Fat Acceptance and Vaccine Rejectionism #359

Guest article by Rony Guldmann

Dear friends of Daily Philosophy,

Continuing our recent series of articles on philosophy in daily life, today we have a very interesting and provocative article by lawyer and philosopher Rony Guldmann, who compares the public discourses (mainly from a US perspective, but with similarities in other Western countries) around obesity acceptance and vaccine rejectionism. It’s easy to dismiss such thoughts, because we all have our own, often quite entrenched opinions on these matters — I know that I do. But I found the approach of Dr Guldmann very interesting, and so I would like to ask you to temporarily suspend your default opinions and consider the article’s arguments for a while. Of course, you don’t need to agree with any of the points made in the article, but I find it valuable that we can discuss these matters in a calm and rational way. Something that, unfortunately, seems to have become rare in the public discourse in recent years.

And after you’re done reading, I would love to hear your opinion! You can easily leave a comment by pressing this handy button here:

Thanks, and have fun reading and discussing!

Fat Acceptance and Vaccine Rejectionism

By Rony Guldmann

Sweetgreen CEO Jonathan Nemen sparked a firestorm in October 2021 when he posted on Linkedin that America hadn't been paying enough attention to obesity's role in aggravating Covid's dangers. While endorsing the vaccines, Nemen seemed to downplay their usefulness as public health measures, lamenting that Covid "is here to stay for the foreseeable future" because "no vaccine nor mask will save us." Foregoing these false hopes, Nemen recommended focusing on the root cause of many Americans' susceptibility to Covid's worst outcomes, our unhealthy lifestyles and, specifically, surging rates of obesity, suggesting that, with government health mandates now de rigueur, we might consider taxing "processed food and refined sugar to pay for the impact of the pandemic" and "incentivize health."

This foray into social commentary drew sharp rebukes from progressives, who condemned Nemen for fat shaming, devaluing the vaccines, and blaming obesity on individual lifestyle choices rather than larger socioeconomic inequalities. Neeman later apologized for his insensitivity on these fronts, while apparently standing by his larger message that obesity is a grave public health threat and the driving force behind many Covid-related hospitalizations and deaths. But this larger message, too, offended some progressives, as it effectively shifted responsibility for Covid's ongoing ravages from one of the American Right's putative victim groups — unmasked, MAGA-inclined vaccine rejectionists — to one of the Left's, fat people laid low by a fatphobic culture. Whatever Nemen's intent, the refreshing message heard by many right-wing anti-vaxxers was that fat people, not they, were the ones exacerbating a public health crisis. The subtext was that fat people — and especially their enablers in the fat acceptance movement — had yet to be held to account for their unhealthy preferences, even as Covid vaccine refusniks had been dragged through the mud by mainstream media, dismissed as cranks.

Conservatives eagerly seize on fat acceptance as a paradigmatic illustration of everything wrong with the cultural Left and its nihilistic rejection of traditional values, such as discipline, self-control, and deferred gratification. The Daily Wire's Matt Walsh condemns the movement as a "celebration of self-destruction." His colleague Ben Shapiro contrasts the elites' censoriousness toward anti-vaxxers with their embrace of fat acceptance, lamenting the hypocrisy of cultural norms that facilitated an endless slew of Covid-era health mandates while making it fatphobic to tell someone they need to lose ten pounds. Conservatives believe fat acceptance gives the lie to the liberal shibboleth that right-wingers are more greatly anti-intellectual or anti-science, as liberals' sympathy for a movement that denies or downplays the health risks of obesity suggests they're fully prepared to sacrifice scientific truth to ideological convenience. The Sweetgreen affair could serve as a culture wars flashpoint because it foregrounded this conservative grievance against a perceived double standard that shields the Left from attacks that are routinely meted out to the Right.

The parallels between fat acceptance and vaccine rejectionism are noteworthy. Both insist that established medical authorities have either fabricated or overblown health risks — whether of obesity or remaining unvaccinated — to bring the masses into compliance with the cultural preferences of a dominant group, arguing that the reigning medical consensus on their issue is the ideological instrument of an unjust social hierarchy. For fat acceptance, the bottom of that hierarchy is occupied by fat people victimized by fatphobia dressed up as expertise and benevolence. In this vein, Deborah McPhail and Michael Orsini charge that "obesity" is a "deeply problematic" medical concept that "causes harm to people under the guise of benign objectivity." For today's vaccine rejectionists, the marginalized group is right-leaning "ordinary Americans" held in contempt by an expert class of liberal elites convinced of their moral, intellectual, and cultural superiority. Tucker Carlson, for example, has inveighed that the covert purpose of the military's Covid vaccine mandates was to identify and root out sincere Christians, freethinkers, men with high testosterone, and anyone else not supporting Joe Biden.

