Fat is the New Black.

Why are we accepting, sometimes even promoting, fat-shaming?

Photo by Jennifer Burk on Unsplash

May 9th was National Barbie Day. This eating-disorder-inducing doll is celebrated in the USA, in the 21st century after the #MeToo movement?! Women empowerment, as long as you look like a disproportionate stick. And you wonder why the USA is a leading country in obesity?

Fat shaming is the new Black: It is not only an allowed discrimination, the ok “racism”, it is welcome, embraced and practiced regularly.

It has been the new “trend” everywhere. People are taking a jab at overweight and obese people, because they “know better”. From Bloomberg who wanted to tax the Gulp, to Bill Maher- both I like and agree with most of their political views. Even Ricky Grevais joined the “gang, after he lost the weight. You’d think an insider will be more compassionate and understanding. No, he is now a born-again-fit-person and somehow that makes him an expert stating obesity is only a question of intake Vs. output. I have some news for you, Mr. Grevais, keep reading. Bill Maher, it seems, made it his not-so-new stand-up central theme. I love Bill Maher’s brain, most of the times. He is super intelligent, liberal, pro human rights for all, except for overweight and obese people. Why? Because it’s allowed! With his big mic, he is doing it almost on every show. Why the obsession? When your team is on a dry spell you decide to take it on obese people? What obese pole have done to you?

Everybody seems to be a Registered Dietitian (RD) these days:

Former First Lady Michelle Obama. Her Let’s Move! initiative moved more food to the trash and pounds onto our kids bodies. She didn’t include a single RD in her team. The result: school lunch went to trash and child obesity was increased at the end of Obama administration! Bravo!

Dr. Oz- it is a mystery to me how he is not disciplined, at the very least, by AMA for promoting things that at best do nothing, at worse- cause harm. He had to testify, more like being questioned, in Congress for the misinformation and products he promoted on his show. He stoped for a bit but now he’s back on it. If he practiced medicine this way, he would have been ripped off of his license and credentials. But nutrition we allow everybody to “sell”, even if there is no science base support, or worse, evidence of harm. Let me tell you the biggest secret in healthcare: Medical schools do not include more than one class about nutrition, if at all, in their entire curricula. Doctors know almost nada about nutrition.

A plumber needs to be certified, before you’d allow them to “treat” your toilet, right? But in most of the 50 states, everybody can call themselves “nutritionists”. Most 50 states do not require licensure for nutrition consultation, but for plumbers they do. Different pipes call for different experts!

Mayor Adams- another reincarnated “celebrity-Mayor” who thinks, because vegan diet worked for him (good for you, Mr. Mayor), that it is the cure for everything. More so, it should be served for low income kids whose diet is already deficient, and are dependent on school meals to get adequate nutrition. So let’s give them a diet that will deplete their growth needs even more. Check NYC schools vegan menu on Match 13th, for example. It is void of adequate protein in both breakfast and lunch. Vegan diet is very easy to do wrong, and Mayor Adams is placing our kids at a higher risk for more nutritional deficiencies! Even he couldn’t follow it and was caught eating fish, TWICE! Mr. Mayor, you are not vegan.

Then come the Fad Diets: Don’t eat this, eat ONLY that. Once upon a time, dietary fat was to blame. Then came the carbs. From Paleo diet (because cavemen lived long healthy lives), to Atkins or Keto and of course vegan diet. All deficient in important nutrients. No wonder, a lady in the bus declared to another rider tat “cabbage is good for the diabetes”.

