Sociologist Sabrina Strings traced this history in her 2019 book "Fearing the Black Body." She argued that thinness became a marker of white respectability in the 18th and 19th centuries, partly to set European women apart from African women. Fatness was then framed as a sign of being less civilized.
Anti-fatness has practical costs. Fat patients report having symptoms dismissed and conditions blamed on weight. The body mass index, developed in the 1830s from data on European men, is still used to screen patients and set insurance rules. In 2023, the American Medical Association adopted a policy calling BMI an imperfect measure and noting its racial limits.
Few US laws protect against weight discrimination. Michigan has banned it since its Elliott-Larsen Civil Rights Act of 1976, and New York City added height and weight to its human rights law in 2023. Because Black women have the highest obesity rates in CDC data, anti-fatness compounds racial and gender bias.