Having rejected the medical consensus, both movements must insist that what purports to be the cure — dieting or vaccination — is more dangerous than the alleged disease. Just as some anti-vaxxers insisted that millions were dying, not from Covid but from the vaccines that were said to thwart it, so fat activists attribute the myriad illnesses from which fat people suffer disproportionately to the psychic harms inflicted by the "diet culture" of a fatphobic society, rather than to fatness itself (ignoring that rates of obesity and a host of associated diseases have skyrocketed hand in hand with the introduction of ultraprocessed food across the globe, irrespective of local cultural values). Fat activists and anti-vaxxers alike may have sundry scientific studies at their fingertips to support their renegade opinions, and genuine experts will readily discern why the support is superficial, but untutored laypersons may be ill-equipped to debate the ideologically committed activists. Both movements also have credentialed advocates who lack specialized expertise in the relevant subject but whose MDs or PhDs lend their views a patina of intellectual credibility in the eyes of their followers.

These parallels should not obscure what are also meaningful differences. Just being fat cannot directly impinge on the health of others, whereas remaining unvaccinated potentially can. Unlike vaccine rejectionism, fat acceptance isn't an evangelizing movement. Fat activists don't urge thin people to become fat, whereas anti-vax agitator RFK Jr. would attempt to proselytize complete strangers, explaining, "I see somebody on a hiking trail carrying a little baby and I say to him, better not get them vaccinated." The body count can be gleaned by comparing excess death rates among Republican and Democratic voters during Covid, a reflection of different vaccination rates. By contrast, no one has ever been persuaded to become fat by fat acceptance ideology, and the vast majority of fat persons would prefer to lose weight, other things being equal. There is also no fat influencer with the prominence of RFK, Jr., who now heads the Department of Health and Human Services.

These differences do not make fat acceptance innocuous, however. While the movement may not encourage people to become fat, it isn't as obvious that it doesn't persuade them to stay fat when they otherwise might have shed pounds they needed to shed, as a fair number of fat activists oppose intentional weight loss as an inauthentic surrender to fatphobia. While the state of being fat may carry relatively few externalities for others, that isn't necessarily true of fat acceptance as an ideological movement. Fat activist parents may not insist that their offspring become fat the way anti-vax parents insist theirs remain unvaccinated. But the practical effect of their skepticism toward the medical consensus may be the same. One fat dietician laments that we live in a world where "kids in third grade have already thought negatively about their weight or have already attempted weight loss." The problem for fat activists isn't the spiraling number of third graders who are already overweight or obese (and possibly diabetic or prediabetic) but that these children are being made to feel there's something wrong with this situation. This inversion of the common sense consensus follows naturally from the premise that the cultural stigma of fatness and corresponding moralization of food preferences are more damaging to our health than fatness itself. Hence the parenting philosophy of fat activist Virginia Sole-Smith, whose children are always left free to forego chicken and broccoli in favor of Cheez-Its and chocolate chip cookies. Fat activists will defend this as "food neutrality," but ant-vax parents could equally claim to be "vaccine neutral" insofar as they leave their toddlers free to decide for themselves whether to have metal syringes plunged into their flesh. In both cases, the practical effect of neutrality will be anything but neutral.

And yet Ben Shapiro is surely correct to suggest that fat acceptance is much better received in liberal elite circles than vaccine rejectionism. Women's magazines and fashion advertising have been known to indulge the conceit that excess fat isn't inherently unhealthy. Plus-sized model Tess Holiday not only made it to the cover of Vogue but was also invited to a United Nations panel on eating disorders after claiming to be anorexic notwithstanding her heft. The Los Angeles school district was once promoting fat acceptance through a video advocating "food neutrality." Yet it is difficult to imagine a major public school system going out of its way to cast vaccination as a mere lifestyle preference. This isn't to suggest that all progressives unreservedly embrace fat acceptance's more extreme claims. Still, it's fair to say they don't place fat activists in the same now-proverbial "basket of deplorables" as right-wing anti-vaxxers, notwithstanding that the impulse to deny or downplay the well-established association between obesity and a host of diseases would seem just as anti-scientific as vaccine rejectionism — even if less socially pernicious.

Is there some defensible rationale for what appears on its face to be a problematic double standard in progressive attitudes? Is the ostensible double standard superficial, or does it confirm conservatives' perennial grievance that leftists have seized the commanding heights of cultural institutions to impose moral and intellectual standards on right-wingers that they won't demand of themselves?

