Fat Bias Starts Early and Takes a Serious Toll

Implicit bias can result in discrimination against people who are seriously overweight.

Comments: 333

  1. From 'The NY Times' 2007
    "Obesity can spread from person to person, much like a virus, researchers are reporting today. When one person gains weight, close friends tend to gain weight, too. [A] study, published in The New England Journal of Medicine, involved a detailed analysis of a large social network of 12,067 people who had been closely followed for 32 years, from 1971 to 2003. The investigators knew who was friends with whom as well as who was a spouse or sibling or neighbor, and they knew how much each person weighed at various times over three decades. That let them reconstruct what happened over the years as individuals became obese. Did their friends also become obese? Did family members? Or neighbors?

    The answer, the researchers report, was that people were most likely to become obese when a friend became obese. That increased a person’s chances of becoming obese by 57 percent. There was no effect when a neighbor gained or lost weight, however, and family members had less influence than friends."

  2. I'm not fat because I have overweight friends. They lose weight because of their friends with better habits. Goes both ways. 45% of Americans are obese through no fault of their own? C'mon. The future of America is discipline, not indiscipline.

  3. Discipline will get you through your day and allow you to make a success of yourself, but it will not reduce your weight. There is more going on than just laziness. You offer no insight into what that might be.

  4. I had an obese friend who was always trying to undermine my efforts to eat sensibly, always offering me candy and energy bars with hundreds of calories even after I explained many times that I did not want them. It's such a relief and so much easier when I hang out with trim people who eat sensibly and are active.

  5. Didn't mention that almost 45% of Americans are considered obese? We're not talking merely fat, we're talking obese. 45%! That negatively impacts healthcare costs (and especially for fit people who have to foot their bills due to some notion of "insurance equality"), negatively impacts GDP growth (impaired cognitive function even you've written about, among other impacts), and more. There's also no way, zero way, that 45% of Americans are obese due to no fault of their own. Sorry. And using modern mores seems a conceit. When humans were hunter/gatherers rather than couch potatoes, do you really think fat people had a chance?

    It's one thing to say some people make other people feel bad. It's another thing to claim pure innocence among the target group and that it has no social impact on its own. The fittest nations will survive and in many forms of fitness, physical and mental fitness being paramount.

  6. I'm not sure your claim on health care costs is accurate. In many cases, fit people suffer very long and expensive final illnesses and dementia - the body outlives the brain for a long period of time.

    This reminds me of the issue with cigarettes, where the smokers actually save the health care system money because they die suddenly or at least quickly.

  7. I'd rather have a nation of fit people contributing to the greater overall good for as long as they can, even if there are later-in-life illnesses. The rest of their lives were productive and healthy and less strain on all systems. Fit people should not subsidize fat people any more than non-smokers should subsidize smokers. Fat people don't have to swallow. Smokers don't have to smoke. Sorry.

  8. That sounds sort of eugenicist drivel. I have a healthy BMI so do not attribute my statement to self-justification, I just think that there's a lot more going on that you refuse to acknowledge in an effort to get some malice out of your system.

  9. Old folks like myself would probably agree that the overt biases have diminished significantly in the past 30 years, yet the general trend toward obesity continues. How can that be reconciled with the weight-bias-leads-to-more-eating argument?

    I'm not trying to be insensitive here, but this is important. We should work to reduce and eliminate the bias for the sake of civility and emotional well-being, if nothing else, but this article implies that it will help reverse the obesity epidemic. I see little more than anecdotal evidence to support that claim and no data, whatsoever, on the possibility that the threat of weight bias keeps some at a lower weight that they would otherwise be. (I am NOT saying that this is good.)

    Again, I know most will be inclined to look past my plea for clarity and reflexively challenge the fact that I won't accept an incomplete picture, but the problems of both incivilty and obesity deserve better science.

  10. Sorry Shawn, but bias is NOT incivility. It's oppression.

  11. Excellent point. I have friends who were scarred by fat shaming 50 years ago, but the obesity epidemic hadn't begun then.

    Forgive me for repeating myself, but we know what's causing the obesity epidemic -- more calories, in the form of carbohydrates, particularly added sugars. No one ever got fat from carrots or apples, but that soda with 16 teaspoons of sugar in it is a different matter entirely.

  12. I have a cousin who told his little brother to call me fat names. That was 45 years ago. I avoid spending time with those cousins because of this. I know. I should forgive them. I did. But I still avoid them.

  13. You're under no obligation to forgive people who cruelly made fun of you, especially the older cousin. The younger one may not have understood the harm he was inflicting.

  14. DNA does not give anyone a pass to be "mean" and mean is what they are (I'm sure they haven't changed).

  15. You don't need to forgive them if they haven't atoned and asked for your forgiveness. Seriously? Move on as best you can, but until they own their hatefulness, you owe them nothing. (Yes, you can tell, I'm not from the "turn the other cheek" culture.)

  16. Wow, four comments, and so far nobody's congratulating herself for her superiority in being thin because of her "lifestyle"* and looking down her nose at overweight people.

    *Having enough money to buy low-calorie, healthful foods, especially lean protein and fresh produce; having enough leisure and the ability to control your time to exercise, control stress, and prepare quality food; having ectomorph genes.

  17. Ever heard of beans and rice, frozen veggies, and peanut butter on whole grain bread? Let's stop pretending healthy foods are out of reach for even the most indigent among us.

  18. Sorry, those aren't good examples of healthy food. Whole-grain bread being healthy is a food myth that you're perpetuating. You claim to live in NYC where actually good, fresh ingredients are abundant year round, yet you recommend badness. If I were you, I'd take a look at my own diet.

  19. Actually, EMS, "the most indigent among us" haven't money for any food and depend upon food pantries and school lunch programs.

  20. Schoolyard bullying over weight and other issues leaves terrible scars, and it's high time we did something about it. There is also no excuse for weight-based discrimination in employment.

    That said, I fear this article veers in the direction of political correctness in discussing weight. The implication that people of normal weight are somehow extremely thin is absurd. Obesity is not normal to our species -- it is virtually unheard of among primitives and when I was growing up 50 years ago it was rare in the United States as well.

    What has changed is our diet and with 71% of American now overweight it is doubly important that we must resist the urge to make obesity, a condition that is as lethal as smoking, the new normal.

    I know that personally when I eat sugary foods I get fat and when at the opposite extreme I replace carbs with fat I lose about two pounds a week until I reach my ideal weight, without hunger. If I eat a moderate carb diet like paleo my weight remains stable.

    Having struggled to avoid temptation and binging I'm not going to judge others: modern ultra-refined foods are addictive and lethal. But at the same time, I'm not going to pretend that obesity isn't a matter of personal choice and personal responsibility.

    We can't change how others view us but in the case of obesity, we can change ourselves, and while we should fight bullying and discrimination we have at the same time to acknowledge that obesity is undesirable and a self-inflicted condition.

  21. Well said!

    The more times we excuse personal responsibility, labeling an ever growing list of things "diseases", the more our population is given a pass to say "it's not my fault!".

    The number of truly medical obesity cases is small *in comparison* to the number of obese individuals. Many can influence their weight if they put in the effort.

  22. Does one case, yourself, makes for as statistical significant sample?

  23. Weight is partially under our control, but not fully. Most people can manage to lose and keep off about ten percent of their weight, what we need to keep in mind is that the person may have already lost that ten percent and still be very fat.

    It also takes time and energy to diet, both of which can be in short supply in modern times. People are shorted sleep, which causes weight gain, and shorted pleasurable ways to exercise which is good for our health no matter our weight for most people. I think there are some mitochondrial disorders where exercise is counter-productive, but I know little about them.

    Personally, I think medicine and research are needed. Given the very poor long term effects of dieting, my best guess is that it is as difficult to lose weight alone as it is to deal with depression alone. We have medicine for depression now that helps those whom therapy and exercise alone are insufficient. I hope that in the future we will have medicine for those for whom diet and exercise are insufficient to manage their weight. Better medicine than surgically destroying the digestive system that is.

  24. Weight bias may be alive and well, but ageism remains an acceptable form of discrimination, stereotyping, infantilism, and shaming.

  25. As is bias against atheists, muslims and many other folks as well. I didn't like that remark either. There is no last acceptable form of discrimination, there are bunches of them.

  26. They're not mutually exclusive. And imagine the bias against people like me who are both overweight and aged.

  27. You can't stop time but you can stop over eating.

  28. The phrase, "cultural ideals of ultra-slimness," may be better stated as "From the beginning, was not fat." (Look it up.)

    Watch the smallest of children in the playground. The obese waddle; the very fat cannot climb the monkey bars; the overweight cannot run or jump.

    The other kids, the kindest among them, know something's not right.

    Why are we defending something that we have known for all of our history is wrong?

  29. Fatness has been considered attractive and even ideal in many cultures since forever. It's been a signifier of wealth and health. Your assertions are just plain incorrect.

  30. I teach languages, which requires knowledge of Western countries literature and art. Plumpness was a sign of wealth (no one connected it with health -- where is evidence for that?) in some areas, not all.

    Obesity -- the obesity commonly seen in any Walmart -- wan't known. Point out one painting, one story where there is happy mention of a man or woman weighing 300, 400, 500 pounds.

    And even if fatness had been considered OK in the dark past, why would that make it so today? Lots of things OK then are gruesome now.

  31. "Why are we defending something that we have known for all of our history is wrong ?"

    "We"?!

    You are ignorant as well as cruel. It's not true that overweight children can not
    run, jump or climb monkey bars. I have five nieces and five nephews.One of my nephews was obese when he was a child. He ran, jumped, climbed monkey bars and was a very good basketball player.

    "The other kids, the kindest of them, know something is wrong." How would you know what children think ?

    Certainly, you could not know what "the kindest of them" think,
    as you display not a shred of kindness.

  32. So the fat people themselves "reported coping with weight stigma...by eating more food". What kind of study lets the subjects write their own self-serving conclusion? "People can internalize weight stigma, blaming themselves for their excess weight...." Oh dear -- instead of blaming everyone else for what they put in their own mouths?

    And society is also supposed to "help to absolve them of personal responsibility for their weight"? How nice to absolve them of the personal responsibility for their damaged babies, diabetes, dementia and for using up more than their share of the world's resources.

    Why take any responsibility for anything? All together now, "My body is bee-oo-tiful."

  33. I wish that, instead of looking for who is to blame, people would focus on what can be done. With everything: unemployment, addiction, poverty, child abuse. Deciding who to blame (and inevitably, punishing them) is satisfying, but useless. You just wait for the bad thing to happen, and beat someone up to vent your anger. Trying to find a solution is difficult, it takes longer, sometimes you have to listen to scientists, and there is no emotional reward involved. Even so, in the long run it is the only thing that makes sense.

  34. While you're enjoying criticism of others' shortcomings,
    you might take a look at your ability to empathize or even to help.

  35. What qualifications do you have to back up what you say? Have you studied metabolism? Are you an endocrinologist? Many years ago I did see these experts, and they all explained to me that I had a metabolic disorder and that my body did not properly metabolize my food. One doctor said i was too bad society was so judgmental since I had no control of my pituitary problem. Sanctmonious people like you are a detriment to society.

  36. When I was in my twenties, I noticed something: I unconsciously held my breath around fat people.

    Now I'm fat, I don't bother anymore.

  37. A lot of people seem to think it's ok to make fun of heavier people. Many of the shamers think that it's just a matter of will power. What I've observed is it clearly not that simple. However some people seem to maintain a a healthy weight effortlessly while other people seem to gain weight no matter what they do.

  38. "No matter what they do?"

    I'll bet you $1,000,000 that no one who eats 2000 calories a day and gets mild to moderate exercise for 30 minutes 5 times a week gains weight.

    Want to take the bet?

  39. I would take that bet. Hope you can pay out.

  40. @Tom B:
    This is absurd, because metabolic rate, hunger/satiety, and fat storage are all variable and interdependent. Two people can eat the same amount but have different responses based on differences in metabolic rate, gut microbes, age, hormonal status, sex, previous health history, etc, etc. Humans are not toaster ovens.

  41. "A new study by researchers at Duke University, for example, found that “implicit weight bias” in children ages 9 to 11 was as common as “implicit racial bias” is among adults."

    This is amazingly on target, part of our social fabric. Reading this instantly recalled a fourth grade playmate, age nine, in 1949, whose real name I never knew, since he went by "Porky"--even to teachers.

  42. Fat bias may be due to fear among those who bully the obese.

  43. Another opportunity for the self righteous thin folks to disparage and humiliate the overweight. If you are thin and smoke, it's fine, you are not incurring more health care costs. If you are thin you are healthy. Such bigotry, it really is disgusting.

  44. Your argument is false. You are right that there is prejudice against fat people. You are wrong that people think smokers are "fine". Many companies have policies to limit smoking in or near the workplace, some offer smoking cessation programs, and some will refuse outright to hire smokers. Activists and legislators have worked to limit depictions of smoking in film, and 5 states have passed laws raising the age at which one can purchase cigarettes to 21.

    Very few of us think smokers are fine.

  45. We don't know why people become obese, not everyone can gain that much weight.
    We don't know how to lose weight, all methods work for a while but each sets up more problems in the future.
    We don't know what a "normal" or healthy weight is or how to measure it.
    We haven't been taking obesity seriously because it was a woman's problem. Discrimination against fat women is worse than against fat men. Women have always had more weight problems than men and women have always had more sedentary occupations. Now that many jobs for men also involve sitting all day and men are getting fatter we are beginning to seriously look at obesity.
    So maybe this discrimination has to do more with our failure to address our misogyny and ignorance.
    I propose an alternative theory. We are training our metabolisms to do more on less. It is not possible to sit on your backside eight hours a day, preceded and followed by an hour sitting in the car each day and have a working metabolism, no matter how much you exercise in the hours between your job/commute and going to bed or what you eat. It is not possible to have a working metabolism with this much sedentary behavior. But in our society, if you aren't working full-time you are lazy and you will get no healthcare benefits. The more you work those long hours the more you will need those benefits.
    Can someone use some common sense and break this cycle?

  46. Good points about metabolism.

  47. I'm going with the flow, dog.
    Ah, McDonald's just ahead.

  48. Agreed. We also mess with our day/night cycles and insist people subsist on poor sleep, both of which contribute to messing with our hunger hormones and cause weight gain. Poor people in particular have less free time to exercise and sleep.

