Category: weight stigma

A girl making a negative face and giving two thumbs down. By Thomas Park for Unsplash. Paying people to lose weight: always a terrible idea
fitness · weight loss · weight stigma

Paying people to lose weight: always a terrible idea

catherine wLeave a comment

CW: discussion of paying people to lose weight, with an eye to showing its flaws, both medical and moral.

Saturday morning I was perusing my email and ran across the most recent Ethicist column in the NY Times. I enjoy and respect philosopher Kwame Anthony Appiah’s thoughtful answers to sometimes thorny, sometimes appalling social and moral questions. We don’t always agree, but then again, what two philosophers are always on the same page? We even manage to make a living (if not a very handsome one) disagreeing.

Articles, books and comics all honoring philosophers disagreeing. It's a thing.
Articles, books and comics, all honoring philosophers disagreeing. It’s a thing.

Back to the issue at hand. The Ethicist was called to weigh in on the following question:

Can we ask our son to go on weight-loss drugs in exchange for a house?
Can we ask our son to go on weight-loss drugs in exchange for a house?

If you’re in a hurry, here’s the answer: no.

For those of you who prefer pictures to words:

No. Absolutely not. Thanks, Debby Urken for this colorful NO.-- yellow wood letters against a blue wood background.
No. Absolutely not. Thanks, Debby Urken for this colorful NO.

Before I get into what I think is wrong with paying people to lose weight, let’s hear from Appiah. He was his usual measured self, but he came down strongly on NO. Here’s a bit of the question:

Several years ago, my husband and I purchased a house for our son, with an agreement that he would pay us back. He remodeled it from scratch and has been making his payments to us fairly regularly, though he misses occasionally when other priorities arise. We both agree that we would like to gift him the remaining balance on the house...

Our son, however, is morbidly obese, and my husband wants to condition the gift on his getting on a GLP-1 program, which would mean using about half his monthly savings to pay for the medication. I feel that a gift is a gift and you should not extort a grown man, even when it is in his best interests. Your thoughts? —

Basically they’re asking if it’s okay to withhold giving the house to their son (which they had already planned to do) until he starts taking a GLP-1 weight-loss drug for weight loss.

What does The Ethicist say in response? Here’s an excerpt:

It’s not always wrong to attach conditions to a gift. Sometimes the conditions are intrinsic to what’s being given. There’s nothing coercive about a college fund that requires enrollment…

By contrast, your son is fully capable of judging the evidence and deciding what to do with his own body. His choice not to pursue treatment may be misguided, but it’s his to make, and the condition is unrelated to the gift. What your husband is considering isn’t extortion; withholding a benefit isn’t the same as imposing a penalty. But it’s disrespectful. 

…not only does your husband’s plan treat your son like a child, it also may not be effective in the long run.

So consider another gift, the kind where the condition is intrinsic to what’s being given: Offer to defray the costs of his treatment. You have the means, and this way you’d be giving him something without saying anything about how much you trust his judgment. He may still decline. If he does, you’ll need to make your peace with the fact that it’s his body and his life.

Okay, I think that is an okay, if overly mild-mannered answer.

Here’s my non-mild answer, which is in three parts, in increasing levels of non-mildness.

Part one: Paying people to lose weight isn’t effective long-term.

There are loads of studies examining the effectiveness of financial incentives for weight loss (as well as smoking cessation and other health-related behaviors). What’s the upshot? Some people respond in the short-term (that is, during the period of the study or cash payments). In this 16-week study, participants were put into three groups: 1) playing a lottery in which they won money if they hit target weight; 2) depositing their own money and receiving funds if they complied with protocols and also hit target weight; 3) control group.

What happened? After four months weight loss in experimental groups was higher (13–14lbs) than in the control group (3.9lbs). But at the seven-month follow-up, differences were not statistically significant. And few of the participants opted to continue the financial incentive study.

There are loads of such studies, along with systematic reviews, and they generally show the same outcome: maybe a little weight loss to start, but 1) it’s a small amount; and 2) participants regain weight after the study ends. Which is demonstrably bad for health– yo-yo dieting leads to lots of bad health outcomes.

Part two: paying people to lose weight is coercive, showing disrespect for them as autonomous persons.

In the studies I looked at, the participants tend to report lower incomes, and the financial rewards are typically in the $300–500 range. This amount may convince someone who needs the money to participate, but it preys on their economic insecurity rather than appealing to whatever motivations they have about any health-directed behavior change. We see this pattern in other global health care ethics issues, in particular around surrogacy tourism, where vulnerable populations have been targeted for coercive financial arrangements. Read more here about surrogacy tourism in India.