There is no simple answer to this question. The ostensible double standard is certainly justified insofar as there is nothing in fat acceptance remotely comparable to the conspiracy theory that Covid vaccines contained microchips whereby Bill Gates or other elites could monitor us. A full 20% of respondents in an Economist/YouGov survey deemed this hypothesis to be definitely or probably true, with only 46% dismissing it as definitely false — revealing that the madness was hardly confined to the fringe. By contrast, fat activists are scarcely delusional when they call attention to the stigma and discrimination spawned by the unscientific moralization of fatness. Even in this ostensibly scientific age, many people still interpret obesity as the externalized, physiological manifestation of the vices of sloth and gluttony. Yet these vices cannot, any more than genetics, explain why so many around the globe are so much fatter now than just a few decades ago. The causes clearly lie in myriad environmental factors — from ultraprocessed foods to obesogenic chemicals to stress-filled lifestyles — that have conspired to undermine our metabolisms.

Moralistic conservatives propose raw will power as a panacea for obesity, condemning fat people for failing to make the requisite effort to lose weight. But research discloses that the requisite effort is far greater for some people than others. Those having been spared the misfortune of growing up on a junk food diet will typically find it easier to summon dietary willpower. To lay eyes, it's obvious that whereas paraplegics genuinely lack control over their bodies, fat people have control but self-indulgently elect not to exercise it out of an immature preference for fleeting gastronomic satisfactions. But a more scientifically informed outlook on weight gain and obesity blurs this sharp dichotomy. Studies indicate, for example, that an obese mother may impart to the fetus epigenetic changes in utero that will later conduce to obesity.

And so it isn't obvious why fat people shouldn't be entitled to some level of special accommodation in public venues and employment, as is extended to the disabled generally in advanced industrial societies. Many would bristle at the thought of a fat traveler being alloted an extra airplane seat for free, viewing those demanding such accommodations as freeloaders looking to have their more virtuous fellow citizens absorb the costs of their self-indulgence via higher airfares. But this framing of obesity is scientifically unsound. To be sure, weight isn't an immutable characteristic to the same degree as blindness or paralysis, and we cannot but assign people some level of responsibility for their weight. But what exactly this should be presents difficult questions that the glib moralization of fatness doesn't help answer.

The bullying, discrimination, and stigma highlighted by fat activists draws much fuel from this moralization. Having misjudged fatness to be a manifestation of some profound truth about a person's inner character, too many people are prone to overestimate how much obesity disables or limits fat people (who may not make for ideal Navy SEALs but can still be productive citizens in many other ways). The alleged oppression of anti-vaxxers does not appear to have any comparably tangible foundations. Whatever condescension they may have detected in the tone and manner of a Dr. Fauci, they cannot claim to have been bullied by liberal elites the way many fat people have been bullied by thinner peers starting in early life. However questionable fat activists' efforts to downplay the deleteriousness of fatness may be, the movement at least identifies tangible harms that subsist independently of the purely symbolic ecosystems of the culture wars, which cannot be said of anti-vaxxers locked in a phantasmal struggle with the ethereal specter of elite condescension.

Still, fat acceptance remains problematic on many levels. Fat activists demand not simply sympathy or understanding for a condition lying outside their control but equal respect for fatness as a distinctive way of being human. "What if we embrace a range of body masses as a beautiful part of human diversity?," asks philosopher and fat activist Kate Manne. It isn't enough to resist unfair, over-broad generalizations about fat people, who must be recognized for their contributions to this diversity. It follows that they should be afforded supplemental airplane seats not because an affluent society should do its utmost to accommodate disabilities of every kind but because air travel as presently constituted forms part of a vast structure of oppression subordinating those who deviate from hegemonic body norms. Fat activists insist that they, no less than the gay and transgendered, have been slandered by a dominant culture that denigrates the core of their personhood as a contingent defect to be reformed away, with exhortations to weight loss thus becoming analogous to conversion therapy for gay people. Fat activists can detect the genocidal undercurrents of a fatphobic culture because, having elevated fatness into an identity, they can discern no morally significant distinction between wishing that fewer people be fat and wishing that there be fewer fat people.

