Destroying 10 Lies That Are Used to Justify Weight Based Discrimination

After a year of exploring wellness culture and its discriminatory foundations, I've identified 10 arguments people use to justify discrimination against fat people—and I'm dismantling every single one. From the "health concern" disguise to the false claim that being fat is a choice, from economic justifications to the burden of proof fallacy, these arguments collapse under scrutiny. 

The truth is simpler and darker: discrimination against fat people isn't justified by evidence or ethics—it's justified because it makes people feel morally superior, saves institutions money, and allows society to continue a comfortable prejudice. When people are dying in real-time because doctors deny them care, calling it "medical reality" doesn't make it less harmful—it makes it systemic violence dressed up as medicine.

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Chapters

• 2:41 Why We Discriminate Against Fat People
• 4:41 Arguments 1-3: Health, Concern, and Healthcare Costs
• 14:41 Arguments 4-6: Statistics, Choice, and Public Health
• 23:41 Arguments 7-10: Medical Reality, Protected Characteristics, Special Treatment, and Burden of Proof

Transcript

Hello, and welcome to episode 39 of the Fat Doctor podcast, Season 5. We're almost at the end of Season 5, almost at the end of 2025, and those two things go hand in hand.

I am very excited about today's episode. I hope you're nice and snugly and warm and toasty. I especially want to welcome everyone watching me on YouTube. Especially, especially the haters watching me on YouTube. Special welcome to you, and a salute from me. Today is for you, it's for everyone, really.

I have spent this year exploring the last year, really exploring wellness culture, like the underlying principles of wellness culture, modern-day wellness culture, medical and kind of ridiculous wellness culture that allow people to, or that justify this kind of very narrow-minded, ignorant, and non-evidence-based viewpoint that you can't be fat and healthy, or that you must be unhealthy if you're fat, or that being fat is bad, wrong, whatever. What is it? I've been exploring it over the year, and I've come to the end of that exploration, I think.

And I think deep down, what I've realized is that people like to discriminate against fat people. Society in general liked to discriminate against fat people. Fat people like to discriminate against fat people. Smaller fats like to discriminate against bigger fats. Even big fats, bigger fats like to discriminate against other fat people. We like to do it. We enjoy it. It's fun. It's fun to discriminate against fat people, I think is the truth.

And I've come up with 10, that's right, 10 arguments that people use to justify their discrimination against fat people. And I am going to decimate all 10 of those arguments. You ready?

Number one: We discriminate against fat people because being fat is unhealthy, and people need to take responsibility for their health.

This is an ad hominem logical fallacy, we talked about this last week. Remember when you attack a person's character, rather than actually using evidence? Listen, we don't discriminate against people who ski, or skydive, or play professional sports, or drive motorcycles, or bungee jump, or use tanning beds, or practice unsafe sex. We don't discriminate against them, or we don't justify discriminating against them. Maybe we do discriminate against them, but we know as a society it's not okay to discriminate. We don't discriminate against thin people, by the way, with diabetes or heart disease. The medical profession doesn't discriminate against thin people with diabetes or heart disease.

Health status, whether it's real or assumed based on what a person looks like, never justifies discrimination. We can't discriminate against somebody just because of their health. Whether or not weight and health are related, it doesn't matter. Just the idea, if we allowed health to justify discrimination, then we have to discriminate against anyone and everyone with a health condition. Everyone. So, what's okay for one has to be okay for everyone. So either we agree, as a society, that we're going to discriminate against anyone with a health condition, or we're not going to discriminate against anyone. One or the other.

And so whether or not weight and health are related, I don't even have to argue that with you. I'm just telling you, then you can't discriminate against a person based on their health status, real or assumed. Health is not a moral issue. Never has been, and never will be. The fact that it has become a moral issue and that we use it as a moral issue, that's a you problem, not a truth.

Argument number two: It's not discrimination, it's health concern. It's not the same thing.

This, again, we talked about this last week, this appeal to pity, this disguising harm as help. Counter-argument: Weight stigma causes measurable health harms. It increases cortisol, it increases inflammation, it increases cardiovascular stress. So if you genuinely care about health, you do not stigmatize people, you do not discriminate against them. Because that is actually harming their health. And we have genuine data to support this.

Also, weight stigma leads to healthcare avoidance. Healthcare avoidance leads to delayed diagnosis and worsening health outcomes. Weight cycling is known to cause poor health outcomes. People who are shamed into dieting on a regular basis are going to have poorer health outcomes. Discrimination causes chronic stress. Hey, guess what? Chronic stress is an independent risk factor for disease.

