Body Positivity Taught Women Not to Hate Themselves. Did It Make Health Harder to Talk About?
ATHENA | HEALTH & CULTURE Women • Bodies • Social Media
Former body-positivity influencer Gabriella Lascano says the movement that gave her confidence eventually made weight loss feel like betrayal. Her story has reopened a difficult argument: can society acknowledge the medical risks associated with obesity without returning to humiliation, discrimination and the demand that every woman become thin?
By ATHENA Health & Culture Desk
NEW YORK — 19 August 2026
At her highest weight, Gabriella Lascano says, her world began to grow smaller.
She could no longer wear heels as she once had. Some dresses stopped fitting. Seats on aeroplanes and rollercoasters became difficult or impossible. She had built an online identity around fashion, confidence and the idea that women should not postpone their lives until their bodies became acceptable. Yet she was beginning to feel that parts of her own life were slipping away.
Lascano did not suddenly decide that larger women were undeserving of beauty or respect. She began asking a more unsettling question: had the language of self-love made it harder for her to admit that she was worried about her health and wanted her body to change?
That is the argument at the centre of Confessions of a Former Body Positivity Influencer, a New York Times Opinion video published in February. In it, Lascano describes a journey from body-positivity advocate to outspoken critic of what she considers the movement’s most rigid online form.
Her testimony has been embraced as brave, condemned as anti-fat propaganda and absorbed into a much larger cultural fight over obesity, weight-loss medicines, beauty standards and who gets to define “health.”
But the most useful question is not whether Lascano or her critics have won that fight.
It is whether women are being offered another false choice: deny every health concern in order to love your body, or hate your body in order to care for it.
The movement gave her what the culture had withheld
Lascano began posting on YouTube in 2010. Fashion and beauty content brought her an audience of plus-size women who told her that seeing someone like them dress boldly and live visibly made them feel less alone.
Over the following decade, she secured collaborations with major clothing brands and built a combined Instagram and TikTok following of more than 600,000, according to People’s account of the video.
The community offered a powerful counter-message to a culture that had long treated thinness as a condition of femininity, discipline and success. A woman did not need to become smaller before she wore the dress, entered the photograph, travelled, dated, danced or allowed herself to be seen.
That message was not frivolous. Body shame can consume years of a girl’s life. It can distort eating, movement, intimacy and self-worth. It can persuade women that their bodies are public projects awaiting correction.
Research suggests that body-positive media can provide genuine relief. In a 2019 randomised experiment involving 195 young women, brief exposure to body-positive Instagram posts improved mood, body satisfaction and body appreciation compared with thin-ideal and appearance-neutral posts. A 2025 review and meta-analysis of 56 studies also found immediate improvements in body satisfaction and emotional wellbeing, although the researchers said questions remained about longer-term effects and body surveillance.
Body positivity did not invent the need for dignity. It named a need that fashion, advertising and sometimes medicine had refused to meet.
When acceptance began to feel like a loyalty test
As Lascano’s following grew, so did her weight. She says she reached close to 400 pounds and began experiencing limitations that mattered to her daily life.
At the same time, she says, some online creators were treating words such as “healthy” and “obese” as unacceptable and describing intentional weight loss as inherently fatphobic. She disagreed but initially remained quiet, fearing the response from the community that had helped build her career.
The deaths of two women in or near her body-positivity circle, Jamie Lopez and Brittany Sauer, became a turning point in her account. Lascano has been careful about the limit of what she knows: she said she could not be certain that their body size caused their deaths. The reporting reviewed by ATHENA did not establish that causal claim. What is clear is that the losses forced her to confront fears about her own future.
In a TikTok posted around 2023, she said she felt guilty for participating in a movement that, in her view, had stopped making room for honest discussion of health. She says other creators called her fatphobic and treated her as a pariah.
She subsequently distanced herself from the body-positivity label and began losing weight. Her present position is not that self-acceptance was a mistake. It is that acceptance must include autonomy: “We can still love ourselves even if we want to lose weight,” she said in the video, as reported by People.
Her experience deserves to be heard. It does not, on its own, prove that a global movement caused her weight gain, that its members share one doctrine or that every larger person who rejects intentional weight loss is ignoring illness.
It does reveal how a liberating idea can harden into an identity test online.
The medical risk is real — and it is not a moral verdict
Obesity is not imaginary, and discussing it is not automatically an act of prejudice.
The World Health Organization classifies obesity as a chronic, relapsing disease produced by complex interactions among genetics, neurobiology, eating behaviour, access to nutritious food, commercial forces and the wider environment. In 2022, 16 per cent of adults worldwide were living with obesity.
At a population level, excess body fat is associated with greater risk of type 2 diabetes, cardiovascular disease, sleep apnoea, osteoarthritis, fatty-liver disease and several cancers. Those risks should not be erased because the subject has too often been discussed cruelly.
Yet risk is not destiny. A statistical association cannot diagnose the person standing in front of us. Not every larger person has current organ dysfunction, and not every thin person is healthy.
Body mass index, or BMI, illustrates the problem. It is an inexpensive screening measure based on height and weight, but it does not directly measure body fat, distinguish fat from muscle or show where fat is distributed.
A 2025 global commission published in The Lancet Diabetes & Endocrinology therefore proposed separating “clinical obesity” — excess adiposity accompanied by organ dysfunction or substantial limitation in everyday activities — from “preclinical obesity,” in which excess adiposity is present without current organ dysfunction, although future risk may be elevated. The commission recommended supplementing BMI with measures of body fat and waist distribution and assessing the individual’s symptoms, function and health.
That framework makes Lascano’s story more meaningful without turning it into a universal rule. The relevant issue in her account was not simply a number on a scale. It was the loss of activities she valued and her concern about what her body was telling her.
