Students should rethink the language used to discuss body weight and size. (Mimi Cole)
Students should rethink the language used to discuss body weight and size.

Mimi Cole

Intuitive Eating with Mimi: Why I don’t believe the “Obesity Epidemic” is a problem

How the body processes nutrients and the many contributors towards weight

January 4, 2020

Photo by Drew Baxley

One phenomenon that most people agree upon is that an “obesity epidemic” has swept our country. The public tends to attribute the lack of time spent outdoors, a decrease in exercise and increased consumption of “junk food” as the root of the epidemic of larger bodies in our country. However, I believe that this “obesity epidemic” is actually a moral one that values some people over others based on their bodies. People’s health and character have nothing to do with their bodies, and fat actually serves many helpful functions in the body.

The body mass index (BMI) scale commonly used by doctors to measure health is very outdated, and doesn’t account for factors like bone density and muscle mass. The BMI scale even changed overnight when standards shifted in 1998, causing individuals who were once considered normal weight to be considered overweight the next day. In fact, in a longitudinal study examining hundreds of thousands of individuals through the National Health Interview Survey (NIHS), researchers found that being overweight was associated with lower mortality, and was actually a protective factor against death. 

The notion that individuals can simply eat “right” and lose weight easily is saturated in diet culture; false misconceptions about how weight is determined and how the body processes food are rampant. Weight loss studies that show that maintenance of weight loss and personal anecdotes typically do not account for long term (greater than 5 years) follow-ups, weight stigma, weight cycling and weight suppression that returns later. These studies also don’t account for chronic dieting and disordered eating, both of which are associated with the development of eating disorders. The most important factor to work on for optimal health is changing health behaviors (i.e. adding more nutrient-rich foods rather than subtracting or restricting; incorporating sustainable and joyful forms of movement), independent of weight, as up to 95 percent of dieters will regain the weight lost, and more back.

The idea that if you just expend what you consume, you will lose weight, simply offers people a false sense of control over their weight. When we consume calories, or energy in the form of joules/kilojoules.This energy is processed and stored in our bodies in different ways. Eating fat does not make someone fat; it is used in the body to keep our organs functioning well, keeps us warm and helps us attain satiety. The body uses a variety of nutrients and knows what to do with them. We can trust our bodies to use the food we eat to support our energy needs and for cognitive, mental and emotional functioning. 

There are several contributors to a person’s weight that have little to do with their diet and exercise. Accessibility to a variety of foods can be limited in food deserts, socioeconomic status can influence ability to buy different types of nutrient-rich foods and genetic predispositions towards metabolic rates are all contributors towards weight. Our bodies are not the problem. The eighth principle of intuitive eating is to respect your body weight. It will fall at its set point, or the weight at which optimal functioning occurs for your body, when you learn to honor your body’s homeostatic cues of hunger and fullness. You can trust your body to tell you what it needs and when, so don’t worry about your weight if you are honoring your body cues. 

So what does this mean for you as a college student? Individuals in larger bodies are just as worthy as those in smaller bodies; this outlook informs our language in the ways we talk about our own and others’ bodies. It means that we begin to stop shaming people for the fat on their body or belittling others because of their weight. Disrespecting others’ bodies with the words we use is often a reflection of the way that we feel about our own bodies, and can have negative consequences for our society when we ostracize those in larger bodies. It means that if you’re studying to become a doctor and/or politician, you advocate for healthcare that is weight-inclusive. The Health at Every Size paradigm is a social justice movement to accept and learn to value people in larger bodies, and it is something that begins with our studies here. We must examine our own biases towards fat and our narratives about the worth of people in larger bodies, and work towards equitable treatment of people in all bodies.

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Comments (13)

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2 years ago

Thank you Mimi for having the courage and energy to write about a very complex (and clearly controversial) topic in a sensitive and thoughtful way. Though I can understand why some readers may have alarmed by your reference to the study suggesting a link between overweight and lower mortality, I think they greatly misunderstood the point of your article.
I certainly don’t have the credentials to comment on those findings, but I think it’s quite telling that the mere suggestion that being « overweight » might not, in itself, lead to poorer health can elicit such strong (and perhaps a bit aggressive) reactions. If maintaining a healthy body were only a matter of knowing about the health problems associated with obesity, wouldn’t we have solved the « obesity epidemic » by now?
As someone who has been fighting an eating disorder for many years, I strongly believe that widespread messages exhorting everyone to monitor their diet and exercise to maintain a certain BMI are missing the target and causing unwanted damage. And I really don’t see how valuing and respecting people of all body types should be seen as dangerous in any way. I will keep following your reflections on this topic!