Accordingly, fat activists call on the public to repudiate not just the moralization of obesity as the physiological manifestation of an inner character defect but also its pathologization as a disease and/or precursor to disease. McPhail and Orsini explain that fat acceptance opposes "thinking about obesity as a disease or medical risk (such as for severe COVID-19)" because this "positions larger bodies as drains on an already taxed health care system," attaching to fatness "a sense of moral weakness and failed citizenship." To acknowledge the health risks intrinsic to obesity is to acknowledge that obesity is intrinsically undesirable on some level, but this is, for fat activists, no different from claiming there's something inherently undesirable about being black or gay. And so, they see little practical difference between diagnosing fat people as biologically diseased and condemning them as morally decadent, these being just alternative vocabularies for the same fatphobic revulsion. With its airs of scientific detachment and moral benevolence, medicalized fatphobia merely endows fat shaming with a patina of plausible deniability and intellectual respectability, denigrating an identity from behind a veil of medical benevolence.

Fat activists must therefore resist any suggestion that fat people are any worse off for being fat except insofar as this is attributable to societal discrimination and stigma. Convinced that these sow the low self-esteem and anxiety that leave fat people disproportionately susceptible to myriad chronic diseases, the activists must seize on the flimsiest pretexts to dismiss the longstanding medical consensus on the perils of excess fat. The limitations of the body-mass index as a proxy for metabolic health are used to discredit the very distinction between healthy and unhealthy weight ranges, just as the futility of fad diets is exploited to dismiss the very possibility of exercising any modicum of control over one's weight. Fat activists' indignation toward "diet culture" is warranted insofar as this refers to the fetishization of thinness or to gimmicky, unsustainably restrictive, diets that prioritize rapid weight loss over long-term cardio-metabolic health. But in practice, "diet culture" is a nebulous concept that serves to obscure the differences between healthy and unhealthy dieting, thereby giving the activists license to just wave away mainstream medical concerns about obesity as a recipe for anxiety, low self-esteem, and disordered eating.

Fat activists don't uniformly deny the scientific consensus. Some will acknowledge the health risks of obesity while insisting that the risks to their mental health posed by dieting are greater still. But in general, the imperative to destigmatize fatness propels fat activists to, at a minimum, downplay its medical dangers, to which end they will engage in intellectual contortions whose dishonesty liberals can readily recognize when it emanates from the Right or from corporate interests. Manne, for example, highlights "that the relationship between fatness and health is far from straightforward — that many fat people are healthy and many thin people are not, that the correlation between being fat and having certain diseases is complex and generally mediated by other risk factors." Indeed, and it's likewise true that many smokers don't get lung disease whilst many non-smokers do, yet we're all prepared to declare cigarettes unhealthy without equivocation. It's also true that the correlation between going unvaccinated against Covid and landing in the ICU was, as Manne says of obesity's consequences, mediated by a complex array of other risk factors (including obesity), yet progressives were still prepared to state categorically that remaining unvaccinated was a bad thing. It goes without saying that weight isn't the sole determinant of health, but excess fat has been repeatedly confirmed to be a significant risk factor for a host of chronic conditions. Applying Manne's logic to climate change, today's denialists are eager to underscore that the contribution of rising global temperatures to regional weather disasters is "far from straightforward" because always mediated by a complex host of factors unrelated to carbon emissions, which is equally true and a calculated distraction from the larger issue.

There is also much disingenuousness in the idea of "metabolically healthy obesity," which, like many fat acceptance talking points, rests on a grain of truth. Studies have shown that some obese people have normal bloodwork and vitals, and fat activists have seized on this to argue that the association between obesity and poor health is therefore mere prejudice. But studies have also established that "metabolically healthy" obese people remain at higher risk of cancer and cardiovascular disease and are unlikely to stay metabolically healthy as they age. Twenty-something fat influencers perhaps cannot fathom that their young bodies' resilience before routine metabolic beatings will wane with the ravages of time. But that's precisely why physicians and laypersons alike deem fatness to be unhealthy, not because they're convinced that any fat person they encounter must have elevated blood sugar but because they rightly see fatness as a harbinger of future illness that could already be impairing some rather critical human functions, even if progressive joint deterioration, fatigue, and labored breathing don't technically count as diseases. Yet by reframing these veridical perceptions as an ill-informed snap judgment about specific fat people's present biomarkers, fat acceptance arrogates the mantle of civil rights, with its esteemed tradition of combatting negative stereotypes that tar entire populations. Just as Martin Luther King admonished Americans to judge each other by the content of their character rather than the color of their skin, so fat activists now tell us to judge them by their bloodwork and vitals rather than with crude barometers of health such as the body-mass index.

