The western world has an epidemic of obesity. The World Health Organisation (WHO) tells us that worldwide obesity has nearly tripled since 1975, that 39 per cent of adults were overweight in 2016 and that 13 per cent were obese. I, myself am one of the latter. WHO also revealed that most of the world’s population live in countries where an excess of weight now kills more people than being underweight. Most importantly, it tells us that obesity is preventable and that “the fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended”.

We knew this, though, didn’t we? We knew that people get overweight if they eat too much and underweight if they don’t eat enough. There are certainly plenty of people who insist they eat very little and yet are heavily overweight, but it’s hard not to notice that in regions where people genuinely don’t have enough to eat, none of them are obese.

During the 1970s the Fat Underground spouted slogans like “Doctors are the enemy. Weight loss is genocide.”

Similarly, people who tell us they are obese because of their genes do not seem to have answers for where all these obese genes suddenly came from as our grandparents’ generation did not have the same problem.

Nevertheless, it is now considered highly problematic to say that obesity is an epidemic, that it is unhealthy and that it is caused by eating too much. The charity Cancer Research was accused of “fat-shaming” in 2018 for saying that obesity is a risk factor for several cancers. To the comedian Sofie Hagen it was evidence that this campaign by the organisation which has done so much to reduce deaths by cancer is, in fact, a “piece of shit”.

Although Cancer Research responded that it was simply reporting the findings of science, angry “Fat Activists” called for the campaign to be removed and threatened to stop supporting Cancer Research if the research did not stop revealing things that contradicted their activism. Last July, dozens of academics from leading UK universities criticised Cancer Research for a billboard revealing that obesity is now linked with more major cancers than smoking. They admitted that a high BMI was linked to an increased risk of cancer but were concerned that the campaign told obese people that cancer was their fault.

The obstacles now faced by medical research organisations and medical practitioners in providing information and advice about obesity and by obese individuals (like me) seeking to make use of it to make informed decisions about their health are being erected by those calling themselves “Fat Activists” and “Fat Scholars”. Fat Activism began first in the United States with the founding of the National Association to Advance Fat Acceptance (NAAFA) in 1969 and the development during the 1970s of the Fat Underground which spouted such slogans as “Doctors are the enemy. Weight loss is genocide.”

Rooted originally in radical feminism, Fat Activism quickly spread to the UK and the rest of the Anglophone world. Arguably the most influential Fat Scholar and activist is a British academic, Charlotte Cooper, who usefully traces this development across the Atlantic in her book Fat Activism: A Radical Social Movement. Although feminists have long raised obesity as a feminist issue due to their perception that patriarchal society requires women to fit certain beauty standards and not take up much space, Fat Scholarship as a distinct subject has developed mostly this century. It has increasingly rejected radical feminism and taken on a postmodern tone situating itself within the intersectional framework of marginalised and oppressed identities.

This is seen most clearly in the journal Fat Studies, founded in 2012, which describes its mission statement thus:
Fat Studies seeks to challenge and remove the negative associations that society has about fat and the fat body. It regards weight, like height, as a human characteristic that varies widely across any population. Fat Studies is similar to academic disciplines that focus on race, ethnicity, gender, or age.

Although it seems incredible that any activism or scholarship on behalf of the overweight, obese and morbidly obese — those in imminent danger of death — would actively work to prevent people from accessing scientific research to inform their decisions about their diet and weight, this is exactly what is happening. This was inevitable as the scholarship is rooted in a type of postmodern theory which is explicitly anti-science.

Fat studies is much indebted for its conception of knowledge to the thought of Michel Foucault. Foucault argued that knowledge is a construct of dominant discourses — ways of talking about things — and that this works in the service of power. In the Foucauldian conception of the modern world, people are disciplined and constrained by what has been legitimised as knowledge by powerful forces in society. This constructed knowledge is then spoken by everyone on all levels of society and thus power works through everyone to control everyone. Because science is widely regarded as the most authoritative producer of knowledge, science is therefore understood as largely an exercise of oppressive power. He called this “biopower”.

Fat studies draws strongly on concepts from queer theory (of which Foucault is considered the founding father.) This is largely based on the claim that because homosexuality was once pathologised as a disorder, but is now overwhelmingly recognised as a naturally occurring, morally neutral and harmless natural variation, this means obesity is too. That is, we only think obesity is a problem because we have been socialised into having a moralistic disgust of fat people and science is used in an attempt to justify this fatphobia.
Attempts to make a parallel between homosexuality and obesity abound in the Fat Studies literature despite the fact that homosexuality appears to be an innate and perfectly healthy sexuality while obesity is the result of eating too much and tends to kill people. As Kathleen LeBesco tells us in The Fat Studies Reader, “Scientific knowledge doesn’t reveal all there is to know — or even very much — about how body size and sexuality are socialised and politicised. It is, I contend, these processes that must be transformed to alleviate the heavy burdens carried by fat and queer folks in a homophobic and fat-hating culture”. She credits Foucault for this stance: “Michel Foucault’s work has shown us that placing bodies under the microscope of science, in the name of liberal projects of self-improvement, in fact reinscribes their deviance and increases their oppression.”

