What Bill Maher Got Wrong About Fat-Shaming

A few weeks ago, I watched comedian Bill Maher’s biting segment calling for fat-shaming to make a comeback. Maher attributed excess weight to overeating (or a result of a calories in/calories out imbalance). He encouraged viewers to blame fat people for being fat.

That’s a cruel and ineffective suggestion, as late night talk show host James Corden pointed out in his viral response to Maher. It’s also a suggestion grounded in poor nutrition science. It’s not overweight people who should be blamed for being overweight. It’s the scientists and medical professionals who, for decades, have been advising us to eat food that makes us fat.

Calories in/calories out is one theory about how we gain and lose weight, but it’s not necessarily the correct one. Doctors may focus on calories because they’re something that can be easily measured. But we’ve long known that not all calories are equal, and that obesity is caused by a hormonal imbalance, today usually exacerbated by processed foods. Eating 100 calories of meat is not the same as consuming 100 calories of juice, though the food industry has done a very good job at convincing us otherwise. The main factor responsible for controlling our weight is insulin. 

“All carbohydrates break down into sugars, and when we eat them, our bodies secrete insulin,” explains endocrinologist, Dr. Mariela Glandt. “Insulin is the hormone that carries sugar out of our blood and into cells, where they can use it for energy. When there’s too much sugar in the blood, the body secretes more and more insulin to cope with the excess sugar. This can eventually lead to metabolic syndrome.” 

Since the 1980s, doctors have been recommending a low fat diet full of carbohydrates. A low-fat, high carb diet is a recipe for hunger. Essentially, we’ve spent decades eating according to guidelines that ignore the facts of human metabolism. It’s dietary fat and protein that make us feel full, while carbohydrates drive insulin, and insulin drives hunger. Obesity is rarely a person’s fault. We’re victims of an experiment called, What happens to Americans when you remove the natural fat from their diet and replace it with carbs and refined oils?  The answer is more than 100 million adults have pre-diabetes or diabetes. Some 122 million people have cardiovascular disease, which causes approximately 840,000 deaths each year. And three-quarters of American adults are overweight or obese. 

Thanks to the food pyramid and the plate-method of eating, we’ve created a situation where our bodies are constantly over secreting insulin, and it’s making us sick. As The NYT headline that Maher highlighted says, poor diet is the leading cause of death in America. 

In 2020, the USDA will release updated recommendations. Those need to be based on the current evidence of soaring obesity rates since low fat recommendations became our guidelines. It’s time to ditch the instructions that gave our grandparents and parents high blood sugar, fatty liver, high blood pressure, and high triglycerides, cardiovascular disease and strokes, and have made so many of us overweight. What needs to make a comeback is not fat shame, but dietary fat. Seriously, bring on the cheese. Get rid of the carbs.

Many medical professionals will say that we haven’t run enough trials to know whether a diet with more fat is safe. But we do have all the evidence of what humans were like before we made cheese puffs a food pyramid category. Over two thousand Americans dying every day of cardiovascular disease is not an indicator of good heart health. And you don’t need to go to medical school to be able to understand that  hundreds of millions of fat people means we’re doing something wrong. 

How many people with Type 2 diabetes will it take to change regulations?

Maher is right that we should be having a conversation about the obesity epidemic. It needs to be a fair one, based on good science and heavy on empathy and compassion. Earlier this month my colleague Elizabeth, who lived with severe diabetes complications, comitted suicide. Although in recent years she had found her way to a low carb lifestyle that enabled her normalize her blood sugar levels, she couldn’t undo the decades of damage diabetes had done to her body. In her suicide note she wrote that she couldn’t bear the pain and cost of diabetes complications any longer. Near the conclusion of her note she wrote that the “utterly useless advice by diabetes educators to eat anything in moderation and focus on whole grains and low fat guaranteed the development of intractable diabetic complications over time.” 

The American Diabetes Association’s website says, “Everyone’s body responds differently to different types of foods and diets, so there is no single “magic” diet for diabetes.”

While it’s true that we all have our food tastes and preferences, what we have in common is that metabolism and diabetes are pretty much the same in everyone. For a vast majority of people with diabetes, a low carb diet with protein and fat would be that single “magic” diet, if only we’d acknowledge it. 

Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and has continued to write essays and fiction while raising her three sons (and many pets).

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Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and continues to write essays and fiction while raising her three sons (and many pets). Jessica’s work has appeared in The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, Tablet Magazine, and elsewhere. She is the diabetes correspondent for The Faster Times. In 2009 she and her husband, both type 1 diabetics, founded A Sweet Life, where she serves as editor-in-chief. Jessica loves spending time with her sons, cooking with her husband, playing with her cats, reading, biking, drinking coffee, and whenever possible, taking a nap. Follow Jessica on Twitter (@jessapple)