“If everyone in the U.S. saw half as many headlines about the obesity epidemic as they see now, the world would be a much better place.”
Note on language: In this piece, “fat” is a neutral descriptor for body size in alignment with one area of academic study. This article strays away from terms such as “obesity” and “obese.” According to researchers in the discipline of fat studies, both terms are pathologizing, meaning they equate weight with health and frame larger body sizes as abnormal. Most often “obese” is used in a clinical setting, often in reference to the flawed BMI scale.
The “headless fatty” trope, a phenomenon coined by psychotherapist Charlotte Cooper, is one way journalists contribute to weight stigma and the negative everyday experiences of fat people.
The headless fatty trope occurs when photos or videos of fat people are used in visual news without their consent. The clips, often stock or file footage known as “b-roll,” show people’s torsos and bodies but not their faces. In one study, researchers analyzed photos of fat people used in news media and found that nearly half showed bodies only from the shoulder down.
Kate Phelps, a fat studies researcher and professor at the University of Wisconsin–Madison, says these dehumanizing clips are used as a “cautionary tale and form of fear mongering around a constructed obesity epidemic that is often not engaged with in a critical way other than by academics and activists.”
According to Mikey Mercedes, a doctoral candidate at The Brown University School of Public Health, “Fat people are paid less, they’re evaluated more harshly. They’re ostracized in many social scenarios.”
Weight stigma, or anti-fat bias, is discrimination against people because of their body size. Weight stigma affects many facets of life and is often perpetuated by news media.
According to a growing number of fat studies experts and activists, nonconsensual b-roll of fat bodies is just one of the ways news media do harm and perpetuate weight stigma.
These experts argue that journalists can and should humanize fat people and combat weight stigma by investigating widely held beliefs about the correlation between health and weight, being careful about language, platforming fat people’s voices and valuing their expertise.
The state of current coverage
Despite media’s role in propagating weight stigma, few guidelines for better reporting exist. The AP Stylebook currently offers no guidance on whether such words as “obesity” should be used.
Fat studies experts say the term “obesity” is often harmful and that the “obesity epidemic” is an artificial framing that does not accurately illustrate the relationship between weight and health.
In 2014, the American Medical Association named obesity a disease, but the decision was controversial and went against the recommendation of their own panel of experts.
“It has this ripple effect into how we are going to think about it,” Phelps said of the AMA decision, adding that the effect extends to how journalists report and the language they use. “We’ve seen that in the last 10 years around how people are reporting out about issues surrounding obesity and health and how we continue to conflate thinness with health.”
Rachel Fox, a doctoral candidate at the University of California San Diego studying the oppression of fat people, echoes Phelps’ concerns. “Obesity is not naturally an epidemic,” she said. “That is a human construction of changing rates of a particular body size over time.”
Fox said media plays a major role in creating medical phenomena and questioned what the world would look like if the media covered weight and health differently.
“If we’re talking about diabetes, let’s name that,” Phelps said. “Let’s not use body size as a proxy for saying, ‘This population of people is unhealthy or diseased because we’ve named it as such.’ If we’re going to talk about issues related to chronic illness, then we should be naming that.”
Phelps, who uses she and they pronouns interchangeably, said some of the best journalistic work she has seen from a fat studies perspective does not engage with the language of body size at all in relation to health.
“That’s not to suggest that the language of obesity can’t be used, but I think it does need to be used in a much more critical way than it has,” they said. “Because that really harms fat people and dehumanizes them.”
“That is part of why news reporting on obesity and its health consequences is so hard because it is this constant presentation of a connection between fatness and badness,” they said. “When that’s all you see, of course, that’s what you internalize.”
The sheer number of articles covering the “obesity epidemic” and correlating fatness with negative health outcomes causes harm, some scholars argue.
“If everyone in the U.S. saw half as many headlines about the obesity epidemic as they see now, the world would be a much better place,” Fox said.
One of the things Mercedes is most critical of in mainstream writing about fatness and health is attribution. According to Mercedes, people believe that challenging long-standing myths about why people get and stay fat can disrupt weight stigma.
