This Book Helped Me Unpack My Fat Phobia

A review of Fearing the Black Body: The Racial Origins of Fat Phobia, the book that taught me about anti-Blackness in medicine.

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Like many people during the summer of 2021, I embarked on a transformative (re)education journey. But instead of trying to "optimize" my health, I challenged myself to dig deep into the origins of fat phobia and anti-Blackness. I’d like to give you a clear explanation of what prompted this, but the truth is I can’t remember. All I know is that around this time, I became aware of Dr. Sabrina Strings' groundbreaking book, Fearing the Black Body: The Racial Origins of Fat Phobia. Before I knew it, I was slowly consuming Strings’ book, which challenged everything I thought I knew about health and the systems surrounding it.

Why This Book?

When I picked up Fearing the Black Body, I was a few years into recovering from disordered eating and an (undiagnosed) eating disorder that had significantly shaped my relationship with food and my body. Just reading the title made me question why Black bodies are feared and what that has to do with fatphobia. Well, this book was about to do more than expand my knowledge. It offered a lens through which I could begin to understand the historical and systemic roots of fat phobia and its disproportionate impact on Black women. For me, this was not just academic—it was personal.

Dr. Strings’ work met a pressing need for me and, I suspect, for many others: it unpacks how fatphobia isn’t just a “health concern” but a racialized construct that continues to influence clinical practices and societal norms. By this, I mean that it made me aware of and rethink my biases. It challenged me to question why I assumed that thinness equaled health or that fatness equaled ill health. It also made me question the frameworks that inform medical decisions and public health policies. If my doctors were making informed medical decisions, they would have seen my rapid weight loss and questionable dietary habits as flaming red flags that my “healthy habits” were far from healthy. But I digress.

What Makes This Book Stand Out?

1. An Eye-Opening History of BMI

One of the book's most striking revelations was the historical origins of the Body Mass Index (BMI). Did you know that BMI was created in the 1830s by Lambert Adolphe Jacques Quetelet, a Belgian mathematician who collected data exclusively from white European men? Women and people of color were excluded entirely - at least in the beginning.

Despite its flawed origins, BMI is still widely used today as a health measure—often to the detriment of women and marginalized groups. Because of BMI, it’s not uncommon for women and marginalized groups to go undiagnosed or be misdiagnosed due to a belief that all their health problems will go away if they just lose weight. Yes, I take particular issue with this as a Black woman who went undiagnosed for autoimmune disease because my doctor thought it was due to my high BMI. We’ll get to that hot mess express in a future newsletter, but just know that my autoimmune diseases aren’t BMI-related. Nevertheless, learning about the inaccuracies of BMI did send me spiraling down a rabbit hole to discover diverse populations are still excluded in medical research, perpetuating inequitable care and inaccurate conclusions. If this doesn’t give you pause as a healthcare provider, advocate, or researcher, it should.

2. The Disturbing Legacy of Eugenics

Strings also connects fat phobia to the eugenics movement, which sought to “improve” humanity through selective breeding. For many reasons, I simply gag at the thought of this and the educational institutions that helped perpetuate this nonsense. What is deeply troubling is that the legacy of this pseudoscience-fueled discriminatory practice based on race, ability, and class persists in modern healthcare. Now you see why I have to gag? It’s gross on so many levels.

As a Black woman with disabilities, after reading Strings’ book, I found myself questioning whether the discrimination I’ve faced in clinical settings was “all in my head.” Spoiler alert: I don’t think it ever was. Dr. Strings’ work affirmed that these experiences are not isolated but rooted in a culture that systematically devalues Black bodies. It was a painful but clarifying realization that helped me contextualize—and resist—the systemic biases I’ve encountered. Hence, firing that doctor who thought that my high BMI was the cause of my health concerns instead of the autoimmune diseases I would later get diagnosed with. While I will never know for sure, I will always question if my doctor had not allowed her fatphobia to inform my treatment, would I have gotten diagnosed sooner? We’ll never know, but I will always wonder.

Why Healthcare Providers Need to Read This

Every clinician, coach, practitioner, trainer, administrator, and policymaker should read Fearing the Black Body. This book is more than a history lesson; it’s a call to action. If you don’t understand the intersection of anti-fatness and anti-Blackness, you risk perpetuating the same harms that fuel today’s stark health disparities.

This book should be read in medical schools, health coaching programs, and any institution that prepares professionals to care for diverse populations. As healthcare providers and advocates, we must confront our biases and the systems that sustain them. With this critical foundation, we can hope to achieve equitable care.

Transformative Takeaways

Reading Fearing the Black Body fundamentally shifted my perspective on health and wellness. I learned:

• How fat phobia is deeply intertwined with anti-Blackness and colonial ideologies.

• Why BMI is not—and has never been—a reliable health measure for diverse populations.

• How the enduring legacy of eugenics continues to shape modern medical practices.

Armed with this knowledge, I’ve become more intentional in addressing my biases and advocating for systemic change. This book reinforced my commitment to challenging harmful practices and creating spaces where all patients feel valued and respected.

Final Thoughts

Dr. Sabrina Strings’ Fearing the Black Body is a powerful, necessary read for anyone in healthcare or adjacent fields. It confronts the uncomfortable truths about fat phobia’s racial origins and offers invaluable insights for building a more equitable healthcare system.

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