Short answer: Not necessarily.
Despite people continuously talking about how evil or bad being fat is, when we look at the research the relationship between weight and health isn’t as clear cut as what people think.
What some of the popular discourses have led us to believe is that if you gain weight or are fat, you will get diabetes, cardiovascular disease, cancer, and/or some other health condition. Basically it has been stated, or at the very least implied that being fat causes a variety of health conditions. This message has added further fuel to assumptions and judgments of people and their bodies, and built a shield for people to hide behind when they engage is weight stigma and discrimination. The “I am just concerned for your health” shield. Weight discrimination is left to run rampant, and is the only form of discrimination on the rise.
Clarify Causal vs Correlational
But let’s back up a little bit, to the stated or implied weight causes health conditions. In research, for something to be a causal factor there needs to be observation of before (A), then a factor gets introduced (B), and it leads to an outcome (C). What this would look like in relation to weight would be; “average” size person (A), gains weight (B), leading to health issues (C). This would then need to be observed over and over again creating a picture of consistency, such as all or near all people exposed to B develop C. AND other factors that could be creating C are ruled out or accounted for.
That is not what weight research looks like or has demonstrated. Weight research has generally been correlational. That is, the research indicates that there is a relationship between factor A (health issues) and factor B (weight). Occasionally there is a comparison group, and the research may demonstrate that factor A (health issue) is observed more frequently in factor B (larger bodies) than in factor C (small or average bodies). The research does not indicate that they always occur together, nor the exact nature of the relationship between the factors. Other factors that could account for the two occurring together or more frequently in one group compared to another, may or may not be ruled out, controlled for or even investigated. It can be the research equivalent to “its complicated”.
Impact of Exposure to Bias, Stigma & Discrimination
A factor that may account for or impact the observed correlation that has not (until recently) been explored is the impact of stigma and discrimination. Ongoing exposure to bias, stigma and discrimination can put the body into a stress response. The stress response impacts many systems within the body, and prolonged activation of the stress system is associated with a wide range of conditions- including those often associated with being fat.
Inequal Access to Health Care
So, prolonged exposure to weight stigma and discrimination creates a strain on the body that can impact a person’s health. Add to that, when a person who is fat goes to access healthcare services, they often encounter further discrimination and do not receive the same healthcare that those in smaller bodies encounter. This in turn can impact their ability to seek healthcare.
During COVID-19 we saw the impact of these factors combining. Remember that time during COVID-19 in which people were saying fat people are more likely to die from COVID-19? Well what was happening for a number of people was they would take longer before they would approach health care services (possibly due to concerns regarding weight discrimination), and then when they did approach they did not always get the same response as others. So, you have someone presenting sicker and then not getting the same response, and then when they die or have greater severity/duration of illness, it is blamed on their body size.
So for those who are making comments and treating people differently based on their weight because they are “just concerned about their health”, that concern for health would be better directed at reducing weight stigma and discrimination, as opposed to contributing to it.
Impact of Yo-Yo Dieting or Weight Cycling
Yet not only is exposure to stigma and discrimination a factor that influences health, another factor is the impact of yo-yo dieting or weight cycling. Despite diets or cleanses (or whatever the latest packaging for that stuff is today) proposing to be healthy and good for you, they actually put you body through a lot and can be harmful, particularly when coupled with the inevitable regain of weight. Those who engage in weight cycling have been observed to be at higher risk of loss of muscle tissue, chronic inflammation, hypertension, cardiovascular disease and mortality.
If that list sounds similar to the list associated with being “overweight” or “obese”, it is because it is similar. Is it the weight, or the impact of discrimination, or the result of weight cycling, or something else all together?? We don’t really know exactly what is happening because there are so many things that could be happening.
Is it Really Anyone’s Business?
Using a person’s weight to determine their health is not effective or accurate. But even if we were to put all that aside, is a person’s health any of your business? Personally, if I have a health issue the person I’d wanting to talk to about it would be doctor who knows how to properly monitor and treat it. I do not want to be having conversations about my health with someone who has eyeballed me and made assumptions based on the size or shape of my body while claiming to be “just concerned about my health”.
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