Am I saying that paying people to lose weight is ethically just like paying them for surrogacy, or for their organs? No. But, once money is in the mix, exploitation, coercion and abuse have quickly followed, and this is well-documented.

What Appiah suggests instead is that the parents offer to cover the costs for GLP-1 meds IF their son wishes to take it. That’s the mild-mannered approach I mentioned above.

Here I part ways with him. Is offering to pay for another person’s GLP-1 meds a sketchy move? Yes. Why? Making such an offer is implicitly making a negative judgment about another person’s weight (namely, that it should be lower), conveying that judgment to them, and forcing a confrontation/discussion about the person’s own weight and health values and goals, which are nobody else’s damn business.

To be sure, we commonly negotiate uncomfortable and personal discussions with people we are close with, especially about health-directed behaviors. Sometimes those discussions are useful, resulting in extra support that is appreciated.

However, in the case of body weight, I argue that silence about it is always golden. We are all aware of what our bodies are like, and are reminded constantly of the ways they may fail to conform to unrealistic media standards. In short, the son knows what his body size is like, and is doubtless well-versed in general population concerns about body weight ideals. Which leads me to part three:

Part three: making an unsolicited offer to pay for another person’s GLP-1 meds reinforces the culture of weight stigmatization and discrimination, and burdens the other person with a vivid reminder of it in the face of someone they care about.

Yeah, pretty much that. The son is getting a clear message that his parents think his body is unhealthy, too big and needs to be smaller. And they are considering leveraging his need and desire for a HOME against their desire for him to change his body size. Ew.

And even Appiah’s soft-soap approach still conveys the parents’ thoughts and judgments, even if it doesn’t implicitly threaten him (yes, they are making a positive claim– giving the him a house– but there’s a negative one underneath–making him continue house payments).

Just as the son certainly knows what the parents think about his body weight, he also probably knows that they will help him if he asks. IF HE ASKS.

So, my advice is saying nothing until and unless he asks for financial help in paying for GLP-1 meds.

This baby says be quiet, hold up, say nothing. Thanks, baby.
This baby says be quiet, hold up, say nothing. Thanks, baby.

My dear readers, you may agree with me, or you may disagree. As a philosopher, I welcome all comments. So tell me what you think…

fat · fitness · health · stereotypes · weight stigma

Medical Decisions Still are Sometimes More Art Than Science

Diane Harper2 Comments

This is an anecdote, not a study result so take it for what it’s worth to you.

I needed some prescriptions refilled so I went to my doctor to get the annual testing done to confirm I still had the correct dose. He sent me a message saying that he recommended doubling my cholesterol medication because I am pre-diabetic (I am not) and have a history of heart disease.

I pushed back, pointing out that similar testing had been done at the heart institute three months prior, and the results were well within normal ranges for fasting blood tests. While my non-fasting results at the clinic were a little higher, they were still normal. This led to some back-and-forth about risk factors as a heart patient.

I wasn’t happy with what I was hearing so booked another appointment to discuss in person. I am “lucky” enough to have results of a recent CT scan on my femoral arteries, an angiogram, and a carotid ultrasound. All showed that my arteries are very clear. My heart disease is a mechanical thing that will be fixed with surgery. He admitted he doesn’t normally have access to that level of information so started to shift his approach.

He moved on to lifestyle and how I was possibly still high risk. Eating patterns: near-vegetarian who pays close attention to fibre intake. Exercise: at least 5 hours of moderate to intense movement each week. Weight: yup, it’s heavier than BMI recommendations, but it’s also mostly solid muscle (see previous note on exercise) and it has remained unchanged for over 30 years.

Diane in one of her favourite fat athlete photos. She is wearing a colourful bikini and blue cap. She is holding her orange float for open water swims and posing in the Ottawa River on a grey and cloudy day.

In short, I am a case study on why medical professionals should not rely on weight to judge overall health.

In the end, he agreed that my risk assessment should drop from high to low. My medication will not be changing.

Thanks fellow bloggers, especially Sam and Catherine, for writing so often about this issue and giving me the courage to speak up.

A yellow and black triangle sign that says no body shaming. Talking to family (or friends, or anyone) about their weight: the NYT commenters save the day
fitness · weight stigma

Talking to family (or friends, or anyone) about their weight: the NYT commenters save the day

catherine wLeave a comment

CW: discussion of body weight, weight gain and body shaming.

This week in the New York Times Ethicist column (written by a famous and very good and very nice philosopher, Kwame Anthony Appiah), the featured question was by a couple who expressed their concern about their adult daughter’s weight.

An emoji saying sigh, not gain.
Sigh. Really?

Okay, I guess there are people on the planet that haven’t yet gotten the memo that talking to people about their weight is virtually always (as a philosopher I admit that maybe there’s some strange exceptional case, but I can’t think of one) the wrong thing to do.