Unsettled Undergraduate
2 years ago

This article is disturbing and moreover patently dangerous in its ignorance. Cherry-picked observational data masked with misleading context is not sufficient to validate the author’s claims, regardless of their “feelings” and “different ideas”. I respect that the Hustler provides a forum for its columnists to voice their opinions, but opinions offered against scientific basis should be relegated to the realm of pseudoscience. I wish the author the best in continuing their health sciences education, and hope they are able to put scientific evidence and rigor ahead of their intuition and sentiment.

Lenny Husen M.D.
2 years ago

I like Mimi’s article. I am a practicing Physician who supports the Health At Every Size paradigm. I do not believe in “The Obesity Epidemic” and have a strong bias against using the word “Epidemic” to describe a natural phenomenon that is not an Infectious Disease, or a Disease at all. Rather, Obesity is a very complex condition which Tends to occurs when genetics interact with plentiful access to food, usually unhealthy processed food, limited activity and often limited resources.
Obesity does have health consequences which I cannot deny.
Here are the facts:
Losing a small amount of weight and keeping it off long term can be beneficial whereas large losses and regain are extremely detrimental.
Intuitive eating and a mostly plant-based diet seem to result in a healthier body.
Fasting and Restrictive Calorie Diets are not advisable due to a probable rebound binge-eating which is biologically driven and not caused by lack of character.
I advocate exercise, and joyful movement for all bodies. An hour a day of exercise is ideal and even more if possible.
Speaking for me and most physicians, as well as most Americans it is very difficult to get enough physical activity. We need to choose between work, technological distractions, passive pursuits such as reading and watching media and seated conversations, games, versus getting up and moving.
There is no easy way to eat the perfect amount and type of food. There is no easy way to exercise enough unless you are a natural athlete or hyperactive child perhaps.

I believe societal weight stigma and body shaming and thin doctors judging fat patients is much much worse a threat to health than is obesity.

Thanks Mimi for a thoughtful article.
I agree with the majority of the points you make.

Bernie Sanders
2 years ago

This disappoints me so much that I’ve decided to withdraw from the presidential race. This article has disgraced this once great institution.

2 years ago

I work with some people in their 50s who are about 50-60 pounds overweight and have been carrying this weight for years. They now have joint pain and use canes and sometimes have to use crutches. I assume there is a link to their weight? I imagine using a c-pap machine at night wouldn’t be much fun. Don’t obese people typically use those? I guess it’s a quality of life issue and Mimi seems to ignore that aspect. I doubt carrying an extra 40-50 pounds is much fun. Is there a faculty advisor at the Vanderbilt Hustler who might screen some of these columns? Seems like the advice provided by Mimi is a bit…mmmmm….suspect.

Jane Doe
2 years ago

As someone who has had extensive education on this topic, I strongly agree with Mimi Cole. The HAES movement is far more concerned with an individual’s relationship to food and their body and supports that when a person is listening to their hunger and fullness cues their body will reach its set point, which might not be in the “ideal” weight range (the outdated BMI chart.) Unfortunately, diet culture has caused many people to lose any kind of connection to their body. The HAES movement and what Cole stands for supports acceptance and equal treatment of all bodies of all sizes because health looks different for every single body. Thank you for this article!

John Doe
2 years ago

I think the idea that our diet culture and general way of treating people who are overweight or obese is not actually helpful when it comes to making a change, but I STRONGLY disagree with the discounting of the actual health issues that result from weight problems. Citing one observational study is not enough evidence to counteract a medical consensus that has clear biological explanations,

Another Annoying Jane Doe
2 years ago

Your statement about chronic health conditions being linked to higher weight individuals is correct; a correlation has indeed been identified. What your comments neglect to note, however, is the fact that these weight loss “success” studies are unable to conclusively find a casual relationship between “overweight” and “obese” individuals and the health conditions listed. Confounding variables mitigate the relationship between the correlated items, and we must note that individuals in larger bodies are often greater victims of weight stigma, yo-yo dieting, and weight cycling. PhD researchers Linda Bacon and Lucy Aphramor explain in their book, Body Respect, that weight cycling may explain all of the excess heart risk seen in individuals in larger bodies (2011). It isn’t a far jump to wonder what other chronic diseases—that we typically blame on higher weight—can be explained by confounding factors such as weight cycling. I’d also encourage you to take a look at masters-level dietitian Christy Harrison’s final debate slides from the FNCE conference last year where she debated a weight management physician about this very topic:

These unfortunate comments also fail to recognize the fact that the Health At Every (read: not “any”) Size movement is not inherently anti-health; on the contrary, the movement is very pro-health.

