This is a topic that is very close to my heart and something that gets me insanely worked up! This is a bit of a long post so please read the whole the post before commenting!
Cosmo has recently put plus-sized model, Tess Holliday on the cover of their magazine and the internet has exploded. There has been every comment under the sun from fat shaming to obesity glorification. Everyone is having an opinion.
So here’s the thing – Tess Holliday is morbidly obese with a BMI of 46.6 and this kind of obesity puts you at risk for many chronic conditions including:
- cardiovascular disease (heart disease) the leading cause of death around the world
- type 2 diabetes – our fastest chronic illness
- high blood pressure – a major cause of stroke
- some cancers such as breast and colon
- kidney and liver disease
The World Health Organisation (WHO) has stated that obesity is the leading preventable cause of death and disability. Around the world, over 1 billion people are overweight and of that, approximately 600 million are classified as obese. It is so serious that it has now been labelled a global concern.
But what I need to point out is that poor heath and obesity are not mutually exclusive. We don’t know much about a person by looking at them and we certainly don’t know if they’re healthy or not. I get so incredibly frustrated by people using size as a sole measure of health. I know SOOOOO many people who are slim and VERY unhealthy and those who tip the BMI scale into the obese category who are very healthy. In fact, I have written about this before. Here’s a snippet:
When someone is considered to be metabolically healthy, they have normal markers such as blood pressure, a normal triglyceride to HDL ratio, normal insulin levels and normal blood glucose levels. Why are these markers so significant? Because they are markers for cardiovascular disease (CVD). This year alone, 33% of deaths in Australia will be due to this condition, which equates to almost 50 000 people. What really scary is that many people are completely unaware they have CVD, with their first warning being a heart attack or stroke. Sadly for many, this is the only warning they get. So how is it possible that someone can be completely unaware they’re so sick?
Well, just as there is a class of people who are obese but healthy, there is also a class of people who are normal weight but very unhealthy. These people are called metabolically obese normal weight individuals (MONWI). These people show signs of metabolic derangement (such as elevated glucose, insulin and blood pressure) but don’t know because these factors are initially asymptomatic. In addition to this, they are slim (or have a normal BMI) which means they are under the false premise they are healthy. Sadly they then believe that what they’re currently doing is working. This means they are not being encouraged to change their diet or start exercising by health professionals, when in fact they are walking heart attacks. It seems that medical professionals are generally only encouraging people to lose weight when they tip the BMI scale over 26. Otherwise, it’s business as usual.
Now don’t get me wrong, I am the first to say that excess body fat is not ideal BUT it needs to be in context. I am more concerned when I see body fat deposited on the abdomen than I am with body fat distributed evenly, subcutaneously (under the skin). In fact, there is a lower morbidity and morality associated with fat on the lower body. This is because the real danger is in a type of fat called visceral fat. This is the fat that is distributed around your organs (of particular concern around your heart and liver). Increased fat around the heart can lead to heart arrhythmias, heart failure and heart attacks whilst fat around the liver can promote non-alcoholic fatty liver disease (NAFLD) – a significant health concern and contributing factor to many other serious medical conditions. In fact NAFLD is linked to insulin resistance, elevated blood glucose levels and high blood pressure – all markers of metabolic derangement.
What’s important to understand is that you cannot tell how much visceral fat someone has by looking at them. Just because someone has a high subcutaneous fat, does not mean that they also have a high visceral fat. The two are not mutually exclusive. And even more importantly, it means that a low body fat does not equal a low visceral fat.
So back to the case of Tess Holliday – here’s what I get really worked up over! What REALLY grinds my gears is that we have so many people screaming about how we are glorifying obesity by putting her on the cover of Cosmo BUT how many people do they put on the cover who are smokers, binge drinkers, drug takers and skinny fat? It is beyond hypocritical to suggest that Tess should not be on the cover because it promotes an unhealthy lifestyle when they do not screen other cover models for unhealthy behaviours. Never mind that her critics are only using her BMI to assume her health. They don’t know if she’s exercising, eating well or if she’s lost weight already. Then there’s the teensy tiny issue that health is multi-factorial – it is not merely the absence of disease but a complete state of physical, mental and social well-being. So who bloody knows how healthy she is? Maybe we could ask her to take a survey 😉 I don’t know how it happened, but obesity has somehow become the worst crime. Our society has made it a public declaration of lazy, gluttonous, stupidity. The number one social sin!
I’d like to also point out that obesity is a state, a medical condition not who someone is. I don’t want people being called obese anymore as it is a classified medical condition; one that is highly resistant to intervention, highly susceptible to relapse and one that robs people of their confidence, their power and ultimately their lives.
I want people to know this: You are not obese. You have obesity. Obesity is not who you are. It is something you have. It does not define you. It does not make you less of a person. It does not mean anyone can treat you less than you deserve and I say shame on every single person who has said that by putting Tess Holliday on the cover of Cosmo, it glorifies obesity. I say, it says that people who are obese, are just as deserving, just a worthy as any other person be on the cover of a fashion magazine!