What's Wrong With Fat? (30 page)

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Authors: Abigail C. Saguy

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

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According to Wann, the Human Rights Commission for San Francisco noticed the media and wrote a letter to 24-Hour Fitness, saying that they thought the billboard was offensive and discriminatory and did not live up to the tolerance and acceptance for which San Francisco stands. However, they did not have the authority to tell them to remove the billboard, and 24-Hour Fitness never acknowledged the letter. Pointing to the power of the medical and public health crisis frame, the commercial gym insisted that they were communicating a health message. “Obesity is one of the leading causes of health care costs in our society,” said the Northwest division president. 89

In response, Tom Ammiano, president of the San Francisco Board of Supervisors, held hearings before the human rights commission. Wann was one of five activists who collectively worked with the local political entities. She was able to draw on her extensive contacts to bring out more than 15 people and, with another activist, to coach them to tell their stories in the five allotted minutes. An African American man, who had started an employment agency to help black people get jobs, testified that fat people (of all ethnicities) suffer from the same kind of discrimination. He spoke publicly about how highly qualified fat people are turned down by employers after the in-person interview. One of Wann’s contacts spoke to the business community to preempt their concerns. Many high-profile fat rights activists and scholars attended the hearings. As a result of these hearings, San Francisco passed a statute specifically outlawing discrimination against people based on their weight in June 2000, becoming one of the few cities (along with Santa Cruz) or states (Michigan) to have such laws.

In sum, frames matter. Different ways of understanding fatness enable different actions and outcomes. An interaction I had with my daughter drives home this central point. I conclude this chapter by sharing notes of this exchange, which I scribbled down shortly after the event:

It is early morning in October 2011 and my nine-year-old daughter Claire is standing in the hallway, halfway dressed, in a pair of jeans and nothing else.

“Mommy, do I have a big butt?” she asks me.

“Yes!” I say with a big smile, “you’ve got a big ol’ butt.”

“Huh?” she looks puzzled, shocked, and somewhat amused.

“It’s great to have a big butt.” I say. “I’ve got a big butt,” I add, slapping my own rear.

“You don’t have a big butt, Mom,” Claire replies.

“What?” I say, looking off ended. “I do, too.” Then, to make my point that big butts are desirable—and much to Claire’s amusement—I rap a few verses from Sir Mix-A-Lot’s song “Baby Got Back,” followed by a sung rendition of Queen’s “Fat Bottom Girls.”

“Do you know what my college friend M. says about a good butt?” I inquire with a smile.

“What?” she asks.

“He said that the test of a good butt is that you can put your hand under it when it is raining and your hand doesn’t get wet.” My friend, who was of Jamaican descent and grew up in Brooklyn, felt strongly about this theory. I had adopted it as my own.

“Why do people like big butts?” Claire then asks.

“They’re sexy,” I blurt out, wondering if she is too young for such talk.

“My friends S. and C. don’t have big butts,” she says.

“Shh! Don’t tell them,” I urge, “you don’t want to make them feel bad.”

In the background I hear my seven-year-old son singing, “I’ve got a big butt!” and feel pleased. I may be up against a whole culture of fat phobia, but this morning my children are feeling good about their bodies.

CH
APTER 6: CONCLUSION

In 2011 and 2012, the Strong4Life and Children’s Healthcare of America campaign ran a series of television advertisements and billboards against “childhood obesity” in the state of Georgia.1 In one black-and-white TV spot, a heavy white boy about 10 years old sits opposite his mother in a large, empty space and plaintively asks, “Mom, why am I fat?” His mother sighs and hangs her head, ashamed, her body language suggesting that it is she who is to blame for her son’s weight. The next black and white screen projects the following message in capital letters: “75% OF GEORGIA PARENTS WITH OVERWEIGHT KIDS DON’T RECOGNIZE THE PROBLEM,” followed by: “STOP SUGARCOATING IT, GEORGIA.” The stark words and dramatic sound effects leave no doubt about the ad’s message: negligent or ignorant parents are feeding their children to death.

This campaign included other television commercials and large black-and-white billboards, featuring fat boys and girls from a range of ethnicities, looking directly and forlornly into the camera, shown in figure 6.1.
Below their sad faces, the word
WARNING
stood out in bold red capital letters. Below that were statements, such as, “Fat kids become fat adults,” “Big bones didn’t make me this way. Big meals did,” “He has his father’s eyes, his laugh, and maybe even his diabetes,” “Fat prevention begins at home. And the buff et line,” “Chubby isn’t cute if it leads to type 2 diabetes,” and “It’s hard to be a little girl if you’re not.” The scariest message, “Chubby kids may not outlive their parents,” was based on a discredited—but widely circulated—2005 back-of-the-envelope calculation that this generation of children will die at a younger age than would their parents, if rates of obesity continued to increase unabated. 2 However, the ad was worded so that it makes it sounds as if parents will be burying their children, most parents’ worst nightmare.

Image 6.1:
Strong 4 Life and Children’s Healthcare of America campaign against “childhood obesity”.

