Anne Coleman considers herself to be “body positive,” part of a social movement that accepts different body shapes and sizes. She takes pride in her appearance and has attended size acceptance events like the Curvy Con, an annual convention celebrating plus-size brands and individuals, and an early screening of “Fattitude,” a film about weight stigma.
And yet Ms. Coleman, who weighs more than 200 pounds, would like to weigh less. She doesn’t want to be “skinny.” Just able to move around more easily.
“I want to walk a certain distance without getting out of breath,” said Ms. Coleman, 32, who works in attorney recruiting at a Manhattan law firm. “I want to walk around New York in the summer without sweating to death. I’d like to climb Machu Picchu.”
It’s an issue she regularly wrestles with. As someone who supports size acceptance — the rights of all people to not be judged for weighing as much or as little as they want — Ms. Coleman wonders: Is it OK to rail against fat discrimination but still want to lose weight? Or does that make her part of the problem? “I’ve had people question whether I truly love myself if I want to be thinner,” she said.
Her feelings are similar to those expressed by the author Roxane Gay, who once weighed 577 pounds and has discussed her own ambivalence about weight loss. “I worried that people would think I betrayed fat positivity, something I do very much believe in, even if I can’t always believe in it for myself,” she wrote in a 2018 essay on Medium, after admitting that she had undergone weight loss surgery. “I worried that everyone who responded so generously to my memoir, ‘Hunger,’ would feel betrayed. I worried I would be seen as betraying myself.”
The core argument of the body positivity movement is that intentional weight loss doesn’t work and, in fact, causes more harm than good. In an effort to try to attain some impossible standard of beauty, the thinking goes, people end up with lasting emotional and physical damage that sabotages any efforts to lose weight and could even cause early death.
Studies back this up: Most weight-loss efforts are ineffective in the long term and can lead to weight cycling, a risk factor for hypertension and diabetes, among other health problems. According to a 2015 report in the American Journal of Public Health, the probability of an obese person ever attaining a normal body weight is low; most people who do lose weight gain it back within five years.
And though many appreciate the work of larger-bodied celebrities like Lizzo, Chrissy Metz and Joy Nash, size discrimination is very much alive. Piers Morgan, for example, slammed Cosmopolitan UK for featuring the plus-size model Tess Holliday on its cover. “Apparently we’re supposed to view it as a ‘huge step forward for body positivity,” he wrote on Instagram in 2018. “What a load of old baloney.”
Last year, on “Real Time With Bill Maher,” Mr. Maher said that “Fat shaming doesn’t need to end, it needs to make a comeback.”
Fat shaming is also playing out during the global Covid-19 pandemic. Recent studies have linked obesity to an increased risk of complications from coronavirus. These findings, size activists argue, only exacerbate the vitriol they already feel, especially by the medical establishment.
“Fat people have faced tremendous stigma from doctors and tend to not seek medical attention until their illnesses is more advanced,” said Ragen Chastain, 43, a fat activist in Los Angeles who blogs at Dances with Fat. She said that in addition to sheltering in place to protect others, “the fat people I know have been strictly observing quarantine because of a fear that we will experience weight stigma if we do need medical care.”
Deb Burgard, the co-founder of Health at Every Size, an online community that promotes weight neutrality, agrees. “People wouldn’t try to lose weight if the world didn’t conspire to make them feel so terrible about being fat,” she said.
But the tension among fat-shamers and fat-accepters can be wrenching for the swath of people who are overweight and trying to figure out whether they need to strive for self-acceptance or start another diet.
“I kind of feel stuck between people bashing me for having obesity and telling me I should lose weight, and the other half that says you should love yourself and that means you shouldn’t lose weight,” said Sarah Bramblette, 42, of Miami. “I’m bad for wanting to lose weight, and I’m bad for not losing weight.”
Ms. Bramblette, who weighs nearly 500 pounds, had gastric bypass surgery in 2003, and a second procedure in 2010. She lost about 250 pounds after the operations, but had medical complications and gained it back. Ms. Bramblette, a spokeswoman for the nonprofit Obesity Action Coalition, said she can’t deny that her excess weight is hard on her body and contributes to illness.
A 2013 study from Columbia University found that obesity contributes to nearly one in every five deaths among Americans between ages 40 and 85. And the Centers for Disease Control and Prevention links obesity with heart disease, stroke, Type 2 diabetes and some cancers.
“The tricky thing is that the people who advocate ‘health at every size’ are sort of assuming that people who are overweight don’t have any health issues,” said Katie Rickel, a clinical psychologist and the chief executive of Structure House, a psychologically oriented residential weight facility in Durham, N.C. “The vast majority of our folks have diagnosable health conditions that would be corrected with weight loss.”
Doctors and nutritionists are grappling with the best treatment methods. But their approaches vary. At Structure House, “we take the stance that it’s negligent to not address that and not to honor people’s real desire to get to a healthier weight,” said Dr. Rickel.
Then there are “anti diet” nutritionists who refuse to weigh patients and don’t keep scales in their offices. Instead, they tell clients, many of whom struggle with overeating or binge eating disorder, that weight loss might occur as a result of healthier eating and improved self-care, but that it shouldn’t be the goal.
Dana Sturtevant, a nutrition therapist in Portland, Ore., said that she does not recommend weight loss for her clients. “I tell clients ‘You will gain weight, lose weight, or it will stay the same.’ Anyone who says they have a solution is lying and colluding with weight culture.”
Molly Carmel, 42, understands the conflict between wanting to be thinner and wanting to rebel against cultural norms. At her heaviest, she weighed 350. She lost 170 pounds from “gastric bypass surgery and bulimia,” as she put it. Then she founded The Beacon Program, an eating disorder center in Manhattan.
While she does weigh clients, she doesn’t let them see the number. “I’m not saying to get into this skinny mini body,” said Ms. Carmel, author of “Breaking Up With Sugar.” “But when you’re eating in a way that’s supporting a really heavy body, it’s arguable that that’s self-love. When I weighed 325 pounds, I couldn’t get into the shower. My underwear stopped fitting. That girl deserves to release weight if she wants to, culture or no culture.”
In her essay, Ms. Gay put it this way: “I had to face the extent of my unhappiness and how much of that unhappiness was connected to my body,” she wrote. “I had to accept that I could change my fat body faster than this culture will change how it views, treats and accommodates fat bodies.”
