“Fat” is without a doubt one of the most loaded words in our culture, especially for women. For many of us, our earliest question about ourselves wasn’t something innocuous like What am I good at? or What do I like? It was, sadly, Wait. Am I fat? followed quickly by a feeling of abject terror.
From our very youngest days, women are taught that fat is basically the worst thing to be — and we should do everything we can to avoid it. It’s why teen girls are more likely than teen boys to worry about their weight, per the latest survey on teen health from the World Health Organization (WHO). That report, which included answers from 220,000 teens from Europe and North America, found that despite only a fifth of teen girls being classified as overweight or obese, nearly half of 15-year-old girls said they were “too fat.” It’s also why there’s a new viral thinness “challenge,” in which teen girls find a new absurd way to measure their fatness, seemingly every month. It’s why eating disorders strike twice as many women as men.
Every year, around this time especially, the onslaught of reminders to “blast fat,” “beat flab,” and do whatever you can do to get that “bikini body” starts up. Though the movement to squash this harmful concept has grown stronger in recent years (hell, even Barbie — who is arguably many girls’ first encounter with the thin ideal — got a body-diversity makeover recently), that hasn’t stopped people like Kayla Itsines and the “Tone It Up” girls, Karena Dawn and Katrina Hodgson, from building booming businesses around promoting this very narrow definition of beauty — and health.
The result: “Fat” remains a dirty word. “Even as there’s a strong body-positive movement building, there’s an anti-fat backlash rising up against it,” explains Linda Bacon, PhD, author of the groundbreaking book Health At Every Size. Many people, including that jerk from third grade who has since grown into an eager Facebook pundit, express concern that body-positivity activists are only glorifying poor health.
“80% of chronic diseases, such as arthritis, high blood pressure and Type 2 diabetes, are preventable by lifestyle changes, but the only one we stand on our high horse on is obesity,” says Yoni Freedhoff, MD, professor of family medicine at the University of Ottawa in Canada. A big reason for that is because it’s so visible: “We have a world that constantly permits itself to make fun of [weight],” he adds. “Every time I go to a movie with my three little girls, I’m appalled that all the villains are portrayed as gluttonous and evil, as if weight’s a way to personify sloth. It teaches people from an early age that success is driven by the scale, which isn’t true.”
Even as there’s a strong body-positive movement building, there’s an anti-fat backlash rising up against it.
The irony is that this anti-fat line of thinking doesn’t make anyone healthier — in fact, research shows that it doesn’t even make people thinner. For starters, we know that patients who are obese are in general less likely to see their healthcare providers and less likely to get lifesaving screening tests like Pap smears and breast exams. This could be due to shame or embarrassment about weight or because they feel judged or disrespected by their doctors.
On top of that, when someone feels bad about their body, their risk of depression goes up, which makes them less likely to stay active and eat healthy — the habits that actually do make a difference in terms of health, Dr. Freedhoff says. One study found that people who felt they’d experienced discrimination because of their size gained more weight over four years, compared to those who felt the opposite. Another found that people who feel judged by their doctors are more likely to attempt weight loss, but far less likely to succeed. The bottom line, Dr. Freedhoff says: “Fat-shaming is part of the obesity problem and not the solution.”
In light of all this, the real story about body fat — what it is, what it does, and why it’s actually kind of important for your health — has gotten lost in the shuffle. Ahead, we’ll dive into the truth to show you why it’s really not the enemy you’ve always thought it was.
What your fat does for you:
Something that gets lost in all our obsession over fat is why it exists in the first place. And that's a shame, because it actually serves a variety of really important purposes. (Yep, fat is a good thing.)
“Fat is paramount to survival: You need it for warmth and insulation, for cushioning your bones and internal organs, for energy, and even to think,” says Carl Lavie, MD, medical director of Preventative Cardiology at the John Ochsner Heart and Vascular Institute in New Orleans and author of The Obesity Paradox. About two-thirds of your brain is made up of fat, which provides not only its cell membranes but also the myelin, the fatty insulating sheath that surrounds nerve fibers throughout your body and enables them to carry messages faster.
Fat also bolsters immunity: “the cells that are precursors to fat cells, called preadipocytes, act like special immune cells that devour invading germs and bacteria, which helps explain why people who diet to extremes tend to get sick more often,” Dr. Lavie explains.
Fat is paramount to survival: You need it for warmth and insulation, for cushioning your bones and internal organs, for energy, and even to think.
It helps produce a slew of hormones crucial to your health, including reproductive hormones such as estrogen, appetite-regulating hormones like leptin, blood-pressure-controlling hormones like angiotensin, and tumor necrosis factor-alpha (TNF), which helps keep cells healthy.
Another fun fact: We tend to talk about fat like it’s something you shed and gain, but in reality, the number of fat cells you have is set during childhood and adolescence, and that remains pretty much constant throughout adulthood. Research shows about 10% of your fat cells die each year and are automatically replaced. When you gain or lose weight, what happens instead is that these fat cells simply expand or shrink, Dr. Lavie says.
Yes, you can be overweight and healthy.