So, if you care, if your stated goal is health improvement, you're concerned about health, but your actions are actually causing harm to people's health, then your reasoning is completely contradictory, illogical. You cannot claim to care about someone's health whilst doing things proven to damage it. Discrimination causes the very problems you are claiming to address.

Argument number 3: Fat people cost more in healthcare, so discrimination is economically justified.

Two problems here. Number one, as I have pointed out many, many times, do not confuse correlation with causation. We love to do the two. There are quote-unquote obesity-related conditions, even though we've never been able to prove that being fat causes these conditions, we still label them as these conditions, and we use these as an excuse to discriminate against people. We also have this ridiculous post-hoc fallacy. You're fat, you became sick, therefore one caused the other. Again, completely and utterly illogical, not backed by science in any way.

Counter argument, very important: Healthcare costs correlate with a number of factors. Age. Income. Access to healthcare are just 3 that I can think of. Being male, fourth. Weight stigma, discrimination creates healthcare avoidance, increases healthcare costs, because if you avoid healthcare and you don't do the preventative stuff, then you end up being sick, and that actually costs more. Or if you end up in an emergency department instead of community treatment, that costs more, right?

Denying preventative care, denying healthcare, so restricting access to people based on their BMI, is also going to end up costing you more in the long term. There's no question about that. Because if you don't treat the knee that needs replacing, then that person is permanently disabled. And that person doesn't get to exercise as much, and is more likely to develop, I don't know, say, heart disease, and then they have heart problems, and that's gonna cost you eventually more, right? It's just illogical.

Denying somebody healthcare access is actually going to make their health worse. It's also going to mean that they're disabled and are less able to do their job. There's no logic to that. Also, there is this huge assumption that people who are higher weight are going to be metabolically unhealthy, which is not true, as I stated on many occasions. Do not confuse correlation with causation. Do not use ecological fallacies and all of that jazz.

Again, there's no actual evidence to support the fact that all fat people are a burden to healthcare, and of course, there are thin people who are a burden to healthcare economy, and we don't justify discriminating against them.

So, even if higher weight people had higher healthcare costs, even that is disputed, but even if that's the case, that would be correlation, it is not causation, and discrimination itself is likely driving those costs through delayed care and lack of access to healthcare.

Again, what's good for the goose is good for the gander. If you want to discriminate against people based on their cost of healthcare, then you must discriminate against older people, you must discriminate against lower-income people, you must discriminate against males. Because if you're going to use that as your excuse to discriminate, then you must just do it universally. You can't just pick and choose. We'll discriminate against these, but not these.

Argument 4: Statistics show that fat people are less healthy, so treating them differently is justified.

Applying group statistics to individuals, again, logical fallacy, ecological fallacy. Many higher weight people are metabolically healthy, many thin people have serious health conditions. Individual health status varies widely within any weight category. You cannot determine an individual's health by looking at them and measuring their weight and height. You just can't.

And if we discriminated based on group statistics, again, we need to do this universally. We need to discriminate against men. We need to discriminate against elderly people. We need to discriminate against anyone who has, is statistically more likely to be less healthy. And since we recognise that this is completely and utterly unjust, because you're not allowed to discriminate against somebody based on their age or their sex, or their race, their ethnicity, there are laws in place to prevent that from happening. But there are no laws in place to prevent you from discriminating against a person because they're fat. Why?

Argument number 5: Being fat is a choice, so discrimination is therefore just. Because, yeah, consequences of your actions.

Again, that's not true. Being fat is not a choice. We have so many studies that show that genetics accounts for most of your weight. That all sorts of other things, poverty, trauma, environment, social determinants of health, medications, medical conditions, hormones, can all impact, can and do all impact your weight. That actually diet and exercise have, and anything that is voluntarily under your control, I should say, have the least amount of impact on your weight. But the biggest risk factor for higher weight individuals is attempting weight loss. So there's no evidence to justify this sweeping generalisation that being fat is a choice. It's not true.

But even if it were true, is that still okay? Is it okay to discriminate against people who have made a choice to do something? Again, are we gonna apply that to everybody who makes a choice? Do we apply it to the skydivers? Do you apply it to the bungee jumpers? The people in professional sports? Do we say, oh, well, you know, mate, you were the one who chose to be a professional football player. You injured your ACL, that's your problem. You deal with it. Consequences. Actions have consequences. You made a choice. Is that okay? No, it's not okay, is it? We don't do that, we don't justify that. We feel sorry for the athlete that injured themselves and injured their ACL. Fat person who injured their ACL, tough shit. Got BMI of over 30, there's nothing we can do about it, sorry.

