People have a lot to say about other folks' bodies. Arguable, too much to say, especially when it comes to people who are fat. So when it comes to someone like Lizzo — a talented and beautiful celebrity who's insistent on loving herself and empowering people who look like her to reject hiding and hating themselves — critics refuse to leave them alone.
Despite keeping her Twitter account set to private, last month, the singer was driven to respond to another onslaught of fatphobic and body shaming comments because of a video of one of her recent live performances, saying that the constant remarks were really starting to make her "hate the world," and she was "tired of explaining myself all the time." These attacks focused on another person's physical appearance, especially their weight, aren't new, and they intersect with issues like race, gender, and socioeconomic status. Scholars and advocates have spent decades researching and advancing a better understanding of fatphobia and efforts to eradicate it, but the work is arduous.
Sabrina Strings is a chancellor's fellow and associate professor of sociology at UC Irvine and the author of "Fearing the Black Body: The Racial Origins of Fat Phobia." Rachel Fox is a doctoral candidate at UC San Diego in the communication department and the science studies department, and is also a critical gender studies graduate who focuses on fat studies. She's also the co-author of an article from the Journal of Applied Social Psychology on combating weight stigma. Strings and Fox took some time to discuss fatphobia, the ways that it intersects with other issues, and its effects on people's lived experiences. (These interviews have been edited for length and clarity. )
Q:How did you first become interested in this topic of body weight and the stigma people have attached to it? What first brought you to this work focused on the stigma around body weight?
Strings:My grandmother left the south, an area around Atlanta in 1960 and headed to Los Angeles. When she arrived in L.A., for the first time, she's living working around a lot more White people. She was blown away by the number of White women she met who were on diets, and she was like, 'What is this?' Then, in the middle of the '90s, when I was a teenager, she would pull me into conversations about it, and she's like, "These White women are killing themselves to be thin. Why are White women dying to be thin?" She came from a context in which, first of all, you're Black under Jim Crow, you don't have a lot of food. Just getting enough food to eat was a big deal for her. Second of all, because of that, my grandmother was slender, and people would hit her with a bunch of different leg disses, like "chicken legs." Culturally, it was such a shock that she never really was able to wrap her mind around it, fully. Like, 'What are these White women doing?' Our close connection with her being my grandmother, one of my primary caretakers, was what drove me to become interested in this in the long run.
Fox:My first foray into fat studies was through the field of Health at Every Size [a program through the Association for Size Diversity and Health, creating an alternative to a weight-centered approach to treating patients], which is also sometimes called critical weight studies. Those are the folks who are really digging into the scientific, medical, and epidemiological research into obesity and asking, 'Is this real? Does it use rigorous methods? Are the conclusions justified by the data?' At the time, I wasn't even super aware of fat studies. I was just trained as a scientist and trained to understand this literature, so I got really interested in it. I was like, 'Ohhh, a lot of this is not sound science. A lot of this is very clearly biased, or pretty clearly motivated by pharmaceutical companies looking to create a market for their drugs.' At the time, it was really powerful and kind of transformative for me.
In a lot of ways, it was deeply personal because I am fat, I've been fat my whole life, and it really helped me make sense of a lot of the ways that I have been treated, especially by medicine. One thing in particular that comes out of Health at Every Size and critical weight studies is the idea that maybe a lot of the harms, or the illness, or the pathology that we associate with "obesity" actually comes from discrimination, stigma, and withholding medical care from fat people. I came across that idea and I was like, 'Oh my God, that describes my experience to a T.' A lot of 'this hurts' and 'Well, you need to lose weight.' Or, 'I'm in too much pain to lose weight' and 'Well, then I can't help you.' Or, 'This medication isn't doing what you said it would' or 'It's giving me these really weird side effects,' and they'd say, 'Well, that just sometimes happens for fat people. You can stop taking it if you want.' Very dismissive, hostile, and just a lot of harm that made me truly hate myself in a way that did a lot more toward damaging my health than anything else, I think.
Some research that I've been doing with some medical students, who are now medical residents in Connecticut, was we were putting together an education module designed for medical students under the guise of weight stigma. The point of it was to deprioritize weight loss counseling and reprioritize whatever a patient has come to see you for. As part of that research, we were really looking for evidence of what does weight loss counseling in a clinical encounter do when you go to the doctor and you just get told to lose weight? The literature is pretty clear: it does not lead to weight loss. It really has gotten me interested in the question of whether it most often leads to people not seeking care. Could we even make the claim that that's most likely the outcome of weight loss counseling? My gut sense is that, yeah, we know that fat people put off seeking out health care until they're really, really sick for reasons like being told to lose weight, not having their concerns addressed, not being taken seriously, not being listened to. When that happens a couple of times in a row, what could possibly motivate you to go back unless you're really, really sick? At that point, they're like, 'Oh my God, all fat people are so sick' and it's like, 'Well, yeah, you see us when we're really sick because we can't come to you any earlier.'