Over the past few years, there’s been more and more evidence that a little fat can actually do the body good. “Being slightly overweight actually seems to increase longevity: Study after study shows that overweight people with certain chronic diseases like high cholesterol or diabetes actually often live longer and do better than normal-weight patients with the same conditions,” Dr. Lavie says.
People who are classified as overweight actually have a 6% lower risk of dying from any cause, according to one 2013 study. “One theory is that fat helps guard the body from damage, particularly as we age,” Dr. Lavie says. “Anytime your body is fighting an illness or dealing with a chronic disease, it requires more energy, so it makes sense that that extra fat is helpful.” This seems particularly true if your fat’s located around your butt and thighs, according to one Oxford University study. “The thought is this fat traps the potentially harmful fatty acids that can travel through your bloodstream to your heart,” Dr. Lavie says.
So knowing all this, why do many health experts continue to wag their fingers about obesity? “When it comes to being overweight or obese, there’s a myriad of factors at play, including how fit you are, if you have other health conditions, and what your attitude is about your weight [that determines your health],” explains Dr. Lavie. But there does often come a point at which weight gain can begin to affect your ability to stick with the healthy habits (like exercise) that are really important for your health.
“If you’re overweight or slightly obese but fit and metabolically healthy — normal blood pressure, normal cholesterol levels, normal blood sugar — then it’s hard in that situation to show that being thinner would make you even healthier,” Dr. Lavie says. “But the picture changes once you really become obese.”
Simply put, obese people have a harder time with exercise, both because it’s physically harder if you’re heavier and because weight stigma can keep people from wanting to be seen at the gym. If your weight interferes with your mobility, or even just your motivation, then that’s probably going to affect your heart health as you age.
The bottom line: You absolutely can be fat and fit — your level of health has everything to do with the way you're treating your body, and not its size.
The body fat glossary you didn't know you needed
While how much body fat you have does matter somewhat, what kind you have, and where you store it, matters much more. Here’s what you should know — and do — about the three (yes, three) different types.
White fat. This type of fat, also called subcutaneous fat, is the most common type in your body. It usually settles around your hips and thighs, but it can be found pretty much anywhere. White fat sits right underneath your skin, providing padding and creating curves. But it also serves a second role: It burns energy and produces a hormone called adiponectin. Research suggests adiponectin has anti-inflammatory and “insulin-sensitizing” properties and that may help reduce your risk for Type 2 diabetes.
Now, here’s where it gets confusing: You’d think that the more white fat you have, the more adiponectin you’d have, too. But nope. It’s the opposite. Smaller fat cells actually release more of the hormone than larger fat cells. So, “when you gain weight and fat cells increase, you produce less adiponectin,” explains Louis Aronne, MD, director of the Obesity Clinic at Cornell University. This is important because it explains how this type of fat can play a supporting role in the development of Type 2 diabetes. That said, regular exercise has also been shown to increase adiponectin.
What to do: Don’t stress too much over this kind. Just focus on the next two.
Brown fat. This so-called “good fat” acts more like muscle, which means it burns energy even when you’re inactive. For years, experts assumed this type of body fat was only present in babies as a way to keep them warm, and that it went away during childhood. But research now shows many of us still have brown fat cells lurking in our bodies: One 2009 Harvard study revealed that 7.5% of women and 3.1% of men had small amounts of brown fat, and that these people tended to have healthier metabolisms.
What to do: You can grow your brown fat with regular aerobic exercise, like a steady 45-minute session on the elliptical or a long bike ride, a few times a week. This type of activity releases the muscle hormone irisin, which helps convert white fat into brown fat. Weirdly, exercising in the cold also seems to help. (So keep that in mind next winter when you’re shivering on your long walk to the train.)
Visceral fat causes problems because it churns out stress hormones like cortisol and inflammatory substances called cytokines that affect your body’s production of insulin. The result: increased risk of both Type 2 diabetes and heart disease. You’re more likely to pile it on as you approach menopause: The natural estrogen drop activates certain proteins in the body that promote fat storage around your middle.
What to do: Develop healthy habits, like eating a balanced diet and exercising regularly, now — so that as you age (and visceral fat becomes more of a thing), you’ll be more likely to ward it off. Also: Know your family history. Research suggests that genetics may play a role in what type of fat you store, and if many of your family members have struggled with Type 2 diabetes or fatty liver disease, you may be more at- risk.
Now that you know the beautifully messy full story about body fat and your health, it's time to forget the jerk from third grade and that feeling of abject terror, once and for all. There's a popular quote shared online among body-positivity circles that goes: “You are not fat. You have fat.” And the fact that we need a reminder that the shape or composition of our bodies isn’t definitive of who we are shows how badly we need to take back the word "fat."
Admittedly, flipping the script on this is much easier said than done. “It’s a hard leap for many women to jump to loving their body in a culture with such strong standards as to what’s considered attractive and what’s not,” Dr. Bacon says. What you can do, though, is remind yourself of the phenomenal stuff your body does for you on the daily, whether that’s your legs (fat and all) powering you through an indoor cycling class, or the curve of your hips making a perfect resting place for lugging groceries up the stairs. As Dr. Bacon says, when you really think about it, “it’s hard not to be in awe of the human body."