The world has never been heavier. In so-called develop nations the prevalence of being overweight has more than doubled in the last 3-4 decades (living memory for many of us). More than half of South Africans are overweight by medical definition (BMI > 30). The negative health effects are well known and include heart disease, diabetes, stroke, kidney failure, various cancers, musculoskeletal problems like back pain and osteoarthritis, and more. The science behind this is solid and for the most part, undisputed – there are gaps (things we do not yet fully understand) and there are some controversies (like BMI being a somewhat imperfect measure), but the overall big picture is clear enough, and has long been so.

But there are some growing concerns around fat-shaming. Why? Surely, in the face of a clear link between weight and ill-health, we should be willing and able to discuss these very real concerns? Well yes, and maybe no…

The concern really comes down to respect for individuals. Individuals’ right to choose how they live. Without facing personal attacks or criticisms. We uphold these rights in many areas like freedom of speech, freedom of movement and association, freedom even to smoke and in many countries, to use certain drugs (cannabis a good example here). As a society we want everyone to enjoy these freedoms and in the most admired nations, these rights are constitutionally guaranteed. The choice to be overweight or obese, is seen by many, as a right, in the same way that other, undoubtedly harmful lifestyle choices such as smoking, are seen as choices we have the right to make.

Fat-shaming is when overweight people are “shamed” or personally insulted in a manner that goes beyond sincere health advice and becomes more of a personal attack (even at a group or community level). Mature societies are increasingly of the view that there is no place for such personal “attacks”. The debates get complex and the details perhaps tricky, but it does seem that some “heath warriors” sometimes go too far and cross the line into personal insult and judgemental attitudes. This is cruel and it is also unhelpful – ask any overweight person if they find criticism motivating! Let us be clear: accurate information, solid science, and undisputed facts, are realities we all need to understand and discuss. But there is a line we should not cross.

What we need is a more constructive, caring, respectful approach here. Let us not fudge the facts or pretend that unhealthy living is desirable – fat is not good for us, as individuals and as society and there is no harm in noting that, and there is no harm in working towards a healthier world for all. But not by disrespecting people. Not by insult. Not by bullying in any form. Fat is a massive health issue, fact. Fat shaming is a disgrace, fact.

Author: Dr Colin Burns, retired medical practitioner and wellness coach