Disrespecting People Who Want to Feel and Look Their Best

Woman at the MirrorSeriously, it is not a problem if people living with obesity value their appearance. Do we really have to say this? Apparently we do. Because all too often we see a subtle bias in discourse about obesity that adds up to disrespecting people who want to look and feel their best.

Physician and writer Matthew Rehrl expressed this recently:

“Cosmetic improvement (for example, clothes fitting a little better) isn’t nothing.

“It’s OK to feel better about how you look. I don’t think we should demonize that aspect of these medicines or surgery.

“In a perfect world how you look shouldn’t matter. But the world isn’t perfect, and in fact, for obesity stigma, I think it may be getting worse.

“So, apart from the objective health benefits, if someone gets judged less and gets a little less abuse, then – for them – that’s ok.”

Issues of Appearance

A recent open letter from Eli Lilly and Company makes it clear that this is a tricky subject. The company writes:

“Mounjaro and Zepbound are indicated for the treatment of serious diseases; they are not approved for – and should not be used for – cosmetic weight loss.”

Certainly, we agree that trivializing the medical significance of obesity care is a problem. The idea that obesity treatment is all about appearance is far too common. Check with the Washington Post if you don’t believe us. Some insurers label obesity treatment as cosmetic and deny coverage for care on that basis.

Above all, this is false. People who get effective obesity care enjoy better heart health, metabolic health, joint health, and often relief or protection from a wide range of medical complications of obesity. Medical treatment of obesity is about much more than weight loss and appearances.

Disrespecting People

EugeneNonetheless, dismissing the importance of how people look and feel about themselves is nothing less than disrespectful. It is also a subtle but sure expression of weight bias.

We will not forget an esteemed specialist in pediatric endocrinology who told us that children with obesity should not be seen as happy, normal children. She objected to this image of a teen who was seeking care. “He shouldn’t look so happy,” she told us.

Her words bring to mind all those dehumanizing images of headless bellies and buttocks to illustrate what obesity is. Some people cannot bear to think of people living with obesity as whole and worthy persons. This is a foundation for stigma.

We reject it.

Click here for further perspective on the tension between health and appearance in culture and medical care.

Woman at the Mirror, painting by Cagnaccio di San Pietro / WikiArt

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January x, 2024