The Fat Studies Reader is a treasure trove of Foucauldian ideas. In its foreword, Marilyn Wann informs us that “every person who lives in a fat-hating culture inevitably absorbs anti-fat beliefs, assumptions, and stereotypes, and also inevitably comes to occupy a position in relation to power arrangements that are based on weight”. She too implies that obesity is an immutable characteristic whose increasing presence in the population warrants no concern saying, ludicrously, “The population is getting taller, but we do not bemoan overheight or warn people to keep below, say, five feet eight.”

Charlotte Cooper also pays the obligatory obeisance to the founding father: “Michel Foucault’s work on governmentality is commonly used to theorise bodies in relation to power and has been used by people interested in how fat people are socially controlled, stratified, surveilled, regimented, patrolled, and self-governing.” In her book, Cooper simply jumps over the health risks of obesity to focus on her interest in people’s experiences: “I am not going to explore whether or not fat people are healthy, the prime concern in the world of obesity, although I am very much interested in how fat people cope with being treated as unhealthy.”

This neglect of science happens a great deal in Fat Studies, because, for the scholars and activists, “other ways of knowing” about obesity are far more important. Because of fatphobia, they believe, these other ways of knowing have been denied validity and deprioritised in favour of a focus on how obesity disables and kills people and how to help them prevent this from happening. This privileging of matters of life and death over matters of ideology, identity, wishful thinking and hurt feelings is understood as a failure of “research justice”.

Research justice is the aim to treat all sorts of beliefs, ideologies, experiences and feelings that aren’t research as though they are. As Cooper says, “This book represents a different way of knowing and finding out about fat. It reflects a conviction that obesity research must address fat activism if it is to be ethical, and that fat activism should consider adopting the values of Research Justice if it is to transform knowledge.” What are these other ways of knowing and alternative forms of research?

Critical dieticians Lucy Aphramor and Jacqui Gingras provide one example: “Rather than locate our writing in the culture of positivism by choosing a relatively static scientific discourse, we have instead chosen to engage poetry …” Apparently, this is how to craft “a praxis-oriented culture” and “trouble the status quo”. Wonderful.

Fat activists insist that failure to validate weight problems as healthy is a form of bigotry

This kind of fact-free scholarship then trickles down into activism where the idea that we have been socialised into the belief that obesity is undesirable when actually it’s just fine can be applied to everything. Thus, we hear from Virgie Tovar that not being attracted to obese people is “romantic discrimination”. Meanwhile, Mandy Cowley tells us that “fatphobia and diet culture permeate our society, our beliefs and our language … Please know that when I challenge your fatphobia and commitment to diet culture, I am only continuing to try to save my own life. And if you’re able to listen, it may help set you free as well.”

Concern about obesity is not only a matter of prejudice against fat people which endangers their lives and from which we all need liberation. It is also racist. Dani Beckett asserts that “fatphobia is fundamentally built into our societal structures and sits on a foundation of racism and colonisation that’s the perfect base for privileging thinness”. She warns us to “never forget that fatphobia has its roots in racism and white supremacy”.

If concern about obesity and associated disease, disability and early death is understood to reflect a hatred of fat people, be linked to homophobia and have its roots in white supremacy and imperialism, it naturally becomes immoral to take any steps to reduce one’s obesity. As Victoria Welsby, the “badass babe” behind the website Fierce Fatty, tells us, “If you intentionally lose weight, that act of intentionally trying to make your body smaller is inherently fatphobic and you are not therefore, acting in a body positive way.”

This may explain why a model who lost 17 stone received death threats. I, myself, have been subject to hostile interventions by Fat Activists when talking online about the problems my weight gain has caused for my joints, mobility and fertility, and especially when celebrating weight loss and the corresponding improvement of those problems or declining to make obesity my identity.

This is all extremely troubling. There is a genuine need for activism and advocacy for the obese because obesity is an extremely dangerous health condition. Even when we know this, it can be difficult to take control of it for all kinds of reasons, many of them psychological. Nevertheless, we recognise eating disorders which cause people to become dangerously underweight as a psychological problem requiring treatment; we should be able to address beliefs and behaviours leading to becoming dangerously overweight in the same way.