Q: Lizzo was, again, the target of fat shaming last month, resulting in her expressing frustration about consistently being the subject of these kinds of online attacks about her body. What were your initial thoughts when you heard about these latest comments and their effect on the singer?
Strings:On the one hand, I was a little bit surprised that people are still this openly fatphobic, despite all of the amazing things that so many people have done — Lizzo, herself, in order to bring greater awareness to the fact that you can be any size and you can be healthy, you can move your body, you can be sexy, you can be fire, all of that. We see all of that on social media every day, so I was a little shocked that she's still being hit with so much fatphobia, but that's something that I should have known would still be going on. We are in a moment right now in which there is a fat liberation movement and it's being led by organizations like the NAAFA [National Association to Advance Fat Acceptance]. There are so many people now who are aware of the fact that, A) you can be healthy no matter what size your body, and B) people often like to hide behind some trumped up health concern in order to just stigmatize fat people because they want to be gross. So, I was shocked, but I shouldn't have been because I do know that fatphobia has existed in the Western world since the 18th century and it has overwhelmingly targeted Black women in history.
Fox:Since the rise of the war on obesity, let's say the late '90s to early 2000s in the U.S., the way that I want people to understand that effort is as an effort to get rid of fat people in the world. In my work, I call it an elimination campaign. If we think about the war on obesity and this whole effort as an attempt to get rid of fat people, to create a world without fat people and posit that that world would be a better world, then people like Lizzo who are in the public eye and who say things like, 'I'm here and I'm fat and that's OK' or 'I love myself' or 'I'm going to get fat back-up dancers because I value fat people,' doing that is basically the antithesis of the attempt to create a world without fat people. She is staking her claim, she's asserting her own value, and she's pushing against that idea that a world without fat people would be better. By doing that, she's challenging this very kind of tacit, taken-for-granted idea that underlies all of these anti-obesity efforts. I admire her so much because I think it's a really dangerous, heavy thing to do to continually assert your value in a world that says you shouldn't be valuable to the point that you shouldn't exist. I think she's amazing, but it also doesn't surprise me that if that's the perspective, that all of these comments that she gets and the fact that she, in particular, gets them — knowing that anti-fatness is also interlocked with or holds up sexism and anti-Blackness, especially in the U.S. — that pattern of attacks becomes really clear. Frankly, that she has resisted that as long as she has, and that she continues to assert her own value, is so brave. That's what I think about when I see those kinds of things.
Q:Your 2019 book, "Fearing the Black Body: The Racial Origins of Fat Phobia," traces the history of the social reception to fat bodies and the way that that reception intersects with race. First, can you talk about what fatphobia is?
Strings:Fatphobia is the fear and aversion to fat people, and this really developed in the Western world as a result of the creation of race science. Slavery, as we know it and talking about the transatlantic slave trade, really started to take off in the late 14th, early 15th century. For a very long time, they were mostly relying on the location in which you could find people to enslave, which was largely sub-Saharan Africa. Then, also skin color. As you might imagine, 200 years into this extremely lucrative and dehumanizing enterprise, skin color is no longer a very good determinant of a person's origins, so this was the moment at which they decided to develop race science because they were like, 'We think there are natural slaves. There are people who are born to labor for others, and we believe that Africans are those natural slaves, but let us start thinking about all of the qualities and characteristics that we can find amongst African people that prove that.' This is when they started to say, 'OK, it's not just that they have dark skin,' (because, by now, people of African descent can have so many different skin colors as a result of all of these interactions going on in the colonies) 'we think they lack self-control. They are barely above the four-legged animals' on what was known as the Great Chain of Being, which was supposed to be one lineage of humanity that extended just below God and right above four-legged animals, so they said Black people were just above four-legged animals. 'We know that because they are wholly given up to the so-called animal appetites of having as much sex as they can and as much food as they can,' so they said, 'This is the reason why we find that Black people' they argued, 'are far more likely to have these venereal diseases and also are far more likely to be fat.' So, they were trying to argue that this was an index of low racial character.
Q:You co-authored a 2021 article in the Journal of Applied Social Psychology ("Working toward eradicating weight stigma by combating pathologization: A qualitative pilot study using direct contact and narrative medicine") that looked at this stigma directed at people who are fat. Can you talk about what weight stigma is?
