'Health at Every Size' Group Razes the 'Racism and Healthism' of Physicians Fighting Obesity

(Peter Hvizdak/New Haven Register via AP, File)

Are people “healthy” at every size? Some say yes. As for those who disagree, they’re purportedly “healthist.”

The American Academy of Pediatrics (AAP) recently released its Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. The group deduces obesity isn’t ideal:


Obesity is a common, complex, and often persistent chronic disease associated with serious health and social consequences if not treated. … The current and long-term health of 14.4 million children and adolescents is affected by obesity, making it one of the most common pediatric chronic diseases in the United States.

One organization is unimpressed. The Association for Size Diversity and Health (ASDAH) has released a response to the report, complete with an asterisk framing “obesity” as an obscenity:

We firmly and unequivocally oppose the Academy of American Pediatrics’ Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Ob*sity.

Evidently, the AAP is facilitating phobia:

Not only do the guidelines fall short of adequate scientific rigor in interpreting the research base, they worsen medical fatphobia and ultimately degrade the quality of healthcare for fat children, teens, and their families.

The doctors have disqualified themselves:

It is abundantly clear that the authors of this paper have failed to adequately address their own fatphobia and weight bias and thus are unqualified to author this paper.

And not just that, they’re racist…

[T]hey claim to incorporate “non-stigmatising care” and the social determinants of health to improve health equity for Black and brown young people. (But) by co-opting this language, they are putting those most harmed by the medical system at greater risk.


Otherwise, how has the AAP dropped the ball? The ASDAH counts the ways:

  • Omitting any discussion on the racist origins of fatphobia and the BMI. … Fatphobia was born out of eugenicist and racist ideas
  • Underestimating the impact of weight bias and stigma on health and health outcomes.
  • Failing to consider key ethical considerations underpinning the recommendations. Fat people, and especially fat children, are not responsible for the medical fatphobia of our care providers.
  • Using hyperbolic and sensationalized language. (No example is offered)
  • Failing to consider alternative and plausible explanations for the correlation between health and weight.
  • Repeated conflation of correlation and causation.

Might it merely be a coincidence that morbidly obese people are less healthy? It seems so:

[The AAP claims] that being in a larger body is affecting the current and long-term health of fat children. They cite two articles that measure the prevalence of ob*sity, not whether it causes or is even correlated with disease.

ASDAH isn’t alone; University of Denver Professor Erin Harrop is squarely on its side. During her late-January “Addressing Weight Stigma, Diet Culture, and Eating Disorders in Neurodiverse Clients” presentation, she asserted the following:

“[The] connection between weight and health may be less attributable to the actual adipose tissue in people’s bodies and more attributable to the stigma of that adipose tissue from other folks.”


Per the University of Denver website, Erin — who has a Ph.D. in Social Welfare and identifies as plural — is an expert in intersectionality:

Their dissertation featured an arts-based mixed-methods longitudinal study of individuals with atypical anorexia. They approach their research and clinical work from an intersectional social-justice-informed, fat liberation, and Health at Every Size® lens.

As noted by Campus Reform, Erin addressed additional social ills in her seminar:

During the Q&A session…a participant asked about a neurodiverse and transgender client who wanted top surgery but had difficulty finding a surgeon who would not require her to lose weight.

[Erin] said that she felt “so angry” over such requirements for “gender-affirming surgery.”

Earlier in the presentation, she said that neurodiverse clients can make peace with their bodies by exploring their identities, including their gender identities.

The presentation also suggested “[p]referred terms” that would replace “[s]tigmatized/loaded terms.” Rather than use terms such as “[o]verweight” or “[n]ormal weight,” one slide suggests using “[p]erson of size” or “[p]erson of thin privilege.”

Might we only be one phobia-freeing sweep away from a world in which hordes of huge humans are highly healthy? To hear Erin tell it, possibly.

ASDAH is sitting on go; its ready to see fatphobia, racism — and don’t forget “healthism” — hit the road.




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