Gravely misinformed ideas about health, beauty and body image still dominate, as derogatory reactions to plus size model Tess Holliday’s October Cosmopolitan UK magazine cover prove. TV presenter Piers Morgan, for example, posted a photo of the cover on Instagram with a caption that called out this “step forward for body positivity” as “a load of old baloney”. He went on to add: “This cover is just as dangerous and misguided as celebrating size zero models.”

Debates along the same lines run throughout discussion of the magazine cover on social media, with many people arguing that the image promotes obesity and an unhealthy lifestyle. There are plenty of supportive and celebratory comments too but why do many diverse audiences – from newspaper op-eds to online fitness coaches to social media users – react to this cover with immediate disapproval?

It comes after a glut of “summer shredding” diet plans and health programmes addressing the obesity panic and offering “fast fixes” to solve health issues by putting patients under dramatic weight loss regimes. Yes, there are correlations between obesity and other health issues, and it is important for us to think and talk about health. But the ways we have been going about this are often not accurate nor helpful.

Fat stigma, thin privilege

Many of the social media comments responding to Holliday’s magazine cover start by exalting the efforts of body positivity and body acceptance movements. But there is always a “but” – “but this isn’t healthy”, “but she’s going to get diabetes”, “but she’s going to die early”.

Why do we feel entitled to comment on anyone’s health when we most likely know nothing about them, their health, nutritional choices or fitness activity? Fat stigma has led us to draw a direct and exclusive connection between fatness and ill health, often disregarding the many other aspects of a person’s life that also bear on their bodies and health. Research has also shown that the stress experienced by fat people in the face of fat phobia, stigma and shaming often make it far harder for them to address the health issues they need to.

Read more: Obesity is about much more than an unhealthy lifestyle

There are plenty of thin people suffering from illness and all manner of health complications too. But the privileges Western culture has accorded to thinness mean that these people will never be subject to the same interrogations, or faux concerns, about their health. Unhealthy diet fads hardly come under the same kind of criticism.

Meanwhile, contemporary Western societies glamorise and laud numerous unhealthy lifestyle practices on a regular basis. People boast about their excessive drinking jaunts, or glorify stress by exalting those who work hard and are constantly under pressure. These practices are not only permissible; they have almost become something to aspire to. But the moment a fat person appears on a public platform, huge concerns about health are suddenly developed.

UConn Rudd Center for Food Policy and Obesity

Multiple body stories

Slurs against fat people almost always draw on two main stereotypes: that they eat copious amounts of unhealthy food and that they are too lazy to exercise. Scrolling through the comments about Holliday’s Cosmo cover alone will pull up a few of these.

Such slurs do not only exclude and deny the material experiences of people suffering from such conditions as hormonal imbalances, genetic issues or other health complications that lead to weight gain. More harmfully, it ignores the many other affective, emotional and mental factors that contribute to an person’s relationship to their body.

Instances of childhood abuse, sexual assault, peer bullying or fractured familial relationships are only a few of many reasons my own interview participants (for my ongoing PhD) have shared of the subsequent damaging practices they took towards their bodies. These include starvation, over-exercising, binge-eating, self-harm or excessive preoccupations with certain beauty practices such as plastic surgery or skin bleaching.

Read more: Discrimination against fat people is so endemic, most of us don’t even realise it’s happening

Seeing bodies differently

People never just arrive at looking a certain way overnight. It is harmful and counterproductive to assume that a woman is very fat because she just eats junk food all day and fails to exercise; that a very thin woman is anorexic, or that people with hair on their bodies or acne on their faces are dirty. A complex set of traumas, experiences, relationships and interactions lie beneath the surface and have led them to where they are – and we need to honour these stories too.

Instead of seeing fat bodies simplistically and sanctimoniously as a glorification of bad health, we might instead try to reframe any display of an unconventional body as a means to understand that health can look very different and take varying forms. We should view a publicly visible fat, confident, self-accepting fat body, like Holliday’s, not as a sign that she is promoting unhealthy life choices but as the opposite: that whatever size we are or whatever state of health we are in, we might begin to find some peace with our bodies.

If health is really what we are concerned about, surely this might be a more helpful and kind approach. After all, the current knee-jerk reactions to images like Holliday’s magazine cover (or any number of her social media posts) of horror and disdain, and consequent shaming and bullying, haven’t been working. They only cause more stigma, and the bodies that may need help and healing become more invisible.