago.

    In reality, stigmatizing obese people leads neither to weight loss nor better health. On the contrary: people who experience fat-shaming are more likely to overeat and binge-eat and less likely to exercise. Being fat-shamed has been linked to higher blood pressure, higher levels of stress hormones like cortisol, and higher levels of CRP, an inflammatory biomarker strongly associated with heart disease and type 2 diabetes.[6]

    So yes, it matters when a major fitness magazine sends the message loud and clear that you don’t have to be thin to be a runner. That you can improve your health even if you wear a size 18. Maybe Schenk’s image will make some guy on the street think twice before mooing at a plus-size runner, or make a doctor understand that obese people, like thin people, are more than their BMI.

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     This topic brought to you from psychologytoday.com
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