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"Fat Acceptance" raises concerns among health care professionals

Tuesday, August 11th, 2009

For years, when it came to pop culture, only thin was in. But these days – Several new TV shows feature curvy protagonists dancing, dating, and being in charge. Health care professionals are glad to see fewer of the media images that fueled eating disorders. But they are worried that things have swung too far in the other direction: Some Americans who are overweight or obese now seem to think their weight is just fine.


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It’s called fat acceptance. American television is embracing a greater variety of body types – a trend that goes beyond the reality shows about weight loss. Fox recently premiered More to Love, its new version of The Bachelor, featuring a willing lineup of “BBWs” Big, Beautiful Women. Then there is “Drop Dead Diva” and “Dance your Ass off.”

The latter is a favorite for Carla Hangley – who has felt uncomfortable in her round body every since she was a teenager. She says she enjoys seeing large people portrayed as sexy:

Hangley: They show these very voluptuous women and men really dancing – pole dancing, fast dancing, and it’s just a very different way of looking at sensuality even beyond a person’s body size.

Health care professionals are quick to say they are happy to see a diversity of body shapes in pop culture. But they are wondering how people’s perceptions of their own weight are changing.

In comparing two national surveys completed ten years apart [the first group was surveyed in 1988-1994, and the second was surveyed in 1999-2004], researchers found that in the later survey, more people thought they were lighter than they are. Lead researcher Mary Burke says we tend to assess our own status by looking at others:

Burke: So you look at people around you or maybe you hear news stories that now two thirds of Americans are now overweight or obese, and you think, oh I’m not doing so bad, overweight is now normal.

Temple University gynecologist Marisa Rose saw similar results when she asked her clients to pick a silhouette shape that best matched their body type. Two thirds of women with weight issues picked a smaller size.

Rose: Obese women often selected the overweight woman and the overweight woman often selected the normal weight woman.

Rose worries that women who don’t see themselves as overweight are ignoring health risks such as heart disease or diabetes:

Rose: They don’t recognize that they have these risks and will be less likely to address them.

But even as round bodies have become more mainstream, many people feel that society’s acceptance of weight goes only skin deep – and disdain lurks — prejudice prevails:

Wheeler: Oh, they are lazy, they are stupid, they don’t read, they don’t know that these foods aren’t good for them.

Philadelphian Jennifer Wheeler has been struggling with weight issues since high school – and recently joined Weight Watchers. She says health is a motivator, but admits the way others see her, and what she sees in the mirror offers more incentive to stay on her diet:

Wheeler: It’s vanity HAHAHA, well, it’s a little bit of both because I do know in my family there are health issues related to weight, diabetes, heart disease, but I also know that I feel better now mentally.

Dr. Sharon Herring works with obese patients at Temple University Hospital. She tries to strike a balance between body acceptance and encouraging women to lose weight.

She usually avoids setting numerical weight loss goals, and instead talks about making healthy choices. But if patients are concerned about the way they look, she’ll go with it:

Herring: So if the patient says “My biggest motivation is fitting into size eight pair of pants, and that’s really their biggest motivation, we’ll go with that and we’ll set goals around fitting into that size 8 pair of pants again. But I think to start we always want people to realize that where they are , whether they are at a size 14 or a size 21, are that’s beautiful, too.

Feeling beautiful is at the core of the issue for Carla Hangley. She carries extra weight, but has no health problems and is physically fit.

In addition to exercising and eating properly, she is trying to learn to accept her body:

Hangley: If I do that, and if I am loving myself, and I am loving my body, then I think that I will naturally just start to become smaller.


  • Dee says:

    Oh horrors! People are making peace with their bodies and (hopefully) concentrating on more important things, like living a full life. God forbid that anyone forgo vanity and the illusion of control over health and longevity.

    Anyway, people who are classified as overweight (BMI 25-30) are the longest lived Americans, and people who fall into the “type 1 obese” range (BMI 30-35) – by far, the majority of people who are classified as obese – live as long as people who are classified as normal weight (BMI 18-25). So, despite higher weight being a risk factor for heart disease and diabetes, there’s little impact on longevity. Logically, then, weight loss for most people is an issue of quality of life. Quality of life is a balancing act that each individual has work out for themselves.

    Additionally, almost nobody manages to stay 20%+ below their maximum weight for more than a year or two, and being 10-20% below one’s maximum weight confers pretty much all the health benefits of weight loss – but none of the social benefits. If you’re in the “obese” range, then a 10-20% weight loss is going to mean that you’re still overweight or obese.

    Naysayers: is it self indulgent and irresponsible to accept your body when you’re maintaining the type of weight loss that eliminates your risk factors, but still look fat, even if it denies others the ability to judge health by body size? Well, I hate to break it to you, but that doesn’t work, anyway.

  • D Bhatt with all due respect you are too full of yourself. Fat people in this country have needless suffered emotional abuse, there are studies that have found they have the same emotional distress as other discriminated against groups. Very few people are fat because of self-indulgence. It is either genetic or a result of environmental factors not easily controlled. In fact, obesity in industrialized societies is correlated with poverty. Why don’t you learn the facts before you rant.

  • They are really afraid of losing those profits. Years ago I read an article on how attractive bariatrics is to doctors. First, there is no need for special training. Anyone with an MD can call themselves a bariatrican. The profits are huge and it is far less stressful than being a regular GP. Since the patients almost always blame themselves for weight regain, there are few malpractice lawsuits. No wonder they want to condemn fat acceptance and protect their easy money.

    I am a sociologist who has researched the stigma of obesity for a very long time. Except in the extremes, fat people CAN be perfectly healthy. Sadly, many of the ill health affects attributed to obesity come from risky weight loss practices and yo-yo dieting. Pharma and the medical profession has done more to kill fat people that all the Big Macs in the world!!!

  • D Bhatt says:

    I am regular listener of “All Things Considered”, and enjoy it most of the time. But the show this Wednesday struck a jarring note. First, there was a very sombre description of the atrocities going on in Congo and rather shocking story of a young girl molested by militia, made to live in a hole for months, and then shunned by her own family when she was returned pregnant. It took me a long time to even fathom the severity of this poor child’s horror, when the show transitioned to the above “investigative report” of how obese women in the US are coming to terms with their body, and how they are begining to love themselves. The show went on to say that “some” health professionals are worried that obesity will now become more fashionable – I wonder who those pros are! I was in my car and wanted to scream at this rather ridiculous report. What a bunch of baloney! Maybe my reaction is more anguished than expected because this report came just after the sad story. But really do we want to hear about how and why narcissistic people are begining to gain more self-festeem in this country? Believe me, I love all kinds of programs, not necessarily serious, but reporting on self-indulgence is a waste of time, especially in the guise of “investigative reporting”.. Sorry, I just had to write to you…

  • Marci Lall says:

    I think it’s just an excuse for overweight people to not be responsible for their health.

    Sure you can dance around, be comfortable with your body and love your body for what it is.

    But when it all comes down to it they’ll still have problems with their health in the long run.

    They need to correct their lifestyles, and take responsibility for their health by staying at their ideal weight range.


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