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  • Kayla Hartman

Who’s Really Paying for the So-called “Obesity Epidemic”?

Members and affiliates of NAAFA gather in NYC to support the ban of weight discrimination. 

In 2012, NBC graced their audience with the headline, “If you think we’re fat now, wait till 2030.” Since the early 2000s, foreboding articles about weight gain in the U.S. have run rampant in the news and social media. In 2004, the CDC released a statement claiming that 400,000 people died as a result of obesity in 2000, speculating that obesity could surpass smoking as a leading cause of death in the future. However, months after this article was published, the CDC admitted that the number was a gross overestimation due to methodological errors. This statement did not quell the increased fear surrounding the “obesity epidemic” and the increase in article headlines in recent years that perpetuate anti-fatness: the attitudes and policies that “keep fat people on the margins.” Even after the CDC article retraction, defense of the article persisted. For example, a 2005 paper by Katherine Flegal that contained findings against the CDC’s 2004 piece was met with a disproportionate level of heavy criticism, calling Flegal’s work “dangerous” to science. This criticism mirrors the rejection of the body positivity movement seen in popular media. 

Discourse surrounding body positivity and obesity research, no matter the findings, uses the BMI system. BMI has been used for diagnosing obesity since the 1970s and has only seen significant pushback in the last decade. The BMI is too simplistic of a system, as it does not account for muscle mass, age, gender, and race; however, many doctors have used BMI as a tool to evaluate the health of children as early as two. 

Even with the use of BMI, there is weak scientific evidence for a causal relationship between weight and chronic diseases for people who are overweight or even moderately obese. A 2007 study found that greater levels of physical activity, regardless of what weight categorization a person was in, was a stronger predictor for mortality, discovering that the J-shaped relationship between BMI and mortality held up. Therefore, according to this study, weight categorization has less to do with life expectancy than physical activity levels do; an overweight person who exercises four times a week is more likely to live longer than a person with a normal BMI who never exercises. However, this fact is often disregarded by researchers, health care providers, and ultimately the public, who often favor attaching costly comorbidities to “obese” populations. 

The “costs” of obesity have repeatedly been claimed by the media to be burdening our federal healthcare system, despite research showing that one of the most prevalent chronic diseases, heart disease, is not a direct cause of overweight or obesity. In 2021, Forbes claimed that there are over 170 billion dollars in extra medical costs due to the obesity epidemic. These cost estimates are often calculated based on the sum of costs of heart disease, diabetes, hypertension, and other illnesses attributed to being a direct cause of weight gain. Despite there being no actual confirmation that these diseases are caused directly by being overweight or obese, the costs of treatments for these diseases are seen as the cost of healthcare for an obese person. If the evidence is still unclear and most people are not categorized as at risk (by an already flawed BMI system), why is the ruthless killer obesity that the media has told us it is, “sweeping the nation”?

Often, the studies that indicate overweight and obesity status as a cause of common chronic diseases are  sponsored by companies that manufacture weight loss drugs. For example, a 1995 report, which classified a BMI over 25 as overweight, was influenced by the work of the International Obesity Task Force, who funded two weight-loss drug making companies. This report was released by the World Health Organization (WHO), which is widely regarded as a trustworthy source. Even though the information given to the public about obesity is delivered by well-established sources, the scientific basis for their conclusions that weight gain is a reason for many deaths in the U.S. are funded by profit driven companies. This puts into question the legitimacy of the research that pushes obesity as a burden and might help explain why Katherine Flegal’s 2005 paper, as previously mentioned, received such intense backlash.  

Portrait of Jackie Molloy during a NAAFA campaign event.

Additionally, the bills that overweight and obese people are supposedly contributing to do not outweigh the negative perceptions of obese people and the social and economic burdens that those attitudes place upon them. The quality of care for patients that healthcare providers perceive as fat is often worse than those they view as having a normal weight. Due to this, the solutions doctors often give to overweight patients tend to revolve around that person losing weight, instead of focusing on the expressed needs of the patient; a 2012 study found that almost 70 percent of “overweight or obese” women experienced these attitudes from a doctor. This tendency discourages obese patients from seeing a doctor when they experience health complications, which likely leads to the progression of illnesses and deaths that could have been prevented. Weight bias incidents also come from family members, peers, and educators in the form of negative comments and differential treatment, ranging from school-age bullying to workplace decisions to job discrimination. Additionally, anti-fat sentiments make it harder for overweight and obese people to be hired. 

Placing the cost of healthcare expenses in the U.S. on the shoulders of “overweight and obese” people as a scapegoat is not only unfound, but it is also unproductive in the move towards decreasing the prevalence of heart disease and other common chronic conditions. Dissolving the fear around being overweight would be a huge relief for people bearing the social and economic implications of being overweight or obese. This cannot be done without an overhaul of conflicting interests of medical researchers and the attitudes proliferated on social media and in news articles.


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