Fat people: #IAmNotADisease

Story highlights

  • The American Medical Association classified obesity as a disease
  • Marilyn Wann: Because of the label, fat people will likely encounter more weight bias
  • She says the AMA is focused on profit by focusing on weigh and weigh loss approach
  • Wann: If the AMA truly cares about the health of fat people, they will end the war on obesity

In deciding last week to label one third of Americans -- fat people -- as diseased, the American Medical Association not only went against the advice of its own experts, they also failed to include anyone from fat community in that decision.

There is a consensus among three groups of people -- those who proudly self-identify as fat, fat studies scholars and advocates of the Health at Every Size approach -- that the AMA is putting profits before people and redoubling its focus on weight and weight loss when that approach has, for decades, failed to produce on its promises. It doesn't make people thinner or healthier in the long term, and it encourages weight stigma, prejudice and discrimination.

The AMA seems eager to expand weight-loss treatment and convince insurers to reimburse for it. Big Pharma has two new weight-loss drugs out, with users losing at most only 10% of their body weight at a monthly cost of $100 or more and possible health complications.

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Bariatric surgeons would doubtless like to expand insurance reimbursements for the practice of surgically interrupting healthy internal organs. And the $66 billion per year weight-loss industry has a stake, too. (Although "weight-loss" industry is a misnomer when so many dieters regain lost weight that repeat customers are a basic part of the industry's business model.)

"I can guarantee you that if there was no money to be had in this, the term 'obesity epidemic' would not exist," said clinical psychologist Peggy Elam.

Marilyn Wann

At news of the AMA's pronouncement, fat community members started the #IAmNotADisease hashtag on Twitter. I posted this petition on Change.org. The fat community's oldest civil rights group, the National Association to Advance Fat Acceptance, proclaimed a vote of no confidence in the AMA and called for "an immediate roundtable discussion that includes higher-weight people from every community."

As a result of the AMA's decision, fat people who face health challenges will encounter even more weight bias in medical settings and will likely encounter more difficulty obtaining treatment unrelated to weight. (The classic story in fat community involves going to the doctor with a sinus headache and being told to lose weight although many people's stories of medical weight bias are far more dire.)

Weight stigma itself is a direct threat to fat people's health.

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"Overall, it feels like another form of systematic discrimination and oppression," said blogger TaRessa Stovall.

Author Lesley Kinzel wrote, "For all of our cultural hand-wringing about how much fat people are allegedly costing health insurance companies, the AMA sure doesn't seem bothered by potentially causing an explosion of unnecessary prescriptions (and surgeries!) among the one-third of Americans who are suddenly now 'diseased.' "

When doctors rely on weight, or a phrenology-era number such as BMI, they will misidentify more than half the healthy people as unhealthy, psychologist Deb Burgard pointed out.

"They do not seem to understand that calling one-third of the natural variety in a population 'sick' is a hostile act and undermines the trust that millions of people would otherwise place in their doctors' advice," Burgard said.

As one petition signer, Victoria Centanni, commented: "My doctor already [attributes] all of my health problems to my being fat. [It] makes me want to avoid seeking health care for any reason."

For more than two decades, health professionals who promote the Health at Every Size concept have argued that a weight focus does no lasting good and much harm to physical and mental health and to fat people's social status.

They are finding that a weight-neutral approach based in self-acceptance and social justice yields far superior results for people's health and happiness. People are able to develop enjoyable, sustainable eating and exercise habits and a positive feeling about their bodies.

If the AMA truly cares about the health of fat people, they will end the war on obesity.

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