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A new book by UCLA sociologist Abigail Saguy argues that American attitudes about fat might be more dangerous to public health than obesity itself. “What’s Wrong With Fat?” untangles the escalating concerns around the obesity epidemic by exploring two imperative questions: First, how and why has fatness been medicalized as “obesity” in the first place? Second, what are the social costs of this particular way of discussing body size?

Saguy believes that simply using the term “obesity” suggests that weighing over a certain amount is pathological. “This perspective shuts out other interpretations of fat as, say, potentially healthy, an aspect of beauty, or even as a basis for civil rights claims resulting from discrimination, which has been well documented.”

Although Saguy does not deny the health risks associated with higher body mass, she cites medical research showing that even this association may not be causal. “It’s not clear whether obesity per se causes diabetes, whether diabetes causes obesity or whether both conditions are caused by a third factor, such as poor nutrition, stress or genetic factors,” she says.

When searching for the root of the “obesity epidemic”, Saguy argues that while experts scramble for answers, they mistakenly focus on individual responsibility. In placing blame on the individual, they disregard the ways in which body size is strongly controlled by genetic factors and shaped by social factors. This book systematically examines how the medical profession, researchers, corporate-sponsored associations, and the mass media, have transformed fatness into an international public health crisis.

America’s frantic debate on the “obesity epidemic” and rapid hunt for answers has glazed over some of the most important questions: How has fatness come to be understood as a public health crisis at all? Why has fat become a matter of morality, character, and medical pathology? Why can’t weight become consistent with beauty, wellbeing, health, and success? What are the consequences for understanding weight in more positive ways?

Saguy encourages readers to set aside entrenched assumptions of fat and obesity. Considering fatness in a new light could have profound implications on the lives of many Americans – easing weight based discrimination, bullying, and misdiagnosis. “What’s Wrong With Fat?” will be published on January 3rd by Oxford University Press.