Fox:When I participate in the field of weight stigma, I don't really use a lot of their terminology because it is very psychological and I find that it makes what I consider a structural or systemic problem, their language often turns it into kind of an individual problem, or maybe an interpersonal problem. I usually refer to it as fat oppression, rather than weight stigma. When I talk about fat oppression, what I mean is that fat people's life opportunities, their access to the world, to love, to jobs, to space, to happiness, to flourishing are impeded or limited on the basis of their weight. That's the term that I use the most frequently. Weight stigma, I think you could use a similar definition, and within weight stigma literature, it's usually bias, discrimination, negative attitudes, and stereotyping on the basis of weight, which is also encompassed in my definition of fat oppression.
Q:And can you tell us a bit about the historical context for the way we currently engage with this understanding of fat bodies?
Strings:One of the things that I continue to find troubling is that you can expose this history, people can understand it, but they still think, 'Well, that has nothing to do with the so-called obesity epidemic.' There were some really disgusting trolls who were sort of making claims about Lizzo, using the term "obesity," because if you're relying on medical terms, it makes it seem as if you're actually being compassionate instead of patronizing because you're supposedly caring about a person's health. When this whole question of fat made its way into the medical field, it did so in the late 19th, maybe early 20th centuries, and they relied heavily on race science. In fact, there was a eugenicist by the name of Charles Davenport, who took racial ideas, or ideas about differences in body size according to race, and then applied something he called "index of build." "Index of build" is, indeed, the BMI. All that happens is that, in the 1970s, a man by the name of Ancel Keys decided that he wanted to "create" a tool to be able to understand the relationship between fat and health. He decided on the name "body mass index," but the tool was the "index of build," that Charles Davenport had actually brought into the American medical field. I have a paper coming out about this in the American Medical Association Journal of Ethics next month. People don't realize this made its way into U.S. medicine through eugenics.
Q:People have argued that their comments about someone else's body are motivated by physical health concerns, pointing to medical research linking obesity to cardiovascular disease, type 2 diabetes, and chronic diseases. On the other hand, there is also research exploring the concept of metabolically healthy obesity, outlined as a higher body mass index with much lower risk for the health issues commonly linked to obesity. What do you think we collectively tend to misunderstand about the idea of physical health and fat bodies?
Strings:In the United States, many people, especially doctors, are so determined to suggest that fatness is some type of illness, that they actually have a term, a so-called "obesity paradox" to describe when they are wrong. There is no paradox in being fat and healthy except for the expectation of the medical field that fatness is a sign of illness. That's what we are missing. Fatness is not a sign of illness. Being fat is simply a fact of many people's bodies. The word "fat" is a descriptor, just like the word "skinny" can be a descriptor. These words don't necessarily have to have any type of moral, cultural value, but we put a certain type of value on these terms. So, a lot of people think that they're somehow being compassionate when they use terms like "overweight" or "obese," but these terms are also patronizing because they suggest that your weight, in and of itself, is wrong.
Fox:Previous to my dissertation work, motivated a lot by Dr. Strings, I was looking at weight loss interventions in children and adolescents in the U.S. from around 1920 to the present. I stopped doing that project because it made me devastatingly sad. What I learned from doing that project and looking at the medical literature from 100 years ago was that pediatricians were saying nearly identical things to what pediatricians are saying now. They said things like, 'We have to help this boy lose weight so that he has a chance at a normal life. He's getting bullied. He can't get a girlfriend. He can't keep up with his classmates in gym class. It's our job as pediatricians to help him lose weight.' If you look at the guidelines that were released this year from the American Academy of Pediatrics, they say very similar things, like 'doctors have to help obese children because their quality of life is very low, they're experiencing bullying,' and whatnot. What that tells me is, from the origins of medical research into obesity, and then later epidemiological research into obesity, which started happening in roughly the '50s and '60s in the U.S., is that there has never been a time that doctors or medical, scientific researchers have tried to figure out what the health effects of fatness are where they weren't also inadvertently looking at the health effects of discrimination. I would say I'm not sure if we know anything about the relationship between higher body weight and health. I would say what we do know is the relationship between oppression and health, which is that being oppressed or being discriminated against is really harmful for your health.
I will say this is not a take that I think a lot of scholars like to make. It's much more on my activist side, but I would say that it's a zero-sum game. Fat shaming is a zero-sum game. If you do it, you cannot help fat people, you can only hurt them. The only thing that you can do is the opposite of that; the only thing that you can do if you really want to help fat people, is to fight fat oppression.
Q:Other celebrities have also talked about the body shaming they've experienced, including Bebe Rexha, Kate Winslet, and Arnold Schwarzenegger. Do you see something different about the attacks that Lizzo has received? How do race and gender play a role in the public response to her body?