    I am convinced, as I mentioned in an earlier comment, that we need good medical solutions for weight; and I don't think it will be the same for everyone. It's as ridiculous to expect that diet and exercise will work for every fat person as it is to expect that it will help every depressed person (exercise is excellent for mental health too), but a significant number of depressed people need medications to function and I'm thinking the same will be true for fat people, we just don't have those medicines yet.

    Someday people will tut at all those who expected people to lose weight alone as they tut now at everyone who expected depressed people to just cheer up and snap out of it.

  49. Is it really prejudice when drawing conclusions based on someone's weight? Obesity, for the vast majority of people, is a result of diet and activity level. An individual's choices make them obese, it's not inflicted on them from some uncontrollable force.

    No one deserves to be stigmatized, bullied, or shamed. Everyone deserves to be treated with compassion and respect. This article just goes too far claiming that obese people are helpless victims in their fate, with society adding insult to injury in their unfortunate predicament.

    Obesity is a choice, just like an opiate addiction. I'm sure drug addicts are more likely to use if they feel stigmatized as addicts, that doesn't mean society should become more accepting of heroin use.

  50. You might want to read Sam Harris' "Free Will."
    (I had no choice in writing this comment, btw.)

  51. Given that you believe that opiate addiction is a choice, it's unsurprising that
    you believe that obesity is a choice. Both reflect your ignorance.

  52. A few weeks ago I saw a German TV documentary about the decades-long efforts of the sugar lobby (American Sugar Association?) in America, unfortunately successful, to promote sugar as a healthy nutrient and to get it into more and more food products. A TV commercial from the 1950s even claimed that sugar would help you LOSE weight. We got so used to, and addicted to, the sweetness of sugar, that if Mom didn't buy Frosted Flakes, we put it on corn flakes and rice crispies and Cheerios. In later years, when people thought they were becoming health conscious, the industry was slipping it into bread, yoghurt, the bran muffins that were trendy for a while, spaghetti sauce (it was already in ketchup), juice "nektar," instant oatmeal, and if that wasn't enough, the cheaper version called high-fructose corn syrup came into broader use and seemed to do even more damage. Sure, you can take "personal responsibility" by buying everything fresh and unprocessed, and cooking everything yourself, but you may have to cut down your work hours substantially to be able to spend enough time in the markets and in the kitchen, and not everyone can afford to do that.

  53. Well said, Barbara Pines. I'd like to add many of these people work two jobs and take public transportation, which makes meal preparation even more difficult.

  54. Barbara, exactly. I do just that, cook from scratch, but I'm retired and have the time to.

    That said, you can speed up the process and spend very little time on it if you batch cook once a week and freeze the meals. Takes maybe two hours in all.

    I do wish you could buy healthy prepared meals at the supermarket, but until that happens, this is the best we can do.

  55. You can buy a take-out salad just as easily as a take-out pizza. There are cut-up veggies and fruits that are packaged for you just as there are packaged macaroni and cheese or lasagna dishes. You can snack or dine on prepared low-calorie, high nutrition casseroles and soups just as quickly as you can stuff yourself with canned, frozen or boxed junk.

    If everyone can afford the overpriced garbage, they can afford the reasonably priced good stuff.

  56. The Times, one of the best and most important sources of information in the world, seems to have a quota for articles making victims out of one group or another. These articles use extreme anecdotes and hyperbole to paint a grim picture of a biased and hostile America. Perhaps they could take a cue from many of the comments posted in response to these articles and publish the occasional piece debunking this attitude.

  57. I'm old enough to remember when there were no obese young people, just a small number who were "pudgy." So I can't help but think that obesity is a lifestyle choice for those younger than middle age. There is little sadder for me than seeing an obese young person. If what you are doing is making you gain weight, cut down on the calories and up the amount of exercise. A half century after high school my stomach is again as flat and firm as it was then--thanks to exercise and diet management. I do not starve myself in the slightest. Why can't others do this?

  58. My husband and I rarely watch broadcast television but were recently drawn to a particularly good series on A&E about the incarceration of a potentially innocent man, Scott Peterson. The show was good but the interruptions every 10 or 15 minutes for commercials for pizza, hamburgers, all-you-can-eat lobster buffets, etc was alarming. Go out and eat fatty, carbohydrate laden food and enjoy seemed to be the message.
    Even, I, who at a typical meal, eat 6-8 ounces of salmon, quinoa, and mixed greens, was salivating. If I were a teenager, I'd probably reach for the phone and call Pizza Hut.

  59. Hmm... or maybe, since you're "old enough to remember" a time with few overweight young people, you're also old enough to have lived through some major shifts in our social environment?

    Also - serious question - do you really think that announcing the ease you personally have had in accomplishing something actually means it's just plain easy for anyone? Because by that measure I could sit here and say "Well, gosh, earning that ph.d. sure was easy for me! Why doesn't everyone have one?" or "Boy, running that marathon was so simple! How come everyone doesn't do it?" Sounds dumb, right?

  60. They just aren't as wise and disciplined as you are. Is that the response you are looking for?

  61. My daughter had a normal pre-pubescents weigh gain and was hassled about it again and again. After our doctor told her at age nine she should not have eaten a bagel for breakfast she started restricting her eating. Upon loosing 30 pounds at age 12 people many people commented to her and to me how great she looked. She did not look great--she looked thin, and was on her way to anorexia. After professional treatment and much work on her part, she is in recovery from an eating disorder. Thank you for this article. Stigma is real and and can be deadly.

  62. Some girls will gain weight before puberty, and my daughter was one of them. We had bagels in the house because it was the only thing my other daughter, a picky eater, would eat for breakfast. Why do you feel compelled to write this? My daughter gained weight in puberty without increasing her food intake and struggled very hard with fat shaming and bullying that imprinted her for life.
    When she started eating salads people praised her for loosing weight.

  63. Anorexia and other disorders are the primary result of fat shaming, and are far worse for the person's health than being severely obese. People just don't think sometimes.

    I hope your daughter continues her recovery successfully.

  64. Ever since the NYT switched to Google Jigsaw to screen comments, more posts like Eater's are making it through moderation. Blaming a parent for her daughter's anorexia because - gasp! she gave the girl a bagel for breakfast! - is the kind of cruel and gratuitous comment that real people catch but software misses.

  65. It's rather telling that even in an article about the scourge of fat bias, the primary negative consequence that the author warns of is...weight gain. If that's not irony, I don't know what is.

  66. I was obese from 3rd grade of elementary school to the age of 20. I will be 55 soon. The abuse - verbal, emotional and physical - at home, in schools and jobs is something I deal with to this day.

    I don't know if weight problems are caused by genes, lack of discipline, environment, etc.

    I ask that everyone treat those with weight problems in a respectful manner.

    Thank you.

  67. You say you don't know the cause of weight problems. How did you solve your problem when you were 20? You surely figured something out. P.S. Intake regulation is statistically the highest explanatory factor. And the most obvious and common sense.

  68. We need to differentiate between fat children and fat adults. For the most part, unless a rare but serious illness is involved, children are only fat because their parents/caregivers feed them nutrient deficient foods in excess. Blaming fat children for their weight is unacceptable. Parents/caregivers should be held accountable for putting the children in their care at risk for physical and mental harm, and society in general should try their best to be compassionate when it comes to overweight children so as not to make their situation worse. Fat adults, on the other hand, are in control of their own food intake. I understand as much as anyone the addictive qualities of processed foods, but I also know the challenge of food addiction is not insurmountable. Also, the truth is, society rarely discriminates against the mildly overweight (i.e. the new average), and it is scientifically dubious to say that a few extra pounds will kill someone. On the other hand, morbid obesity is a death sentence for which the individual is personally responsible.

  69. One of the more thoughtful, balanced comments here.

  70. I think it is horrible that parents of obese children are not held accountable. I have seen so many people suffer as adults because they were not taught proper eating habits while young. My husband suffers daily trying to lose his excess weight. When he did not have to deal with anything related to food besides eating meals I prepared, his weight was quickly reduced (100 pounds in 6 months) and managed without a "diet", now he has to do all the cooking and cleaning because of my illness and he rapidly falls back to the bad habits, eating while you cook, clean, watch TV, drive, etc. because that is what he learned while young. Teaching needs to begin at birth and parents should be held accountable for overweight/obese children as child abuse and should suffer consequences. Once a child suffers with the weight problem it becomes the roadmap for their entire life with a weight problem because of how they were taught in regards to eating and how their metabolism was messed up for life.

  71. I'm not at all sure you are right. Growing up in the 60s, we ate our share of junk food, Mom made dessert most nights, we drank Coke in somewhat small glasses, and we were slim. Just about all of my friends. Because we played outside and walked everywhere we were going. We burned all those calories. Today's kids are kept indoors and driven everywhere. My kids were too, but they inherited their dad's "slim" genes.

  72. Recently ate at a national fast food chain -- which was outside of my regular routine -- as a very young woman I overcame cancer and have followed a basically 'clean' eating plan now for fifty years. I knew that fast food was filled with unhealthy fats but it was outright amazing to discover just how much fat saturated the food. Honestly, for people who just live their lives without tuning into the actual nutrients in their food, or without carefully measuring what they do eat is certainly at the bottom of much obesity. For me, back to carrot juice in hopes of washing out that awful meal -- and I won't let myself get talked into returning to the fast food joints -- even for the sake of friendship.

  73. The assumption underlying this article is that the only reason people get fat is by overeating and under-exercising. Yet decades of obesity research shows otherwise. Consider these:

    1. A slender woman received a fecal transplant from an overweight donor in order to treat an entrenched C. difficile infection. The woman gained 30 lbs in one month, despite no change in her diet or exercise levels. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438885/

    2. People who undergo bariatric surgery to regulate their weight must take substantial dietary supplements to ensure that they get the nutrients required for survival. In other words, they must exist on near-starvation rations for the rest of their lives or risk putting the weight back on. It they eat a normal diet and maintain a normal exercise regimen, they become obese.

    3. People who have overgrowth of bacteria in their small intestines (SIBO) experience massive weight gain. Treating the bacterial overgrowth often re-adjusts their metabolism, making weight loss easier: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276985/

    4. Weight gain after liposuction is typical. The reason, as obesity researchers point out, is because the body registers the net deficit in fat mass and adjusts its metabolism in order to make up the deficit.

    So perhaps what we need is an attitude change. When we see an obese person, rather than thinking "lazy gluttonous slob", think "person with a disordered metabolism."

  74. How do explain me and at least 10 friends and coworkers I can name who lost 60-100 lb each and have kept it off for on the order of a decade or more, without surgery or medications? Did our gut flora suddenly change?

    We all did the same thing. We stopped eating crap and started getting a little exercise, and understood that we weren't trying to make a drastic temporary change but instead a sustainable permanent lifestyle change.

  75. 45% of the American population is obese. Your suggestions are nice ones but aren't significant at the scale of nationwide obesity. Sorry.

  76. Oh, they are! Each person needs to change and if we just "accept that it's ok" that isn't going to help.

    Look at how much we've reduced smoking in this country with a campaign that emphasized how unhealthy it is, warning labels on cigarettes, advertising to fight the tobacco companies, cigarette taxes, nicotine patches, etc.

    How about a big warning label on every package of candy that says "This will lead to metabolic disorder and obesity". How about putting candy behind a locked door at the store and you have to ask the clerk to open it up to get it? I'd prefer we don't show calories but instead "miles of running" - e.g. this double cheeseburger takes 4 miles of running to burn off.

    You're suggesting we can't suggest across society that people stop eating garbage?

  77. It is dismaying to see how many of the commenters here still blame and shame. Dear fellow human beings, it has been tried. Fat people have been blamed and shamed forever, they have been bullied, insulted, maltreated, refused medical treatment, and they have subjected themselves to all kinds of horrible things to get thin. And it has not helped. Your decision to blame and shame a bit more will not help either. Blaming and shaming has not made a single person less fat. It has, however, made a huge number of people more miserable than they already were. Thank you.

    And I am not even fat, and never have been. I just loathe bullies, and they are very concentrated here.

  78. Well put, Noname!

    And those folks who stigmatize others on the basis of their appearance don't feel the need to do any good works themselves. Like taking up social causes for instance.

    I wonder what a survey of people who shame others for their appearance would show about what kind of selfish frightened people they are?

  79. Amen to Denise. The implicit attitude even in this article is that fat people shouldn't be fat, and that the most negative result of bias against them is that it keeps them from losing weight. The change that needs to take place is to recognize that body size varies and to accept bodies of all sizes. Emphasis needs to be placed on enhancing health, not on reducing size.

  80. I don't like to hang out with people who abuse tobacco, alcohol, or heroin. I assume that everyone is OK if I make a choice not to associate with people like that.

    Why can't I make the choice to not want to associate with people who ABUSE food? Is there a genetic component (maybe? maybe not. But there are genetic components to the other abuses I describe as well). But as a physician, I refuse to believe that human genetics have evolved dramatically over the last 40 years while obesity in the US has doubled. So much of it is not genetic.

    When someone who weighs 300 pounds is eating a triple baconater, that's food abuse and I have every right to feel the way I do about that person.

    (here's my kicker - 10 years ago I lost almost 100 pounds without surgery or medications, and have kept it off. How? I stopped eating entire bags of Doritos in one sitting and got a little exercise instead. MAGIC!)

  81. "... as a physician..."

    Wouldn't an MD have at least some elementary notion of statistics and of what makes a significant sample? One is not enough to surmise anything.

    As for "entire bags of Doritos in one sitting" just about anyone overweight wouldn't do that. After stringent diets, their body becomes extremely efficient at using fewer and fewer calories --and just about all overweight (or imaginary overweight) folks have gone on several diets.

    See for instance what happened to ALL the contestants of the "Biggest Looser" (several studies have been reported -- just look them up). They regained their weight even as they have cut down calories to the level that would make anyone who hasn't gone on a stringent diet emaciated.

    There are specific figures as to how many calories our bodies will make do with after suffering from famine (voluntary or involuntary) for a length of time. Actually there are even studies that if one generation exists at a near starvation level, the offspring even 2 generations removed will be more efficient calorie users and thus might be prone to storing more fat (you know, evolution has made our bodies adjust to periods of famine and periods of plenty)

    But then of course what physicians doesn't know this?

  82. You know, maybe just cheering up would cure all the people with depression! It did me when I felt sad!

    Magic!

  83. "As a physician"

    Lumping together food with alcohol, heroin, and tobacco? I'm sure one of those is required for survival, the others not so much.

