Britain has launched a program called “Better Health” that is claiming that it will improve health by perpetuating fatphobia and convincing people to engage in so-called health interventions that almost never work (and promoting for-profit companies that do the same.)
It utilizes the “eat less, move more” theory that has been proven not to work since at least 1999. and that even Canadian Health Professionals who sell weight loss have admitted doesn’t work. But encouraging people to attempt intentional weight loss despite the fact that there isn’t a single study where more than a tiny fraction of people succeed at significant long-term weight loss is, sadly, nothing new.
Tying it to the equally questionable idea that fat people are at a higher risk for COVID-19/more severe symptoms because of their body size (and not because of the unequal treatment we receive in society, and the very medical weight stigma at the root of this program) is new, and terrible.
Quick history lesson – during the H1N1 outbreak, fat people had poorer health outcomes (and everyone jumped on the bandwagon to figure out exactly what about fat bodies was the cause.) It turns out the actual issue was that fat people were systematically treated later with antiviral medication than thin people. Per a study on the subject “After adjustment for early antiviral treatment, relationship between ob*sity and poor outcomes disappeared.” More about the issues with the claim that being fat increases COVID-19 risk/severity can be found here and here.
Besides which, we don’t know that making larger people (temporarily) a bit smaller will do anything to change their COVID-19 risk, nor do we know if encouraging people to restrict food and exercise to create a situation where their body has to consume itself to survive could actually make things worse. The idea that if we make fat people look more like thin people then their health outcomes will be the same is not remotely scientifically sound.
They are making the incredibly dubious claim (with absolutely no evidence) that if every person who is considered fat loses 5.5 pounds (an amount many menstruating people gain and lose each month, and that I could personally lose right now with a haircut and a loofah) it will save the NHS $135M in five years.
In fact, the only arguably “smart” (though still terrible) thing they did is make this only a 12-week program. Almost anyone can lose a little weight short term. Then, like almost every study on weight loss, they’ll stop tracking results before the vast majority gain it all back (with many gaining back more than they lost) and claim success, blaming the *almost everyone* who gains the weight back.
This will do an incredible amount of harm in the following ways:
First, any time there is a national campaign against fat people, it increases the stigma that fat people deal with. Studies have shown that this stigma is correlated to many of the same health conditions to which being fat is correlated. Making people hate their bodies does not improve health outcomes.
When programs like this correlate weight loss with health it sets people up to give up on supporting their health when they, almost inevitably, fail to maintain weight loss. Health, by any definition, isn’t an obligation, barometer of worthiness, or entirely within our control, but setting us up to believe the lie that the only way to pursue health is through weight loss, and then fail (often repeatedly) at weight loss does not improve health outcomes.
Many of the things that people are claiming may cause fat bodies to be at higher COVID-19 risk are actually correlated with weight cycling (yo-yo diet) which is by far the most likely outcome of multiple weight loss attempts, which Britain’s program will actually increase.
Consider weight cycling as an example. Attempts to lose weight typically result in weight cycling, and such attempts are more common among obese individuals . Weight cycling results in increased inflammation, which in turn is known to increase risk for many ob*sity-associated diseases . Other potential mechanisms by which weight cycling contributes to morbidity include hypertension, insulin resistance and dyslipidemia . Research also indicates that weight fluctuation is associated with poorer cardiovascular outcomes and increased mortality risk [64–68]. Weight cycling can account for all of the excess mortality associated with ob*sity in both the Framingham Heart Study  and the National Health and Nutrition Examination Survey (NHANES) . It may be, therefore, that the association between weight and health risk can be better attributed to weight cycling than adiposity itself .
In addition to the calorie counting push being destined for failure based on all the research that exists, this kind of campaign does real harm to people who may develop, are living with, or are recovered from eating disorders.
The government is insisting on putting calorie counts on menus which has been found to do nothing to change food choices but increases the chances of triggering an eating disorder. (Also incredibly triggering is a massive media campaign that focuses on the idea that thin(ner) is better.)
Perhaps most frustrating of all, it is entirely possible to create public health interventions without weight stigma, thus actually increasing the upside while eliminating the downside for people of all sizes. (Though, of course, those don’t generate profits for diet companies, or shift the blame from the government’s piss poor handling of a global pandemic onto fat people for simply existing.) We should hold our leaders to this standard and refuse to participate in these farces that claim to be about wellness but are deeply, inextricably linked to fatphobia.
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19 thoughts on “Britain’s Plan To Fight COVID-19 With Fatphobia Is Terrible”
OMG it’s an ad pitch! It’s a great big ad pitch! I went to the NHS’s Better Health site and the first thing there is an ad for a fitness tracking app (with a link), then ads for dubdub and Slimming World and all their bros (with links) and then some more apps (all with links). Between them are interspersed Woman’s World level dietary advice like “swap out your soda for water.”
