Is being fat really that unhealthy?

Obesity now outweighs hunger worldwide, more than half of all South African women are classified as either ‘overweight’ or ‘obese’, and in the US, childhood obesity is believed to have tripled in the past 30 years. But several groups are saying we should ditch the fight against our growing waistlines, ban the body mass index (BMI), and forget diets – because, they say, being fat isn’t actually as unhealthy as society says it is. 

What is ‘fat acceptance’ or FA?

It’s the shift in focus from numbers and measurements to health and wellbeing, and the effort to change what the movement’s supporters say is a widespread discrimination against the overweight and obese – basically, they say, it’s not fat that’s bad, but rather a lack of physical activity, and that you can’t tell whether someone is healthy simply by looking at them. Linda Bacon, author of Health at Every Size and founder of the movement of the same name, says trying to achieve a weight that falls within the accepted ‘healthy’ range is ineffective, and people should rather focus on ‘physical activity, self-acceptance and normalised eating’.  

Can you be healthy and overweight?   

Yes. ‘People who exercise regularly and eat healthily but are slightly overweight are healthier than those who are “thin” but don’t exercise and eat lots of junk food,’ says Cape Town clinical dietician Kim Hofmann. Hofmann says that regardless of your body size, when you’re living a healthy lifestyle you are healthy, even if your BMI is in the overweight category. Which is why Kate Harding, an FA blogger and activist, has launched the BMI project – to show that the tool many people take as the authority on whether they fall into the healthy, overweight or obese category is inaccurate and misleading as it doesn’t take into account your level of activity, bone structure, muscle mass or body shape.

Are some people just destined to be fat?

Yes, says New York molecular geneticist and obesity researcher Jeffrey Friedman, who says that genes determine obesity just as much as they determine height. And while he accepts that a high-calorie, low-movement lifestyle contributes to people packing on the kilos, Friedman maintains that those who have a genetic predisposition to obesity will be more affected by this lifestyle than those who don’t. Bacon agrees, saying that biology dictates that most people regain the weight they lose, ‘even if they continue their diet and exercise programme’. Says Harding: ‘Many fat people can and do eat balanced diets and exercise just as much as thin people without losing weight – that’s where the whole genetic thing comes in.’  

Can obesity kill?

No, says Bacon, it’s a myth that fat kills and, on average, ‘overweight’ people live longer than people of ‘normal’ weight. ‘No study has ever shown that weight loss prolongs life’. But Hofmann disagrees. ‘You can take the Health At Every Size message too far: being very overweight (in the region of obese) is hazardous to our health – you’re at greater risk of having high blood pressure, diabetes, or a heart attack. People in this category have to concentrate on their eating patterns, exercise routines and mental wellbeing.’

So what should we focus on?

We need to move away from being obsessed with reaching a specific weight that is often unrealistic and the result of the way society values ‘thinness’, says Hofmann. Instead, says Linda Omichinski, a registered dietician who campaigns against dieting, we need to realise that there is no ‘one’ right shape, size or weight.‘We are trained to think we have to be thin to be healthy, happy, attractive, and worthwhile. We’re trained to believe that success and value are determined by the number on the bathroom scale. But we all have different body shapes, metabolisms, and activity levels.’