    I'm a fat man. I've lost weight and gained it back too many times to count. I'm embarrassed by the way I look.

    I recently took a trip to the UK. I was the fattest man riding the tube in London, biking through the Trossachs in Scotland and hiking a 1000' hill in the Highlands. I'm trying to stay active on vacations and my job requires me to be on my feet and walking 50 plus hours a week. I'm just doing the best I can.

    I'm also a kind, loving and generous person. I have a lovely wife, we took our nephew to the UK as a gift for his high school graduation as we have and will with each of our three nephews and one neice. I volunteer weekly at a local hospice and speak to hundreds of people a year about the dangers of drinking and driving. I'm just doing the best I can.

    I've got a great sense of humor, I may overcompensate for my obesity, but I make others laugh out loud daily. You'll never know me though, just because I'm fat.

  84. There is nothing inherently good or bad about differences in gender, ethnicity, race and sexual orientation and all of these need to be protected from discrimination. The same cannot be said for normal weight versus obesity.
    As a society we need to help obese people overcome their weight problems and this should not be done via shaming or bullying but to present body mass as a value free entity is counterproductive and dangerous.

  85. I suspect you may have a few faults (as we all do) that I would not presume to think society needs to "help you overcome". Are you serious?

    People are imperfect. Society can't do anything about it.

  86. I am so appalled by the unkindness that is expressed in the responses to this article. My mother was the champion in teaching me to hate my body just as she hated hers. I am 69 and was the only fat kid in my class. Amazingly, I was never ridiculed, at least to my face, and had many friends. When I was 16, I lost the excess weight but gained a lifetime eating disorder - anorexia, bulimia, unrealistic body image, and self loathing. I have had multiple liposuctions, and a variety of weight related procedures. I am a walking calorie counting book.
    Recently, after enduring several months of profound stress, I allowed myself to self medicate with food and alcohol, assuming that when I resumed my usual diet and exercise routine the weight would drop off. It did not. When I consulted an endocrinologist, she told me there was nothing she could do for me. What I heard was that I was consigned to this new size. I became suicidal and spent a week on a behavioral health crisis unit.
    For many overweight people, food is their comfort, their addiction. There is a correlation between childhood sexual abuse and food addiction. When you choose to shame an overweight person you are adding to the shame they carry around 24/7 from the sexual abuse. Many overweight people need psychotherapy and empathy not more emotional pain. The shame, is on you to contribute to their pain. What if the person that is targeted were your mother, your child? Is that what you would want for them?

  87. People need to take responsibility for my own children. If your parents created your situation, you should 100% blame it on them as a child. BUT, you're an adult now. An advanced adult. Hard to continue blaming your parents for your problems approaching 70 years old. At some point, you have to take responsibility for your own body and mind. Probably closer to 21 than 70. Sorry.

  88. I am sorry to hear you have gone through all of this, my little sister commited suicide some years ago because of bulimia-induced deep depression. Shaming or avoiding people because of their weight is evil and many in my family have suffered deeply for it. Myself just a bit, but I am male. I guess women are targeted more viciously.

    I hope you are now in the way of healing yourself. God bless.

  89. Keep your disingenuous "sorry." Don't worry so much about moral hazards on our economy. You truly need to worry about being a moral person, because your post was mean-spirited. A person with morals is one who treats others the way they would want to be treated. That means not putting down people who are dealing with any kind of addiction. A very easy morality lesson that you can wrap your "sorry" around, right? Because, here's the thing - a civilized society takes care of it's weakest citizens. No human being is perfect. Take it down a notch, Eater. The Upper West Side has big enough sidewalks for all of us to share.

  90. I have the feeling that the people most likely to say negative things about fat people are also likely to not support any efforts or regulations to deal with this health crisis. People in the US are getting heavier across the board, with poorer people being hit hardest. There are trends in the broader culture, society and economy that have lead to this result. It didn't just happen because suddenly people decided to get heavy and oh well who cares.

  91. Let's examine this issue as a moral hazard. If one elects to swallow a lot of ice cream and potato chips using their own resources and as a result: raises healthcare costs for everyone, impacts productivity for everyone, expects taxpayer-funded government handouts for "regulations" or some other form of health crisis intervention, then everyone might as well just do the same. The government will take care of it. I don't make smokers smoke. I don't make opioid addicts shoot up heroin. Our tax money didn't pay for them to get that way. Our tax money shouldn't be used to clean up after their mess either. Economics is the best method: make it too expensive for fat people to get insurance coverage and voila fewer fat people. I know it can come across as crass or heartless but seriously, it's the only way. If you can't afford it, don't do it.

    45% obesity rate in America is not due to lack of public funds, lack of education, lack of access to guidance, lack of access to decent food. In pockets, perhaps, but not nationwide. We've become a nation of lazy and personally irresponsible people unwilling to take matters into our own hands.

    Sorry.

  92. If losing and maintaining weight loss was so easy, there wouldn't be a multi-billion $ weight loss industry dependent on the ongoing failure of their customers. It is a complex problem and requires complex solutions.

  93. Losing weight is easy: stop eating more than 1,000 calories a day. Control hunger by allowing very few of those 1,000 calories to be from carbs. It works every time, all of the time. I've done it for months at a time; the hunger goes away after a couple of weeks because the hunger is psychological.
    Once you've lost the weight, you can eat about 1200 calories a day to maintain your weight.

    The problem is that overweight and obese people don't want to face facts and stop eating so much--mostly because they use food to self-medicate mental health issues, which is why they are overweight/obese in the first place.

  94. So you recommend that a 5'11 woman should "face facts," stop self-medicating, and eat 1,000 calories a day to lose weight? You consider that to be healthy? Again, please provide peer-reviewed research before dispensing, quite cavalierly, such dangerous, ill advised advice.

  95. @Honeybee:
    Cutting to 1,000-1,200 calories per day is starvation for an adult. It may work for short term weight loss, but much of the weight lost will be muscle unless the diet is also high in protein. If maintained over several weeks (or months?!?), the body decreases metabolic and increases hunger to compensate. This has been demonstrated over and over again throughout a century of obesity research.

    Hunger is a fundamental physiological drive. Do you think your need to breathe or your need to drink water are "psychological"?

  96. I think there are two varieties of this problem at play here. There are the "regular" overweight people, and then there are the morbidly obese so common in the US as to have become the global symbol of American fatness, laziness, stupidity, consumerism, big-business-controls-everything-ism, and other such qualities that the rest of the world loves tacking on to the stereotypical American, so they can hate him/her even more. And it's really not helping that the US is a world leader in the existence and spread of such inhuman obesity. Until I came to the US 14 years ago, I had never seen a truly obese person. The magnitude of fatness I encountered here was so mind-blowing that it seemed unreal.

    "Fat" people have always existed to some extent. In the past, they were the rich or the royal, because they could afford to eat a lot, so fatness was a sign of prosperity. The image of fat people has changed through the years. But what is new, and truly alarming, is that second category. People who are simply overweight aren't necessarily sick, and haven't been thought of as such historically, even when fatness was no longer desirable. Theirs has been an attractiveness issue. But obesity is actually dangerous to your health. So let's keep those categories separate. It's fine to preach self-acceptance to simply overweight people. But obese people, while respected, need to be helped and encouraged out of their category. Obesity is not a state that we can afford to accept or learn to love.

  97. It's easy to condemn. I have a friend and a relative each who became Boise due to anti epilepsy medication. The friend started this at age 10 and so has been made miserable for 40 years.

    Even people who have become obese for "voluntary" reasons cant just switch it off dues to homeostasis and other reasons

    Obesity is dreadful on a physical basis, but you are blaming the victim.

  98. Where exactly did you see me blaming the victims?

  99. you midded the point. what they're saying is until they got to US, they didnt see fat peope. and they didnt exist in this country until about 20 years ago. humans have been around for over 100,000 years but just got disgustingly fat in the last 20. so what happened?

    1. cell phones. constantly. ad nauseum.
    2. sitting on your butt all day.
    3. too much tv.
    4. too may people emotionally cant cope w/life (many causes)
    5. the economy rigged to ridiculously favor the ultra rich and being stressed from it (including being rich enuf to get skinny w/help from Dr's and trainers) knowing their stuck where they're at.
    6. industrialized, processed crap masquerading as "food" thats been filled w/garbage additives to make you "comfortable".
    7. every tv show (and the nyt) who constantly, constantly, ad nauseum are forever putting out "new recipes".
    8. short attention spans and virtually no ability whatsoever to delay gratification in even the most minute way. all verifiable mental problems aided and abetted by the "love yourself" types.

  100. Fat bias is quite real and destructive, but hardly the last "acceptable" discrimination out there. Try being a short male. Same issues and the open discrimination, bullying, and shaming start at about the 6th grade. It peaks in early to mid-20s in the dating scene (women can be devastatingly deliberately and cruelly callous, especially when in public with friends), and then seems to mostly vanish by mid to late 30s. This is the age when women figure out the person is far more important than the faux image and one -upsmanship with rivals. But still, people generally have no intent to restrain comments, or have the slightest empathy. I'm glad now to be in my mid-50s and married with kids -- long past the hard days, but now fighting the middle aged waistline! Go figure.

  101. I hear you. My husband, also short, has an outsized personality that got him through school on all levels (senior class president) and beyond into his career. Just keep smiling!

  102. At what age do men figure out that the person is more important than the faux image?

  103. Tell us something we didn't know! While many of the comments posted prove the articles point they also demonstrate how ill informed so many people are about the nature of being overweight, the causes, the effects, and the necessary solutions.
    Beyond the realms of calories & exercise, there is a world of genes, hormones, basal metabolic rates, employment, lifestyle, economics, poverty, stress, psychology & medical conditions that all play a part in an individuals ability to gain/lose weight.
    Steroids, PolyCystic Ovary Syndrome, the pill, antidepressants, Cushings Syndrome, Arthritis, Diabetes are just a few of the medical conditions & medications that cause weight gain. Fat shaming people already dealing with serious health issues that pre-date any weight gain is cruel and un-necessary. Did you stop to ask for a full medical history that last time you fat shamed someone?
    Dieting itself also reduces the basal metabolic rate, making it harder to maintain weight loss.
    Fat shaming really can ruin lives. I speak as someone who's been both fat & thin as an adult. Despite being a healthy weight I was on my first diet at 7yrs old. I had my first eating disorder at 9, another by age 12, self harming by 13 & a breakdown at 22.
    There is no doubt that obesity is an epidemic, one that needs to be solved but the emphasis for any individual, and for society as a whole, should be on being healthy. Science shows people respond far better to the positive so let's not be negative - Please!

  104. I have lost weight and kept it off. The trick: Eat less and weigh yourself daily.
    What we weigh is up to us, not anyone else. Eat whatever you want, but don’t eat so much of it. I have given up eating almost everything containing added sweeteners of any kind. That helps tremendously. The scale will tell you how you’re doing. You can do it!

  105. @XYZ:
    If it works for you, that's great, but just eating less without also paying attention to types and qualities of foods is broadly ineffective.

  106. Here is the congratulatory note you are looking for:
    Congratulations: You did it right, and you are An Awesome Person!

    The rest of us are not great at discipline and if anyone else is overweight it is clearly because s/he is far less proficient than you--in terms of self-control, of course.

    Your weight, of course, tells us nothing of your kindness, hope, peacemaking, perseverance, generosity, hospitality--so many other things that make up human existence and a good life. But now that you've achieved svelteness, I hope you are experiencing good life in lots of other ways as well.

  107. "he rest of us are not great at discipline" . . . the saddest of excuses. And yet, an excuse.

  108. Almost everybody advocates for some form of self-control. We are certainly expected to exercise self-control when it comes to how we treat others; indeed the current national mood is one of increasing expectations for self-control in many personal realms (e.g. racism, sexism, etc.)

    Yet when it comes to materialism (personal consumption) we stigmatize self control. We encourage unbridled consumption as a means of and a reward for getting rich. Similarly, this article argues for a form of body-image libertarianism; it implies that the attempt to exercise self-control in food consumption is at best futile and at worst immoral.

    Since we demand high levels of self control from individuals so as to keep them from being racist or sexist, (with the implied message that this really easy to do) it stands to reason that we may want to extend our conceptions of self control to other realms e.g. being fat.

  109. There was a time when I truly believed that most Americans were good people. Mostly generous and kind. No more. Lately I have come to see how very wrong I was. The comments here from people congratulating themselves on their "flat" stomachs and discipline and overall perfection are absolutely ridiculous. Every person has faults. Everyone. Even the fat shamers commenting here.

  110. You were naive and now you have wised up. Human nature is not good or bad, it just is. We are not that different from your average pack of feral dogs.

  111. Pretty obvious Botticelli's the problem. Need to remove--or build a plywood in front of it--his painting from the Uffizi--too symbolic. Can't have that in the modern world, can we?

  112. Most people don't regard Botticelli's Spring as obese and, contrary to the prevailing PC narrative, painting and sculpture show a fairly stable standard of - let's say - what the artist chooses to portray.

    With the exception of a few fertility goddesses, the effect is universal.

  113. I'm thinking you missed her point...

  114. People aren't fearing another person's health crises. They are fearing being fat themselves. They ridicule and shame what they are afraid of. Sound like anything else? It's shameful. Try to empathize, not criticize.

  115. But, didn't you just criticize? And make some pretty strong assumptions.

  116. I don't think the abuse stems from a fear of being fat. It's more a case of a warped sense of punishing justice: "The fat are indulging while I suffer denial, so I'm going to make sure they also suffer."

  117. Back in my younger days in elementary school about 1,000 years ago when we were stupid and shallow we made fun of kids who were little more than chubby. Today they would be of average weight or even better. The number of people walking around the Chicago area and beyond who can barely walk they are so heavy is staggering. What happened?

  118. Sugar, fats, computers, television, impoverished social lives....

  119. Difference here, is that you cannot change your skin color or nationality but most of the time you can do something to change your weight, so weight does reflect of your habits, and in teaching your children and yourself healthy habits it's hard to do so without saying that bad habits will make you overweight. I've struggled with mild obesity all my life, but right now I am more commited to exercise and healthier habits more than I have ever been, and the results are starting to show. And my kids can't unsee this. We strive for them to eat healthy too, limiting the consumption of junk food for one and setting them up for sports courses on the other. What they make of it, I can only hope for the best.

