Make Believe About Obesity Blended with a Social Agenda

The Soap BubbleWe confess to a significant amount of fatigue with a social agenda related to size and weight getting overlaid on the medical concern of obesity. The bickering of people who want to make believe that obesity is a purely social issue can be too much to bear.

This has been one of those weeks.

Moral Hazard

It starts with moralists who see a hazard in offering medical care to people with obesity. If we do that, says Arthur Caplan, “the majority of humanity may use injectables not just for obesity control but simply for maintaining normal weight while eating as they please.” With his broad brush, he suggests obesity is a problem of people who feel “no need to give up on dessert.”

So his social agenda for obesity emphasizes a struggle with lust, greed, and gluttony.

Medical Denial

At the other end of the spectrum we have fat activists who have a very legitimate gripe about fat phobia, weight bias, and stigma. They resent relentless depictions of larger bodied people as a walking medical burden.

But instead of sticking to the social issue, they wander into the sphere of medical disinformation – denying that obesity is a medical concern. What if doctors tried to medicalize tallness? That would be the same thing as they are doing to fat people, they told us.

Writing in the Washington Post, fat acceptance advocate Kate Manne explains that:

“Whether certain elevated health risks for heavy people are caused by their weight per se remains unclear.”

The word obesity is one she cannot bring herself to write, perhaps because she does not accept it as a legitimate diagnosis.

Blurring the Lines

Here’s the thing. Obesity is real. It causes real suffering, harms to health, and shorter lives. This is not a disease of size or appearance – it is a disease of abnormal or excess fat tissue that impairs health. Obesity is affecting more people than ever before. Because most of these people cannot get good medical care for this condition, it causes many other chronic diseases – diabetes, heart disease, liver disease, joint disease, and cancer, to name a few.

And yes, the social issues of bias and stigma, exemplified in Caplan’s writing, make it worse. But fighting those social issues does not make it necessary to make believe that obesity is not real.

That game of make believe hurts people who need good obesity care.

Click here for Manne’s essay and here for Caplan’s.

The Soap Bubble, magic realism by Cagnaccio di San Pietro / WikiArt

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February 3, 2024

One Response to “Make Believe About Obesity Blended with a Social Agenda”

  1. February 03, 2024 at 9:37 am, Allen Browne said:

    To Dr Caplan – learn about a disease before commenting on it.

    To Ms Manne – obesity is a disease of energy regulation and is bad for most people. Ignore ways to improve your health , if you want to, but don’t tell others how to handle their health problems.