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Authors: Abigail C. Saguy

Tags: #Health & Fitness, #Medicine, #Public Health, #Social Sciences, #Health Care

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The hold of a personal responsibility frame is so powerful that even health at every size advocates sometimes emphasize it for good nutrition and physical activity. For instance, Glenn Gaesser strongly urges readers to improve their personal lifestyles by getting at least 140 minutes of exercise (including yard work and playing actively with children) each week and by eating a diet low in fat and sugar and high in complex carbohydrates.
Gaesser argues that “obesity may not be a direct cause of disease, but may serve as an imprecise marker for an imprudent lifestyle,” suggesting that those who do not exercise or eat poorly are irresponsible or careless. 86 In the following passage from his book, he ironically explains how individuals can choose to create abdominal fat, associated with heart disease:

Exercise as little as possible, eat fiber-depleted foods loaded with fat (especially saturated fat) and refined sugar, drink a lot of alcohol, smoke cigarettes, and subject yourself to as much stress as possible.... But if you can’t indulge in every one of these behaviors, one or more will still be effective—especially if you choose physical inactivity and fat and sugar-laden food, the behaviors of choice for millions of Americans. 87

By Gaesser’s account, even exposure to stress is a choice, as opposed to a product of social factors (such as poverty or limited job opportunities) beyond individual control.

QUANTIFYING BLAME FRAMES

My claim that a personal responsibility frame dominates news coverage of obesity is supported by several empirical studies and by systematic news media analyses I have conducted with several of my students. 88 As part of these analyses, my students and I read and coded a random sample of 262 news articles on overweight and obesity published in
The New York Times
or
Newsweek. The New York Times
has among the highest national circulation of any newspaper and is widely regarded as the newspaper of record, giving it influence over opinion leaders and policymakers and shaping reporting in other news media. 89
The New York Times
has a relatively high quality of reporting, biasing the sample toward more sophisticated reporting. I included articles from
Newsweek
to add longer articles to the sample, as news magazines typically publish longer articles than newspapers. Both publications have the advantage of being available in the LexisNexis database for the entire 1995 to 2005 time period. This sample misses some of the range of the news media, including women’s magazines, the ethnic press, or political presses. 90 Specifically, given that the majority of readers of these papers are from the middle class and are white, these publications may be more likely, than ethnic presses or presses catering to a more working-class audience, to uncritically reproduce negative stereotypes regarding heavier people, the poor, and ethnic minorities. Nonetheless, given their cultural influence, they are important to study. 91

Before looking at the relative discussion of different blame frames, let us examine the prevalence of different problem frames, discussed in the previous chapter. Almost one-third (31 percent) of this sample refer to obesity as a health crisis, and 22 percent call it an “epidemic.” In comparison, only 11 percent discuss weight-based discrimination and 1.9 percent discuss the possibility of being fat and healthy. Moreover, discussion of obesity as a health crisis increases from 17 percent of the sample in 1995–2001 to 39 percent of the sample in 2002–2005. Similarly, discussion of obesity as an “epidemic” increases from 12 percent of the news sample in 1995–2001 to 28 percent of the news sample in 2002–2005. In contrast, there is less discussion of weight-based discrimination in 2002–2005 (7 percent of the sample) compared to 1995–2001 (17 percent of the sample).

Within this sample, news reports are more likely to discuss individual-level contributors to obesity than sociocultural or biological/genetic factors.
Specifically, as is shown in figure 3.1, 41 percent of this sample discuss individual-level causes of obesity, compared to 29 percent that discuss sociocultural contributors and 16 percent that discuss biological factors.
While only a small proportion of articles (8 percent) specifically discuss cultural contributors to obesity, 17 percent of articles mentioning blacks, Latinos, or the poor discuss cultural causes (compared to only 4 percent of articles not mentioning these groups). Discussions of responses to the alleged obesity problem similarly focus on individual-level behavioral solutions (56 percent), whereas 24 percent of articles discuss medical solutions and 21 percent discuss policy solutions. Other research has shown that, compared to print news coverage of obesity, television coverage focuses even more heavily on individual behavioral causes and solutions. 92

As can be seen in figure 3.2, however, discussions of sociocultural factors and policy interventions have increased over time. In contrast, discussion of biological factors remains low throughout the time period surveyed and discussions of individual causes and individual-level solutions remain high. 93 Thirty-four percent of articles published between 2002 and 2005 discuss sociocultural contributors to obesity, compared to 9 percent of articles published between 1995 and 2001. Policy interventions are discussed in 28 percent of articles in the later period, compared to 9 percent of articles in the earlier period. 94

The way in which my students and I coded the newspaper articles to include any mention of a cause does not capture the way in which, even when factors other than personal responsibility are mentioned in an article, they were often discussed alongside personal responsibility. In fact, in most cases, a personal responsibility frame dominated the discussion, as in the following 1999 article:
“They’re pushing these super-sized foods at restaurants, and customers want value for their dollar.... Am I going to go to the restaurants where I get a 3-ounce burger for $3, or to the one where I get an 8-ounce burger for $3?” 95 While industry pressures are identified, “customers” are still portrayed as ultimately facing a choice, rather than being passive victims, as with pollution.