Strings:When you occupy a minoritized identity, especially when you're Black, people feel that much more emboldened to diminish you to try to make it seem as if you are subhuman, or in some other way beneath the rest of humanity. This is something that Black women have experienced since the founding of this country and it is so common for people to feel that they are justified in attacking a Black woman who they think is not living their life according to White bourgeois principles. This is another thing that comes out in some of my later work, which is that a lot of the things that we think are about health or morality are really just about Whiteness, at the core. So, if you are, say, a fat, White woman, people will shame you, don't get me wrong. Or Adele. Adele deals with a lot of body shaming, so it's not as if people don't body shame White folks; but when you are Black, you have much less of a community of people who understand your life, your history, your family, so many things that factor into who you are, including your body size. People assume that it's just eating, but that has very little to do, overall, with our weight. There are so many other factors and many of them are not well understood. So, the end of it is that when you're White, you are a part of a community of people in which you have a greater amount of support. To be Black, to be marginalized, to be a Black woman, especially, is to be constantly open to attack and, especially, attacks on your appearance in a society that fetishizes White femininity.
Q:What kind of psychological impact do these kinds of comments have on the person who is being targeted?
Fox:First of all, one of the benefits of thinking of fat oppression as a structural problem is that there are a lot of structural problems, or structural forms of marginalization that have been studied a lot more — racism, sexism, classism, ableism, transphobia have all of these really negative consequences on the people who experience them. The same, I think, is true for fat oppression. One of the benefits, for me, is when you start to see this as more than an interpersonal problem, or a problem of self-shaming, then people telling you from a young age that you would be more lovable, more enjoyable, smarter, better if your body didn't look the way that it does, it's pretty clear that that can have devastating psychological consequences and devastating health consequences, in general. I think that telling people that the world would be better off without them is a fundamentally destructive thing to do. I think every fat person navigates that message differently, or copes with it differently. Some people are very resilient and stubborn and reject it. Some people wholeheartedly take it on and they diet and destroy their bodies in search of thinness because they believe it. I think that message is all around us all the time. I feel like the world is saturated with it and the toll that it takes varies from person to person, but it is, at its core, a very destructive message.
Q:Is there a ripple effect from weight shaming? What does this stigma do to other people who are fat, but who aren't the direct targets of these comments?
Fox:I think it's very scary watching someone get told over and over that 'You don't deserve to exist in public, you don't deserve to be idolized, your talent is negated by the size of your body.' If I'm just an average person, I'm no Lizzo, what does that mean for me? What if I can't defend myself by being super fit the way that Lizzo is, or super talented? It's just watching, over and over, people saying, 'You shouldn't exist, you don't deserve attention, you don't deserve admiration,' and that's very scary to live with to know that there are so many other people who feel that and who feel it so strongly. When I say that, that's a lot of fat people, too. Fat people get taught to hate ourselves very deeply, so it's not even like you can turn to another fat person and say, 'Oh my gosh, doesn't that suck?' because they might say, 'No, it's justified,' so it just makes the world feel very hostile and unsafe.
Q:Does weight shaming work? Is it effective in the person on the receiving end changing behaviors in the way that the person doing the shaming is arguing that they're concerned about?
Fox:No, not at all. Not in any way, shape, or form. There is no way to justify it. It is a profoundly unethical thing to do, it is a profoundly harmful thing to do, and there's no both sides. It's just bad.
If you care about someone's health, what part of their health do you actually care about? If it's their blood pressure, then what are you doing to help with their blood pressure? Just take weight out of the equation. For health care providers, weight-neutral care, or fat-positive care that is actually informed by recognizing that fat people are deeply discriminated against and accounting for that in medical care is really important. Just treating people for what they're seeing you for and treating them like people who deserve health care, who deserve care, period. That's really important. For people who are not health care providers, honestly, there's nothing that I would recommend that they can do. I would just recommend that they stop commenting on other people's bodies. There are so many other public health crises that we are experiencing, pick one of them and you will do more good for the world than you could ever do being concerned for "obesity." Anything. Work on combatting pollution or gun violence or COVID or a million other public health causes that are so important that would help the world so much more. If you really don't want to give up fatness as your focus, then you can take up fat oppression as the thing that you want to combat. You can take up fat oppression, or weight stigma, as a public health problem and you can start challenging that.
Q:In the work that you've done, have you found like any potential solutions, appropriate responses, or what this shift should look like in practice?
Strings:I'm going to quote Angela Davis and say that freedom is a constant struggle. We absolutely can conquer fatphobia, but we can't do it in isolation of all of the other questions. To the extent that it is tied to anti-Blackness, we need to be thinking about eradicating anti-Blackness, sexism, queerphobia; all of these things are operating when someone chooses to shame an individual. The idea is that you're supposed to look as much as possible like an elite, White person. So, we have to undo all of these other forms of oppression alongside fatphobia. I am an optimist, I do believe that we can get there.
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