However, Mercedes said changing what fatness is attributed to will not solve the issue of weight stigma. “Maintaining that fatness is bad, even if it’s not in people’s control, is still stigma,” they said.
In their article, “No Health, No Care“, Mercedes rejected many of the patterns they have witnessed in mainstream news media and research.
“I was really stubborn about starting that article with the assertion that fat people are worthy of their lives regardless of how close they are to health,” they said. “I don’t really care if fatness is linked to health. The research doesn’t support that assertion, which is important, that’s the misinformation piece. But ultimately, I do not care.”
Weight as a social determinant of health
In addition to experiencing prejudices in day-to-day life, fat people have a different experience with health care. “Fat people experience a completely different two-tiered healthcare system, one that not only deprives them of basic levels of care but also harms them,” Mercedes said.
Weight stigma, and the harm fat people face within the health care system, are factors affecting fat people’s health.
“We have enough evidence already that clearly describes that the association between weight and health is weight stigma,” Mercedes said. “But that has not been taken up in the literature … people do not talk about weight stigma as a social determinant of health.”
Because weight stigma is not included in much of the research about the association between weight and health, journalists are left without information that might help them report more accurately.
“It is a normal, acceptable social practice to diagnose fat people with disease,” Mercedes said. When there is an attempt to call out anti-fatness, they argue, people are quick to respond by saying that fatness is unhealthy, so they should discourage people from being fat.
Media also play a major role in causing people to have this “clinical sensibility” about fatness.
“The way journalists do their job circulating or dispensing scientific information is just one of the main mechanisms by which the public develops a clinical sensibility about fat people,” Mercedes said.
Samantha Murray, author and Cultural Studies lecturer at Macquarie University, argues that “The discourses that circulate around fatness reproduce it as a pathology” and ultimately impact the public perception of fat people. Research has shown that prejudice against fat people is a problem worldwide, and the public continues to make negative assumptions about fat people.
Even when journalists attempt to report with nuance, they often start by framing obesity as a “health care crisis.” According to Mercedes, this assertion negates attempts to include nuance because it automatically links fat people to disease and death.
“I have seen very few pieces of mainstream media that do not have that assertion,” they said.
Platforming new voices to avoid medical misinformation
“One of the things that we see is not privileging or prioritizing the voices of fat people in stories about health,” Phelps said.
Phelps pointed to journalist Michael Hobbes and an article he wrote in 2018 called “Everything You Know About Obesity is Wrong.” The article started a conversation because it took a new approach by “changing the narrative and centering voices of fat people in the experiences that they’re having in the clinical settings,” she said.
Mercedes is often approached by journalists for their work as a fat activist, research on how anti-Blackness and anti-fatness shape health care, and her lived experience.
“There are many times I’ve been engaged by journalists for my lived and learned expertise, but ultimately, only one kind of expertise shows up in the actual article,” they said. “And it’s the traumatic stuff, where I have been told that I’m gonna die by a doctor since I was 8 years old, things like that.”
The pattern of journalists including fat people’s lived experiences, but not their expertise, means that anti-obesity researchers determine the narratives surrounding weight and weight stigma.
“These are the people who are determining what is within the scope of weight stigma and what isn’t. And then there are fat people, who are often brought in to sprinkle some lived experience on the media that exists,” Mercedes said. “That’s one of the biggest divides I see that perpetuates harm through journalism on the issue of weight and weight stigma.”
Fat activist Charlotte Cooper coined the term “stitched-up” to describe how Western media manipulates sources when including both activists and researchers in the same articles. Fox referenced Cooper’s work, saying the dominant narrative in most news correlates fatness with poor health and encourages a world without fat people. Activists share a perspective that counters that narrative. However, when their words are paired with “experts” who are taken more seriously in the public sphere, there is an imbalance.
“I think it’s important that journalists are doing their due diligence and that they are examining issues from multiple perspectives and attempting to report in ways that are driven by facts,” Phelps said. However, she agrees that sometimes expert opinions and research do not tell the whole story.
Phelps said it is “critical” journalists consider whose voices they are including in their work.
“Whose voices are present here?” she asked. “If you are championing information or quotes from people that represent AMA, are you also representing the voices of patients with experiences within a clinical setting?”
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