You're Not 'Plus Sized' You're Dying

Buckle up folks. Yes, there are many healthy body types that are likely fine for most people. However, there’s a dangerous game that society has been playing and it goes by the name of “body positivity.”

Thebodypositive.org explains that their movement is about “creating a world in which people are liberated from self-hatred, value their beauty and identity, and use their energy and intellect to make positive changes in their own lives and their communities.” Before I begin, let me just say that I think this description of body positivity, and the movement itself, is fantastic. Unless, of course, you’re using it to pretend that your weight problem is anything less than a problem. We’ve been pretending it’s okay to be massively overweight. If you’re comfortable weighing in at 300+ pounds, more power to you, that’s fantastic. I’m just tired of pretending that it’s fine for your health. Simply put, the higher your body mass, the higher your risk of a multitude of chronic diseases and premature death (all of which are largely preventable). Even WebMD is right with this prognosis—you will die early if you have a sky-high body mass, and you can counteract most risk factors for obesity through diet, physical activity, and behavioural changes.

DISCLAIMER: I want to make it clear that I understand that there are a plethora of factors that contribute to obesity. Genetics is only half the puzzle, and lifestyle factors play an instrumental role in health. Some of these factors are preventable, and some can be harder for us to control. Family dynamics, inactivity, poor diet, age, sex, socio-economic factors, and countless social determinants of health are all contributors to obesity. This article will focus on identifying the costs of fat acceptance when you do have some control of these preventable behaviours. I hope to encourage you to be conscientious of your decisions and what factors YOU can control in order to be healthy, and mindful of the consequences that go along with simply accepting yourself as who you are.

I won’t claim to be an expert in what body positivity is, but from what I’ve read it seems to be a movement that surrounds doing away with the idea of the “standard body” and instead celebrating the differences that can be present in these bodies. Or as some may define it, “It’s deciding what feels good and healthy for you personally, and letting other people do so for themselves. It’s understanding that you deserve to live in your body without receiving the prejudice of others.” It encompasses far more than just weight, but for our purposes I think it deserves a more focused analysis. I understand the need for people to be body positive I think that the girl that is 20 overweight should be able to feel as good about herself as the 12-year-old boy that feels like he could gain twenty pounds. However, “This is what feels good and healthy for me” should not be used as a way to ignore the effects of being obese or morbidly obese. But, if you haven’t realized already, obesity isn’t a cosmetic issue. What is perhaps most frustrating about the body positivity movement is that it has created yet another “privileged” class of individuals, those who are “thin.” I won’t touch on privilege here but I do think that “thin privilege” is a really funny way of spelling “exercise and healthy eating.” What is alarming about blindly accepting obesity is that our choices impact one another, and pretty soon we have a whole society that is naïve to an increasingly important issue. It is well-documented that parental behaviours influence children, and with more and more parents becoming obese (2/3), more and more children are likely to follow in their footsteps—having two obese parents was related to greater weight gain and lower rates of physical activity. What is concerning, is that parents of overweight children greatly underestimate their children’s weight, and this reinforces the issue with the body positivity movement. We cannot forget that obesity is not just a social condition, but rampant disease.

Obesity is defined as having a body mass index BMI over 25 kg/m^2. While there are limitations to the BMI classification system, being accepting of obesity is something that is less than positive, and at least, in my opinion, is nearly akin to enabling someone with a harmful addiction. In fact, obesity has become known as “New World Syndrome," which speaks to the magnitude of this modern, largely preventable epidemic. In fact, obesity rates have increased by as much as 25 percent in the last decade. Obese people have an increased risk of morbidity and mortality relative to those with ideal body weight. The effects of being overweight are obviously varying and come at different degrees of severity. Obesity is associated with diseases and conditions such as:

• Hypertension
• Coronary heart disease
• Cerebrovascular disease
• Varicose veins
• Deep venous thrombosis
• Sleep apnoea
• Hypoventilation syndrome
• Hyperlipidemia
• Diabetes mellitus
• Menstrual irregularities
• Fatty liver disease and cirrhosis
• Haemorrhoids
• Hernia
• Colorectal cancer
• Gallstones
• Breast cancer
• Endometrial Cancer
• Prostate Cancer
• Cervical Cancer
• and Osteoarthritis

Obesity can affect quality of life by also causing issues such as:

• Depression
• Disability
• Sexual problems
• Shame and guilt
• Social isolation
• and Lower work achievement

Yes, you read those right—those are just a FEW conditions linked to obesity affecting various systems in your body. Canadians with a BMI over 30 kg/m^2 are four times as likely to get diabetes, three times more likely to have high blood pressure and 1.5 times as likely to have some form of heart disease.