I also want to point out, since weight loss is unsustainable, what you're doing is you're saying being fat is a choice. But if being fat was a choice, then none of us would be fat. It's the same with being queer, about being gay. About being trans, that's choice. If it were a choice, I would be making a different choice. Maybe, maybe not so much anymore. Maybe I've got to the stage in my life where actually I'm proud to be queer, I'm proud to be fat, I'm proud to be trans, and therefore, even if I had a choice, I would make the same choices.

That being said, I do not like being discriminated against, so if you're telling me that it's either choose to be discriminated against or choose not to be discriminated against, there's a chance, a very big chance, that I would say, do you know what, I choose not to be discriminated against. If it was a choice, the majority of us would have chosen not to be fat. Don't give me the shit. Going on a diet makes me fatter. I've already told you that. I have evidence to support that. Weight loss is the biggest risk factor for long-term weight gain. And so, weight is not under my control. And stop saying it is.

Argument 6: This is for public health. We need to stop glorifying obesity. We need to discourage obesity for public health.

Again, the glorifying obesity thing is a slippery slope argument. And these arguments are always not based on any semblance of reality. Like, if you don't discriminate against fat people, fat people will take over the world. Sure.

Listen, discrimination isn't actually a motivator. It doesn't actually work. So if you're saying we discriminate for the sake of public health, then you have to demonstrate that it actually works and it doesn't. Also, body autonomy is a fundamental right. Public health, body autonomy, two go hand in hand. We cannot, and we will not, and we should not police people's bodies for the sake of public health. That's not how public health works.

Public health is about creating a safer and healthier environment for individuals to live in. For example, some great moments in the history of public health: Clean water! Sanitation. Vaccinations! These are all really important public health issues, which we should be addressing on a regular basis. How do we ensure that people are living in a safe environment? Dealing with pollution. That's great. That's fine.

But it's not about policing bodies. Public health has never been about policing bodies. I mean, that's not true. People have been policing bodies under the guise of public health for a long time, but that is not what public health is about.

So again, if public health justified discrimination against individuals, then we can justify discrimination against anyone with a health condition or a genetic predisposition, it doesn't even have to be an actual health condition. We could say you have a genetic predisposition to a health condition, and therefore we can justify discrimination against you. We've been doing that for a very long time. It's called eugenics.

But this totalitarian argument is not compatible with bodily autonomy, human rights. So it's not public health, it's eugenics, two very different things.

Argument number 7: It's not discrimination, it's just medical reality. Stop mollycoddling your patients, just tell them the truth. This is the reality of their lives. It's not discrimination, it's just reality.

We love to use the term reality to mask discrimination. But when you deny somebody care based on their weight, that is the definition of discrimination, it's not reality, it's just you're choosing to do it! That's nobody's reality. You chose to, you said, I am not going to treat you based on this one arbitrary factor, which is weight.

It's the equivalent of saying, I'm not going to treat you because of the color of your skin, or because of your religion, or because of your sex, or because of your gender, or because of your disability. That is illegal. It's not medical reality, it's illegal. We're not allowed to do that. We cannot justify denying people healthcare based on any other kind of factor. So why weight?

When we look at things like equipment barriers, when we look at MRI machines that have weight limit, that is an MRI machine problem. That is the issue there lies with the manufacturer of MRI machines. Not with individuals. That's not my fault that you don't have equipment to treat me? That's your fault, and it's your responsibility to fix that.

But this is, medical reality, this is reality, it's the way we live, it's the way we do, it's just how it is. Something we can do about it, it's how it is. Of course, it's something you can do about it. Somebody somewhere is buying MRI machines with weight limits. Somebody somewhere is manufacturing MRI machines with weight limits. Now, I know for a fact that you can make an MRI machine that can accommodate any size. I know this because they make MRI machines for large animals in zoos.

So if they can do that, they can do it for humans as well. If we can do it, then why aren't we doing it? And why don't they exist? And it's little things as well. Sometimes there's not even an MRI machine, it's like a blood pressure cuff. Now, those I know exist. I've seen them. Just because you don't have one readily to hand is not a me problem, it's a you problem. This is not medical reality, this is discrimination under the guise of medical reality.