FOLLOWED BY A DISCLAIMER THAT BETTER HEALTH ISN’T QUALIFIED TO OFFER DIETARY ADVICE!
They even use the “health journey” euphemism!
I know aggressive systematic mass-targeted fatphobia coming from the government is the least funny thing ever and that this is going to get real people really killed for real, but at the same time, it’s like O’Brien strolled into room 101 in his boxer shorts with a smiling cartoon kitty-cat and paw-print pattern. You know his hate for you is real and he’s about to put some serious permanent hurt on you, but it’s hard to stifle the giggles, because he looks so ridiculous.
I don’t know, lose a leetle bit of weight, get a leetle bit less COVID…?
I am the very model of an expert on obesity
on counting fats and carbs and micronutrients and calories
I’ve calculated BMI and adages dependable
for keeping track of intake and of energies expendable
I offer lifestyle changes and the journies healthological
with many arcane theories ’bout your problems psychological
I’ll tell you how to cut out sodas, burgers, fruit pies and Twinkies
And tell you it’s impossible you might avoid them already
I’m very good at shaming, though I shun it in the public eye
The stereotypes I’ll indulge but fat acceptance I’ll decry
In short, for counting fats and carbs and nutrients and calories
I am the very model of an expert on obesity
I know the cure for cancer and the flu, and it is “just lose weight”
For pandemics and plagues my helpful good advice will not be late
I know that when the fatties are all gone, we’ll need no quarantine
I know I earned my thin privilege, and also it’s not a real thing,
I’ve memorized the pundits’ names, from Maher down to Meme Roth
I know that if you really tried, then you could keep all that weight off
In gym class I will run the fat kids ’till they fall upon the ground
And then I’ll fail them anyway because they didn’t lose a pound
For my medical knowledge, though I’m passionate and maudlin
has not surpassed the ‘you are what you eat’ of Claudius Galen
But still, in counting fats and carbs and nutrients and calories
I am the very model of an expert on obesity
Holy fuck this is completely amazing! Please tell me that you are planning to record this…
Unfortunately, I’d never be able to record this myself, thanks to a childhood throat injury that makes singing… well, kinda painful, and touch-and-go as far as the sound goes.
Although it’s not just the song; you could do a whole-play parody where instead of being different classes than the women they want to marry, the pirates are stymied by being technically overweight thanks to the BMI system, and therefore spare anyone who tells them they’re on a diet, as they have been on diets since they were children. Then at the end they get news the BMI charts have been reverted to their pre-revision standards and they aren’t overweight anymore.
…I don’t know if it’s funny or depressing you’d have to change so little to make that work.
Also, thanks! I’m glad you liked it!
It’s definitely an #lolsob situation…
I’m so sorry about the injury. I’m not sure about taking on the whole play – though it’s genius! – but wonder if it might be ok with you if I record the song – giving full and total credit to you for the lyrics of course. My singing is nothing to write home about but I enjoy it and especially enjoy parody songs. If you would prefer not for any reason of course that’s fine. If you are cool with it just let me know how you would like to be credited (you can tell me here or e-mail ragen at danceswithfat dot org)
I don’t mind if you sing it at all! I’m actually stoked you liked it that much! I’m fine with being credited as “Lady R” (the full handle’s a fictional character’s name, which might be a little too silly).
Also, dunno if you want it or not, but I actually tried to post an “encore” verse right after the song (because encore’s part of the joke) and WordPress ate it, so let’s see if it goes through this time:
I’m very good at getting governments to open up their purse
reciting every slimming corporation’s name in person-first
with laws of thermodynamics, I’m known for playing fast-and-loose
I’ll listen to your words, but then, I know that they’re just an excuse
And even though I say the BoPo party mantras with the best
I know you’d be a thin person if only you would just eat less
Obesogenic properties I constantly am rooting out
For banning sugar, sizes and screen time I’ve got a lot of clout
In short, in counting fats and carbs and nutrients and calories
I am the very model of an expert on obesity
More genius. Can say we knew you when! Love to hear Ragen singing it.
Awesome sauce! This is completely genius and I’ll keep you posted as I do it (it will be a while, I don’t know the tune super well and this is a lot to memorize!)
Applause, applause, applause — and that’s from a lifelong Gilbert and Sullivan fan who (so they tell me) sat and sang “I am a pirate king” in my highchair . . .
LOL, I seriously considered leaving the “whistle all the airs from that infernal nonsense Pinafore” line untouched.
(WITH CAT!LIKE! TREAD! UPON OUR PREY WE STEAL!)
Wow, that was amazing! Brava!
It was worth reading the post about the infuriating anti-fat behavior just to get the song parody!