For months, public health organizations have been urging Americans to get a COVID-19 vaccine. Health experts have continuously emphasized the safety and importance of getting vaccinated to help reduce the spread of the coronavirus. And yet, as soon as Krispy Kreme launched a promotion meant to incentivize vaccination — a free glazed doughnut every day for the rest of the year for anyone with a vaccination card — many of these same public health experts were quick to criticize the campaign. As a public health expert, I can’t endorse a diet of daily donuts,” one physician tweeted, although she did express appreciation to Krispy Kreme for incentivizing vaccines.
Suppose someone indeed eats an Original Glazed #KrispyKreme donut every day as your offer provides and changes no other aspects of their diet/exercise. In that case, they’d gain approximately 15 pounds by the end of 2021. Another physician went even further, saying, “Krispy Kreme offering free doughnuts for getting vaccinated is like Marlboro showing free cigarettes for getting a flu shot. Other health experts swiftly called out these tweets as fatphobic, shame-based, and misguided. To be clear: Weight stigma and fat-shaming are everywhere, all the time. Fat people face these things every day. The Krispy Kreme promotion has prompted a more widespread conversation, but it’s just the tip of the iceberg.
Let’s take it as an opportunity to learn why shame and stigma are wrong and don’t work and how we can do better.
Fat shaming is bad for health, but it’s highly prevalent in health care.
Evidence shows that shame-based messaging around health and food choices doesn’t work and has adverse health effects. Fat shaming is particularly harmful.
The experience of weight stigma is associated with worsened physical and mental health. And health care providers are incredibly guilty of perpetuating this sigma. On average, they hold significantly more anti-fat bias than the general public. People with higher weights generally receive a lower quality of care than their smaller peers, and they may even avoid care altogether because doctors make them feel so much shame about their weight.
“Weight stigma is such an integral element of the medical-industrial complex that many providers don’t think to challenge it,” said Monica Kriete, a writer. Her newsletter focuses on weight stigma in health care. She pointed to entire disciplines of medicine that are dedicated to “obesity counseling,” “weight management,” and weight loss surgery, as well “obesity prevention” messages in public health.
Kimmie Singh, a New York-based registered dietitian, agreed, saying, “I feel like there’s often this idea among doctors of, ‘I know what’s best for you, so it’s fine if I say it in the harshest way possible because I’m doing what’s best for you.’”
Of course, many doctors are well-intentioned. But they are constantly pushing weight loss onto clients with higher weights, and giving eat-this-not-that nutrition recommendations don’t improve health.
“By couching this in terms of health, people can more readily express fatphobic sentiment without repercussion because it’s seen as coming from a place of ‘concern’ for well-being.”
– Jeffery Hunger, social psychology researcher at Miami University of Ohio
The Krispy Kreme panic isn’t about health. It’s about weight and fatphobia.
Those who have spoken out against the free doughnut incentive argue that eating doughnuts might ruin someone’s health. But other experts pointed out that this isn’t really about health — it’s about fatphobia.
“By couching this in terms of health, people can more readily express fatphobic sentiment without repercussion because it’s seen as coming from a place of ‘concern’ for well-being,” said Jeffrey Hunger, an assistant professor and social psychology researcher at Miami University in Ohio. He studies the health consequences of stigma.
The result is a harmful discourse that only serves to ostracize the fat community.
A lot of folks use fearmongering, and inflammatory language that claims simply giving away free doughnuts will somehow result in massive weight gain from coast to coast,” Hunger continued. But the idea that is eating doughnuts equals weight gain isn’t true (more on that later). And the reality is that these claims aren’t really about health but an extreme fear of weight gain.