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Ash Pariseau's avatar

I think this misses what women are actually pushing back on. Most women know health matters. We live in these bodies. We know when we feel strong, tired, heavy, inflamed, anxious, attractive, disconnected, all of it. The issue is not that women want to be unhealthy. The issue is that women are tired of their bodies being treated like public property.

Elizabeth Wilkins-McKee, LCSW's avatar

I think this essay dramatically oversimplifies a remarkably complex area of research.

We know that chronic shame, self-loathing, weight stigma, and repeated weight cycling are associated with poorer physical and psychological outcomes. We also know that hating yourself has proven to be a remarkably ineffective long-term health intervention.

Contemporary obesity research is far more nuanced than this essay suggests. Weight is one variable but it is not the only variable. Health is influenced by metabolic factors, physical activity, cardiorespiratory fitness, sleep, trauma, medications, socioeconomic conditions, chronic stress, genetics, and access to healthcare. Two people with the same BMI can have very different health profiles.

That doesn't mean obesity is irrelevant. It absolutely deserves thoughtful clinical attention. But reducing an extraordinarily complex biopsychosocial issue to "feminism wants women fat" is neither good science nor good public health.

The essay also ignores where much of the field has moved over the past decade. Increasingly, clinicians are talking about body neutrality, not body positivity. The goal is not to convince people to love every inch of their bodies. The goal is to help people care for their bodies without making weight or appearance the center of their identity. That is a very different proposition.

I'd also encourage reading more broadly across the obesity literature. One book worth considering is "Big Fat Lies". One of the ongoing challenges in obesity research is disentangling the effects of adiposity itself from the effects of weight stigma, discrimination, healthcare bias, chronic stress, repeated dieting, and the lived experience of being an obese person. Those variables are extraordinarily difficult to separate in longitudinal research, which is precisely why sweeping claims should make us cautious.

Finally, I think this essay replaces one reductionism with another. It rejects one ideological narrative only to substitute a different ideological narrative. Women's bodies deserve better than becoming the latest battleground in someone else's culture war.

If we're going to write confidently about women's health and public health, we owe readers the breadth of the evidence not simply the evidence that confirms our preferred worldview.

And perhaps the better question is this:

Who benefits when women spend their lives believing their bodies are projects to be fixed?

The answer is not simply "feminism." It is an entire ecosystem of industries, weight loss, wellness, beauty, pharmaceuticals, social media, and yes, parts of medicine that profit from women's dissatisfaction.

That is the conversation I wish this essay had taken seriously.

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