No one, I repeat, no one wakes up one morning and decides “I want to be obese”. So many reasons people are gaining weight, being “lazy” is not one if them. Here are just few of them:

• Poverty is one of the strongest links to obesity. Do you know that there are food deserts in USA 2023, including in my great state of NY and NYC. Not only access to fresh, high quality food is difficult, it is also more expensive than processed food. I never understood that; Why processed food, literally food that you handled more, cost less than the one that was just picked up from the ground/tree? And if that is not enough, often, these very people, who already have difficulty accessing healthy food, the only cooking used is frying. Because when you cannot afford the good cuts of meats or the freshest produce, frying it makes it edible. And now, all of you rich people are taking the liberty of judging them because they don’t fit to your standards of filthy-rich, comfortable life. Who made you the judge or the jury?!
• Sleep deprivation: When you work 2–3 jobs just to sustain yourself and/or your family, you are sleep deprived. Studies shows it causes a cascade of hormonal reactions, not to mention leading us to less desired food choices. We tend to choose more fatty, sugary and/or salty food and snacks when we are tired. Sleep deprivation also causes weight gain, increased risk for diabetes and hypertension. Stress from not meeting end-needs will cause sleeping disturbances and disorders, causing a vicious cycle. When you work those three jobs just to keep afloat, who can come home and start cooking? Sleeping 7–8 hour a night? In your dreams. So buying your child a happy meal in McD is easy, accessible, affordable (!) and satisfying. A Meal! Provided! But did you notice, even happy meals have improved slightly in past decade or so. Why? Part due to legislation that prohibits advertising for kids, the other part is education: The public demanded improvement. Now, milk is part of the kids meal, not soda, and salad is available too on McD menu. Not that it is my go-to place for a salad (as an Israeli-born, salad is more than lettuce and two slices of tomato) but it’s better than fries. More on education later.
• Menopause- YES, guys! Stop poking at your lady-friend and think you are funny. You are not going thru this hormonal changes, don’t even try to understand. Just be supportive and loving. More so, women who were pregnant, had to gain weight to support the healthy pregnancy and fetus. In our society, we are also expected to be “back into the jeans” in no time. Then we get pregnant again. And lose the weight, again. This yo-yo is very unhealthy and makes it harder to lose weight on the next attempt. Because of that yo-yo, many of us [mostly] women do in our lives, due to pregnancies and thanks to men and society, it is much harder for most women to lose weight with age, even with no regards to menopause. Because society is more friendly towards men didn’t in that regards (except for any men), they don’t experience that yo-yo effect as often or as harshly. If on the same diet and exercise regimen, men will lose weight faster than women. Partially also because they have a higher muscle mass, too. Yes, there are those anecdotal “skinny bitches” who are just having a basketball for “pregnancy” at 9 month, deliver without epidural in 5 minutes and they are skinny all their lives. We hate them. They are the exception to the rule. They eat, and the rest of us gain the weight. Which brings me to…
• Genetics. Need I say more? Genetic is a new field in medicine and nutrition. Maybe one day we will know exactly which gene makes some people obese and others not. And even this doesn’t mean we will be able to treat it soon after. What we know so far, some people have more “brown fat” (no, I’m not being racists), with more mitochondria. This makes their metabolism faster, more efficient in burning energy, specifically from dietary sugars and fat. These are the “skinny bitches”. We have yet to find the way to increase genetic production of mitochondria to fight obesity. Because when you deal with genetics, you may fix something now, only to discover a decade later, you screwed up something else, which could be deadly. Remember Dolly the sheep?
• Education- how many people I recommended not be approved for bariatric (weight loss/ gastric bypass) surgery because they didn’t have basic knowledge of food groups. For example: some of the candidates I interviewed said that broccoli is a source of dietary fat or dietary protein. I swear! No one is addressing this central problem. Nutrition education post-op was not part of that program! In my own daughter’s high school, one of the best in NYC, over a decade ago, her gym teacher taught nutrition. I once emailed him a professional article from The British Journal of Medicine, one of the most respected professional medical journals worldwide. He refused to even look at it, saying he is relying on…..wait for it: Shape magazine!

On my bus ride today, one lady informed another rider that “cabbage is good for the diabetes”. Everybody is a registered dietitian (RD) these days and they all the right “poison” to solve which ever nutrition-related problem you may have.