None of this is to deny fatphobia, including medicalized fatphobia, which remains a real thing even if we don't define it as expansively as the radicals. The philosopher Martha Nussbaum has written of human beings' perennial susceptibility to moralized disgust. Spurred unconsciously by "magical ideas of contamination, and impossible aspirations to purity, immortality, and non-animality," large-brained primates saddled with awareness of their own mortality will be naturally tempted to externalize their primal sense of animal vulnerability onto designated outsiders, who can then be otherized as symbolic embodiments of the human frailty everyone would prefer to deny in themselves. Much that fat acceptance condemns as fatphobia consists in this kind of scapegoating projection, the disgust that fixates on others' physiological deterioration to suppress the awareness that such is one's own eventual fate as well, however fit and healthy one may presently be. So, fat activists aren't always mistaken to discern little functional difference between the ostensibly enlightened, medicalized pathologization of obesity and its seemingly more hidebound moralization, as both can channel the same all-too-human impulses.

But the possibility that fatphobia might assume a medicalized guise in some physicians' condescension toward fat patients does not undercut the accumulated evidence of obesity's dangers. This problem of fatphobia originates in the moral frailty of the human condition, not in "diet culture" or medical misconceptions about obesity. The extent to which the right moral education can reform the more regrettable facets of human nature remains an open question, but the solution will not be found in the intellectual contortions and deflections that characterize fat acceptance discourse. Fat activists may not suffer from the kind of deranged conspiracism that's common among anti-vaccine agitators. But, as I have sought to show, fat acceptance is still given to some subtler epistemic vices, which progressives cannot deny without giving ammunition to the conservative grievance about left-wing double standards. Fat activists may not invent phantasmal counter-realities by asking us to believe that scientists the world over could have observed the Covid vaccines helping none and killing millions but then entered a conspiracy of silence in a gesture of class solidarity with Big Pharma. But fat activists are rather adept at erecting strawmen and promulgating tendentious arguments that exploit a few grains of truth for far more than they're worth.

And while fat activists may not be unhinged, they do suffer from something like false consciousness about the real powers that be. The activists see fat acceptance as a hard-earned authenticity liberated from our cultural obsession with thinness. Through this liberation, we become reconnected to what Manne celebrates as our "natural appetite for rich and sugary foods," which has been repressed by a fatphobic culture dressed up as the false virtues of self-control and self-improvement — demanded by our alienating economic order. For in embracing this natural appetite, we resist the forces that would turn us into "more productive little capitalist machines that don't have needs," as Manne puts it. Rejecting the self-commodification of diet culture and the broader economic imperatives that drive it, the noble gastronomic savage enlightened by fat acceptance declines to sacrifice the primordial pleasure of eating to the vain ostentation of thinness.

But for all their denunciations of capitalism and neoliberalism, fat activists' call to just freely indulge whatever appetites grip us at the moment — exalted as "intuitive eating" — is suspiciously consistent with the consumerist logic of late capitalism. Indeed, the assertion of fatness as an immutable human identity is best understood as the cumulative outcome of our toxic food environment and the commercial interests that drive it, which is why a large snack company such as Mondelez is keen to promote fat acceptance talking points. Fat activists insist that our cultural preference for thinness is socially constructed, but this is at least as true of what Manne exalts as our natural taste for rich and sugary food. For this taste is being constructed every day in the amply funded labs of food manufacturers, whose scientists can be relied upon to maximize the addictiveness of the ultraprocessed foods that dominate supermarket aisles and fast food menus. Yet fat activists have little to say about these commercial interests. The true villains, we are told, are all the fatphobic doctors, nutritionists, and exercise coaches admonishing us to lose weight (perhaps now with the aid of Ozempic). Fat acceptance is false consciousness because it naturalizes a contingent historical byproduct of capitalism — widespread fatness — as a form of personal authenticity, in the process obscuring the fact, and causes, of our collective oppression by a toxic food environment.

---

Editor’s note: I have removed multiple links to conspiracy and misinformation sites from this article. The author had links to both right- and left-wing misinformation sources cited in the discussion, but I feel that Daily Philosophy should not promote conspiracy and misinformation by linking and sending new readers to these sites. If you wish to access such information, it is available on the Internet, and you can always google it.

Rony Guldmann is a New York class action attorney specializing in employment law and consumer fraud. He received his B.A. in philosophy from the University of Michigan, his Ph.D. in the same from Indiana University, and his J.D. from Stanford Law School, where he was a research fellow after graduating. He is the author of Two Orientations Toward Human Nature (London and New York: Routledge 2016). Before his legal career, Rony taught philosophy at Iona College, Hofstra University, and Fordham University. He has also published The Star Chamber of Stanford, a philosophical memoir about academia as experienced at Stanford Law. He has now completed a manuscript titled Conservative Claims of Cultural Oppression, a philosophical examination of the American culture wars. Information about the memoir and manuscript, as well as contact information, is available at: https://ronyguldmann.com/