This doesn’t scare you? Maybe the story of Tammy Mackinnon will help. Tammy stressed the pressure of the body positivity movement: “I almost feel sometimes like we’re supposed to glamourize being overweight, or our plus-size bodies.” She went on to explain that: “I want people to feel confident in their bodies… but the reality is being overweight rarely is healthy.” Tammy herself had a wake-up call when she was diagnosed with a heart condition and type 2 —and was bluntly told by her physician “lose it or [her] conditions would get worse/” Dr. Christine MacNeary supports the movement, but emphasizes that "when people start to suffer… the health consequences of the obesity… that they’re unlikely to embrace this body positivity movement."

So what can we do? Well, if you’re in the position to make change (which you likely are if you’re reading this article, and paying $8,000 a year for tuition), then taking steps such as changing lifestyle behaviours can make a huge difference. Diet, exercise, and reduced sedentary behaviour are all great steps to take to lose weight. A modest weight reduction in the range of 5–10 percent of the initial body weight leads to improvements in a multitude of co-morbid conditions. Additional treatment options include behavioural therapy, pharmacotherapy, and consulting your family physician can help you find something that works for you.

We here in Canada are not immune to the obesity epidemic societally, and pretending it’s “okay to be fat” is only making it worse. If you’ve decided that you’re okay with ruining your own life, then consider the implications of your choice on the rest of Canadians (yes, that includes ones who are disadvantaged and CAN’T control their weight due to burdens in their life). According to the Canadian Institute for Health Information (CIHI, 2016), an estimated $228.1 billion was spent on health care in Canada in 2016. This is equivalent to a whopping 11.1 percent of Canada’s economy, or $6,299 per Canadian. It’s estimated that obesity in Canada costs the economy nearly $7 billion a year, or to put that in perspective, just enough money to pay off the current Canadian federal budget deficit in four short years. A 2010 study found that the costs of obesity and being overweight counted for 4.1 percent of Canada’s total health care budget, and this does not include losses in productivity, tax revenue, psychosocial costs, and undetected co-morbidities resulting from obesity. The costs of our aging population, the obesity epidemic, and astonishing rise in chronic disease prevalence is leaving our health care system in a dire place—so dire that Duncan Sinclair, former Dean of Medicine at Queen’s University, bluntly testified that “if [the Canadian health-care system] were a business, it would be out of business.” The aforementioned, and covered, $6,299 would sound super sweet if we were forced to go to a non-universal health care model, or other alternative, and this is something we will have to consider if current spending trends continue.

To conclude, I understand that the sentiments expressed in this article are unpopular. There is no mistaking that. However, the idea that society should stop ignoring that you’re unhealthy because it hurts your feelings is absolute unfettered trash. There is an absolute plethora of medical science that would suggest that there is indeed something very unhealthy about being overweight, obese, or underweight. Myself and the kinesiology student who wished to remain anonymous have presented those things here. There is a reason you don’t see 300-pound 70 year olds walking around, and it’s because they weren’t “plus sized,” they were dying. I’m not vying for a war on the overweight or a ban on trans fats, I’m asking that we stop denying medical science in the name of people’s feelings. So I suppose you could say, I recommend a little “body realism” to solve our problem. You may argue that "we all die," but I raise you some questions: At what age? With what degree of suffering? With what degree of preventable illness? (Nancy Krieger; Harvard University’s School of Public Health). The answers to these questions are largely up to you and your attitudes towards health. The JOINT REPORT FROM THE PUBLIC HEALTH AGENCY OF CANADA AND THE CANADIAN INSTITUTE FOR HEALTH INFORMATION states that “there is unlikely to be a single solution that will reverse the rising prevalence of obesity in Canada… rather, a comprehensive, multi-sectoral response may be needed.” Now I challenge you to think about your attitudes surrounding body positivity, and the role you can play—you may just make a difference in your life and those around you.