Basically, the daughter used to take dance classes, which the parents really liked. But she doesn’t dance now, and they think she eats too much sugar and fat in her diet. They ask for advice from the Ethicist, wrapping it up this way:

She may be headed for a serious weight problem. How can we raise this with her without making her feel self-conscious or judged, and without pushing her away from us? We love and respect her and want to see her live a healthy life. Please advise! 

This would now be the perfect time for the Ethicist to say, kindly:

Be quiet. Do not talk to her about this. Say nothing. Shhh!

Shhh! By Kristina Flour for Unsplash.
Shhh! By Kristina Flour for Unsplash.

But no. He didn’t do that. Instead he said this (an excerpt from his response here from the New York Times):

If the undertone of your concern is nostalgia for the lean dancer she used to be, she will hear it, no matter what words you choose, and you’ll only push her away.

If, however, what you truly want is to support her well-being, then speak to her as an adult, with respect and candor, rather than as a child whose body you wish were different. That means keeping the focus on health and family history. Make sure she knows the concern comes from love, not disappointment — that your concern is for her well-being, not her waistline.

Well, the NYT commenters had other thoughts.

This frog begs to differ. So do I.
This frog begs to differ. So do I.

There were 1.1K comments this week, and, while I didn’t read all of them, they were pretty much of one voice about talking to the daughter (or anyone, ever) about their weight. Here’s one of my favorite comments:

Don’t comment on others’ weight. Never. Not when they’re pregnant, not when they’ve lost weight, not when they’ve gained weight, not when they have cancer. It is never helpful.

Some folks in the comments section were genuinely interested in whether there was something you COULD say that would be helpful. Here’s how that went:

“There has to be a way to productively comment on someone’s weight in a way that will help them.”

If that were true, don’t you think we would’ve hit on it by now?

Yep. Totes agree.

I liked this response, too:

To the mother asking “Should I tell my daughter I’m concerned about her weight?” – Trust me: you already have.

Many commenters told stories about having been fat-shamed by family and then distancing themselves in order to maintain their own well-being. Others maintained contact but still feel the hurt. They all agreed:

Just don’t do it. Ever.

Lots of questions about personal interactions are complicated. This one isn’t. The NYT commenters have spoken.

The people have spoken!
The people have spoken!
KIds doing exercises outside. Byaleksandar-andreev for unsplash. Bring back the President’s Physical Fitness Test? Uh, just no. Why not? Read on.
fitness · research · Science · weight stigma

Bring back the President’s Physical Fitness Test? Uh, just no. Why not? Read on.

catherine w1 Comment

CW: some mention of body weight in children and use of the word “obesity”. Sorry, I’ll keep it to a minimum.

If you’re a news-attentive person, you know it’s become hopeless to keep track of all the evidence and good-sense-absent decisions by the Trump administration.

Full and happy discplosure: most of my info is from the superb podcast Maintenance phase episode on this topic. You can listen here and read the transcript here. And I recommend listening to other episodes of this podcast, hosted by the superb Aubrey Gordon and her superb co-host MIchael Hobbes.

If you need a reminder about what exactly was the President’s Physical Fitness Test:

It sort of started with the Kraus Weber Test, developed in the 1940s, which tested children once on a few physical tasks (this I got from Wikipedia):

  1. A simple sit-up with knees bent and feet planted
  2. A sit-up with legs extended and not bent
  3. Raising feet while lying on the back
  4. Raising head, chest and shoulders off the ground while lying on the stomach
  5. Raising legs off the ground while lying on the stomach
  6. With knees straight, bending forward to touch the floor

Then, American Bonnie Prudden used the test on American children (insert lots more detail I’m not including), and found that 58% of kids didn’t pass the test. Meanwhile, only 8% of European children given the test (under other circumstances at different times, etc.) failed the test.

Insert big panic here.

Then-President Dwight Eisenhower was horrified at these results. So, instead of turning to education or medical or public health experts to investigate to see if there was actually a problem (along with increasing funding for physical education in schools and communities), he founded a presidential commision:

The President’s Council on Youth Fitness, which morphed over time into the President’s Council on Fitness, and is now the President’s Council on Sports, Fitness and Nutrition.