No one watching a seven-minute video can diagnose her. But neither should a movement require her to ignore those changes in order to remain ideologically acceptable.
Stigma is also a health hazard
There is another truth that cannot be edited out: contempt does not make people healthier.
Get ATHENA’s stories in your inbox
Join Medium for free to get updates from this writer.
An international expert consensus published in Nature Medicine found that weight stigma is widespread in employment, education, families and healthcare. Between 19 and 42 per cent of adults with obesity reported weight discrimination, with higher rates among women and people with higher BMIs.
In medical settings, that bias can mean shorter appointments, less health education, symptoms being attributed to weight without adequate investigation and patients delaying or avoiding future care. Weight stigma is also associated with depression, anxiety, binge eating, exercise avoidance and other harms.
This matters because “I am concerned about your blood pressure, breathing, blood sugar or joint function” is a medical conversation. “Your body proves that you are lazy and irresponsible” is a stereotype.
The two have often been confused.
For decades, larger patients have described seeking care for pain, reproductive symptoms or mental distress only to be told to lose weight before the underlying complaint was properly examined. Others have encountered equipment that did not fit them, gowns that did not cover them or clinicians who presumed their behaviour from their appearance.
A health movement that challenges those failures is not anti-science. It is demanding better science and better care.
Likewise, a patient who asks for support with weight loss is not betraying larger people. She is making a decision about her own body.
What body positivity was built to do
Online body positivity is often presented as a collection of slogans and photographs. Its political roots are older and more demanding.
The National Association to Advance Fat Acceptance was founded in 1969 to challenge size discrimination and protect the rights and quality of life of fat people. The movement that followed addressed employment bias, public accommodation, medical mistreatment and the exclusion of larger bodies from ordinary social life.
Those aims do not depend on proving that every fat person is healthy. Civil rights are not prizes awarded after a favourable blood test.
The Health at Every Size approach is also frequently caricatured as declaring that everybody is medically healthy at every weight. Its institutional advocates instead describe a size-inclusive approach to health that opposes discrimination and seeks equitable access to care. People can disagree with elements of that framework without pretending that its only purpose is to deny disease.
Critics of the New York Times video say it collapses these structural goals into the most extreme comments Lascano encountered online. Fat activist Vinny Welsby argued that the video misrepresented the history of body positivity and repackaged anti-fat beliefs as concern. Writer Virgie Tovar described a deeper split between body positivity as an individual project of self-esteem and fat liberation as a collective campaign against discrimination in a Forbes commentary.
That criticism is important. Lascano can truthfully describe the community she experienced without speaking for every activist, clinician or larger person.
But history cannot be used to dismiss her account either. A movement’s formal principles do not guarantee that every community formed in its name will practise them with nuance.
The algorithm prefers a body war
The conflict is intensified by the economy of social media.
Platforms reward certainty, transformation and outrage. “You deserve dignity whatever your size” becomes “any desire to lose weight is self-hatred.” “Excess adiposity can increase health risk” becomes “a fat body is evidence of failure.” The careful sentence travels slowly; the accusation becomes a trend.
For an influencer, the pressure is more intimate. Her body is not only her body. It becomes content, community, product and promise. Followers may see a change in weight not as a private decision but as a breach of the identity that brought them together.
The thinness industry then claims the same woman from the opposite direction. Her old photographs become “before” images. Her smaller body is treated as proof of virtue. Health becomes indistinguishable from appearance, and the body she once defended is used as a warning.
Either way, her body remains public property.
Even supportive body-positive imagery carries this tension. The 2019 Instagram experiment found that body-positive posts improved how participants felt, but both body-positive and thin-ideal posts increased self-objectification compared with appearance-neutral content. In other words, expanding which bodies may be admired can help while still keeping women’s attention fixed on how bodies look.
Body neutrality offers another possibility: a person need not find her body beautiful every day. She can value what it enables, care for it and live inside it without turning it into a permanent referendum on worth.
Self-love and treatment are not opposites
The answer to this debate is not a timid compromise between two slogans. It is a clearer separation of dignity, diagnosis and personal choice.
Human dignity is unconditional. A person does not have to demonstrate health, thinness, discipline or an intention to change before she is entitled to respectful treatment, suitable clothing, safe seating, employment, romance or competent medical care.
Health assessment should be individual. Weight can be relevant, but so can blood pressure, sleep, mobility, laboratory results, medication, genetics, mental health, food access, disability and the person’s own priorities. BMI may begin a conversation; it should not be allowed to finish it.
Weight loss can be a legitimate goal. So can seeking greater strength, mobility, metabolic health or freedom from disordered eating without making weight the central outcome. Evidence-based care may include nutrition support, physical activity, psychological treatment, medication, surgery, monitoring — or no weight-loss intervention at that time.
None of those decisions should be made by an audience.
Lascano’s story does not prove that body positivity failed. It shows what happens when a movement that began by defending freedom becomes another place where a woman feels she must seek permission to change.
It also warns against the opposite backlash. If her story is used to restore ridicule, treat every larger body as diseased or reduce health to thinness, the lesson will have been lost.
A woman should be able to say, “I love myself, and I want help.”
She should also be able to say, “Do not diagnose me from a photograph.”
A body should not have to remain unchanged to deserve love. It should not have to become smaller to deserve care.
ATHENA will continue reporting on body image, weight stigma, women’s health and the forces shaping how girls learn to see themselves.
Reporting sources: The New York Times Opinion, People, the World Health Organization, The Lancet Diabetes & Endocrinology Commission, Nature Medicine, the National Association to Advance Fat Acceptance, the Association for Size Diversity and Health, PubMed-indexed body-image research, Forbes and Fierce Fatty.
