Fat Talk. Parenting in the age of diet culture

Virginia Sole-Smith, the illustrious author of Fat Talk, is a writer with an agenda, but a writer first. I subscribe to her "Burnt Toast" Substack blog and read her new book hot off the press. This book wacks fat phobia wherever it raises it's ugly mole head.

I am a straight, white, card carrying pediatrician with a dad bod - BMI at the edge of obesity but not real fat, who Ms. Sole-Smith has expressed disagreement with directly on one point for sure. All of those kinds of people represented by me come in for a lot of scolding in Fat Talk but I am wholeheartedly in agreement with her on everything she says. She has done a lot of homework - 46 pages of notes/references to the infinity of stuff in the fat science literature. She mentions a lot of the standard classics of obesity and nutrition. She has abundant primary personally explored examples accrued over many years.

I can chime in with the folly of the American Academy of Pediatrics (AAP) about childhood obesity. (2) In numerous publications over the years the AAP says obesity is not your fault but you can fix it by.... If it you were not doing something wrong how could you fix it. I agree with the misguidedness of Michelle Obama's first lady theme about childhood obesity but Ms. Sole-Smith extols Ms. Obama's more recent nutrition project. I can agree over all that it doesn't matter what you eat and you cannot change your size and shape without causing more trouble than it is worth and so we should stop persecuting fat people. I appreciate that we can use the word "fat." It should not be a bad word. She agrees about that with Aubrey Gordon and her book, "You just need to lose weight." I wasn't so sure before.

The stories make the book very readable but begin to describe too many trees in the forrest and get too deep into the weeds sometimes. Thankfully she gives pediatricians permission to weigh their customers as long as they don't point to it or calculate BMI.

Finally, I agree that obesity surgery can be a problem and it is very drastic and the new GLP-1 analogs, that are a magic obesity-surgery-in-a-pill, do not have a long track record are very expensive and will almost certainly require life long administration. But if we ever do get an effective permanent reasonably safe treatment of severe obesity that would by the way also simultaneously cure, type 2 diabetes, hypertension, cardiovascular heart disease and stroke, fatty liver disease and put internists out of work and increase longevity, then I think it would be OK to treat fat.

1. Virginia Sole-Smith. 2023 by Henry Holt and Co. New York, New York.

2. https://johnditragliamd.substack.com/p/the-new-obesity-promulgation-by-the-AAP