This is just medical bias that has been codified into medical practice. Healthcare outcomes always worsen when discrimination is normalised. So when we can call discrimination a medical reality, it doesn't make it less harmful, it is just as harmful, if not more harmful. If the medical system is creating barriers for certain bodies, that is systemic discrimination that needs to be fixed, not justified.

Argument number 8: Weight is not the same as other protected characteristics. It's not the same. Being queer, it's not the same as weight. It's not the same as being black, it's not the same as being Jewish, it's not the same as being autistic. No, it's not the same, they say.

Which is weird, because it feels the same to me, but whatever. This is when we make this exception to the rules without any justification.

I want to point out that if you look back throughout history, every form of discrimination was once considered different to the others, justified. It was okay to discriminate against black people because they weren't the same as white people, it was okay to discriminate against queer people because they weren't the same as heterosexual people. It was okay to discriminate. It's not the same, it's not the same. It's a choice, it's a this, it's a that. There was all sorts of excuses made, but if we go back throughout history, people have fought for the right to be treated the same as everyone else. And it took a whole bunch of convincing. And still, to this day, it's not happening. I mean, technically and legally, perhaps, but it's not actually most people's reality.

Weight is no different to any other so-called protected characteristic. We've already talked about this. Weight is not controlled. It's not something that you can control for the most part, and trying to control your weight actually causes you to gain weight, so that's really tricky, isn't it? It's so unfair, it's so unjustified. You're being set up to fail. The more you try to control your weight, the fatter you get in the long term. And then people go, oh, yeah, but it's your fault. It's not. It was never my fault, it was never my choice.

We've already agreed, I hope so far, that health status doesn't justify discrimination. We agree that appearance doesn't justify discrimination. And so, there is no difference. Whether you see it as an appearance, whether you see it as health status, whether you believe the two are related or not, it doesn't matter. Neither one apply. It is not okay to discriminate against someone based on either of those two things.

So if the same reasoning structure has been proven wrong and harmful for every other characteristic, why is it suddenly valid for weight? Why is it okay for weight, but not for anything else? I don't get it. Either we have, we apply the same ethical standards, consistent standards to everything, or we don't apply them to anything. And if you're just gonna say weight is special, it's a special characteristic, different to all the other characteristics. If you're gonna say that, at least admit that that is arbitrary prejudice, and at least admit that what you're doing is wrong. You're choosing to do it. It's not justified, it's just something that you're choosing to do because it's convenient for you.

Argument number 9: Fat people don't deserve special treatment.

Fat people are not asking for special treatment. Any marginalized group, they're not asking for special treatment. They're asking for equal treatment. That's all just equal, not special, equal. Equal access to healthcare is not special treatment. Being treated with dignity and respect is not special treatment! Having access to proper-sized equipment? It's not special treatment.

Not being discriminated against is not special treatment. I don't know how else to explain that. This is not special treatment, this is just equal rights and basic dignity.

Rights and basic dignity aren't earned through good behaviour, healthy choices, or any of those things. If they were earned, they wouldn't be rights. It's in the name! Basic human rights apply to everyone universally. If there was something that you could earn, they would be called privileges. Privileges are not the same as rights. If you have to earn them, they are privileges. If they apply to everyone, they are rights. The thing about privileges is we can revoke them. We, as a society, can revoke them from anyone we deem undeserving. Which is why a lot of societies, a lot of countries today have a bill of human rights of some kind. These are the basic rights that everybody, no matter who you are, is entitled to. Because we know that if we don't have them, then we'd be revoking rights, we'd be revoking these things left, right, and center.

Do not confuse rights with privileges. You cannot earn rights, they should be given to you automatically. Access to healthcare should be a basic human right. It's not always, and not everywhere. For example, in the US, if you're poor, you don't have access to healthcare. It's not a basic human right. In the UK, it should be, and is considered a human right. Everybody should have access to healthcare. And if everybody should have access to healthcare, then that should include fat people. They shouldn't have to earn access to healthcare by losing weight.

Argument number 10: This idea that whenever I say fat people are entitled to healthcare, people will say to me, prove it. Prove that you're entitled to equal treatment. Prove that fat people should be entitled to knee replacements. Anybody of any BMI should be entitled to a knee replacement. What's your proof?

I hate the fact that people have shifted the burden of proof to somehow take away the fat, or to somehow justify the fact that not everyone has a basic right to dignity and equal treatment.