  120. I agree - obesity, except in very rare cases, is self inflicted. It is easy to get fat and much, much harder to stay slim. I know this from experience because after having two children, I felt a 'creeping obesity' but stopped it in its tracks. I joined a gym and stopped eating candy and cake. No time for the gym? Just walk - everywhere. Sweat. Cut your portions in half. It's not rocket science people - it's inactivity combined with terrible eating habits.

  121. Oh, Rhonda. I though that people in Lido Beach were more enlightened, or at least more compassionate.Did you learn nothing from Superstorm Sandy,or are you a recent transplant, or someone who was miraculously spared ?! I'm glad that
    you used your full name, so I can back up should I ever have the displeasure
    of meeting you should you ever cross the border into Long Beach .

    Don't pat yourself on the back, too quickly, either. I wish you well, but if you
    ever need to be put on medication such as Prednisone,you'll learn that will power of steel will not combat the weight gain. My niece went from being a rail thin
    4 year old to an obese one on Prednisone. When she was taken off the Prednisone,she returned to her normal thin self.

  122. Here's the thing...kids pick up on the larger memes of a civilization, like dislike of fat, fears, prejudices, money, etc. Media is glad to help out, especially on behalf of it's paying sponsors. Unless a child isn't exposed to them at all, and that takes a lot of vigilance or limiting the child's exposure.
    If children adopt the memes and then aren't educated in why the memes are erroneous then they are likely to retain them. This is why childhood is so traumatic to do many. Many live in impoverished social circles where they aren't receiving feedback from many people to help them develop into well rounded individuals.

  123. As a man who had to start dealing with humiliating hair loss at age 19, I have little to no sympathy for all these obese adults you see everywhere nowadays.

    The idea that obesity is somehow a genetic condition is laughable, in my view. I don't remember nearly as many overweight people back in the '70s and '80s. Put these people in a strictly controlled environment, where they're forced to eat properly and exercise regularly, and their BMIs would eventually start dropping faster than Trump's approval rating.

    Sorry, I'll save my sympathy for the baldies who've had to struggle with a real genetic defect.

  124. Are you a geneticist? If not, you might consider familiarizing yourself with the vast literature on weight loss before you make these statements.

  125. The literature that supports the "fat gene" theory is for the most part spurious. Ignore the supposed "literature" by online experts. Go to the primary literature, such as found in NLM's Medline. You'll find almost all investigations, studies, and trials found such genes, if they exist at all, are rare.

  126. Personally, I subscribe to the belief that "some heads are perfect, the rest God had to cover up with hair".

  127. This article borders the bizarre, especially the insinuation that avoiding obesity is outside of most's control. Go to any typical U.S. grocery store and look at what people are putting in their carts. Look at the menus of fast-food and casual restaurants. The question isn't why are there so many obese people today, the questions is: given all of the garbage we consume, how are more people NOT morbidly obese. 3/4 of the calories that Americans consume have no business being put into anyone's.body. Until the average American diet improves drastically, I don't want to read any more articles about the mysteries of obesity, "fat acceptance," etc.

    P.S. re: "fat people are the last group whom it's OK to discriminate against..." How about drug addicts, alcoholics, pedophiles, criminals? Or how about the elderly, those facing health issues in no way self-inflicted, the unattractive, short men, and a whole bunch of others facing discrimination through absolutely zero fault of their own.

  128. There is quite a huge difference between fat people, drug addicts, alcoholics, pedophiles and other various and sundry criminals. Or do you not agree?

  129. I certainly agree there's differences between all of those groups. The point of my original statement is that the Dr.'s statement is false, not that these groups are equivalent to the overweight.

  130. So many negative comments by the NYT's readers. Are these the same liberal readers that combat racism, Trump, sexism, etc. Leaves me to assume that there are far more hypocrites out there then one would think.

  131. Good response.

  132. Most people are born with the color of their skin, they don't create it over their lifetimes, or even in their childhoods. Same with gender, although that is clearly beginning to change.

    I'm not sure what combatting Trump has to do with the other two.

    The negative comments stem from the continued perception, even by children, that being fat is self created, and is the result of over eating [and is therefore controllable]. When you saw pictures of Governor Christie sitting on the beach recently, are you being hypocritical by thinking that the man in the picture is somehow struggling, and it is reflected in his body?

  133. WHEN does a tiny minority succeed in shaming a HUGE majority-- pun intended. Fifty % of US adult population is obese and another 25% is overweight. KIDS rarely see a thin person. BODY POSITIVITY is the mantra. FAT people feel guilty from the sin of gluttony when one billion people are starving so they shift the conversation to blaming others for their sin. America is based on over consumption and the conflict with the SEVEN deadly sins is obvious.

  134. I joined the Peace Corps a decade ago and my group included about 17 middle aged and older women, the majority of whom were overweight or obese and had been for a long time. During our three month training in our Eastern European country, we lived with host families who gave us food and portions that were typical for this country. We were expected to walk most places. Everyone lost weight and some lost dramatic amounts. After trainng we had more ability to eat extra food, but most women returned to the US the slimmest and healthiest they had been since they were teens.

  135. Thought about this a bit: you had "naturally" restricted portions and exercise. Even more, everyone had real purpose in their lives - they weren't obsessing about what they ate and what they looked like, but what they were doing. Maybe that is the "secret" to carrying a healthy weight.

  136. Going on a diet sounds temporary, something to do when the weight starts to increase, then increases again, etc. It should be, going on a sustainable common sense nutritional program to maintain a desirable weight. But not easy to do, too many good things to eat, then continue because it tastes so good, besides it takes the place of endorphins, makes us feel good too.
    Habits are hard to break after years of conditioning, the excess calories battle wages for years, and food companies, retailers, fast food, slow food restaurants are not helping our battle to stay at healthy weight.
    Marketing companies know what motivates buying impulses, they get paid to entice. Walk down the super high-calorie food aisles, lots of printed propaganda. makes your mind bring back those TV commercials that turn on your sugar cravings.
    It's a war folks, either you win or they do. It's lost or won at the food market, at the restaurants with great looking menus.
    Either you incinerate those excess calories or become more of you.
    We all know what to do if we want to do what we should do.

  137. Beg to differ. What is called fat bias here probably does have a "nature" basis, rather than being totally the result of "nuture" (something we're taught, perhaps inadvertently. We seem programmed by nature to have similar standards of beauty, which is tied to breeding behavior and species health and survival. Of course as civilized beings, we want to be kind and avoid hurting others. However,it would be a mistake to normalize, embrace or celebrate significant obesity, because it is a grave health risk factor, and interferes with the enjoyment of life, sooner or later. We have normalized and even celebrate selfishness (follow your dream), drug abuse, unwed parenthood and sexual promiscuity -- and gee, look where it's gotten us!

  138. 'fat bias here probably does have a "nature" basis'

    two thoughts - as social animals, humans are finely sensitive to perceptions of unfairness - I see tiny kids, and they say monkeys will, reject offers they see as unfair when someone else arbitrarily gets more - the sight of a fat person may trigger basic feelings of 'they got more than me - they've eaten an unfair amount' - stemming from times of famine, while fat people may indeed be the genetic survivors, storing energy as fat, in these times of slim supermodels - thinness being the admired rarer state - fat people may tend to trigger automatic feelings of disgust as in 'what a pig - they ate my share - that's not fair'

    secondly - the most ancient statuettes from prehistoric times are of obese females with rolls of fat - from the rare=desirable model, this suggests that hunger was common, and they might only dream of having too much to eat - thus a figurine to dream about - a fat woman ! I believe even in recent decades Indian female movie stars tended to be overweight - again probably because most Indians were skinny and hunger was commonplace - so - go to the movies and dream - of having a fat woman !

    so - disgust at unfairness, and desire for what we don't have ...

  139. Frank as recently as late 19th C USA, the "gilded age" a phrase popularised by the great American writer/humorist Mark Twain a man in a suit with huge belly was known as "a fine figure of a man". Presidents Wm Howard Taft in the early 20th C, Chester Arthur and Grover Cleveland are examples. They looked rich in contrast to malnourished skin & bones & rickets packs of migrants from starving Ireland and Europe, Even trying on clothes from the 1930´s and 1940´s its obvious that in the depression and war years people were simply shorter and lots skinnier due to want than most are now. So its market forces, the food industry and psycho-sociological effects of late 20th and now 21st C living that accounts for mass obesity, plus from Australia you may not be aware of the lack of comprehensive health care for anybody under upper middle class now in the USA. Its fixable just like the US is fixable.

  140. 'from Australia you may not be aware of the lack of comprehensive health care for anybody under upper middle class now in the USA'

    I'm very aware PJ - and thank my lucky stars for the healthcare we have in Australia - the US 'freedom?' is indeed a world outlier in not having what most other developed nations provide for their citizens.

    Good luck fixing it - US folk have made a good start in rejecting the initial crass attempts to kill off 43 Million 'unnecessary' US citizens ...

  141. I seem to recall that an exceptionally wise person once said "Judge not, lest you be judged." Some commenters here should remember that.

    That particular individual devoted his life to trying to get us all to behave better, and I'm pretty sure blaming, contempt, and bullying weren't in His repertoire.

  142. Really? How do you think Jesus responded to the young rich man, the Pharisees and the money lenders in the temple. The idea that Jesus never shamed or treated people with contempt shows a distinct failure to read all the stories about his life. I am no expert on the Bible and got much of my Bible learning from the Pearl Buck Story Bible, but even I am familiar with these stories.

  143. Plus, it can be risky to play with karma...You may be "naturally" thin, get to eat whatever you want and never gain an ounce, judge your fellow flyers with abandon, blat on about it's all about "health" and health costs, but you may get a disorder, be put on a medication, or just get to the age when this changes...ooops.

  144. I went on my first diet when I was 12. I wasn't overweight but had a naturally skinny mother and I was bigger than her. Instead of telling me that I was ok she would say, just push away from the table. This "support" had the opposite effect. I would eat more and subsequently developed an eathing disorder. I've spent my life thinking of myself as fat, although I've rarely been so. I believe that my body dismorphia isn't unusual, and is probably a factor in many peoples diet issues.

  145. I hosted a few overweight (actually obese) guests recently and they ate the same things we ate BUT in double or sometimes triple portion sizes. Perhaps your mother was doing the right thing to signal portion control? It's really the only tool that works in a normal diet aside from bulking up muscle which increases your metabolic rate in general (and recommended).

  146. Rainbow told us a personal story about her own struggles with weight bias, reflecting the tone of the article with personal experience. Don't diminish that with fat shaming ideology. No, it's not good for a mother to put a young child on a diet that ends this way; we see it causes lifelong emotional pain to tell a child--who may or may not have even been overweight--that she's not good enough because of how much she weighs.

    Additionally, the larger a person is, the more calories that person requires to maintain his or her weight. So presumably these fat guests of yours WERE eating more. And since I presume you weren't weighing all their portions for them to see just how much they were eating, don't you think their bodies are their business, not yours?

  147. Bad gut bacteria can induce craving for food. And it may not be known or the fault or choices of people who are obese.

  148. Body positivity is all very well, but being overweight is unhealthy and should not be encouraged or, frankly, ignored. Weight is entirely amenable to dietary manipulation. I wonder how much of this "weight positivity" stance is from big food and big pharma, which have created the diabesity epidemic and profit handsomely from it, wanting to maintain the status quo, with all its profitable consumers and patients.

  149. Huh?

  150. Our German receptionist at Berlitz Language School here in San Diego told me she was afraid to shop in our grocery stores, knowing that lots of the food was genetically modified, loaded with sugars and additives, let alone pesticides. When I told her about the organic market in our town, she almost cried with relief. It almost seems as if the Big Food industry in America is working hand-in-glove with Big Pharma, with the added irony that many pharmaceutical drugs cause weight gain, among an array of bad side effects. Certainly there were fewer obese people in the U.S. a few generations ago, so what is it that's changed if not what we eat/medicate ourselves with?

  151. I didn't realize we could trust labeling anywhere and that there is guaranteed to be no cheating in an "organic" market. There aren't any real rules. And the kicker is, no science suggests that organic food is worth the uptick in price. Domesticated wheat, organic or not, is likely a bigger problem overall.

  152. Eater - Check out "The Cornucopia Institute" for the latest in the organic food wars.

  153. There are some real rules, though they are under constant assault by corporate America. Check out The Cornucopia Institute to see the game in play. While I agree domesticated wheat is a big problem, it is by no means the only problem extant.

  154. The damage fat-shaming does by causing anorexia and eating disorders is far worse for those victims than any amount of fat. Anorexia is killing younger and younger kids every year and is rapidly becoming an affliction of men as well as women. It is one of the most deadly disorders and kills or maims people at very young ages, taking decades off their lives rather than the few years fat might.

    Shaming doesn't help any fat people lose weight, frequently causes weight gain, causes stress which only exacerbates health issues, and can cause people of healthy weight to develop eating disorders which kill them. It has no good effects other than making the shamers feel momentarily superior, and I'm not even sure that's good for their characters.

  155. This isn't momentary superiority and I doubt only the deranged enjoy name calling. However, saying someone is fat when they're fat is like saying they're blonde when they're blonde. Should we endorse protected speech for hair color? Any shame fat people feel is their own and they should be ashamed and it help should drive them to change.

    That said, this, for me, is about economics and moral hazard and the negative impact to the US with a near 45% obesity rate. 45% of all adults are obese. Doesn't that surprise you? Worry you? Concern you?

    How about this: charging fat people the prices they deserve for healthcare will help make them thin. If they can't afford healthcare, they certainly shouldn't afford donuts. Everyone might as well be fat and unhealthy since the system will just pay for it. Wouldn't you be outraged to pay for a voluntary smoker's lung cancer treatment when it was wholly unavoidable? Or for a coal miner's cancer nobody told them to take a dangerous job. Or a skydiver? Step away from the donuts. Fat is avoidable.

  156. Do you think miners CHOOSE to work in a coal mine? You sound complacent and ill-tempered in every snide reply you make to people here.

  157. You're absolutely wrong on all points. Almost all major chronic diseases are caused by lifestyle but we wouldn't turn away a person or paying for their care if it was heart disease, diabetes, HIV, Hep C...because "they caused this." Do we turn away the alcoholic with liver damage or the drug addict with pericarditis because "they caused this?" What you're implying is that anyone who is fat can somehow "just do it" and they wouldn't be fat. Not true, and there is a large genetic component that you're ignoring when making these types of statements.

