"Fat But Fit Is a Myth" Is a Myth

For the past few days, the British media has been awash in headlines proclaiming it's a myth that people can be both fat and fit, referencing unpublished research that was presented at a European medical conference.

I'm not going to link to the articles because they're potentially triggering for anyone with eating disorders or internalized weight stigma, but they can easily be found in a Google search (seriously, though, TW if you're trying to recover from society's toxic messages about body size).

Since I'm a dietitian and podcaster specializing in intuitive eating and Health at Every Size, many of my clients and listeners have asked for my opinion on these articles. Here's my take: 

First of all, since the research hasn't been peer-reviewed and published, it's extremely irresponsible for these media outlets to run stories about it. There's always a chance that when peer review and publication are complete, the researchers' conclusions won't look nearly as clear-cut as they're making them out to be.

I also highly doubt the researchers controlled for weight cycling, which is associated with greater disease risk and which we KNOW larger-bodied people are more likely to have gone through.

That's to say nothing of internalized weight stigma--I'm willing to bet the researchers didn't control for that--which again has been associated with higher disease risks. So there could be many reasons for their findings that have nothing to do with the people's actual size, but with how people of size are *treated* in Western society, which we know is badly.

On top of all of that, remember that we still don't have any way for people to lose weight and keep it off in the long term, other than seriously disordered eating--which of course brings more acute and immediate health risks than living in a larger body ever could.

It's also true that many different immutable physical traits carry different risk factors for disease. Your height, your ethnicity, even your eye color are all associated with higher or lower risks of certain diseases. Even if body size really does carry a higher risk of certain diseases, it's not something people can sustainably change about themselves, just like these other immutable factors. We all have different genetic risk for certain diseases, and we all have protective factors as well. Whatever our body size, eye color, ethnicity or height, none of us are immortal. We're all doing the best we can, and one day our bodies are all going to break down. Sorry to get morbid, y'all, but it's true.

We shouldn't be prescribing something to larger-bodied people (weight loss) that we know a) doesn't work and b) actually puts people at higher risk of disease because of weight cycling and internalized stigma. The conclusions of those British media articles are basically "so doctors, tell your fat patients to lose weight," which is exactly what fat people have been being told for DECADES, despite evidence piling up that this advice is not helping anyone's health. 

So in short, these articles are garbage. Don't let them drive you toward dieting and away from sustainable self-care. (For more on the research about weight stigma, see LindaBacon.org or do a Pubmed search for this term.)