If you're gonna discriminate, then at the very least, the burden to justify the discrimination is on the discriminator, not on the discriminated. Right? I shouldn't have to prove that you can use my weight to justify denying me healthcare. You should have to prove that you can use my weight to justify denying me healthcare. You have to prove it! You have to come up with concrete evidence beyond reasonable doubt, right? Isn't that how it works? When someone is accused of a crime and they go to court, the prosecutors have to prove that this person committed the crime, and if there's any doubt that the person committed the crime, if there isn't enough evidence that they committed a crime, then that person should be, technically, found not guilty.

And that is the same for fat people. You cannot say we are not going to allow you, we are going to deny you basic healthcare based on your weight, we're going to discriminate against you based on your weight, we're going to call it medical reality, and when I say, hang on, what gives you the right to do that? Your response is, prove it. You proved to me that you deserve it. Why should I have to prove to anyone that I deserve healthcare?

I deserve healthcare because I live in a country where everyone deserves healthcare. If you're gonna discriminate against someone, you have to prove that it is okay to discriminate against them, and guess what? It's never okay to discriminate against someone. There is no evidence that discrimination improves health outcomes. There is extensive evidence discrimination causes harm. In any ethical framework, the default has to be and always will be equal treatment.

So if you want to be living in an unethical world, if you want your reality to be unethical, that nobody actually gives a shit, that nobody has any basic human rights, that everything is earned, that's fine, but then that should apply to everybody. But if you want to live in a world that is fair, where people have access to basic, or people have basic human rights, then the default has to be equal treatment. And if you want to deny a group of people anything, any basic human right, then you have to have, you have to be able to provide extraordinary justification. Prove beyond a shadow of a doubt that you're right.

And I just want to point out that there isn't any extraordinary, there's not even any decent, like, even average justification. The arguments that the medical community, the so-called experts, make to justify denial of healthcare to fat people, to people with a BMI over 30, 35, 40 are so weak, so thin, so pathetic. It's unconscionable.

There's no extraordinary justification, it's the opposite of that. Weight-based discrimination fails this test every single time. Completely, wholly, and utterly. I could, you pick it, you pick a, it doesn't matter what you pick. Any condition, any treatment, any anything, I will destroy you with evidence. Because the evidence that denies people the right to discriminate is overwhelming. The evidence that justifies discrimination doesn't exist, or it's so weak, it's a house of cards. Falls down completely the moment you pick at it.

So, those are my 10 arguments that I have, hopefully, addressed with vigor. Vigor? Or rigor? Both. Both apply here.

I don't know, maybe it's because of the end of the year, maybe it's because I'm in a particular mood, but I just, I'm so sick and tired of listening to people justify the discrimination and the mistreatment and the harm. And actually, beyond that, in some cases, literally extermination of fat people.

We justify it. Oh, this person is dying because their doctors didn't give them the healthcare, well, tough shit. They're fat. That's their medical reality. That's just, you know, it's just life. That's just the truth. That's just the way it is.

I'm watching people in real time dying because of weight stigma, dying because of discrimination against fat people, and it's justified. There is no, there is no legal or other means of arguing against it, of getting justice of any kind. It feels, you know, because of the arguments that I've just, so commonplace, and people don't care.

It suits people's narratives to be able to discriminate against fat people. It's a way of saving money in some cases, it's a way of feeling morally superior in many cases. It's a way of justifying people's shitty behaviour, shitty attitudes. The haters who are gonna hate on this video and tell me that, you know, the usual ad hominem arguments about, oh, just because you're lazy and you can't be bothered, and you just want to stay fat. So, all those haters, it makes them feel good to discriminate against us. And so, that's the reality, isn't it? That's the reality that we're facing.

In some cases, it's money, some people don't actually enjoy discriminating against fat people. But they just find themselves, this is our reality, there's nothing we can do about it. But for some people, it feels good. It makes them feel morally superior. And they need that, because 9 times out of 10, these people are deeply insecure, don't feel good about themselves. So, in order to feel good about themselves, they have to hate on other people. Sad times. What a world we live in.

Anyway, that's the end of that. I think I'm gonna sort of sign off, put a full stop right at the end, sign off on that. It's taken me a year to kind of grapple with all of this stuff. As I said, one day, soon, there'll be a book.

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Anyway, come back for the final episode of Season 5 of the Fat Doctor podcast next Wednesday. And then we'll be taking a couple of weeks break, and then we'll be back in January with Season 6.

Thanks for joining me, folks. Take care of yourselves, have a lovely week.