• Bloomberg wanted to tax the gulp. I argued against it. You’d probably think it’s weird or that I am crazy, as a RD, to oppose it. I believe education is key. Taxing the gulp might reduce sales, but will not change behavior.
• Doctors: Doctors are the worst (ok, most of them) and women doctors are no different: They are not trained to treat obesity, all they know is to prescribe medication. Now, its Ozempic. Great med for diabetes, a game changer, especially for obese people with DM. It is prescribed for weight loss, too. It is Hollywood new preferred “diet”. People lose weight, quickly. No one is telling you that rapid weight loss is unhealthy. Call me in 5 years when yoke an increased in congestive heart failure, because the heart, a vital muscle, was depleted from the rapid weight loss. Doctors just want everybody to be at BMI below 25. Really? NO! Women over 40 should have a little extra, it was found to be protective against bone losses, fractures and even against against dementia. For people over 65, a health BMI range is 23–30! Go tell that to a doctor.
• Medications side effects. I work with people living with severe mental illnesses. The medications that they are on I wouldn’t wish on my worse enemy. One of the most common side effects is severe weight gain, and I mean weight gain of 10Lbs a month and more thereafter, so long they are on this med. If that is not enough, it makes them very sleepy. Add that to their deprivation of family support, lower education and economical state and you have a prescription for institutionalized, pharmaceutical obesity. And this is only one of the many other prescribed meds they are on.
• History of sexual abuse: How many people, who were sexually abused, boys and girls, men and women, end up gaining weight because they found comfort only in food. The shame they felt and often still do, for a crime committed to them. The little kid in them still didn’t get the support they need because they couldn’t tell anyone what grandpa did, or what next-door neighbor did. And now they have to endure Bill Maher? Bloomberg? Your judgmental jabs? Their doctors who didn’t even spend 5 seconds asking why, just said very matter-of-factly the risks involved with obesity, most of them knew it. No one cared to stop and ask what happened. Where and why did it start. So who are you, whoever you are, to judge them because they don’t look like the photoshopped supermodel on Vogue. That’s also true for other traumas.
• Some of the treatments for breast cancer are causing weight gain. And you dare judging these women and men (remember Beyoncé’s father)?

People always like to blame obese people for the cost they cause to the health system and society. They feel that gives them the right to demand they lose weight, start exercising vigorously, and start doing it now. Do they also blame people with skin cancer for not using sunblocks, or for spending too much on the beach 20 years ago? How about people living with HIV because they shared a needle or didn’t use a condom? God forbid. Nor should we. But this is, my friends, the definition of discrimination. I am sure at this point you are infuriated at me, but hear me out: If you want to blame obese people for the cost to society (it is very personal to some of you, as if they are doing this “to you”), you have to equally judge all the other behaviors that “cost society”. Think about the cost of Skin and lung cancer, liver and pancreatic cancer, throat cancer. Oh, it’s the “ Big C”… shhhhh, we don’t criticize people who fight cancer. How about the cost of HIV? Did you know that people with HIV are eligible (yes, if they meet certain criteria, not Magic Johnson) for subsidized housing in NYC? Some of those are in prime real estate areas in NYC. HIV medications aren’t cheap, and like diabetes, hypertension - its for life! But we all love sex, we understand that addiction is a disease, so we won’t dream of criticizing somebody with HIV. Nor should we! We should be supportive, protective, help them fight cancer or live with HIV.

So why, when it comes to overweight and obese individuals, they have to endure being a daily target by professionals (dietitians are not all free from that base either!) , colleagues, even strangers ? Why they deserve to be almost weekly targeted by Bill Maher, who is self-declared il-expersto on the science behind weight and obesity. No, Bill, accepting obesity will not encourage weight gain, but rather, will reduce some unnecessary stressors delivered by society and others like you, thinking its ok to make obese people your new punching bag.