  158. My mother put me on a diet when I was five. The ensuing 57 years have been a jumble of name-calling, fat jokes, faux encouragement ("good for you, coming to the gym!"), weight loss, the inevitable weight regain, self-hatred, and airplane seat belt extenders. Three weeks ago I had bariatric surgery. The first person who tells me I should love myself as I am, rather than mutilating my body, should be ready to run.

  159. It's hot out there, over 90, humid too, got to go to the store, easy to get up from sitting, then get in the car, sit again, pull into the parking lot, damn lots of cars close to the store entrance, looking, looking for the right space that requires as little body movement as possible, right? Wrong!
    At least for me, I took the Me-Mover which is breezy when it gets going, I feel my leg muscles working, my core is tense as I step on the pedals. Maybe this doesn't seem normal for a 79-year-old guy, but it makes me feel better than sitting for hours, then going out to sit some more which most of us do and wonder why am I putting on more weight, why?
    Different can be good, very good, ask your doctor, he/she will concur with me. Just be careful, get acclimated, adapt to something that your body moves you.
    Please stop sitting so much and eating out of boredom, hard to eat doing 15 mph circumventing a sweeping curve, feeling the wind in your face, endorphins kicking in on a Me-Mover.

  160. What's a Me-Mover?

  161. I was disappointed not to see an illustration of a little girl included for this article. But maybe she is invisible, like all us overweight girls are. It's just a shame, all the potential wasted.

  162. When I was assigned a new physician, I was chagrined that he was overweight. I cared about fitness and health and thought he should too.

    I noticed, however, that as a doctor, he was more responsive and seemed to care about my well being more than other doctors I had had.

    During the next year or so, I learned that he had been taking care of his wife who was terminally ill during this same time he was taking care of me and a lot of other patients.

    My initial assumptions about him were wrong on a lot of counts. Yes, I was prejudiced and I hope I've learned my lesson.

  163. I am empathetic towards your doctor, and applaud his performance.

    But exactly what about that should lead to obesity?

  164. So this rise of weight bias corresponds with the ride of obesity?

  165. Probably not, just more "bad examples" to rag on.

  166. What wasn't stressed in this article is that obesity is unhealthy. Trying to get society to accept overweight people for their appearance is fine, but that won't help their hearts and other organs that are under stress.

  167. Who is really the real culprit of having a society with more and more obese people? Genetics? I don't think so, I think is due to the junk-food industry. If I turn the TV on, almost all the commercials are with sugary things, greasy fried stuff, sugary drinks, creamy ice-creams, etc., etc. And, the other half of commercials is about drugs: buy this for cholesterol, this for diabetes, and, of course, this for losing weight. My advice?
    Begin a campaign of TV commercials advertising how great you will feel your body doing exercises (be you either fat or thin), get a dog! (and what a wonderful way of rescuing another pet from a not so good fate!); ads about how wonderful is to eat a balanced meal and not to eat in between meals, etc., etc. So, to begin with: yes ,we live in a sick culture, and one feel so good of targeting the others! We have regrettably, (beyond the issue of body images), recent examples of how low we can go denying humanity to all of those who are not like "us." So, the real culprit is not you, over weighted people: the weight bias-stigma, is no other than the culture of sick consumerism we live on.

  168. Exercise is a poor strategy to lose weight. It's a common misconception.

  169. Exercise is an excellent way to improve mood and well-being, and fitness predisposes people to a host of healthful habits. Active children are less likely to become obese in the first place.

  170. But not exercising is an excellent way to become out of shape and even fat if you want to.

  171. There are different causes of obesity, hormone imbalance, genetics, but the most common one is overeating and eating junk food. How about taking step one to eat less and step two to move more?

  172. I'm sure that no overweight person has ever thought they should eat less and move more! What a brilliant idea!

  173. To think is one thing, to do is another, and yes, brilliant ideas are often the most simple.

  174. @realist:
    Do you think a person becomes obese without ever having tried to eat less or exercise more? This advice is a fundamental misunderstanding of why the body gains or loses weight.

  175. People who self-medicate with food are going to be overweight. We need to address the causes and conditions that create so many citizens who self medicate, whether with food, work, opioids, pornography, or whatever.

    If you child is heavy, they are self medicating. This is a signal of unhappiness, stress or misery. Address their misery.

    While teasing and bullying miserable people is no help, it is also not a solution to normalize hugeness. Especially childhood hugeness.

    Lets address the inner pain that causes the disordered eating.

  176. A child may be heavy because their parent admonishes them to clean their plate, rewards them with sweets, or gives them antibiotics or steroids. Being obese may not be a choice for children. They have so few.

  177. I think humans thrive when leading a hand-to-mouth existence; it's how all other animals live their lives.
    Once human animals get a little cushion from the stress of survival, the anxiety and stress that helped us survive have no outlet and we self-medicate to soothe the build up.

    The existence of an "addiction industry" doesn't help; it sustains itself by never, ever admitting that the problem is psychological and probably best treated with anti-depressants.

  178. This is simply not true. It may be for a small percentage of kids, but most kids are overweight from eating too much. They eat what they are given at home and may be allowed to snack at will and drink sugary drinks. Trying to make everything a mental illness helps no one. Poor diet and poor choices by their parents.

  179. I disagree with the statement that obesity is the last socially acceptable form of prejudice. I think there is a huge prejudice against people who are not academically talented as well. We value where people started mentally rather than where they get after working hard, and that can't have a positive effect on people who are not academically gifted. At the end of the article, Dr. Puhl is quoted as saying that what is really important is “character, intelligence, ambition, effort and contributions to society". However, I disagree that intelligence should be considered so important because we all face mental challenges at some point, and our innate cognitive abilities are less important than our determination and willingness to work hard.

  180. Next, we'll have a protected class for people who claim "cognitive disadvantage."

  181. No, ageism is the last socially acceptable prejudice.

  182. Apparently, we will simply elect them to high office.

  183. Proof of anti-fat bigotry? How resentful people become on an airplane when their seatmate turns out to be wide, but not when their seatmate turns out to be tall. I've observed stinkeye against fat passengers but never against someone 6'6" trying to fit his long legs and torso ahead of or behind them. Being extremely tall inconveniences one's fellow airplane passengers as much as being extremely fleshy, but it provokes zero rage. The health rationale for fat-phobia won't work here. You might be mad about paying for other people's diseases, but you're not doing that on an airplane. Maybe it's a coincidence that almost everyone over six feet tall is a man while passengers who infuriate others for existing in a fat state in coach are often female.

  184. Tall people tend to be more of a bother for people in front and behind them (if they recline the seat) Fat people take up real estate sideways, which is unpleasant for those at the sides. Most people do not want others touching them; easily avoided with tall thin people, but not so much with the obese.

  185. I find it annoying when a tall person takes a seat in front of me at the theatre--because I'll probably be inconvenienced. Similarly when an overweight person sits next to me. I certainly don't hate or blame those people. But the fact is they are likely to impinge on my experience of the play or the flight. You understand that, right?

  186. What? The person next to the fat person is resentful because the fat person is impinging on the other person's already tiny amount of space. The person is resentful because the fat person puts up the arm rest so that he or she will have more room, which means that I am squished. My brother-in-law is a very large man, probably 300 pounds -- and he always books 2 seats. He doesn't expect someone else to pay for his extra space on the airplane. I am more amenable to paying for other people's diseases than I am to paying for someone else's airplane seat. If I'm on the window seat and the fat person's seat is between me and the aisle, there is an excellent chance that it is going to take longer for me to get off the plane because the fat person has to heave out of his or her seat. One tries not to think about exiting in an emergency. LadyProf's comment seems, to me, to be flagrantly insensitive to the experience of the people around her.

  187. "Norm" is not a dirty word. It is not discriminatory; it is not make-believe. (Which is not to say that it has not been misused, e.g., the fashion industry).

    But if one looks to the internet and advertising expecting Truth, stop.

  188. "(The studies lead author) traced the origins of weight bias to ... society at large...(which) blames people for being fat."

    The author of this piece insinuates that the average overweight individual bears little or no responsibility for their weight. She then goes on to detail all of the disordered eating, the decreased likelihood to change food choices or increase exercise when people are "fat shamed" (or even perceive themselves to be). the author seems to want to have it both ways: argue that the obesity epidemic has little or nothing to do with choices, and then blame poor choices that increase the obesity epidemic on the biases of individuals who weigh less.

    Also, the "food desert" narrative is a myth. Food deserts exist because of the dietary preferences of the people (many of whom are overweight) living within them. People are not overweight because of food deserts. Also a common media-driven myth: eating healthy is necessarily expensive.

    --JHU MPH

  189. MPP,
    you are misinformed. Food deserts DO exist, as supported by studies. In the city of St. Louis there are areas where there is no grocery store for miles around and the people have to take busses to get to the nearest one. Not an easy task if you are disabled or elderly or if you want your cold items to keep from spoiling.

    YOU try eating healthy when the only place nearby is a convenience store.

  190. The problem here is not an moral one it is a major Public Health issue that to date has not been embraced in a fundamental way by the majority or the politicians they vote for. Imagine how it might be if a politician got elected on a promise to "make America great again " and then followed up with the public health measures required to get there.

  191. When you are overweight the first person who bullies you is generally your mother. As you get older you dread the obligatory family visit because you know that the first thing your mom is going to do is comment on your weight and it always ends with the "I'm just saying this because I love you." Family is crueler than any outsider would ever dream of being.

    I'm obese. I was an active child and teenager who was thin and muscular. But when I was 14 I was diagnosed with epilepsy and one of the side effects of my medication was that it damaged my metabolism. The weight gain was gradual because the doctors were constantly adjusting my meds which made the damage worse.

    Even after I stopped taking my meds because they didn't work the damage was done. I'm active but even still I have accepted that the body I had pre-med will never return. All I can do is stay active and eat healthy.

    Does it bother me that people assume I'm lazy because I'm obese; absolutely. But I find that I can't do anything to change the mind of those ​who have already formed an opinion without bothering to find out the facts. All I can do is soldier on and try not to let it get to me.

  192. Mothers are damned if they do, damned if they don't.

    Obesity is self-medication of anxiety or other mental health issues.
    Mothers who aren't aware of this put their child on a diet and/or sign them up for exercise regimens. They're trying to help. If they did nothing, their kids would grow up and blame them for doing nothing.

    Mothers who are aware of the problem for what it is seek mental health treatment that often includes anti-anxiety meds. Then they're damned for "drugging" their child.

    Very few people are innately equipped to deal with mental health issues in their own children or other adults.
    Any adult who is obese is self-medicating and not taking steps to address the underlying mental health issues; blaming one's parent is pointless.

  193. Honeybee did you read Ami's post? She developed epilepsy, and the medication for that condition changed her metabolism, causing her to gain weight. It had nothing to do with mental health.

  194. I have a lot of friends who have described their mothers tormenting them as a child about their weight. The same mother who fills the house with unhealthy food. I find it shocking. My mother was certainly not perfect, but thankfully, all the women in my life when I was a child either didn't think about this stuff, or certainly didn't share it with children.

  195. Well what is it ?...Is being overweight killing us or is "fat shaming'...Make up your minds liberals !...You are the first to tell us what to eat as to not become overweight but when someone points out an overweight person you hypocrites are the first to blast at anyone pointing it out !...so which is it ?

  196. I hear you. I understand the dilemma. But I don't think liberals are confusing us. Should there be a public posture that exhorts people to be healthy, eat healthy, be active, with the obvious result being a population that looks a particular way? Or not? You tell me. I don't know. What I do know is that no particular political philosophy created this health question.

  197. @Tom: Really. "Liberals". I suspect that most of the many people speaking out here against normalizing obesity are liberal in some respects. They don't fit your lazy stereotype. Why do you need to conjure up a caricature and apply it to 100 million (give or take) people?

  198. The middle and South of the country is the most overweight and that is Trump country. Trump-shaming is probably enough for those people.

  199. I think there's a fairly simply explanation for the so-called 'fat bias' the author is attempting to describe. In almost all cases, there is a very simple reason why some people are fat and some people are not fat. Fat people eat too many calories. It's that simple. Yes, there are rare medical conditions that cause some to be too thin, some to be too heavy, but these are the exceptions and they do not explain the huge increase in morbid obesity in the US.

    In an America of gargantuan portion sizes of food that resembles throw-up covered in cheese, it takes quite a bit of will power to avoid overeating. It's a struggle I live with everyday, and no one would describe me as thin....but also probably not fat. So, when I see an obese person I do have a bias against them due to the physical manifestation of their lack of discipline in their everyday life. Who doesn't want to sit around all day and eat? If I could avoid the immediate weight gain, I'd start tomorrow.

    Being obese should not be 'normalized'. It should be discouraged and healthier lifestyles should be pushed at the earliest possible age.

  200. This view denies the facts that genetics do cause weight gain. Weight control is not as easy for some people as it is for others. Some people have fast metabolisms and some have slow ones.

  201. I never cease to be amazed by the number of utterly unqualified people who employ the word "simple" to address an issue which medical research increasingly shows is not simple at all. Study after study verifies that it's NOT just "calories in, calories out"; that there's still a great deal we don't know about metabolism; that people who successfully lose a lot of weight fail to keep it off about 95% of the time even when they maintain their lifestyle changes; that the industrialized world is full of people who are fat who do not, in fact, "just sit around and eat" (which I'd argue that relatively few people really want to do anyway); and that shame and stigma do absolutely nothing to help people lose weight or maintain weight loss. These are medical facts. But none of that weighs for a second with people who need someone to look down and need the world to be "simple." It HAS to be an issue of morals and character, or else--OMG--we'd have to get serious about addressing food deserts, the processed food industry, the culture of overwork in the U.S., the connection between obesity and poverty (the latter, if anyone cares, is the single greatest predictor of the former), the class-based components of body shaming, and the mysteries of metabolism. We'd have to support people instead of finding reasons to condemn them. And I guess we all know THAT's not going to happen.

  202. @KCF:
    There is a very simple reason why some teams win games and others don't. The winning teams score more points. This is the essence of "calorie logic" -- perfectly true and also perfectly useless to explain _why_ people are overeating, or why overeating has increased on a population level.

  203. Early in this decade, I took a trip to Western Europe, to see the sights, and perhaps gain some insights into how other societies function.

    While in France, I noticed that there were almost no fat people. Then I took notice of how the French ate. They consumed many kinds of food I had never before seen or eaten, such a foie gras, but always in moderate or small portions. Sweet and calorie-rich foods were on the menu, in small portions. And the French spent a great deal of time (by American standards) eating their meals.