Figure 3.1:
Percentage of
New York Times
and
Newsweek
sample discussing specific causes and solutions for obesity and overweight

Figure 3.2:
Percentage of
New York Times
and
Newsweek
sample discussing specific causes and solutions for obesity and overweight, 1995–2001 versus 2002–2005

Similarly, even when biological or genetic factors are discussed, they are typically subordinated to individual contributors. For instance, a
Newsweek
article discusses both biological and individual contributors to weight but ultimately emphasizes the importance of personal choices: “You can’t pick your parents, but you can pick what you eat and how often you exercise.” 96
The idea that genetics might provide an excuse for body weight is thus explicitly rejected. Rather, the article emphasizes people’s ability (and, seemingly, their obligation) to make choices regarding diet and exercise.
Similarly, another article cites new research on “race and weight,” explaining that, “on average, black women burn nearly 100 fewer calories a day than white women do when their bodies are at rest,” but cautioning that “the new findings do not mean that controlling and losing weight is a hopeless task for people with lower metabolic rates, just that it may require more attention to diet and exercise.” 97 This article thus reminds readers that managing their weight is their responsibility and that a biological predisposition to weight gain requires more, not less, personal vigilance. Such reporting is also common in other countries. For instance, a French
Le Monde
article mentions “genetic” and “endocrinological” factors only to dismiss them as irrelevant “95 percent” of the time: “Only 5 percent of cases can be attributed to genetic or endocrinological factors. In the remaining 95 percent, obesity is due to bad eating habits.” 98

Is the focus on personal responsibility a generic aspect of U.S. news reporting or specific to the issue of fatness? To what extent is it specific to
U.S.
news reporting? To answer these questions, I conducted two comparative news media studies, which are discussed in the remainder of this chapter. As we will see, a comparison of U.S. news reporting on overweight and obesity with U.S. news reporting on anorexia and bulimia suggests that U.S. news reports are more likely to blame people for being “too fat”
than for “thinness-oriented” eating disorders. I argue that this stems from the particular moral valence and racial and class connotations of fatness versus thinness. A comparison of U.S. versus French news reporting on overweight and obesity suggests, however, that U.S. political and cultural traditions of self-reliance make an emphasis on personal responsibility for obesity especially likely in this country, compared to countries with greater cultural and political emphasis on social solidarity, such as France.

WHAT’S DIFFERENT ABOUT FAT?

The U.S. tendency to emphasize personal responsibility is not unique to the issue of fat. 99 And yet, the fact that fatness has been framed as a sign of sloth and gluttony since the early twentieth century seems to make the discourse of personal responsibility even more potent in this context.
Eating disorders and overweight/obesity are both medical categories related to body weight and eating. Yet, while both eating disorders and overweight/obesity are considered medical problems, anorexics are by definition “too thin,” and bulimics are often relatively thin or of average weight. Given contemporary American attitudes that being heavy is the embodiment of gluttony, sloth, and/or stupidity, while slenderness is the embodiment of virtue, I hypothesized that the press may be more likely to invoke personal responsibility in the case of obesity than in the case of eating disorders.

Indeed, my analyses suggest that the news media are more likely to portray eating disorders as a problem for which no one is to blame, while suggesting that obesity is the result of bad personal and parental choices. These conclusions are based on analyses of the news sample of 262 news articles on overweight/obesity described above and 70 articles on anorexia and bulimia published between 1995 and 2005 in
The New York Times
or
Newsweek
.
100 It also draws on qualitative analysis of five additional articles published in these publications in 2006 and 2007 that specifically discuss binge-eating disorder. 101

As shown in figure 3.3, news reports on both eating disorders and overweight invoke personal choices, with more than 40 percent of articles in both categories mentioning personal choices as contributors.
However, several factors are described as contributing equally to eating disorders, while individual choice is the predominant explanation offered for overweight. Articles about eating disorders discuss sociocultural causes at the same rate as individual choices (47 percent for both), while 19 percent of eating disorder articles cite biological causes. In contrast, 41 percent of articles about overweight/obesity mention individual choices, with sociocultural and biological causes mentioned in 29 and 16 percent of articles, respectively. 102 Moreover, qualitative analysis reveals that news articles on anorexia typically evoke “complex webs of cultural factors and psychological processes,” serving to diffuse responsibility amongst several factors. 103

Moreover, articles on anorexia and bulimia tend to discuss biological factors and social constraints as working in tandem, diffusing focus away from individual blame, as in the following
Newsweek
editorial: “Good news: scientists are developing a better sense of how genetic and social triggers interact.” 104 When discussing both genetics and individual responsibility, articles on eating disorders often emphasize the former, stating, for instance: “Parents do play a role, but most often it’s a genetic one.” 105 In other words, when it comes to anorexia and bulimia there is, as the title of one news article proclaims, “no-one to blame.” 106 Contemporary reports on anorexia tend to portray parents as part of the solution, rather than as part of the problem, advising parents “to think of the disorder as an outside force that has taken over their daughter’s life [and] to be unwavering in finding ways to feed their child.” 107

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