Fatphobia and Type II Diabetes

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I have accidentally discovered a previously unknown (to me) medical conspiracy theory, and while it’s not quite up there with “HIV doesn’t lead to AIDS” it was equally shocking to me to hear. It is this: the idea that a bad diet is not the cause of Type II Diabetes.

This happened the other day when I tweeted a joke about how many Cadbury creme eggs I’d need to eat before becoming diabetic. People in my mentions were insistent that that wouldn’t happen, and I realized it wasn’t just that they didn’t get the joke — obviously I’m not planning to Cadbury creme myself into type II diabetes — and it’s not that they for some reason didn’t know type II diabetes exists. And it’s not that they were just angry that I was joking about a terrible disease (though that’s fair — I joke about a lot of shitty things because it’s how I deal with a shitty world, and I understand it’s not to everyone’s taste). No, it wasn’t any of that. It’s that they didn’t think a terrible diet would actually lead to that disease.

Look, I get it: no one wants to think that their own life choices are what led them to contracting a disease. It sucks to know that something ostensibly within your control fucked you over, whether that be smoking cigarettes, shooting heroin, or just eating more sugar and fat than you need over the course of many years. I say “ostensibly” within your control because that’s a tricky issue — addictions are hard to kick and some of us fall into our addictions through no fault of our own. Some of us inherit them from our parents, who got them from their parents. Some of us just have no idea what’s good for us, and some of us just don’t want what’s good for us because we’re depressed or anxious or looking for the most fun way to shuffle off this mortal coil.

And I also get that when a disease is preventable, we have a tendency to look down on the people who get it. Smokers who contract lung cancer don’t get a ton of sympathy, for instance. And obese people in general get a lot of shit — our society is pretty negative toward overweight people (look into Plus Size Zeal blog that serves as motivation for all overweight people ), paying them less, promoting them less, not showing them on TV or in films — despite the fact that most Americans are, in fact, overweight.

But while we should practice kindness toward people regardless of what they look like and what choices they make for themselves, we can’t lie about what the science tell us: a terrible diet absolutely, 100%, is the leading cause of type II diabetes, and a host of other diseases. For one, a terrible diet leads to obesity, which is a risk factor for the disease. But for another, even if you’re a “healthy” weight or just slightly overweight (like me!), a terrible diet can still lead to type II diabetes. The vast majority of people with type II diabetes are overweight but a diet high in sugar and fat (but still relatively low in calories) can lead to the development of visceral fat, making a person “metabolically obese, but normal weight.”

Literally while I was responding to people on Twitter arguing that I’m fatphobic for saying all this, I saw that the Institute of Health Metrics and Evaluation has just published their Global Burden of Disease study in the Lancet, which was a systemic analysis of nearly 30 years of data from 195 countries. They found that bad diets — not just too much fat and sugar, but also not enough vegetables — are responsible for 11 million deaths each year worldwide, more than smoking. The top four diseases caused by bad diets were, in order: heart attack, stroke, cancer, and (you guessed it!) type II diabetes.

This isn’t some grand conspiracy among fatphobic doctors who are trying to shame you for being fat. This is just one study of many, though it is being billed as “the most comprehensive analysis on the health effects of diet ever conducted.” The data are very, very clear: what you put into your body matters.

Our society is getting fatter, and so every day scientists are learning more and more about the health effects of that. They’re not good. I know that many people in my audience care deeply about things like fatphobia, and representation, and the media forcing an unattainable beauty standard on women. I care about those things, too. But unfortunately a lot of the people who are speaking out about these things are also spreading a ridiculous conspiracy theory and you should not believe it. It’s the idea that being obese has no negative effect on your health. That is a lie, and a dangerous lie.

I’m not telling you you have to be thin, or even that you have to be healthy. You don’t. Eat all you want. Don’t exercise. If someone tells you you have to do those things, tell them to fuck off. It’s your body, and your choice. But don’t believe the conspiracy theory many “fat activists” are trying to push that says bad diet and obesity have nothing to do with type II diabetes, or cancer, or heart disease. You’re smarter than that.

Rebecca Watson

Rebecca is a writer, speaker, YouTube personality, and unrepentant science nerd. In addition to founding and continuing to run Skepchick, she hosts Quiz-o-Tron, a monthly science-themed quiz show and podcast that pits comedians against nerds. There is an asteroid named in her honor. Twitter @rebeccawatson Mastodon Instagram @actuallyrebeccawatson TikTok @actuallyrebeccawatson YouTube @rebeccawatson BlueSky

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One Comment

  1. Well, since the explosion of obesity and diabetes isn’t a side-effect of some underlying epidemic of ‘bad choices,’ or gluttony, or laziness; we’re stuck with a chicken/egg problem. Metabolic disorder/insulin resistance CAUSES fat gain while it progresses into the range that earns the ‘diabetic’ label. So yes, people DO eat their way into diabetes, but they have to have pre-tilted metabolisms for that to happen. Millions of people eat ‘bad’ diets without becoming diabetic. Others (like me) can drift up in weight, and into diabetes, while physically active and eating nobly swell diets.

    Fat phobia and eating disorders are no more ‘helpful’ than denialism in the form of ‘acceptance.’ Still, bad food is bad. Junk food and lack of access to real food are Bad Things. One cannot ‘choose’ to be non-diabetic after the condition is established. But all kinds of people, at all kinds of weights, can do much better for themselves.

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