    The French way of eating was almost completely the opposite of the modern American way of eating, with super-sized portions, lots of fat, sugar, and salt, and meals wolfed down in a few minutes. On matters gastronomic, we could learn a few things from the French. Bon appetit!

  204. so true, I have lived in Italy for years and can tell you that despite all the pastas, breads, risottos, etc people are generally thin....that is changing however as more processed foods become acceptable. I think the answers are truly more complicated than we think, genetics and processed foods all playing a role.

  205. They also don't drive as much and have less screen time. They don't work as many hours and they have longer vacations and lunch hours. Meals are a family social event, where everyone sits down at the table and has a conversation. Food is not convenient, it is to be savored. The smaller portions are just the tip of the iceberg. In some ways, I think the American way of eating is a response to stress, and a big part of that stress is that we lack the structures and protections that allow people to live more family- and community-based lives.

  206. " a society-wide reformation that may help to absolve them of personal responsibility for their weight." Utterly ridiculous. If weight isn't a personal responsibility, I don't know what is, beyond the rare individual with a true disorder. My wife and I recently visited the Portland, OR area. Not a fat person in sight. Back home in Iowa where body fat has become normalized, nearly two thirds are huge. The state capital has bacon festivals, the state fair offers deep fried cheeseburgers. This will have a major wave of impact on those needing, among other things, liver transplants, knee surgery, heart surgery, starting in about four years.

  207. I'm from Portland, and we used to have a normal number of fat people here. The reason we don't anymore is that all our lower-income people have been pushed out of the city. If you want to get rid of your fat people in Iowa, make your city so trendy that it gentrifies. They'll all be forced out into the burbs, and, as long as you can afford to stay in the city yourself, you won't have to put up with fat people anymore.

  208. Oh man! A deep-fried cheeseburger... I'll be dreaming of that one! You didn't make that one up, did you?

  209. It might be worthwhile to clear up one point. Genetics is not causing the current obesity epidemic. Processed foods/snack foods/fast foods are causing the epidemic. Genetics plays a role. It creates some bodies that can survive in the current unhealthy food environment without gaining excess weight. Genetics makes it much more difficult for others.

    To the point of the article: I understand fat-bias. I was a fat uncoordinated kid and did not have a happy childhood as a consequence. I grew out of some of that fat, but at about the age of 30 started putting on weight again. At that point I took control of my weight and, using what most consider extreme measures, I have kept my weight under control for the 40 odd years since. I am vegan, eat almost no packaged foods of any kind, never eat snacks, sodas or fast food and still have to strictly control the quantities to keep my weight in check.

    I will confess that in spite of my understanding of how difficult it can be for some people to control their weight, I still have an ingrained negative reaction to obese people. I keep this reaction to myself, hopefully successfully.

  210. I'm glad all the commenters on this article appear to have worked out perfectly the solution to weight equilibrium and have never suffered from unwanted weight gain or eating disorder. Eat less! Exercise more! Overweight people have never heard that one! The self-righteousness dripping from the vast majority of these comments simply underscores the author's very points on fat bias. (And no, being fat does not automatically mean you are unhealthy, despite what all these armchair physicians here seem to think.)

  211. thin people get sick and die too!

  212. I believe that have done studies that people who survived those camps tended to put on quite a bit of weight--the body again, looking out.

  213. @Jus Me NYT:
    It's no secret that any animal will lose weight when forcibly starved. Do you think that imprisoning the obese and rationing their food is a good solution?

  214. To all of the commenters on the far side of the "being overweight is not self-inflicted" side of the spectrum:

    I have been to the grocery store at least 1,000 times during my life. I've seen thousands of individuals with their food selections. For every 30 people who are not significantly overweight (or unhealthily thin), and are buying plenty of garbage and empty calories causing me to think "how can he/she eat like that and not be obese," I see maybe 1 overweight individual buying majority healthy selections and think "it's surprising this individual is struggling with their weight given these food choices." What does that tell you?

    Also, there is a difference between "fat shaming" and being against "fat acceptance" in a country where obesity is an epidemic and a serious public health problem. Yes, there is much much more to people than their weight. And yes, some overweight individuals do have underlying health issues causing or contributing to their weight, and an even larger issue is parents who instill poor eating habits and/or feed their kids garbage leading to overweight kids who eventually become overweight adults. And once an individual is overweight, keeping the weight off after losing it can be very difficult due to hormonal and metabolic changes. However, you can treat people as individuals without accepting a 30% obesity rate in the U.S. Fat-shaming isn't the answer for improving public health, but simply accepting obesity as OK isn't either.

    --JHU MPH

  215. MPP1717, who reports that he/she has carefully observed the food selections of thousands of overweight people while doing her own grocery shopping, asks, "What does that tell you?"

    It tells me that MPP1717 has perfected the skill of looking down on people while keeping one's nose in the air.

  216. It tells me that you make assumptions based on what you see in one grocery selection. What do you think when you see the same people in the fast food line?

  217. Wow, just wow.

    No, call it observations and (mostly valid) conclusions drawn. Just like we learn about so many things in life. People smoke, they die earlier, conclusion drawn.

    Grocery cart observation is fun and informing. As noted, relatively few fat or obese people, in my observations, have the cart loaded with healthy foods. Real foods, as I call them. More typically, processed, food "products" vs. natural, starchy, sugery foods. Even non-diet sodas!

  218. Some of the responses are so cruel, self righteous, and also ignorant of some known pitfalls of chronic dieting - that you might think that fat people were terrorists. What is it that elicits so much fear and anger, and the desire to hurt someone? That might be a good subject for study.

  219. The response to condoning or enabling obesity is not a desire to hurt people. Overweight people are hurting themselves and the rest of the population through increased health issues that plague individual lives and cost the rest of us more due to their health issues.

    I will never hesitate to call attention to that fact.

  220. Well aren't YOU The Responsible Citizen Of the World.
    Think about it: Are you really sure that every single overweight person you meet is overweight primarily because they're irresponsible and don't care about the rest of us?
    And do you also call attention to the "fact" of smokers' health issues? How about people who drive too fast? Do you also track with those who engage in irresponsible sexual activity? Have you made certain you count the steps of all those around you on a daily basis to ensure they are exercising adequately? Because, y'know, it's possible to be svelte but unhealthy--my cousin, a size 2, just had quadruple bypass surgery! Hmm. You've got a LOT of work to do, O Citizen.

  221. My sister, the skinny sister, has a stent and COPD.

  222. Being obese should perhaps not be "normalized" (i.e., of course healthful eating and behaviors should be encouraged), but neither should the stigma against obese people. The article is not about whether being obese is healthy or not, or who or what is to blame. It's about all the rest of us who feel no guilt over our prejudice toward obese people. Like we are somehow superior because we can control our weight. Has it not occurred to any of us that everyone's life is complicated? And sometimes those complications manifest as eating disorders, and sometimes they manifest as being in debt, and sometimes they manifest as having mean miserable personalities, and sometimes they manifest as greediness, and sometimes....etc. Not everyone has the brainspace, money, or time to monitor every aspect of their lives in perfect harmony. But everyone deserves simple human respect.

    And to the author's friend who "can't stand to be around fat people" who claims she can't pinpoint the source of her feelings: whether you developed the bias at age three or not, you're an adult now. Think for two seconds.

  223. An individual's obesity is more of a threat than weight bias.

  224. I disagree. Shame is lethal. If you're obese, shame will keep you obese. Shame makes you withdraw from life.

  225. A threat to whom? To what? To people wanting to achieve perfect bodies? To their co-workers' senses of beauty and aesthetics? What kind of "threat" does obesity pose?

  226. Fine. Enable.

    Or, change. As many have done.

  227. While I don't want to give off a 'holier than thou' vibe, I would like to add (as many have before) that accepting obesity, while civil in the short run, comes with dangerous consequences. It means supporting and encouraging an individual's poor health choices - akin to cheering on smokers for their life choices. It (ultimately) results in increased medical costs, loss of productivity, shortened lifespans, etc. (the list really does go on). Those are, ultimately, the sources of the stigma. Those who are averse to the aesthetic of obesity are shallow and are often the true bullies.
    Acting on this stigma is wrong. Period.
    But carte-blance acceptance of obesity is also wrong.
    I have lost 100 lbs. myself and am very conscious of this problem as someone whose lived on both sides of the stigma. I believe in self-acceptance, but I also believe in self responsibility. It is important to reconcile both of these ideas and understand that they are two sides of the same coin. Taking care of your body and maintaining a (somewhat) reasonable weight/BMI is an important aspect in any person's life.

  228. Have you ever thought that people can make healthy choices and still be overweight? Or because you were able to lose weight, it is always a matter of willpower and mind over food?

  229. Whenever I notice that I tire more quickly when walking up the stairs or taking my shopping back home (up to 20 pounds in a backpack in a town which has a number of hills), I know I have to watch what I eat. That warning sign works every time.

  230. Respectfully disagree. The source of the stigma is that many (if not most) people find fat people unattractive.

  231. Just want to comment on the final quote in the article: I take issue with the inclusion of "intelligence" among the determinants of self-worth. How is that quality any more within the purview of one's control than body shape or size? Why should it be something on which self-worth hinges? What about the intellectually disabled among us, or those who are simply less "smart" in the ways that our society tends to value and venerate? Are they worth any less than those endowed with higher IQs? I believe that a person- any and every person- possesses self-worth is inviolate and unconditional.

  232. *self-worth THAT is...

  233. When I was a kid we teased fat people. Never as seriously as that against "Fatso" in "From Here to Eternity". But we never had to deal with obese people. Ernest Borgnine (the actor who played "Fatso") and Jackie Gleason were fat, more or less. But they did not come close to the obesity we see today.
    Wanting obese people to lose weight yet not having an effective way to communicate that desire.
    Conundrum defined?

  234. You don't need to tell overweight people that they need to lose weight. They already know that and messages come in every day that let them know that. There is plenty of ways that message is communicated. Other people don't need to tell them directly.

  235. I rarely see obesity today, and many people cannot control the genetics that led them to gain weight. Blaming their willpower for something outside of their control is blaming the victim. Willpower will not speed up a slow metabolism.

  236. You may or may not be a doctor, but, who asked you to deal with 'fat' people. Self-appointed commenters in this society are unnecessary, except when we are talking about the political, economic or social issues which will impact this country. Please don't cry to me about the cost of treating 'fat people'. The truth is probably that fat people don't seek medical care, so pleeese!

  237. The comments here debating willpower vs genes make me think of a program I heard about genetics recently, and how they are not static, but subject to change based on conditions. When populations have to endure famines or periods of starvation, even if brief, it can cause mutations that in effect can doom descendants to a tendency toward obesity. It's not in every descendant, and they don't know what activates it in some and not others. But I vividly remember them saying the effect can carry forward for multiple generations. The genes change to cause the body to conserve food as fat for survival, and also cause a predisposition to seek high-caloric foods. Yes people who are overweight eat a lot, but have we ever really objectively wondered about the possible causes of overeating other than to assume it's gluttony or lack of willpower?

  238. In Nessa Carrey's book The Epigenetics Revolution this factor is also mentioned, and it explained why, after my teens, I was never as slender as my mother was. In the first World War my grandmother was exposed to starvation conditions before my mother was born, and while I am not obese, my body loves to store every extra calorie it can get. But, mind you, it is not actually a factor for obesity, it is only that the genes controlling the body's reaction to nutrients have been modified, so that the body is in a hoarding mode on a permanent basuis.

    Oh, one little incident from my teaching days. In a 5th grade, there was one girl in my class who was obese, and the pupils introduced her to me with the words: "This is --- ; isn't she darling?" She was exactly that, always cheerful, and whoever risked teasing her had to account to her classmates.

  239. (to Francois) I've read something similar, about a study of people in some non-western country (I forget where) - what was observed was that the cohort of adults whose mothers had been pregnant with them during a major famine were heavier than those born in years before or years after.

  240. Perhaps the question, then, is "weight" simply not talked about in any shape or form (no pun intended)? Do we express nothing but sympathy for those overweight, thus create an atmosphere of deterministic, not-your-fault-you-bear-no-responsibility attitude?....

    ....or, with care and understanding, prompt/critique those with weight problems to (1) change their diet, and (2) become more (and more) active, (3) other (medical, etc., needs)?

    The latter, IMO, is necessary for anyone wishing to control or modify one's weight, but it is also foundational to everyone who wishes to "aim for good health". Yet, more and more often, to even point out a "weight problem" is viewed as an attack or other sort of discriminatory, hurtful, violent (?!) act...which is where I sort of lose my cool, because it ought not be cool nor acceptable at a national/general/normative level to "be fat" because in the long run, excess weight is a health issue. (And, whilst another topic in itself, we all end up paying for a person's weight problem in various ways, esp. in subsidizing insurance/medical costs.)

    Objectively, though, overweight humans are generally not healthy humans, and learning to manage one's lifestyle - limiting foods, eating more of other foods; creating an active lifestyle, etc. - is a well-researched, positive thing for *all* of us to do. Those with weight issues simply stand out.

  241. In 1959 when the first Barbie Doll came out, the two neighbor girls got real Mattel Barbie dolls, but I got a knock-off Barbie. Her frame was a wee bit bigger, so the clothes did not quite fit--they were a tiny bit snug. I remember my friends noticing and saying "your Barbie is fat". Even at age five, I felt shame, and it was not even my body, but a doll's!

  242. How is it that so many people who are incapable of controlling their compulsion to post ignorant, judgmental, mean-spirited and outright cruel comments believe that it would be a simple matter for oversight people to control their food intake ?!!

  243. Like you?

  244. Why? Because a hundred million people DO manage to control their food intake.

  245. Why isn't this post a NYT pick?

  246. I'm not so sure about "implict" prejudices or bias -- about anything -- race, weight, thinness, redheads, -- may just be an invention of social science (like many other things they have "discovered").

    But this article does point up th4e fact that medical science has almost no clue as to the causes and no real cures (other than hack-and-slash surgery) for obesity.

    Good heavens, still going on about the long falsified "food deserts" theme -- as if the poor and uneducated will buy and eat "what we say is healthy for you" food if they just had an expensive Whole Foods market in the neighborhood.

  247. The "Fat Bias" does, indeed, run deep. The Catholic Church deemed gluttony one of the 7 Deadly Sins. Also, there is a tendency in us to gain extra pounds once we hit middle age. There are a lot worse things to be guilty of than eating too much. The only issue I have with overweight friends is the health hazard.

