Don’t call us fat or obese. Just leave us alone

Obese, or not obese? That is the question. UK public health minister Anne Milton thinks it is time that people took personal responsibility for their weight. And she believes that calling overweight people ‘fat’ rather than ‘obese’ is more likely to encourage them to get trim. Others, however, prefer the medical term ‘obese’, believing that it communicates to overweight people the (alleged) seriousness of their condition.

Yet while the argument over ‘fat or obese?’ has raged in the comment pages and on phone-ins all week long, no one seems to be asking the most basic questions: Is it really the place of doctors and health officials to tell people what to eat or how much they should weigh? Who are they to label us fat or obese?

Professor Steve Field of the Royal College of General Practitioners agrees with Milton. ‘I think the term obese medicalises the state. It makes it a third person issue. I think we need to sometimes be more brutal and honest’, he said, in defence of using the word ‘fat’.

This view was echoed by columnist Rod Liddle – whose young daughter apparently calls him a ‘lardbucket pig’ – in The Sunday Times: ‘In the good old days it was quite common for people to laugh out loud at fatties as they waddled, panting, from the pie shop to the chippy, their arteries growing more clogged at every step…. But all that has been stopped. As a consequence, we have many more fat people than we’ve ever had before – especially in our schools, where one in three of the children is apparently overweight or obese.’ What a relief to know that the mystery of why society has collectively got fatter in recent decades – something that provokes so much debate in scientific journals – has been solved by this esteemed journalist from the comfort of his own armchair. A Nobel Prize must surely follow.

Others were horrified at the suggestion that we should all start using the f-word. Professor Lindsey Davies, president of the UK Faculty of Public Health, told the BBC: ‘People don’t want to be offensive. There is a lot of stigma to being a fat person… I would probably be more likely to say something like “can we talk about your weight?” rather than “obesity”, but that is a judgement you make on a patient-by-patient basis.’

If people don’t know they’re fat, it’s not necessarily because they are in denial – it might just be that they’re not fat. Obesity, as defined in terms of body mass index by the medical profession, doesn’t match what the rest of society understands as ‘fat’ or ‘obese’. An article on the BBC News website in 2006, Who are you calling fat?, illustrates the point very well, showing four men – who don’t by any sensible criteria look particularly overweight – whose weight and height mean they are clinically obese. As one of the men said: ‘I’d have to lose around three stone for the government to think I’m the right weight. That’s just stupid. I’d look ill and I probably would be ill.’

Even for those who are a bit heavier than that, there is little increased risk from carrying a few extra pounds. Indeed, the current definitions of normal weight, overweight and mild obesity don’t seem to bear much relation to health risk. Carrying a few extra pounds is harmless and may even be beneficial: if you have any kind of long illness and you’re off your food, it is probably better if you have some fat in reserve.

Whether obesity is a medical problem or a moral one, there is no obvious, successful cure. It is true that by restricting the amount you eat and/or taking extra exercise, you may be able to lose weight. But unless this is a reversion to a more normal diet after a period of genuine bingeing, such self-denial is unlikely to be sustained. The result will be piling the pounds back on again. In fact, there’s plenty of evidence to suggest that this kind of ‘yo-yo’ dieting is worse than never bothering to diet at all.

So, regardless of whether the officially approved label is ‘fat’ or ‘obese’, it doesn’t necessarily follow that you can ‘take responsbility’ and lose weight in any lasting way – and given the low health risks attached to mild obesity, there is no particular reason why you should want to.

What is really bizarre is that the debate about ‘fat’ vs ‘obese’ appears to be taking place on another planet. Since when has there been any positive reinforcement of being overweight? For at least the past 10 years, there has been veritable hysteria along the lines of: obesity = disease = death. TV programmes like Honey, We’re Killing the Kids and You Are What You Eat have taken great joy in reducing people to blubbering wrecks as the ‘expert’ informs them (or their loved ones) that their weight is going to kill them – a message reinforced by countless magazine articles, news items and government campaigns.

Apart from those from the fat-acceptance movement, who have rebelled against this tyranny of the skinny, no one thinks being overweight is a barrel of laughs. As Emily Hill has argued on spiked, even those few fat celebrities who seem to be in vogue – like James Corden, Dawn French or Beth Ditto – are regarded as cool in spite of their fatness or as weirdly exotic in a world where having the body morphology of a coat hanger is the only truly acceptable state. Fat poor people, on the other hand, are regarded as feckless chavs.

Here’s a statement you’re never likely to hear (unless the person concerned is recovering from a wasting illness): ‘You’ve put on how much weight? Really? That’s brilliant! That extra fat looks really good on you!’ You don’t hear it because it never happens. The outlook today is that skinny is good, fat is bad. Since when did people get abused for being slim?

Indeed, while the po-faced health minister was demanding that fat people be given the unalloyed truth about their adiposity, equalities minister Lynne Featherstone was singing the praises of curvaceous Mad Men star Christine Hendricks. Featherstone, who is campaigning against the ‘airbrushing’ of magazine photos, declared that ‘women and girls also have the right to be comfortable in their own bodies. At the moment they are being denied that.’ Perhaps Featherstone could direct her message about body autonomy to her fat-obsessed government colleagues before banging on about what magazines do with Photoshop.

What would be much better is if politicans just stopped talking about the shape of our bodies altogether. It’s just none of their business. We are more than capable of working out what is best for us on our own. We can even handle a bit of name-calling, especially if it didn’t carry an official seal of approval from Whitehall. We could really do without health authorities refusing treatment to overweight people and government ministers declaring that the obese will bankrupt the National Health Service. It really doesn’t matter what your doctor calls it when he or she makes you stand on the scales and prods your spare tyre – you know what the message is.

Here’s a suggestion: maybe we should take on board this message about being honest and direct. If your doctor, nurse, health visitor or anyone else wants to start giving you government-approved advice about the food you eat or any other aspect of your personal habits, try this riposte: ‘Kiss my big, fat ass.’

Rob Lyons is deputy editor of spiked and blogs about food at Panic on a Plate.