“Obesity,” declares Charlotte Cooper, author of 1998’s Fat and Proud: The Politics of Size, “is just a word used by people to medicalize fat.” Extra weight, once considered a genetic short straw, is increasingly characterized as a crisis threatening the physical, political, and moral health of our nation—even as large bodies are becoming increasingly visible in popular culture.

Detailed discussions of diarrhea (Survivor). On-camera vomiting (The Bachelor, The Biggest Loser). Extensive cosmetic surgery (The Swan). Endless hot-tub makeout sessions (take your pick). On reality tv, no subject is too personal to reveal, no biological function too intimate to discuss—except for one final taboo too terrible to mention: menstruation.