  248. Some prejudices are inherently unfair. No one can change the color of her skin, or his height, or sexual orientation. However, being obese, is more often than not, a sign of food addiction, probably one of the last addiction that has escaped the contempt felt for other extreme dependencies, such as on drugs, alcohol, gambling, etc. In addition, rampant commercial interests have decided it's better to sell clothes to fat people than not. Therefore, the rise of plus size models. To defend or accept obesity as part of diversity is simply wrong. Somethings such as addictions can be helped and should be addressed by those suffering from them for their own health and for the society at large that has to foot the bill for the health problems of the obese. Why should an obese people be considered any healthier or more in control of their lives than alcoholics?

  249. SMS -- there are some fat people who are truly "food addicts."

    But not most.

    The further stigmatization of fat people as also being mentally ill is an effort to reinforce negative stereotypes and unfair discrimination.

    (And PS -- given the comments posted here about aversion to fat people, I think most folks are probably glad not to live in a world where fat people are naked, which is what we'd be if those "rampant commercial interests" hadn't "decided it's better to sell clothes to fat people than not." Whatever that meant.)

  250. Should the fat among us go naked? Or maybe only wear sack-cloth and ashes as they are not worthy of any clothing that is boring let alone attractive?

  251. Unrestricted access to high calorie food a relatively new phenomenon.
    As a health care professional I see large number of complications directly related to obesity.
    Humans are not designed to be obese.
    its not a normal state of being.
    I blame food industry.
    I have seen people who feed their toddlers blended KFC .
    That is shameful

  252. Saying that shaming people for being fat is counterproductive doesn't mean you are encouraging obesity. It is certainly valid to encourage healthy behavior if you really want to help people, but you don't need to shame anyone to do it. Shaming other only helps you feel better, and does nothing to help the person being shamed. None of us need to be holier-than-thou about our lifestyles, because we all have something that we do that might create costs for society (even athletes have sometimes costly injuries that non-athletes don't have).
    To make it even worse, not all the people being fat-shamed are really obese or even overweight, much less unhealthy -- especially among children and teens. There are also medical and mental health issues that make it very difficult for some people to maintain weight, and shaming them isn't going to help them at all.
    The lifestyle choices of other people are, quite frankly, nobody's business except their own unless they are harming another person, and any treatment for obesity or the need thereof is a subject that -- as with any medical disorder -- should concern only the patient and their doctor.

  253. Dare we mention class in this discussion? I come from peasants on both sides. All grandparents were immigrants. They lived off the land, which meant they went through times of famine or near famine. Our metabolisms were obviously designed to keep us alive in times of little food. They weren't fat--but all their descendants are. They weren't dumb, either, and have been very successful in America. But spending a life struggling with weight has caused me to think about this a lot. We are definitely genetically programmed, no matter what we do. I never eat fast food, I stopped using salt in the 60s. I grew up only having dessert on Sunday and candy on holidays. I never bought into diet drinks--i just drank water. I did use sugar and cream in my one coffee a day--now I use agave instead. I eat small portions of healthy food and have for decades. It is a constant struggle to convince my body I am not going to starve, and it is frustrating. I am not obese, but it seems I will always be overweight. Attitudes from small minded not very smart people don't help.

  254. Calannie--your post totally underscores something I posted as well. On the NPR program Radiolab there was an episode about genetics, and the science has shown that periods of famine, however brief, can alter someone's genes to slow metabolism, preserve fat at all costs, and seek high fat foods. This can affect descendants for multiple generations. They just don't know what triggers it in some descendants and not others.

  255. I also have similar ancestry. When I read the humorous book "A short history of tractors in Ukranian" I laughed so hard when the U.K. author described a conversation with her older Ukrainian relatives about losing weight, and they essential replied: why would you want to be skinny? When the famine comes you will be dead!

    I think about that every time I say I want to lose my last 10 lbs. Genetics aren't everything but they are important.

  256. AMEN!

  257. The school district I grew up in is currently failing to comply with the state's integration law. The board of education treats the law as unimportant, unreasonable, and impossible to follow. They treat it as a burden to begrudgingly attempt to follow with no guarantee of full compliance. School segregation is a heartbreaking form of institutional racism. Clearly fat bias is not the "last socially acceptable form of prejudice" since we are pretty adversarial to enforcing civil rights in our schools.

  258. Many commenters bring up the point of responsibility in one way or another. I would say that, yes, as adults we are each responsible for our own health. But... let's also say that doctors, dieticians, and various public health agencies have a responsibility to provide accurate and useful advice.

    The predominant official advice of the past several decades (eat less, exercise more, eat less fat, eat less meat, eat more carbohydrate, etc) has been ineffective at best, and is actively fattening for many people. What if people are following the official advice in good faith, but are still struggling with fat gain? Then where does responsibility lie?

  259. I gained weight all of a sudden when my mom was ill and dying - a combo of grief, lack of time and energy for my usual daily biking and hiking, and eating more comfort foods and foods picked up on the run. I totally noticed how being fat affected people's interactions with me. It is difficult to describe, but when you are accustomed to people treating you in a certain way and it suddenly changes, it's very noticeable and very hurtful.

  260. It is a difficult problem. Clearly, we don't want people to be obese because it is so unhealthy for that person individually, and also because obesity adds to our skyrocketing health care costs.

    But clearly "fat shaming" is not an effective solution to obesity, because we have plenty of both in our society (fat shaming and obesity).

    The easy, quick, cheap availability of addictive processed foods are part of the problem. We need to somehow transform our society away from relying so much on those types of foods. How we do that, I don't know.

  261. Good education and universal healthcare are fundamentally basis of a respectful and inclusive society .
    Some citizens might fall through the cracks , but the greatest majority will contribute to a successful citizenry.
    The few unlucky ones must be helped by all means to overcome their status.
    This article focuses on a widespread phenomenon of discrimination and bias towards our minorities , African Americans in particular.
    The recent obnoxious demonstrations by the alt right movement with the complacent silence of most elected politicians and the highly controversial response of the " so called " president , have generated an insidious effect of perpetration of this dirty politics towards the unlucky of us afflicted by poverty , poor education and lack of adequate healthcare.
    The ones with children are suffering the most in this rich America.

  262. Healthy eating is expensive and/or time-consuming.

    Yesterday I bought two delicious donut peaches. $2.50, which would be a chunk out of minimum wage when you are spending, say, $2.75 for a subway ride to work. I bought a piece of salmon for $9.00 and a demo-baguette for $2.79.

    Last weekend, I bought a lovely organic baseball squash, a portobello mushroom, and brown rice. I plan to grill the vegetables and steam the rice. This will take me about a half-an-hour, not counting the time it takes to go to a farmer's market and the clean-up. I don't work two jobs so taking that time to cook is something that can enjoy.

    On the other hand, when I walk into the local Food Emporium (which I do only when I am in a rush and where I am sure to get limp lettuce and mealy apples), there are stacks of chips and cupcakes invitingly and displayed and on sale. And these foods are engineered to encourage binge-eating.

    So I enjoy the luxury of having the time and money to buy good nutritious food.

    There are many reasons for obesity, but our culture virtually guarantees that none of these can be addressed. But it shouldn't be a matter of privilege to enjoy a healthy and nutritious food.

  263. That it is necessarily expensive to eat healthy is a myth: healthy proteins like eggs, sardines, beans all inexpensive. Fiber from kidney beans, black beans, chick peas, garbanzo beans, oats, apples and other fruits (when in season), all cheap. Veggies like cauliflower, green beans, carrots, tomatos, corn all inexpensive. Nutrients from sweet potatos, plantains, bananas--cheap. Starches like rice and potatos--cheap. I could go on for a long time...

  264. Fancy stores have really tempting treats too, so I'm not really following your argument. And I'm pretty sure that there are un-mealy apples for sale, at the discount store, or even applesauce would be a better choice than an apple pie. It takes about 3 minutes to steam a few cups of spinach or broccoli, maybe even faster in a microwave. And a 5 bean salad takes about 2 minutes, from a bunch of cans.

  265. Schools, both K-12 as well as University, really need to train their students how to focus on the substantial rather than superficial. The effect of the ability to view things intelligently is better jobs, better positions in society. Higher income should motivate these students to work-on this skill.

  266. Very commendable. But at the same time, we live in a culture that worships the image. Everyone is expected to look camera-ready 24/7. Being unphotogenic, which includes being seriously overweight or obese, doesn't cut it.

    The kids are responding to the world they encounter, not the world as it should be.

  267. This article is so true and that is why as a psychologist who lost 51 pounds (20% of my body weight) I wrote the New No Gimmick Diet. As someone who is still not skinny the comments I received either directly or indirectly only reinforce that society does not support reasonable efforts on weight loss. Being told that a diet book had to have a "gimmick" and the snide remarks that I could still lose more weight only made me want to share the hard work it is to lose weight and the much harder work of keeping it off. The very people who think that they are inspiring weight loss actually undermine reasonable efforts to be a healthier size. In our culture the images and messages of what should be our goal do not support reasonable weight loss.

  268. Excellent article. Often you encounter those who focus on social stigmas or those focused on the pragmatic elements of weight loss: PhDs traditionally had the luxury to compartmentalize the two. None of the rest of us do. Still, this only hints at how addressing how the internalized stigma does not necessarily end even if you "look normal" and how that influences longterm weight maintenance. I can say for myself, I never really understood fat prejudice until I lost 200 pounds 12 years ago, and spending 10 years to create a space for post-weight men and women only confirmed how ingrained that stigma is upon the very industries we count on for solutions. What other reason would recidivism rates be what they are?

  269. I know that just getting older changed the metabolism of my body so that I gained weight more easily by eating the same amounts as when I was younger. At the moment, I have to literally fast for four days straight in order to successfully lost weight because my metabolism is so much slower than it used to be. Some people diet by eating five days and fasting two days, but I have to fast five days in order to eat for two days. I see weight bias all around me--my students (two boys in 7th and 10th grade made explicit comments); in potential employers whose faces fell when they saw for the first time I was overweight. No employer will say outloud, "Sorry but your overweight look would be bad for our school brand so we are not going to hire you," but this is certainly apparent from their actions. Schools are concerned about their brand image with parents, students, alumni, etc, and a person who is overweight confuses that brand image.

  270. Have you been to a doctor? How can you be fasting so many days? Aren't you starving? Most slender people eat every day. Unless for religious reasons you shouldn't need to fast to be a normal--not model thin-weight.

  271. You eat two days a week? Wow. Amazing...This can't be healthy. Do you feel tired--food is energy.

  272. Making obese people feel bad about themselves is wrong. Bullying is wrong. Respect others, etc. Nothing new here.
    But it is also wrong to not promote healthy life-styles openly and pretend it is normal (careful of how one uses the term "acceptable") to be obese so that feelings aren't hurt. The WALL-E spaceship world wasn't supposed to be a future utopian goal to remove "fat-shaming".

    And not finding obese people especially attractive is not discrimination. I also don't find very skinny people attractive. So what? Don't shame me for my preferences which happen to align with healthy individuals. This is the type of rhetoric that gets Trump supporters going: extreme PC.

    And their health problems can make them more expensive to employ (Yes, I've experienced this firsthand) so there is an economic slant to this.

  273. Jane Brody encourages weight control in probably 50% of her articles. It's a regular thing she promotes.

  274. Promote healthy life styles all you want. No one is saying that eating an appropriately balanced diet and exercising are bad. But at the same time, stop thinking that "health" can be measured with a scale. Engaging in healthy behaviors isn't going to make everyone thin.

  275. What a mishmash of relevant and irrelevant anecdotes!

    Yes, there is anti-fat bias based on looks. But a parent's monitoring a child's food intake to ensure healthy choices and prevent obesity is part of the job of a parent, along with training a child in traffic and fire safety.

  276. I'm not seeing, in the comments I've read so far -- many blaming parents for their kids' poor eating habits -- any recognition that some parents can't easily give their youngsters healthy food because they can't afford it (and don't have time to cook it). They work three jobs to make ends meet, and fresh fruit and veggies are stylishly expensive. Kids eat mac & cheese, or ramen, or spuds, because that's what their parents can buy. It's much easier to eat healthfully, and feed your kids well, if you are well off.

  277. Did you read the article? Too much monitoring can lead to overeating. You have to be very careful as a parent, not to plant the seed of overeating by critiquing weight and food choices. Obviously, you're the adult and you need to make the big decisions about meals, etc., but micromanaging will backfire every time.

  278. Any Walmart has huge selections of vegetables and fruits at prices that are way below those of the pizzas and chips and hot dogs and all the mountains of other junk that fill the miles of aisles -- and the shopping carts of people who don't know or care about eating well.

    I work (as a tutor) with low-income (or no-income) families. I know what they have to spend. They have sufficient funds to eat healthfully. There are food banks all around. Stop spreading nonsense, please.

  279. I'm all for people accepting themselves, and going beyond what is seen on the outside to find and appreciate the person within. But we can't deny the fact that obesity is a serious health issue and a huge cost to health care. It is not always due to "personal irresponsibility," etc., but it has gotten more prevalent over the decades.

    That said...

    Believe it or not, the uncomfortable feeling of being looked at differently because of size is a two-way street. I am a lifetime member of Weight Watchers who has been at my goal weight for nearly five years. I go to the weekly meetings because I need the accountability. There have been times when I've caught someone's eye while waiting on the scale, or I'll see someone give me a puzzled, somewhat hostile look, implying, "What are YOU doing here?" I'm there for the same reason everyone else is, so please don't judge ME. I admit -- I do feel uncomfortable. And yes, I also admit there are times when I struggle with the concept of fat acceptance, and feel sad at the number of obese and morbidly obese people I see daily. But, I am human, just like those who wonder what I'm doing at a WW meeting.

    A WW leader once spoke about this. She reminded us that we cannot judge others. We don't know their stories; we don't know their lives. We can acknowledge the issue of obesity without the accompanying judgments or assumptions. We are all on our own journeys, doing the best we can, and, hopefully, supporting each other along the way.

  280. I hear you. I've been near ideal weight most of my life, but when I turned 60 I soon got an extra 10 pounds I didn't want or need. Metabolism changes, too much work, too little exercise, an extra glass of wine nightly - who knows, or cares, which. I seriously considered something like WW for support and accountability, but was also afraid of the "what are YOU doing here" looks.

