When Wajahat Ali was growing up, he was “the fat kid.” He remembers shopping in the “husky” aisle at the clothing store; he remembers the teases and taunts. Now a 39-year-old New York Times contributor and public speaker, Ali’s experience of being bullied for his weight — not to mention for being “brown and Muslim” — was so “formative” that it’s become an integral part of his public persona.

Ali is also known for being an outspoken critic of President Trump. So when he took to Twitter on Tuesday to criticize House Speaker Nancy Pelosi (D-Calif.), he drummed up some pushback from his liberal followers.

The writer had been responding to comments Pelosi made in a Monday interview with CNN, in which she called Trump “morbidly obese.” Pelosi was discussing Trump’s statement that he is taking hydroxychloroquine, an anti-malarial drug he’s touted as a treatment for the coronavirus. Growing evidence, however, shows that the drug carries a significantly increased risk of death for certain patients — and its efficacy hasn’t been scientifically proven otherwise.

Although Pelosi mentioned Trump’s “age group” as a reason she was concerned about his use of the drug — at 73, he’s considered high risk — many, including Ali, derided the fact that she added: “and in his, shall we say, weight group: ‘Morbidly obese,’ they say.”

The clip of Pelosi went viral, with some on the left applauding the quip; hashtags like #PlumpTrump and #MorbidlyObese started trending. Many pointed out that Trump has said much worse, particularly about women (he has repeatedly called comedian Rosie O’Donnell “fat”).

Ali and others saw a more insidious effect: that no matter the intention, the comments normalized fat-shaming even at the highest levels of government. “You can mock him for so many other things,” he says. “She could’ve left it at, he was unhealthy. But perhaps she unconsciously went there.”

The message it sent to everyone watching, Ali says, was simple: “This country really hates fat people.”

Pelosi’s office has not responded to a request for comment.

Experts, too, say that discussing weight on a national stage has serious effects for everyone, not just the target. Studies have shown fat-shaming may actually drive weight gain; it’s also linked to anxiety, depression, low self-esteem and eating disorders.

“It’s not just about the president receiving the message,” says McGill University’s Amanda Ravary, who’s published research on the effects of celebrity fat-shaming. “We might think it’s trivial, but it can be really harmful for the average person.”

And even as the body-positivity movement has gained traction, cultural attitudes about fatness persist, according to Rebecca Pearl, a psychology professor and director of research at the Center for Weight and Eating Disorders at the University of Pennsylvania. It’s “a particularly sticky form of stigma,” she says: One study showed that Americans’ implicit biases linked to race and sexuality decreased from 2004 to 2016 — but their bias toward weight actually increased.

When Stacy Hartman, an administrator at the City University of New York who’s based in New Jersey, started seeing the controversy around Pelosi’s comment, she thought: “This is going to be unpleasant.” Hartman remembered when Chris Christie, a Republican, was governor of New Jersey, and people on the left seized on his weight as a point of political attack.

“My political views are not aligned with Chris Christie’s in any way, shape or form, but it always struck me as a very lazy thing to say about someone whose views you disagreed with,” Hartman says.

To Hartman, harping on someone’s weight seemed to link fatness to moral failing — of being lazy or gluttonous or stupid. It’s something she has seen again and again in political discourse, she says, and Pelosi’s comment was no exception. “I understand part of why people have [defended Pelosi] — that he’s called women fat pigs, and that he deserves what he gets,” she says.

“But that still makes fatness an insult. That to me is the harmful part of this.”

Experts point out that weight is affected by a variety of factors, including genetics and socioeconomic status. Many professionals are also moving away from using the term “morbid obesity,” according to Pearl: Various studies, including her own, have shown that patients find it “really stigmatizing” and prefer when their doctors characterize extreme obesity as “class 3 obesity.”

Ravary and Jennifer Bartz, of McGill University, were co-authors of a recent study that looked at the effects that fat-shaming female celebrities has on implicit anti-fat attitudes in U.S. women. Analyzing high-profile events from 2004 to 2015, they identified spikes in anti-fat attitudes among women in the two-week period following such incidents. Events that garnered more media attention created even greater spikes.

“One of the big takeaways is that these comments were often off-the-cuff, not premeditated,” Bartz explains, “and nonetheless they can have an effect and make people feel bad.”

Although their study looked at more overt forms of fat jokes and shaming, Bartz says that raising weight in the context of a conversation about health can have adverse consequences. As she puts it: “That does seem to be a conversation that’s more appropriate for someone and their physician.”

There’s been far less research about male body image. Of course, women have long contended with stricter ideals of thinness — and therefore report a greater prevalence of weight stigmatization and discrimination, Pearl says. But studies have found that about 40 percent of men report some experience of weight stigma, too. “Because there’s less overt social pressure for men to talk about their bodies, that also means there’s less of an outlet for them to get support or talk about their insecurities about their bodies,” she says.

Ali finds it “revealing” that people are still surprised when he speaks up about weight. “It just shows how limited we are as a society when men aren’t allowed to express grief or pain or trauma,” he says.

In this case, though, he wasn’t the only man to join in the conversation. Walter M. Shaub Jr., the former director of the Office of Government Ethics who resigned under the Trump administration, was among several others who weighed in on the debacle.

Katy Stoll, an actress based in Los Angeles, says she was “immediately disappointed” when she saw the clip of Pelosi’s comments.

“Fat-shaming like that doesn’t just hurt ‘fat’ people, it harms all of us,” she says. “It reinforces the idea that our value relies on our weight.”

As she and others pointed out, this moment seems particularly inopportune. Stoll says she’s been having conversations with people about how the pandemic is affecting their eating disorders; she sees a lot of people “struggling.” There’s no need for “extra pressure” on how we look right now, she says.

For Ali, it was never so much about Pelosi’s specific comment as it was about the way others seemed to harp on it, seemed to delight in it.

“As a former fat kid, I know how the trauma lingers into adulthood,” he says. “Because I have experienced it, it makes me more sensitive. We have a health crisis right now, but if we can find a way just to be a little more thoughtful, maybe we can emerge a little more decent.”

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