Important and famous people have served on these commissions. However, no one did any research at all on:

  • whether the original or modified versions of the test actually measured anything meaningful or useful in children (Spoiler: NO)
  • why American children didn’t do better on the test (Spoiler: they hadn’t practiced calisthenics in school like the Europeans did; with 6–8 weeks of practice kids did fine on the test)
  • what a one-time physical fitness test should show– current physical fitness? potential short-term fitness? potential fitness in adulthood? overall health? predictions about future health? (Spoiler: it showed none of these, as determined by later research)
  • If all schools in the US gave ths test every year to school children, what they would do with the data, like develop funded programs for improving fitness from the baselines, or even track kids’ fitness over time (Spoiler: no one did any of this, ever)

The commissions did make very nice recommendations, like:

Set aside more time and facilities and staff and training for kids to do a wider variety of sports that are accessible to everyone—e.g. fishing, bowling, archery, etc. Also, make time for free play with other kids, without the parents/teachers supervising and guiding (from Maintenance phase transcript)

Doesn’t that sound sweet? (Spoiler: the commission’s recommendations were ignored in favor of modified versions of the original test, which– as I think I mentioned earlier– measured nothing at all, other than someone’s ability to do those required tasks at that time.)

So, this test was given all over the US to all the school kids with no health goals at all. Yep.

Until 2012, when the Obama administration pivoted away from the test and toward an emphasis on overall health and activity, rather than measured (for no reason) performance. Yeah, that sounds better, doesn’t it?

Hmmm. Then why does the Trump administration want to bring it back?

In short, (you can read the long version here) because Trump and RFK think that there’s a crisis of obesity, chronic disease, and poor nutrition in the US, especially among children.

Bringing back this test will Make American Active Again, according to the press release (Spoiler: it totally won’t).

Okay. But, just for the sake of argument, why not bring it back?

Glad you asked. In addition to the above information which leads us to believe that this test doesn’t measure anything or contribute in any healh-goal-directed way to children’s health or fitness, there’s this:

Everyone hates this test. Teachers hate it. Kids hate it. Parents hate it. Why? It makes almost everyone feel bad about themselves or children they care about for no good reason.

There’s some evidence that tests like these make kids hate physical activity. That’s the opposite of what we wanted, right?

Oh, and there’s overwhelming evidence from tons of research that physical activity does not have strong effects on body weight. Physical activity is predictive of all sorts of great health outcomes like longevity, improved mental and cognitive health, and loads of other things we blog about regularly. So, bringing back the test will arguably have no positive effects on distribution of body weight among school children.

Here’s a great quote from Aubrey and Michael:

There was no evidence to do it in the first place. The evidence that it works is non-existent. And the evidence that getting rid of it is good is out there.

Need I say more? Oh, I want to. There’s so much wrong with these tests. But I’ll leave it for another time.

In the meantime, dear readers: do you recall taking these tests in gym class? What did you think? Was there one kid who climbed the rope all the way to the top, and can you remember their name?

A tape measure against a pink background. By Ekaterina Grosheva for Unsplash. Research roundup on weight stigma in medicine: it’s still out there, but we are learning more about how it works
fitness · weight stigma

Research roundup on weight stigma in medicine: it’s still out there, but we are learning more about how it works

catherine w

CW: discussion of weight stigma.

You would think that, after study upon study shows how body weight is significantly genetic, that weight stigma would go away.

You would think that, given that virtually all medically-prescribed diet programs result in regaining the weight lost during them after 2–5 years, blaming people for regaining weight would go away.

You would think that. But, no, it hasn’t. Weight stigma is still very much alive and well and out there. However, researchers are studying weight stigma in more detail, with the goal of addressing it (both internalized and external forms) and reducing its harms to all of us. That’s a good thing.

Here are a few examples of what some researchers have been doing about it.

In this 2025 study by Figueroa and colleagues, they concluded that

Weight stigma was directly associated with greater depressive and anxiety symptoms. Moreover, the relationship between weight stigma and greater depressive and anxiety symptoms was mediated by greater perceived stress. Perceived stress explained 37% of the relationship between weight stigma and mental health outcomes, even after accounting for Body Mass Index. 

Using standard measures for anxiety, stress, and depression, the researchers found not only that being stigmatized for one’s weight gives rise to anxiety and depression, but that perceived stress from weight stigma also brought on these mental health symptoms. This was regardless of BMI in the participants.

In this 2024 study by Janet Tomiyama, David Figueroa and others, the researchers examined how changes in information for recruiting people for human research studies might affect the number of higher-weight people participating. They note that higher-weight people are often absent from scientific studies, and considered “difficult to recruit”. As a result, studies in which they are absent are subject to sampling bias. Here’s what this study did:

…this study experimentally manipulated the phrasing of weight‐related information included in recruitment materials and examined its impact on participants’ characteristics.

Two visually similar flyers, either weight‐salient or neutral, were randomly posted throughout a university campus to recruit participants (N = 300) for a short survey, assessing their internalized weight bias, anticipated and experienced stigmatizing experiences, eating habits, and general demographic characteristics.