Be careful next time you tear apart a student’s work, claiming that she ought to have the same expertise as a physician with decades of training. Also, if you’re going to claim that research is “cherry-picked,” make sure that your research isn’t cherry-picked, yourself.

2 years ago

Thank you all for your comments. I read through every single word you write. I appreciate the feedback, albeit negative in its nature. I firmly believe in the Health at Every Size paradigm and the intuitive eating movement based on the research that I have seen and read thus far. I am human, and have of course not read all of the research on both sides: I am always learning. I believe that the idea of an obesity epidemic has done harm to individuals and pathologized those in larger bodies. My goal is not necessarily to promote body positivity, as I more align with body acceptance. My research seems to show that weight cycling, weight stigma, and health behaviors such as incorporating nutrient dense foods and joyful movement are more impactful indicators of health than size or weight. I am willing to admit that I may be wrong, but I believe what I believe for a reason. Yes, I am an undergraduate, but people who have delved into these issues more deeply than I have also aided me in the development of these ideas and this research. I cannot give you all of the answers you are looking for, but please remember that I am a person with feelings and different ideas. I encourage you to consider research on both sides. It isn’t health at any size, it is health that is possible at every size, and I believe this to be a compassionate, well-researched paradigm to look into.

Another Jane Doe
2 years ago

Yes – body positivity is super important. But wow, what a dangerous, bad article.

I think we should treat morbidly obese people the same as stick thin people in terms of respect, rights, etc. Somebody’s weight should not be the basis of how we treat them. I don’t think anybody is advocating in favor of discriminating against fat people.

However, we ARE in control of being at a healthy weight. Yes it is unbelievably difficult psychologically more than physically in my opinion, and eating disorders make this even harder. We should support people trying to be healthy and people trying to love themselves, but that does not mean promoting or normalizing obesity.

Obesity is an issue and typically indicative of other underlying issues. It is very dangerous to blindly promote body positivity in such an aggressive, strange article. Socioeconomic factors exist but they are just obstacles, not complete barriers. The excuse game encourages unhealthy lifestyles, and I think we need to support people without such a toxic misinformed mindset.

Again, this is a poor article. It is bad information and I strongly believe the writer should apologize for spreading such a bad mindset (not because she meant badly but because this has a negative effect).

Billy Joe
2 years ago

It baffles me that this is something the author feels qualified to write on. While Cole does, in all fairness, specify in her column title that this is something she “believes,” (not something with academic merit) this is not the way to practice body positivity. It is absolute nonsense to pretend the obesity epidemic isn’t a problem in the first place—there are situational factors that immediately disprove that, such as the fact that different countries have highly different rates of obesity and related diseases (think US vs France). Similarly diverse gene pools and yet massively different results….it’s almost as though diet and entrenched habits contribute to that “set point” and even the “intuition” that maintains it.

And, quite simply, times have changed. The modern availability and abundance of ungodly amounts of highly processed foods and ridiculously complex sugars the body did not evolve to metabolize is not foreign to the obesity epidemic. And the fact that the times and headlines have literally changed—that obesity was once not an “epidemic” or cause for public concern—pretty much negates Cole’s cherry-picked scientific argument entirely. Though there are certainly genetic determinants that will trend individuals toward various body types, there are ways to reach a more healthy BMI, whether that requires gaining or losing weight. Love yourself for your inner worth, but by all means do not reduce your potential length and quality of life with the misguided belief that you can’t reach a healthy BMI because you were dealt a bad genetic hand.

Tom Cruise
2 years ago


Jane Doe
2 years ago


Please discount nearly everything the author has written in this opinion piece. It’s one thing to promote anti-bias efforts against obese people, and it’s another thing entirely to dangerously say that the “obesity epidemic” is not a problem.

The author has cherry picked one study when the vast majority of studies have shown the correlation between obesity and a wide variety of health problems, including congestive heart failure, high blood pressure, pulmonary embolism, type 2 diabetes, infertility, stroke, dementia, and even cancer.

There are many, many criticisms from actual licensed medical professionals (not MHS majors) to this erroneous “Health at Any Size” movement. See: