Image: ShutterStock

In Britain and elsewhere the so-called ‘obesity crisis’ is regularly headline news. Media coverage focuses on the health risks associated with higher BMIs and the financial implications of this for the National Health Service (NHS). People are encouraged to act responsibly by maintaining a ‘healthy weight’. Politicians and journalists commonly frame obesity as the outcome of individuals making bad choices. This equates higher body weights to laziness, stupidity and immorality.

The fairness and accuracy of this has been challenged by researchers working across many different disciplines, including: genetics; physiology; sociology; psychology; political science. Fat Activism has a long history of challenging these assumptions by highlighting how cultural norms discriminate and oppress fat people. More recently, patient advocacy groups have been established and campaign to highlight how popular ideas about obesity negativity influence the quality and availability of healthcare. While people across these groups may agree that the way fatness and obesity are popularly framed and understood is inaccurate, unhelpful and discriminatory, there are significant differences in what they think should be done about it.

The recent debate on whether obesity should be classified as a disease is an obvious example. Some argue defining obesity as a disease is medically and morally sound and a necessary step towards improving the quality and availability of healthcare. Others argue evidence shows BMI is a crude indicator of metabolic health and that more accurate measures demonstrate many people classified as obese are healthy – not ‘diseased’. While others emphasise the need to not let health be defined by weight as health can and is experienced across a diverse range of body sizes. There is also disagreement about how disease classification will affect stigma. Some argue it could reduce stigma because it re-frames obesity as a medical condition rather than a personal failure. While others say it will not dispel this popular notion. Instead, it legitimises the common belief that all people of higher weights are ill and therefore a drain on the NHS.

So in one sense, academics, activists, advocates and people from other walks of life who challenge long-standing and discriminatory assumptions about body weight and size are ‘on the same side’. But it is certainly not a united front. It is likely this discord inspired the BBC documentary Who Are You Calling Fat? which was recently highlighted as an example of outstanding documentary-making in a review of television from 2019. Now, television has a track record of not handling discussions about weight well. Programmes like ‘The Biggest Loser’ have been shown to increase discrimination. Their emergence and proliferation seem to be motivated by meeting the demand for ‘Fattertainment’ rather than representing a genuine attempt to learn from the lives of the people involved or to provide insight into the complexity of the relationship between health and body weight. Assessing the documentary against these criteria provides a better gauge as to whether it is deserving of the praise it has received.

The programme brought together a diverse group of people who referred to themselves as either fat, plus-size or living with obesity. This meant it had the potential to represent people who took up different positions in these long-standing debates and to bring the arguments to life through their interaction and by sharing their experiences. It also presented an opportunity to challenge stigmatising stereotypes. This is almost certainly how the programme would have been sold to the participants. But what did it achieve and was the trust of those involved exploited?

From the beginning, it was clear the show’s producers wanted to evoke a moral tone and provoke outrage. Promotional material was deliberately provocative. Participants wore all-white outfits whilst eating Magnum ice creams. White outfits have long been used to represent the moral uprightness of ‘goodies’ or to portray divinity whereas Magnums are famously advertised as a ‘naughty’ indulgence – once even releasing a ‘seven deadly sins’ range. From the outset, this unhelpfully framed the participants as hypocritical – presenting themselves as morally superior whilst nonchalantly ‘sinful’.

One of the biggest problems within media coverage of debates about obesity and fatness is that the philosophies and motives behind various arguments are taken out of context and sensationalised. Rather than address this, the documentary doubled-down on it. An obvious example was the way it framed fat activism and body positivity and positioned them in opposition to science and health.

‘Body positivity’ has become a buzzword in contemporary popular culture, with celebrities advocating for (usually women) to learn to ‘love’ their bodies, and resist diet culture. This contemporary trend is widely known as BoPo. It has been criticised for being largely removed from its origins in the fat acceptance movement of the 1960s and promoting the idea that bodies are only acceptable if they are healthy. In contrast, fat activism attempts to dismantle structures in society that oppress fat people by challenging the notions that health is a moral virtue and bigger bodies are tantamount to ill-health, personal failure or deficiency.

On the show tensions played out between those who promoted body positivity and the people who had been patients (e.g., diabetes, gastric surgery) or were patient advocates. The body-positive group were labelled a ‘cult’ whereas the patient group were presented as believing ‘bogus’ science. At one point a misunderstanding about the use of the word ‘privileged’ in a conversation about how bigger bodies are discriminated against in society (something they all had an experience of) sowed the seeds of division rather than solidarity.

Many viewers of the show came away with the idea that fat activism was nothing more than denying science and undermining health in a dangerous attempt to love yourself. This is reflected in the way the show was branded irresponsible for glamourising obesity and sparked an often abusive online debate. This reaffirmed binaries between those who sit on either side of the ‘disease’ debate.

How we talk about weight is incredibly important. This is undermined by sensationalism as those working in media frame complex issues as two-sided arguments to increase controversy and audience engagement. This documentary demonstrated how unhelpful this is. Bringing together people with vastly different life experiences and views offers a great opportunity for learning. But not if it is presumed that there is only one legitimate answer to a complex question. Those who understand that health is not defined by weight should not be framed as cultish. But neither should those who follow evidence-based treatment for diabetes be cast as dupes of bogus science.

This documentary had the potential to educate the public about different views in this debate by fairly representing a diversity of marginalised voices. Instead, shock tactics were used to incite viewer indignation. This missed opportunity is disappointing in large part because the response to the programme suggests it further entrenched problematic assumptions about body weight which in turn incited abuse of people of higher weights. This outcome is the opposite of the programmes stated aim and therefore – irrespective of the perceived ‘entertainment value’ or the number of people who have been brought into ‘the conversation’ as a result – should be seen to represent bad television.

About the Authors:

Oli Williams is a THIS Institute Postdoctoral Research Fellow at King’s College London who researches health inequalities, the promotion of healthy lifestyles, obesity stigma, equitable intervention and co-production. He worked in collaboration with Jade Sarson to create the evidence-based comic ‘The Weight of Expectation’ which illustrates how stigma associated with body weight and size gets under the skin and is felt in the flesh.

Amelia Morris conducts research that cuts across interdisciplinary areas of political science, political economy and sociology, centring around the politics of the body, gender, power, work, discipline, austerity and feminist theory. The book of her thesis, The Politics of Weight: Feminist Dichotomies of Power in Dieting, was published with Palgrave in 2019.

Fiona Quigley is undertaking a PhD to investigate weight-related communication across healthcare settings. She has a background in technology, digital content development and training design, with much of her career to date being spent supporting healthcare professionals across the NHS and the Irish Health service.