Fat activists and scholars hinder this by insisting that any failure to validate obese people’s weight problem as healthy and beautiful is a form of bigotry. They accomplish this by putting obesity into the category of immutable characteristics such as race, sex or sexuality rather than where it belongs alongside smoking, alcoholism or anorexia as a problem people may require sympathetic, expert support to overcome. This is alarming because in the case of race, gender or sexuality, it is both reasonable and ethical to tell people, “There is nothing wrong with you. The problem lies with society’s failure to accept you”, but in the case of obesity, thinking this way can be a comforting self-deception to which many who find weight-loss very difficult may be tempted to subscribe.

Another miscategorisation of the problem lies in the claim that “diets do not work”. The Fat Studies Reader is yet again, guilty here. In the chapter “Is ‘Permanent Weight Loss’ an Oxymoron?” by Glenn Gaesser, the Reader seems suddenly to value empirical data after all, but Gaesser largely looks at how few people successfully achieve long-term weight loss rather than at how diet impacts weight.

Dani Beckett (who informed us that fatphobia is racist) also makes this claim: “Understand that diets don’t work and are the evil child of capitalism and body-shaming culture. Over 95 per cent of people who lose weight through dieting put the weight back on within five years.”

Of course, there are people who simply cannot manage their weight no matter how hard they try, just as there are people who cannot keep on top of their housework

Michael Hobbs, for the Huffington Post, cites this statistic in an article arguing that everything we know about obesity is wrong. Hobbs insists: “Keeping weight off means fighting your body’s energy-regulation system and battling hunger all day, every day, for the rest of your life.” Here, he is half-right. Maintaining a healthy weight does require consistently eating the right amount to maintain that healthy weight. This does not, however, require being hungry forever, although it can feel this way for people in the early stages of a weight-loss programme.

The claim that “diets don’t work” relies upon “diet” being defined narrowly as a short-term weight-loss programme which, by definition, cannot and does not work long-term rather than broadly as “what one eats”, the management of which is the only thing that does work. Defining diets in this short-term way to claim that they don’t work makes as much sense as claiming that cleaning your house does not work because all the dirt comes back again when you stop doing it. Or as claiming that brushing your teeth does not work because they all fell out even though you cleaned them for a fortnight in 1987.

The claim that the majority of people who diet fail to maintain a healthy weight and so dieting is pointless completely ignores the billions of people who maintain a healthy weight by consciously or intuitively managing their diet. Although obesity is a significant and growing problem, the majority of people with access to plentiful food still manage to eat approximately what they need to maintain a weight that is neither dangerously low nor dangerously high. Some of us do not. The question is why.

The answers to this are likely to vary and include bad habits, a lack of knowledge about food and psychological difficulties. We can address all of these issues sympathetically and with evidence-based solutions provided this is not problematised as bigotry akin to racism, sexism or homophobia and provided obese people are not told, by people with PhDs and activists citing them, that achieving and maintaining a healthy weight through diet is impossible.

A vast number of myths have grown up around diet and weight which need to be addressed with reason and evidence. I recommend starting with behavioural psychologist Nadja Hermann’s book Conquering Fat Logic (Kindle, 2019) as she dispenses with myths including “I barely eat anything,” “Obesity isn’t unhealthy” and “It’s my genes”. It is not surprising that such myths exist. Humans are a species whose tastes and appetites evolved in environments where food was scarce and many of us now live in one where it is plentiful.

We are bound to crave the wrong kinds of foods. It is then very easy to underestimate how much you eat and become frustrated and upset and blame your genes or metabolism for sabotaging your efforts or societal norms for their unrealistic expectations. Fat Scholars and Activists who give legitimacy and political power to these tendencies do overweight people (often including themselves) a great disservice.

We, as a society, need to put obesity and weight management in the right categories and not be intimidated or deceived out of doing so. Obesity belongs with smoking, alcoholism and other unhealthy habits. It does not belong with race, sexuality or other immutable characteristics. Weight management belongs with activities like going to work, cleaning your house and other things you have to do continuously as part of creating a comfortable life.

It does not belong with fleeting interests and fads you can pick up and put down or with things you only need to do once. Of course, there are people who find they simply cannot manage their weight no matter how hard they try, just as there are people who find they cannot hold down a job or keep on top of their housework.

This indicates that they should be offered practical, educational or psychological support to overcome the problem. It does not indicate that all of society, including nutrition scientists, healthcare professionals and cancer researchers, should be bullied into pretending that obesity is healthy and beautiful or that maintaining a healthy weight is an unattainable goal. Scholars and activists who do this are terrible advocates for obese people. I, for one, would like them to stop helping.