Aside from the above, it is ok to discriminate, humiliate, emotionally and verbally abuse obese people because humans always need a target to look down at, to hate, to exclude. This is the only group that is not abbreviated or united under a new flag protesting for their right for self-determination , dignity and equality. They walk among us filled with shame, feeling inadequate. They are paid less than their skinny peers, they are promoted less. Often they endure the facial expressions when they walk down the street. No one cares about their story! And I am telling you, each one of them has a different one. None of them is a textbook, none of them should be treated like it is “one Rx fits all”.

And even if we found the one person who made the clear, conscious decision, to become obese, who are you to tell them how to live their lives?! My role as a RD is to educate. After that- your choice what to do with this information. After that- you are the only master on your body. We all fought for women’s rights for self-determination, for her body, but somehow, when it comes to her weight- you have a say? You will pay for any woman right to abort a baby (Yes, I am for that too!), for free Methadone clinics that also provide clean needles, but you are angry when you need to pay for the treatment an obese person needs? This is where you draw the line?

My Motto is Live and let live.

You want to help reducing overweight and obesity prevalence? Here are few simple ways:

Place a registered dietitian in the classrooms. Better yet, hire only a board certified RD in pediatric nutrition (Yes, they have board certifications in certain areas) for all city and state elementary through high schools. Interview them to ensure they are not biased towards overweight or obese kids. This includes having a dietitian who oversees the schools breakfast and lunch menu.

Make it a profession that requires licensure to provide nutrition-related counseling or education.

Food stamps, aka the federally funded SNAPS program, are far from being enough. We need to support our farmers so they can continue to produce, locally, as possible, and lower the prices. Maybe even incentives selling produce farm-to-table in low income neighborhoods, by giving the farmers a percentage per pound of produce sold in low income neighborhoods and food deserts.

Incentivize Whole Foods, Stop & Shop, other supermarkets chains to open one in a food desert, with reduced prices that are affordable to the locals.

Stop nagging the kids when they don’t want to eat certain things, even, and especially, when they are finicky. The more you make a fuss, the pickier they become. Make meal time a family time, not an argument. On the other hand, also stop cooking specially for the picky eater. You are not a restauranteur. When kids are hungry, they eat. Leave the uneaten meal in the fridge.

Make exercise fun from a young age. Not a chore. Schools stopped real gym classes in fear of being sued over simple and expected injuries. Parents have to learn to stop suing the schools for every scratch, or even an accidentally broken bone their kids get in the school yard or gym class.

But most of all: Be supportive, be a friend or a parent, a spouse, a colleague, not the food police. Don’t tell them what and when to eat. Definitely don’t take that fry out of their hand and replace it with a carrot stick. Yes, even obese people are allowed to enjoy a hamburger with fries occasionally, or ice cream, without your side dish of guilt seasoned with judgment. They can do that (and they do) very well on their own.

Stop criticizing what they are eating, especially eliminate “once on your lips forever on your hips”. Not funny! Never was!

Nobody is denying that obesity is associated with increased risk for diabetes or cardiovascular disease. But making this population a punching bag is not the solution, nor it gives anyone the right to target them on your weekly monologues. It makes more damage. However, like Bill Maher, when you punch-bag obesity, it likely makes you feel empowered, entitles, elitist and righteous. That’s all! You help no one but yourself.

If you really want to help a friend: Listen. If they would tell you why and when it started- know you are very special to them as they trust you. Simply be there, listen and reassure them that their very personal story stays with you. If they don’t — respect that, too. Don’t pressure. No matter how close you are, if they are not ready to share, it’s their choice. At least now they know you are willing to listen.

Love them, love them for who they are, with no regards to the number on the scale. Strengthen their inner God/Goddess. Choose them for their strengths.

If you are not invested in their personal story, at least stop judging.

Let’s see Bill & Melinda Gates Foundation, Bill Maher and Bloomberg will join forces and actually fund what I have listed above. Taxing the Gulp is easy. Educating for healthy living, is hard.

And lastly, if you want to help people struggling with their weights, we have to stop, once and for all, celebrating an eating-disorder-inducing, humanely-disproportionate doll.