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Barbara Kay: Fat-acceptance is not the answer to obesity

It should be no surprise that many health professionals who deal with obese people feel they lack discipline and self-confidence.

In a perfect world, body size wouldn’t matter. We’d be attracted to people for their character alone. Alack and alas, our world is far from perfect. Ours is not a cover-up world either. Flesh-baring, form-hugging clothes are the fashion norm. Great for thinnies, not so much for fatties.

People who specialize in treating eating disorders can carry some of the same anti-fat attitudes and “fat phobia” towards obese people as the rest of society, new research suggests.

In what is being described as the first look at weight bias specifically among psychologists, therapists, social workers and other mental health professionals specializing in eating disorders, Yale University researchers found a considerable percentage believe obese patients have poor self-control, no willpower, and are self-indulgent, unattractive and insecure.

The majority had heard or witnessed other professionals in their field making derogatory comments about obese patients. Nearly half believe obese patients lack the motivation to lose weight.

People with a tendency to put on weight are doubly unlucky in our era. They’re pariahs in, on the one hand, a youth and fitness-obsessed culture that prizes bodily perfection, with unrealistic standards of slenderness, and at the same time are constantly tortured by a society fixated on food, much of it cheap, fattening, seductively marketed and readily available 24 hours a day.

We pay lip service to the notion that we shouldn’t be biased against people because of their size. But most of us are. Even some professionals tasked with helping them.

A study by the Yale Rudd Center for Food Policy & Obesity, published online in the International Journal of Eating Disorders, suggests that professionals who deal with the obese are often themselves biased. Researchers surveyed 329 mental health specialists, seeking their views on causes of obesity, as well as attitudes and compliance amongst their patients. They found that respondents felt many practitioners in the field hold negative stereotypes of fat people or feel uncomfortable treating them or lack confidence in obese patients’ ability to lose weight or comply with treatment.

Why is there a fat-acceptance movement when there is no tobacco-acceptance movement?

In addition, the study found that 16% of those surveyed think the obese have no willpower; 15% that they are self-indulgent; 24% that they are unattractive; and 50% that they are insecure.

The researchers seem gloomy about these figures, but unless they were hoping for zero bias – which would be totally unrealistic – these figures are reassuringly low. Professionals are not immune from our culture’s near-religious worship of minimalist beauty.

Obesity is a class issue, like tobacco. People in every class used to smoke, rich and poor, educated and non-educated alike. But when tobacco was conclusively linked to disease, more and more educated people stopped, until the image of smokers reached a tipping point, and went from “cool” to “loser.”

Doctors rightly resent spending time and expertise helping people whose health problems are self-inflicted.

Today, smokers are openly disdained amongst white-collar people; the relatively few smokers in that demographic meekly endure public contempt for their moral weakness. Only blue-collar smokers enjoy their vice without shame. Nobody blames health professionals for their negative attitudes to smokers. Smokers are a burden to the health system, and doctors rightly resent spending time and expertise helping people whose health problems are self-inflicted and amenable to improvement with applied self-discipline. So why should we expect health professionals who oversee obese people to be non-judgmental at heart?

There is no such thing as Smokers Studies in the universities, but there is a “discipline” called Fat Studies, a spin-off from Women’s Studies. In Fat Studies, participants speak of “thin privilege” and “sizeism” and “fatism” as though the prejudice against fat people were a form of oppression tantamount to racism. They play down obesity as a health issue.

Our culture is obsessed with beauty, and shouldn’t be. It’s very tough to be genetically unlucky, desperate to meet the standards of elites that are impossible for certain body types. But fat acceptance is not the answer. Not everyone can be thin, but just about everybody can avoid being obese. Therefore, health professionals who judge their patients are doing them a favour.