Fat people, amirite?

Plenty in the news about award-winning comedian Sofie Hagen these last few days, because she’s pissed. The London-based performer is upset with Cancer Research U.K. (CRUK) for the public health campaign they launched regarding how obesity increases risk of cancer. She called it fat shaming.

I won’t say she’s right or wrong. People always want things to be black and white. Either the campaign is fat shaming, or it isn’t. But there is nuance to this stuff. Shades of grey and all that.

Cohort studies reveal a doubling of risk for many cancers due to obesity. Ethical and practical constraints mean determining causation is impossible, but there’s plenty of evidence to suggest a strong relationship between obesity and higher risk of cancer. Beyond cancer, I made clear in this piece for the Chicago Tribune obesity comes with a host of increased health risks. Of course, there was backlash from the Health At Every Size (HAES) group to that column, which prompted me to write a follow up about my issues with their unscientific opinions regarding the risk of obesity.

HAES was a good idea gone bad. Having self-compassion, endeavoring to live your best life, accepting your body and your potential and limitations and wanting to be happy in your own skin—these are all wonderful things. Denying science and saying there isn’t increased risk and that no one should ever try to lose weight is not so wonderful. Some people in HAES often vehemently discourage weight loss among their members. The irony is, they shame people for wanting to lose weight.

I have a long history of calling out fat shaming. There is no value in it. I’ve referred to it as “the last acceptable form of prejudice.” Vilification of obesity is constant. People with obesity are portrayed as lazy, gluttonous, stupid, unworthy, ugly, a drain on society … it’s a constant barrage of hate from which there is no escape. They are mistreated in public, in the workplace, in popular media, by their families, and by their physicians.

Imagine having “Doc, I think I have an ear infection” met with “What you really need to do is lose weight.”

My friend Dr. Yoni Freedhoff also published a piece about this story today. One thing he pointed out was that Cancer Research UK could better spend their time and money to “mount a campaign to educate doctors about how weight bias has been shown to lead physicians to screen their patients with obesity less frequently for various cancers.”

But CRUK is just trying to educate those fatties so they don’t get all cancerous and stuff, aren’t they? Read Yoni’s piece linked above regarding how we’ve been trying to guilt and shame and scare people into weight loss for decades, and it hasn’t worked.

At the same time, I understand where CRUK is coming from based on a 2016 survey they conducted showing three-quarters of people weren’t aware of the link between obesity and cancer. Shades of grey. Nuance. Not black and white. In other words, I can’t lambaste them for wanting to share important health information, but I also believe it could have been handled better.

Likewise, I can’t criticize people with obesity for fighting back. I don’t know Sofie. I don’t know if her reaction is one based on emotion from years of prejudice, but I have suspicions. These suspicions come from engaging with thousands of people who’ve experienced incessant fat shaming.

In the title, I referred to Sofie as a “plus-sized comedian.” I did that to echo the many articles discussing this story to reveal how they see her. To many, she’s not a comedian, or an award-winning comedian, she’s a plus-sized one, because for many, her body weight defines her. It’s the first thing they see. It’s mostly what they see.

As you can read in the feature photo, Sofie’s initial tweet in response to CRUK’s poster campaign was: “Right, is anyone currently working on getting this piece of shit CancerResearchUK advert removed from everywhere? Is there something I can sign? How the fucking fuck is this okay?”

Now before you start thinking her too sensitive, imagine being regularly criticized for your weight, perhaps almost daily, year after year. It wears on you. Then one day, on your commute you’re feeling okay, but then you see this poster that seems to scream into your face “You’re going to die of cancer because you’re fat!”

And the poster is everywhere.

It’s a constant reminder of how many in society view you as lesser, a drain, weak, cancerous …

And the reply to Sofie’s tweet was about what you could expect. In true Twitter fashion, people tried to outdo each other with their insults about her body.

CRUK also replied to Sofie on Twitter: “Hi Sofie, our campaign isn’t meant to make anyone feel bad about their weight or make anyone think negatively about people who are overweight or obese. Our aim is to raise awareness of the link between cancer and obesity.”

And they did. In fact, Sofie’s reaction and the ensuing media shitstorm likely made the campaign far more successful in that regard than CRUK ever imagined.

But does the success of the campaign matter? Sofie dug in deeper with some HAES-like tweets about how obesity isn’t unhealthy, and I expect many others of that mindset only became more polarized in their thinking. Another thing to consider is that weight stigma creates negative mental and physical health outcomes. It may not have been CRUK’s intention to make people with obesity feel bad, but it did. And they should have known it would and that those negative feelings would translate into negative health outcomes.

The campaign may have raised awareness, but at what cost? One reply to the campaign I believe speaks for thousands of people: “It made me feel like shit the nine times I’ve had to pass it since I first saw it yesterday so thanks for that.”

I don’t think we should hide the truth. But I do see merit in always endeavoring to find a way to help people using compassion and understanding, and this campaign didn’t do that. As I wrote here, going overboard on loving your body can lead to denial of the risks of obesity, but self-loathing isn’t helpful either. Self-awareness is a key component of weight loss, and you don’t have to destroy people psychologically to bring about such awareness.

Before you go on a tirade in the comments, there are some other pieces of mine you may wish to read.

One is my piece about “the solution to obesity,” which has been lauded and shared by many obesity researchers. It points out that obesity is very much an environmental issue; the current situation we find ourselves in seems designed to manufacture body fat. Willpower isn’t the answer to this worldwide dilemma.

You may also wish to up your compassion meter by reading my piece for the Chicago Tribune about sex abuse and weight gain. First off, childhood sexual abuse is far more common than most imagine, and the relationship between adverse childhood experiences and a host of negative health outcomes, especially obesity, is staggering. So before judging people for their body weight, recognize you don’t know their story.

More pieces of mine to read: Don’t forget to acknowledge your fit privilege before you engage in concern trolling over obesity. Also, realize that simply telling people to “eat less, move more” is bullshit. And finally, understand that fewer than 3% of the population has optimal health behaviors before you engage in the hypocrisy of fat shaming.

If you read all those pieces and still feel justified in shaming obesity, I don’t know what to tell you.


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James S. Fell, MBA, writes for the Los Angeles Times, Chicago Tribune, Women’s Health, Men’s Health, AskMen, the Guardian, TIME Magazine and many other fine publications. His first book was published by Random House Canada in 2014. He is currently working on his next book, which is about life-changing moments.