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Who’s to Blame for Fat Shaming?

It’s time for the medical community to admit mistakes and stop blaming patients for obesity

Dr. Jason Fung
5 min readDec 12, 2018

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Obesity is such an emotionally charged issue in large part because it has become entangled with a person’s willpower and character. This makes it different from almost every other disease due to the unspoken accusation that you did it to yourself.

Many physicians unconsciously engage in fat shaming because they believe that pointing out the many ways a person could’ve done better gives patients extra motivation to lose weight. As if the whole world was not reminding them every single day.

When it comes to fat shaming, I believe the camp that’s popularized the “Calories In, Calories Out” (CICO) mentality are responsible for a share of the blame. I’m talking about physicians and researchers who constantly insist that “a calorie is a calorie” or “it’s all about calories” or “eat less, move more.” What they actually imply with this rhetoric is “it’s all your fault.” Instead of treating the disease of obesity with compassion and understanding, this mentality infuses it with personal shame. I’m here to argue that calories in versus calories out is a pack of lies fed to us by corporate interests.

Obesity has come to be understood as a fundamental imbalance of energy and calories. This is a crucial mistake.

If you develop breast cancer, for example, nobody secretly thinks you should have done more to prevent it. Nobody condescendingly tells you to “get with the program.” If you have a heart attack, you don’t face accusations. Yet obesity has become a disease singularly unique in its association with shame. CICO folks imply that if you could just stop eating and stop being lazy, you too could look like Brad Pitt. But it’s not true. Instead, this deflects the blame for the obesity epidemic from ineffective dietary advice that’s been peddled for decades.

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Dr. Jason Fung

Nephrologist. New York Times best selling author. Interest in type 2 diabetes reversal and intermittent fasting. Founder www.TheFastingMethod.com.