Size Acceptance in Public Consciousness


A couple of years back, the performer Lady Gaga caught flak for her very noticeable weight gain. She threw the shame back in the critics’ faces, confessed to a lifelong battle with eating disorders, and created a stir by declaring herself “Proud at any size.”

Lady Gaga’s Body Revolution movement addressed not only obesity but hidden scars, missing limbs, rare diseases, and every other kind of physical calamity that could afflict a person’s life with feelings of insecurity and rejection. The star urged her admirers to be brave, kind, and respectful, and who could find fault with any of that?

Because the cover of this year’s Sports Illustrated swimsuit issue is graced for the first time by the presence of a plus-size model, size acceptance is once again the hot topic that it seems to periodically become. Today Ashley Graham, the zaftig Sports Illustrated cover girl, is making history and representing a fashion line with her name on it. Her website says:

As a role model and body activist, Ashley is regularly invited to speak at numerous high schools and girls’ groups about body image, self-acceptance and female empowerment… She is also a co-founder of ALDA, a collective of models that represents beauty beyond size and challenges conventional notions within the fashion industry.

Like Lady Gaga, Graham uses her media visibility to spread the size acceptance message. But some feel that fat acceptance is a creed that should be privately held, and not openly proclaimed. It is regarded not as a liberating gospel, but as a “misery loves company” ploy that enables obese people to feel more comfortable about themselves while convincing normal-weight people into joining them in their obesity.

If a young woman starves herself down to 88 pounds, friends and relatives feel justified in staging an intervention and clapping her into a hospital. But at 288 pounds, they are supposed to mind their own business.

Pressure from a concerned public has caused the fashion press to cut back on the number of obviously anorexic models because the very sight of them puts unhealthy ideas into the heads of teenage girls. Some people wonder why the same reasoning should not apply to hefty models. Why, they ask, is there such a double standard around obesity?


When a woman looks like Ashley Graham, why shouldn’t she practice the utmost self-acceptance? One problem is, Graham is no more a realistic role model than any other professional beautiful person. Not everyone has Graham’s eyes or lips, her perfect skin or lustrous hair. Not everyone has the drive and the work ethic to carve out a career in a field that didn’t ask for and basically doesn’t want her.

Pound for pound, Ashley Graham does not represent the typical overweight woman. In fact, technically, she is just average-sized. The typical obese American woman is more likely to resemble the troglodytes so cruelly displayed on the “People of Walmart” website.

Another worrisome angle is that fat acceptance can easily morph into pathology. A subgroup that identifies itself as the “gaining community” is made up of individuals devoted to purposefully becoming as large as possible. They may consider themselves to be works of art in the making, or may unashamedly monetize their ambition by starting a webcam operation that charges their fans money to watch them eat. Either way, it’s not a trend that needs encouragement.

The National Association to Advance Fat Acceptance (NAAFA), founded in 1969, characterizes itself as North America’s “oldest civil rights organization working to end size discrimination.” The nonprofit group believes that size discrimination creates medical and psychological effects, results in wage disparity, and affects academic options and advancement, as well as hiring and promotion — all true. NAAFA wages a propaganda war against the idea that overweight people lack self-discipline and willpower, and against the notion that weight loss can be motivated by shame and stigma.

A person who wants to change for the better can only do that after first accepting herself for what she is. But should self-acceptance include evangelism?

Your responses and feedback are welcome!

Source: “Ashley Graham,”, 2013
Source: “The Issues,”, undated
Image: Uncopyrighted Internet image

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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