Although the weight‐salient (vs. neutral) flyer took 18.5 days longer to recruit the target sample size, there were no between flyer differences in respondents’ internalized weight bias, anticipated/experienced weight stigma, disordered eating behaviors, BMI, or perceived weight.

That is, researchers have choices over how they present initial information to potential participants in studies; if they mention weight-related procedures (in this case gathering data about height and weight), they should know recruitment might take longer, but not necessarily affect the outcome of the study.

A paper that came out in 2021, based on the Eating in America study, also by Janet Tomiyama and colleagues, gathered data on some of the negative health outcomes associated with weight stigma. They found:

…weight stigma was significantly asso- ciated with greater disordered eating, comfort eating, alcohol use, and sleep disturbance, after controlling for covariates. No such relationship was observed for physical activity.

They also found that lower BMIs don’t reduce the negative health outcomes for those experiencing weight stigma:

In our sample, individuals across the weight spectrum, not only those with overweight or obese BMIs, reported weight stigma. In fact, moderation analyses indicated that individuals with lower BMIs showed greater disordered eating and alcohol use in the face of weight stigma.

They conclude, quite reasonably:

Taken together, these findings highlight weight stigma as a potential barrier to healthy behaviors, and suggest that one strategy to improve population health may be to reduce weight stigma. Though more research is needed, it may be important to employ more weight-inclusive approaches to health pro- motion, such as removing stigmatizing language or weight outcomes from health policies and program objectives.

Yes, agreed.

Research on weight stigma shows that it’s still very much present and is associated with very many negative health outcomes. It can and should be addressed, and we have ideas on how to do that.

So how about let’s do that. Maybe now, don’t you think?

A weight watchers meeting. Weight Watchers declares bankruptcy, but fat phobia is still as popular as ever
fitness · weight loss · weight stigma

Weight Watchers declares bankruptcy, but fat phobia is still as popular as ever

catherine w1 Comment

CW: discussion of weight, weight loss and fat phobia.

Weight Watchers filed for bankruptcy this month. It’s trying to manage a $1 billion debt after pivoting to a telehealth-focused service that combines its food plans with GLP-1 weight loss drugs and an app to manage eating and weight loss.

This model is a dramatic change from the Weight Watchers founded by Jean Nidetch in 1963. It offered an eating plan, advice about physical activity, and (most important for its members) meetings where people would share their experiences and get support around their weight goals.

Let me say right now that I’m not advocating for Weight Watchers here; quite the opposite. But humor me for a minute while I remind us of what Weight Watchers did and what it has meant (and still means) to some folks.

This 2010 newspaper article about Weight Watchers meetings in Jacksonville, Florida paints a clear picture of the power of Weight Watchers. Meetings feature so-called inspirational talks by women who’ve lost weight (and yes, they include before-pictures; sigh). They also offer nutritional and physical activity tips. All this happens after the initial weigh-in. Yep, they still do that.

Lots of women love this setup. They are angry and disappointed about the mass closings of WW meetings all over the US and beyond. You can read comments at the bottom of this article to get a sense of how important regular in-person contact with others has been. Many women are what’s called Lifetime Members (having reached their goal weight and fulfilled other requirements). The main perk of the lifetime members is free access to WW meetings. It is this perk that’s ending, or rather switching to virtual or app-based. An app is not what these women want. They want support and connection with others.

A New York Times opinion piece this week praised WW for providing a “third space” for women to gather, connect, support each other despite their social differences. It waxes wistfully about the democratizing effects of WW meetings:

In recent years WeightWatchers meetings became one of the all-too-rare places in America where conservatives and progressives found themselves sitting side by side, commiserating about the same plateaus or the same frustrations or the same annoyance that the powers that be had changed the point value of avocados, again.

Okay, it’s now criticism time. Yes, WW provided a space for women to come together and share their feelings about their bodies. But instead of telling them that they were just fine as they were, it (literally) sold them the idea that their lives would change for the better if only they kept focusing their energies and spending their time on reducing the size of their bodies. And, of course, paying for the WW plan.

Weight Watchers didn’t invent fat phobia, but it’s certainly profited handsomely off it for decades. Weight Watchers doesn’t support misogyny in its corporate charter, but it embodies it by pulling in mostly women (this article estimates that 90% of its members are women) and uniting them with the message that they are not acceptable as they are, that they will be happier if they can just lose enough weight to get to some distant goal. They deputize other women to tell stories of their success, not mentioning that in studies, the average weight loss at one year is very small, and regain of weight happens over time in almost all cases.

The 2015 obituary of Jean Nidetch, the founder of Weight Watchers, is a vivid example of how fat phobia follows women throughout their lives, and (in this case) beyond the grave. The writer made sure to publish her weight when she died, pointing out that she weighed the same as she did after her weight loss in the 1960s.