  281. Maybe I can't judge other people but I can judge their statements. When they say that there is nothing they can do, and nothing they could ever do I don't believe it. I am not including the very few people with genetic and metabolic diseases, as well as people who are overweight because of medical treatments and injury.

  282. Karen Kressenberg,

    On My Fitness Pal, there's a group for women who need to lose weight, but not as much as the typical member. It was formed because many of the members felt that their problems weren't being taken seriously. Only you can decide what amount of weight gain bothers you.

  283. To see this phenomenon in action, look no further than the comments section of the recent article on the lack of work for overweight actresses. In the normally inclusive NYT, the typical response was, "Wanna star in movies? Lose weight, for God's sake!"

  284. Unfortunately, obesity is now becoming normalized due, of course, to the sheer number of fat people in this country. Heck, even the current president is likely technically obese. And it appears that things will get even worse in the future.

    In fact, things are so bad in many areas that if you took a world-class athlete in peak physical condition like, say, Roger Federer and let him mill around at the local county fair ... HE'S the one who would look freakish.

  285. I suspect there isn't one obese person who doesn't want to be skinny. That's our dream -- will it come true for me, probably not at my age. But I can keep trying. As for the discrimination, yes, it is very real -- I learned this fact of life early on. Put another way, imagine the comments I heard as a fat little red head. And of course, I was never a part of the "in-crowd."

    This is no pity me party for yes, I have some bad eating habits. But, when I look back at what I accomplished over the years -- college grad, Army Captain, gainfully employed, academic, writer, family man, tax payer, I guess being overweight is a minor thing in my grand scheme of life.

  286. I was the only "fat" one in my family being perhaps 10 lbs overweight. My father constantly brought it up as an issue and chastised me whenever I wanted seconds of any food. From the moment I left home, I've been eating non-stop. I know my obesity is my fault but I still resent his nastiness 50 years later. People should learn to MYOB.

  287. No, man, it's not your fault. That's what society wants to make you believe. Obesity is a disease and it needs treatment. Of course your willingness is essential to lose weight because lots of times you'll have to put an end to lunch or dinner still feeling hungry. But it pays off in the end because you'll be able to run a bus, squat to fasten your laces, climb a couple of flights of stairs without running short of breath, and lots of other things.

  288. It's our business because we will be paying for your poor health choices.

  289. Your father created a toxic dynamic and now doing good things for yourself seems as if you are ratifying the ugly things he said. You need to try to manage that. (Notice I don't say "overcome it" because that may not be possible.) Many of us have issues like that, but they may not involve food. Maybe seeing a therapist would help.

  290. A recent movie review comment pegged mocking West Virginia Hillbillies as the last acceptable public prejudice. So just imagine being an obese Appalachian hillbilly with accent. Throw in some lousy teeth and you´d never have half a chance for a job. Yet the US continues to rob people nationally of health care including preventive and dental and education. Its a cruel country.

    Sure kids mock fat kids. There used to be fewer of them. When I was in grade school in the early 1960´s there were typically 2 in a class of 30 skinny to normals, very little pudge at the time. I assume that´s from current poor eating plus much less running around for kids. But kids behaviours are designed to be moderated - that is the whole point of school and upbringing and "Lord of the Flies". If each of us tries today to see just one person for who they are, their hopes & desires & dreams & humor - hey we will all be better off.

  291. Kids in grade school don't treat each other poorly because of race. But they often do pick on their fat classmates. Why? Is it because the fat child is often unable to run, skip, hop, jump, throw a ball, swing a bat? Is it because the fat child eats like so many fat children do? (Have you watched them eat?)

    Little kids aren't learning their reactions to their fat classmates at home.

    (I've also noted over the years that the same children who pick on their fat classmates will never treat the special ed kids badly. Go watch.)

  292. This group of commenters is easily the most cruel, heartless folks I've ever seen write into the Times in years!
    Do you think your repitition and verbal abuse is a solution ? No! It is not ! So why do you do it? Because you want to feel superior !
    Your life is not in the shape you want it to be, so you'll be damned if you can't find someone to take out your well of self hate upon!
    Oh hey, there's an overweight person! Let me throw a mountain of heartless math equations at him and poof all his worries will be cured! This is why America is the way it is today. We have become a nation of heartless clods! i am ashamed of the majority of cold hearts here today.

  293. "Oh hey, there's an overweight person! Let me throw a mountain of heartless math equations at him and poof all his worries will be cured!"

    That's a total straw man. Most people who've lost weight or who are middle-aged and fairly sedentary understand the difficulties. It is you who are over-simplifying the arguments of people who think that healthy weights are achievable.

  294. you missed the point
    simple answer to complex issue
    will not repeat the debts

  295. Every parent who thinks fat little babies are cute should read this.

  296. Traditionally a chubby baby is a healthy baby. What person can resist chubby baby cheeks? Please don't put the babies or the children on diets. Also try to be more accepting of different healthy body types. Not every one is tall and thin. And many are dieting, and some obese do have health or emotional problems. Some very beautiful people also have health and emotional problems. We all have a bias in favor of the slender and beautiful and against the overweight. Women just a few pounds overweight can be very hard on themselves or judgmental. This article asks us not to solve, but first acknowledge the bias and its effects on ourselves and others. It's uncomfortable and interesting.

  297. My "fat baby" grew up to be a very thin, and at one time underweight adult who was advised by the doctor to gain weight.

  298. I was bullied for years....a very sensitive child who didn't overeat, but was overweight. It seriously hurt and honestly, it still hurts 30 years later.

  299. How could you be overweight as a child if you didn't overeat?

  300. lemonande without sugar.

  301. Here we go again.

    It is not a bias, an unfounded emotional response. The dislike of fat people is rooted in our DNA, in our reproductive searching for a mate. In an evolutionary context, if today's obese people even came to pass (I doubt it), they would have been a not self-supporting member of the tribe or group. Eating more food, not contributing due to physical limitations. Just like today, plus now we have medical expenses.

    My father cheerfully embrace anyone of any race, creed, color, blah, blah. His one "bias" was fat people. When hospice sent a 400 pound nurse who could barely get up the stairs, we had to ask for another.

    I have been obese and diabetic. I did something about it. You can, too.

  302. The fact that fat bias exists "even in obesity specialists" and other medical personnel can be deadly, because sometimes obesity is a sign of an underlying endocrine condition. I can't count how many times doctors and nurses told me to "go on a diet" before an endocrinologist discovered the pituitary tumor that would have eventually killed me.

  303. just look to your own crossword puzzle, nyt. you'll find cutesy puns two to three times a week that all lead to the answer obese. wiil shortz and crew have no problem making fun of obesity.

  304. Forget his show on NPR then. Thanks.

  305. Being very overweight is unhealthy and to a large part preventable. There are a number of basic steps you can take to prevent being very overweight. It should not be socially acceptable to act in a way that is harmful to your health. I wouldn't insult an obese person, but they are partially doing it to themselves and their children.
    1 - it starts with children. Don't give them lots of bad food.
    2 - don't eat garbage snacks
    3 - portion control. Put your food in a bowl don't just eat out of the bag.
    4 - use smaller plates, so you don't put too much food on your plate.
    5 - Don't be sedentary, at least do some walking.

  306. Have you ever lost a significant amount of weight? "Bad food"? Really?

  307. There are a number of basic steps you could take to increase your empathy and understanding. But I won't list them because they are as obvious as your little hints.

  308. Empathy is fine but this person is talking about how not to be heavy in the first place. There is nothing wrong with that. Overweight people now seem to disregard that part and only expect endless empathy etc for something only they can control.

  309. it goes both ways. my wife and I are both preternaturally thin. in many situations we stick out like sore thumbs. my wife is also 6' tall and has a very hard time forming friendships with other females who apparently don't like the comparison or feel we are obsessed with our diets and exercise, which is ridiculous. its a little disorienting as thin people are perceived as being self obsessed and snooty based solely on BMI.

  310. I have had the same problem as Rob and his wife. I have always been thin (the lowest healthy BMI for my height or a tad lower), and when I was younger I worked out and ran very regularly, which kept me fit, too. Since developing some autoimmune disease, it has become impossible to train like I used to, but I walk a few miles every day and do whatever I can to keep myself moving throughout the day. I have been happy with my body (most of the time--always room for improvement!) but have had people, especially since moving to the Midwest, comment on my being "too thin" and even asking me if I am anorexic. I have been ostracized from groups of heavier women at places of employment, had my daily lunch highly commented upon, comments made about thinness vs. "a little meat," etc. These same people were horrified if anyone even insinuated that being overweight is unhealthy or less attractive to some people! The hypocrisy of it all was too ironic.

  311. I have been thin my whole life and people had no problem talking about and making fun of my body. Heavier people were the worst.

  312. Obesity is not the last acceptable form of prejudice. And it is not the worst. Most of us are aware of our mistreatment of the obese. By contrast we discriminate against the mentally ill and have no idea that this is unacceptable.

  313. This is an excellent comment - I think you may be right about this form of discrimination. I had never thought of that. Thanks.

  314. A very important point. Thank you for pointing this out.

  315. heightism is the last acceptable form of prejudice.

  316. Whoa. There a whole lot of judging going on! Here's one more: isn't it shallow and unkind to dismiss people based on their appearance? I'm old enough to remember the adages don't judge a book by its cover and do unto others... .

  317. I'm old enough to remember when most people were thin and people who were obese didn't blame their weight gain on everything except themselves.

    I'm tired of the defeatist attitude and refuse to see morbid and super-morbid obesity normalized. I do not deny that it's a complex challenge for many people, but you cannot go through life carrying enormously more weight than your body was intended and expect to remain healthy. I will never mock you, but I am not going tell you that a 350-plus-pound model is beautiful just to make the Fat Acceptance people happy.

  318. And I am old enough to remember when medicine classified different body shapes as ectomorphs, mesomorphs, and endomorphs--and differences were accepted as a matter of fact. By the way, this season on Project Runway--the models are from size 2 to size 22.

  319. All those who still think it is a genetic condition that causes obesity should read the statistics on the rising rate of obesity in places where there was no obesity! All of Asia, with China and India with nearly 2 Billion people have alarming rates of increase in obesity due to Western life-style and food choices. Which means more motorized vehicles, office bound jobs, pizzas, burgers, KFC, french fries and sugary colas.
    So please face it - it is a life-style choice! Don't fool yourself in believing that it is out of your control.

  320. Go back and look at news photos of people from 75 years ago. There were fat people then, too. It's a class privilege to exercise and eat right and keep your cortisol levels down.

  321. Crowd shots of people all over the world show not a sign of the obesity apparent in U.S. photos of today. The upper classes never exercised as much as the workers in the fields. There have always been plants to eat -- even before we began cultivating and reaping in the fertile crescent.

    Do your research, A Reader.

  322. It's a "class privilege to exercise and eat right and keep cortisol levels down"? Huh??? Are you sure about that?

  323. Well, first of all, Americans seem to be the most obese people in the world, as is VERY frighteningly apparent when walking down any street in America or sitting in a coffee-shop where especially overweight people polish off large muffins and xtra-large, sweet, caramel-infused lattes with whipped cream for breakfast, or brandish large bags of fatty ugly-looking chips. So, don't tell me about genes! I find very overweight people very unappealing. There, I've said it! it's not a character-assassination and not "biased" or my "prejudice" but a question of esthetics, harmonious shapes and a dash of style. And I'm not talking about the crazy skinny obsession. Before I came to America (from Europe) in 1975 I had NEVER seen a grossly overweight person, so no prejudice. People have individual bodies and individual weights - well-rounded, a tad chubby and all is wonderful and part of a personality. Obesity is an epidemic and partly a choice, and needs to be treated, not glorified and accepted as the "new shape" we dare not address out of "consideration" for the "poor victim's" feelings. Let's stop finding murky excuses for unhealthy lives and physical laziness, and please, no "fat is beautiful" battle-cry and the resulting accusation of people who are trying to slap the label of "body-shamer" onto anybody who cares about their appearance and makes an effort to stay shapely. That's a word I like and find something to aspire to.

  324. Sabine -- the problem is that your "esthetic" preference is too often used to rationalize unfair discrimination. That's when it becomes a problem.

    No one is suggesting "glorifying" anything. It's simply a demand that people not be unfairly discriminated against because of the size of their bodies.

    Full stop.

  325. I kind of agree, but don't really understand the anger or resentment against the fat. I also wonder why it's so different in Europe and there are so few obese. I maintain a healthy weight with planning, but when I Europe I eat so much better and more. I typically walk instead of going to the gym. I always drop pants size without trying. It's harder to walk everywhere here unless you live in a city with good public transportation. But I still think we should do a better job especially for the young. People need to be very mindful and careful in the states. I wonder why it feels so different. I don't think all the blame helps.

  326. I do think our food has something to do with it. First, there was a study (article in the Atlantic last month or so) that determined an American eating the same diet, not just the same calories but the same foods, and getting the same exercise today as a person from the 1980s would weigh more (about 20% I think!). Second, the last time I spent a couple of weeks in Europe, I ate and drank more than I do here, walked more but did almost no intense exercise, and lost weight.

    I'm sure the obesity epidemic has many contributors, but removing addictive additives and unnatural junk from our food would undoubtedly help a lot of people.

  327. I share her friend's visceral revulsion at the obese. I try not to show it ... but also try to avoid them wherever possible (e.g. avoid 'all you can eat' buffet type restaurants, etc). In fairness to the obese - who probably can't help themselves (for any of 100 possible reasons) - laws and social attitudes ought to be non-discriminatory. Am unclear whether various prejudices (e.g., racial, or anti-gay, or against the elderly) is due to nature or nurture. For example, I feel slight disgust (but try not to show it) towards male gays, but not towards female gays. I feel no disgust at other races, but know that some (many?) people do. Not sure of the why re my own feelings.

  328. My God, if you are fat then you are FAT. It is up to YOU not to be fat. Control your caloric intake and exercise OUTSIDE or a GYM not the remote control on your tv or your game console.

  329. Only you can make yourself a kinder and more sensitive human being.

  330. Debatable here. I think he's going to need a lot of help. Of course, underneath it all he may not want to become a kinder or more sensitive human being.

  331. More weird research. The article states

    "The study’s lead author, Asheley C. Skinner, a public health researcher, said that prejudices that people are unaware of may predict their biased behaviors even better than explicit prejudice."

    Gee, how do we find the prejudices that people are unaware of? It must come from watching their behaviors. This is using the outcome to define the cause!

  332. There are tools to find implicit bias.