Still Life with Candles and Mirror

Is It Possible to Separate Obesity from Body Image?

One reason that obesity can be such a difficult topic is because people link it to appearance. Thus we live in a culture where people presume they can diagnose a person’s health based on body image. Looking healthy becomes a surrogate for being healthy. People do very unhealthy things to reach for a healthy appearance. Just look at any website or magazine devoted to health and wellness. You will find models with an appearance that popular culture holds up as a healthy ideal. So we wonder if it’s possible to separate obesity from body image.

Can we take the style out of lifestyle?

Pretty Hurts

In a recent podcast, journalist Reema Khrais explains how focused we are upon appearances:

“Beauty can feel like one big scam. Globally, it’s a $532 billion industry, with standards that are always moving and almost always feel unattainable. But from a young age, we are told that to be accepted, to be desirable, you have to spend money and time. And if you don’t, then, well, you’ll pay in a much different way.”

So we invest in cosmetic rituals to enhance our personal and our professional images. Khrais takes us through the life experiences of a Black woman, now a model, with a body that started growing a whole lot of hair everywhere at the young age of 11. Her mother took her for a painful waxing to remove it for her sixth grade graduation. This was merely an introduction to painful routines she would follow for years. Eventually, she made peace with her body hair.

Obesity Awareness?

One of the unfortunate tangents of public health efforts to address obesity has been the effort in the 1990s to “educate” people about BMI as a measure for health. In 2003, schools began screening children for a high BMI. Schools started sending “fat letters” home to parents. Some researchers turned their attention to “body size misperception” as a “determinant in the obesity epidemic.” Researchers in the UK have even developed an intervention to persuade parents that their children are too fat based on a visual assessment scale. It’s called the MapMe intervention.

All of this is based on a presumption that teaching people they are too fat will help to reduce obesity.

But it does not help. Children are quite good at telling each other they are fat. It doesn’t make them slender. People with obesity have not missed the cues that the culture prefers a one-size-fits-all body image. In fact, research suggests that perceiving oneself as “overweight” actual predicts a higher risk of future weight gain.

Image and Health

Can we separate obesity from body image? The popular preoccupation with image and appearance suggests this will not be easy. Nonetheless, obesity is not a disease of appearance. It is problem of metabolic health. Health professionals would do well to keep appearance out of the equation.

Click here for a fascinating podcast on how beauty standards can hurt. For perspective on BMI screening in schools, click here. Finally, you can find perspective on the high prevalence of body dissatisfaction among persons with obesity here.

Still Life with Candles and Mirror, painting by Max Beckmann / WikiArt

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April 29, 2021