The piece is filled with body-shaming terms: pumpkin-shaped (yep, it’s in there), overweight (seven times), chubby, and gluttonous (I’m really not making this up).

Yes, it’s 10 years old. And Weight Watchers itself has become more circumspect about weight loss, marketing itself as a health-focused plan. But we know, and all its members know, that it’s all about the weight– the weight of women. It needs to be watched, all the time, for a lifetime. That’s the message that Weight Watchers is trying to hang onto amidst its restructuring and pivot to GLP-1 drugs. New technology, same fat phobia.

A podcast microphone with a pair of hands holding headphones over it, in an orange circle surrounded by a teal background. Some favorite 2024 podcasts for your listening pleasure
athletes · fitness · gender policing · interview · media · normative bodies · weight loss · weight stigma

Some favorite 2024 podcasts for your listening pleasure

catherine w

CW: some of my recommendations talk about body size, weight loss, fat phobia and weight discrimination. But luckily not all of them…

I love listening to podcasts in the car during my commute to and from work, and especially on long car rides as I go visit friends and family. Here are a few I’ve really enjoyed this year:

Death, Sex and Money— I enjoy this podcast, especially Anna Sale’s sensitive and curious interview style. This episode is one I’m still thinking about (and starting to write about, too): Will he still love me when I’m off Ozempic?

Weight for it— One of the panelists on the above-mentioned podcast is Ronald Young, creator and host of the podcast Weight for it. If anyone you know is fatphobia-skeptical, play them 5 minutes of this episode and they’ll be cured forever. It’s about weight discrimination by the airlines and airline passengers. I wrote about this abomination on the blog a while ago here. But you can listen to Ron and also Aubrey Gordon (host of great podcast Maintenance Phase) here: Into Thin Air

Field Trip— I blogged about this podcast last summer while I was driving to and from western New York State. I loved it so much, it convinced me to plan a trip to see nature in Florida this winter. And I did– I’m going to see manatees in February! More on this later. The episode about Everglades National Park is my favorite (obvs) but all of them are great. They illuminate the complex history and rich experience to be had in national parks.

Tested podcast by the CBC–this podcast six-part series is about sex testing in women’s athletics. It offers some historical information and tracks the stories of some elite female runners whose biology conflicts with (outdated and false) views about what women athletes should be. Definitely worth a listen.

Wiser than me with Julia Louis-Dreyfus–I’ve only listened to a few episodes of this podcast, but I’m lookin forward to hearing more as I travel for the holidays. In eachof them, Julia has long, satisfying conversations with older women who have important, funny and insightful things to say. From Nancy Pelosi to Jane Goodall to Patty Smith to Billie Jean King, there’s an interview to suit everyone’s interests and tastes.

Readers, do you have any favorite podcasts you listen to and swear by? There are so many out there, I’d love to hear what you’ve found.

Weight stigma awareness week-- increasing awareness, building community, taking action, spreading education Weight stigma awareness week: some highlights
fitness · weight stigma

Weight stigma awareness week: some highlights

catherine w

Last week was Weight Stigma Awareness Week. In case you missed it, here are some highlights from their website and from instagram.

They are super clear about the need and importance of fighting weight stigma. And I love the graphics! Purple and orange with peach starts
They are super clear about the need and importance of fighting weight stigma. And I love the graphics!

From a video by Dr. E-K Daufin: This #WeightStigmaAwarenessWeek is all about taking action. 👊 Taking action against weight stigma means actively challenging harmful stereotypes, biases, and discrimination based on body size or weight—which involves spreading awareness and creating environments where people of *all* body types feel respected and valued. 🧡

Here’s Ragen Chastain on how to ask for weight-neutral medical care:

  • Call ahead and ask for a provider who is willing to treat you without weight loss recommendations.
  • Ask the provider to focus on the issue that brought you to the appointment. Not weight.
  • Ask the provider to prescribe what they would for a thin person.
  • You can exercise your right of informed refusal to weight-loss interventions.
Instagram graphic version of the list-- same info, prettier colors. Orange list numbers, purple and peach background.
Instagram graphic version of the list– same info, prettier colors.

If you missed Weight Stigma Awareness Week, it’s definitely not too late to take part. Their motto this year is “Awareness to Action”. We can point out weight stigma when we see it, check it in ourselves (as it’s so deeply entrenched) and support each other in appreciating all bodies for what they are and what they do for us.

Happy Weight Stigma Awareness Week!

abstract photo of a bridge railing in a diamond pattern, captured using ICM (intentional camera movement) to create blur. Photo by Tracy Isaacs Scary trifecta: Weight Watchers, Oprah, and Ozempic
body image · fitness · weight loss · weight stigma

Scary trifecta: Weight Watchers, Oprah, and Ozempic

Tracy I1 Comment
abstract photo of a bridge railing in a diamond patter, captured using ICM (intentional camera movement) to create blur. Photo by Tracy Isaacs
Image description: abstract photo of a bridge railing in a diamond patter, captured using ICM (intentional camera movement) to create blur. Photo by Tracy Isaacs

CONTENT WARNING: this post talks about Weight Watchers and medications used for weight loss.

We have been dissing Weight Watchers here for a long time, from Sam’s “I hate you, Weight Watchers” post more than a decade ago to my “Oprah: Eating Bread, Making Bread,” when Oprah took shares in the company and joined the board in 2016. It’s a business. Businesses are interested in making money. Oprah is a brand unto herself. She too is interested in making money.

The culture of weight loss and diet has a well-entrenched stronghold still today, but the oppositional voices are getting louder. Many of us here at the blog are fans of the Maintenance Phase podcast and host Aubrey Gordon’s book about weight loss myths. We’ve read Kate Manne’s Unshrinking and written about it. And we’ve consistently talked about body image, body acceptance, anti-diet perspectives, the disentangling of size and health, rejection of body-shaming — too many posts to count.

And so it was with interest and not a little bit of suspicion and skepticism that I tuned in to the Oprah/Weight Watchers YouTube livestream “event” the other day to find out what new message WW could possibly be peddling under the title: “Making the Shift: A New Way to Think about Weight.” Could they finally, finally be changing to a new narrative that, despite their brand, is NOT about weight loss?

We have been here before, where they have gone from “Weight Watchers” to “WW,” and where they have gone from “dieting” to “lifestyle” and “healthy habits.” None of these shifts has been enough to change their game entirely. I mean, in the end their users are joining to lose weight. What, I wondered, are they up to now?

The event started off inspiring confidence that maybe, just maybe, real change is afoot. Oprah, in her “girlfriend” way, started with a story of total humiliation during her first appearance on the Tonight Show in 1985, when Joan Rivers asked her how she gained “the weight” and had her promising to lose 15 pounds by the end of the show (after which she gained 25). She lamented her contribution to narratives of “weight loss success” over the years, including pushing liquid diets as a path to weight loss. She claimed that one of her career lowpoints, about which she is filled with regret, is that time she rolled a cart of fat equalling in weight the fat she’d lost, onto her stage.

But in her preamble, right after she told her stories, she identified obesity as a “disease” for which no one should carry shame. We should all, she said, love our bodies. She listed of a range of possible ways to go, none of which anyone is obligated to pursue. You do not deserve to be shamed, she said, “whether you choose to start moving more, whether you want to eat differently, whether you want to change your lifestyle, whether you want to take the medications, or whether you choose to do absolutely nothing.” To be satisfied the way you are, where you are, is totally “up to you.” Then the CEO of Weight Watchers, Sima Sistani, came on and apologized for her company’s contribution to diet culture and the harm it has caused to the people who did not reach their goals on their program.

This “event” is part of a series of media moments paving the way for Weight Watchers to start promoting the use of weight loss medications. This is not brand new news, but it was news to me. And I have to say, if you had asked me to predict that “we should all love ourselves without shame” would end up at “and if that includes taking medications to lose weight so you can conform to the cultural standard for acceptable bodies,” I would not have landed there.

With the diet/points program failing to help people achieve long-term weight loss (because diets don’t work), it had two choices: become irrelevant or start encouraging people to take medication. I’ve had it pointed out to me that in some ways this strategy is more on point with the truth of what is required for successful weight loss. And that may be the case.

What I find most egregious about the live-stream is the mixed messaging. I have never thought that the only reason diet culture is harmful is that it’s almost impossible to lose weight and keep it off. That is a harm, to be sure, if people are going to continue to chase an unattainable goal and support the industry that promotes it. But I continue to think that more serious harm is that it reinforces the idea that the only acceptable body type is slimmer. Whether through diet or exercise or medication, weight loss is still the goal. Are we resigned to maintaining this picture and keeping weight loss as a life goal?

This tweak to the weight loss narrative adds a further layer of personal responsibility onto a problem of cultural harm. Keep in mind too that the drugs work by making it easier to consume fewer calories. So in the end, they reinforce the connection between calorie intake and weight gain or loss, thus offering credence to the view that dieting would work but for the dieter eating more than they “should.”

If we could rewrite that conversation with Oprah and Joan Rivers, the gist of it would still be that Oprah should lose the weight, and if that means taking the meds, then take the meds. But is it not more concerning still, is it not, that Joan Rivers felt she had the right to call out Oprah’s size (at all, nevermind so publicly on national television)? Of course Oprah has now very publicly affirmed her use of the new weight loss drugs, like Ozempic, for the purposes of weight loss. And these have now been built into Weight Watchers’ business plan.

It’s tricky of course. No one wants to say we don’t have choices, and that if people opt for a certain choice that’s their business. But there is a tension in broadening the range of pathways to body-acceptance to include new forms of weight loss. It falls into the same category of tension, I think, as anti-aging cosmetic procedures like fillers and surgeries. The more people opt for these “treatments,” the more the prizing of youthful appearance and the rejection of aging faces and bodies remains the normative standard. Does that mean these things shouldn’t be available as options? No. But does it mean that there would be less harm and more opportunity for a healthier and more realistic range, if fewer people chose them. And it would be better if we didn’t feel that normative pressure so strongly. But it’s tough to be an outlier and it takes energy, effort, and awareness to reject the messaging.

To me Oprah + Weight Watchers + weight loss meds is a scary trifecta. The mixed messages have hit a new low. Their contribution to the fear of being fat has not stopped. It has simply evolved with the times to generate a new and profitable income-stream.

a copy of Kate Manne's book, Unshrinking: how to face fat phobia “My body is for me”: a preview of Kate Manne’s book Unshrinking
fitness · weight stigma

“My body is for me”: a preview of Kate Manne’s book Unshrinking

catherine w

CW: discussion of fat phobia

Philosopher Kate Manne’s new book Unshrinking: How to Face Fat Phobia is out, along with lots of accompanying press. I haven’t read the book yet, but I’m getting my copy this week and will review it for the blog. Most of the reviews are extremely positive, praising it for uncovering and subjecting fat phobia to the kind of scrutiny usually reserved for those of us with bigger bodies. Here’s an excerpt from this review:

In Unshrinking, she argues that it’s not fatness that encumbers us, but “fatphobia,” which she describes as a system of oppression signaling “that some bodies should be ignored, disregarded, and mistreated.” It’s a set of attitudes and behaviors that work, metaphorically, like a straightjacket, with catastrophic results: limiting the freedoms and opportunities of fat people, and also—as Manne demonstrates persuasively yet heartbreakingly over the course of the book—causing them serious harm. 

Fatphobia isn’t grounded in reason, science, or ethics. Rather, its roots are in the dark recesses of the human psyche: disgust. Manne recounts how this aversion to fat bodies was manufactured during the Enlightenment from racist and sexist ideologies, and is operative throughout the world today. The diet industry uses this loathing to its advantage and perpetuates it, knowing full well diets don’t work, but cashing in on the myth that they do. 

We at Fit is a Feminist Issue have written a lot about fatness, diet culture and the ways those of us with larger bodies are discriminated against and discouraged from fully participating in active and full lives. Manne’s book includes many of those same themes.

Body positivity is one way to do battle with fat phobia, especially those negative feelings about our own bodies. However, life just isn’t that simple. Both Sam and Tracy have written about body positivity and another approach, body neutrality. Manne looks at both of these views, moving forward with her own, which she calls body reflexivity. How to explain it? She says its ethos is found in the words “my body is for me”. She elaborates on her view in this article she wrote for Time magazine. Here’s an excerpt:

Body reflexivity is compatible, to be sure, with appreciating our bodies—and also that of others. But the uncritical lens we adopt speaks against anything like scoring… Go for a walk sometime—you can appreciate a sunset, a flower, a dog, without comparing it to others or rating it as superior, inferior, or neutral. There’s a reason the popular X account We Rate Dogs is firmly tongue-in-cheek, with each delightful creature garnering more than a 10/10. It is absurd to rate dogs; dogs are too wonderful. 

And so, I’ve come to understand, are human bodies—without necessarily being, or having to be, beautiful. I have come to channel the words often said to me by my husband—“I don’t look at you with a critical eye,” which means more to me, in the end, than his also telling me I’m beautiful. I have come to view others with an attitude of gratitude and gladness that they are here in the world amongst us, in all of our glorious individuality and diversity; our vulnerability; our differences in size and shape and age and disabilities. We need not assess every body positively or neutrally when we cease to assess bodies altogether. 

OMG. What an idea. At the same time, doesn’t it sound familiar?

One of the things I really like about being in my 60s is gleefully letting go of body and age and fashion norms in favor of loving on someone’s e.g. jewel-toned tunic or new-to-them scarf, or shoes with bows on them– whatever it is that clearly brings them joy. What I don’t say (except to my dear ones) is how lovely or bold or brash they look as a person, how they represent one of the many ways this world is beautiful. Their bodies are for them, and they are taking them out for a spin. I find myself admiring this so much more these days.

Readers, have you heard about or read Manne’s book? Let us know what you’re thinking. I’ll be reviewing it soon and would love to hear your thoughts as well.