While the campaign’s framing of fatness as a public health crisis brought on by irresponsible personal and parental (and more specifically maternal) behavior was business as usual in the public representation of fatness, the “in your face” approach provoked considerable controversy. Those responsible for the campaign defended its shock tactics as necessary to get people to pay attention to the issue. “We felt like we needed a very arresting, abrupt campaign that said: ‘Hey, Georgia! Wake up. This is a problem,’” said one of the people in charge of the campaign. 3 Some public health experts worried that the ads and billboards would reinforce the stigma associated with obesity, thereby making it “even less likely for parents and children to acknowledge that their weight is unhealthy and should be addressed.” In the words of one obesity researcher, “We need to fight obesity, not obese people.” 4

As should by now be clear, the plausibility of this statement, “fight obesity, not obese people,” depends on a framing of fatness as a medical problem and public health crisis. If obesity is an illness of epidemic proportions, surely we should fight it, even if we should also show compassion for those suffering from the disease. Similarly, one might insist that we “fight cancer, not people with cancer,” or “fight AIDS, not people with AIDS.” But consider another case: homosexuality. Does is make equal sense to talk of fighting homosexuality but not homosexuals? While this rings true within ex-gay ministries, in which one is taught to hate the “sin” of homosexuality while loving the “sinner,” it is offensive to those who affirm same-sex desire as a basis of social identity. 5 The gay rights movement has fought hard to change societal assumptions about the pathological nature of same-sex desire, with important successes. Most notably, through their efforts, homosexuality was removed as a disorder from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association in 1973
and is no longer considered pathological among mainstream medical organizations. 6

If the fat rights and health at every size movements could have their way, a similar shift would occur with body size, so that fatness would be valued as a form of body size diversity, rather than denigrated as a medical pathology. In such a world, weight-based prejudice, and not fatness per se, would incite moral outrage. Dancer, writer, health at every size advocate, and fat rights blogger Ragen Chastain provides a glimpse into this alternative world on her blog, “Dances with Fat: Health Comes in All Shapes and Sizes,” writing that “while I sometimes do suffer because I’m obese, I’ve never suffered from obesity.” What she suffers from, she writes, is “living in a society where I’m shamed, stigmatized and humiliated because of the way I look.” She writes about being “oppressed by people who choose to believe that I could be thin if I tried (even though there’s no evidence for that)” and by social pressures to conform to a standard of slenderness. She writes about “suffering from doctors who have bought into a weight = health paradigm so deeply that they are incapable of giving me appropriate evidence-based healthcare.” She objects not only to being pressured to undergo dangerous and ineffective weight-loss treatments but also to being twice prescribed blood pressure medication by doctors who had not bothered to take her blood pressure or look at her medical chart to see that this would be counter indicated. She resents being told that her strep throat was due to her weight. She writes that she is “suffering from living in a society that tells [her] that the cure for social stigma, shame, humiliation and incompetent healthcare is for [her] to lose weight, when the truth is that the cure for social stigma is ending social stigma.” 7 Disability scholars have similarly argued that the difficulties experienced by disabled people are not caused primarily by physiological limitations themselves but from pervasive discrimination. 8

The Strong4Life campaign and fat rights blogs are visible contenders in the current framing contests over fatness that we have discussed in this book. Chapter 2 examined the radically different logics and disparate social influence of three different ways of viewing fat as a public problem (fat as immoral, fat as a medical problem, fat as a public health crisis) and three different ways of
contesting
the idea that fatness is a problem (fat as beautiful, fat as consistent with health, and fat as a basis for rights claims).
In chapter 3, we explained how and why “obesity” is overwhelmingly framed as a matter of personal responsibility, secondarily as due to various socio-cultural factors, and much more rarely due to biological factors, as well as how and why this is especially true in the United States. Chapter 4 examined the ways in which scientific studies and the news media jointly shore up these dominant frames, and how the news media evaluate scientific controversy about the health risks associated with higher body mass.
Chapter 5 examined the social, political, and medical implications of different fat frames.

Chastain’s blog post underscores, as did chapter 5, the social implications of the obese label. Leaving aside the question of whether there are negative physiological risks associated with having a BMI over 30, there are clear negative
social
implications of this label. A large body of research in sociology, called labeling theory, has shown that the way people are labeled leads to self-fulfilling prophecies, regardless of the initial validity of the label. 9 In one classic study, teachers were told at the beginning of the school year that specific children in their class could be expected to be academic “growth spurters,” based on the students’ results on the Harvard Test of Inflected Acquisition. In fact, the test was nonexistent, and those children designated as “spurters” were chosen at random. Nonetheless, the teachers’ expectations led to positive changes in these students’ achievement. 10 Numerous studies have shown how positive labels lead to positive outcomes and the obverse: negative expectations lead to negative outcomes. 11 For instance, it has been shown that the widespread perception of black boys as “bound for jail” leads teachers to respond more punitively to actions when taken by black boys, compared to when the same behavior is committed by white boys. 12

Stated differently, Chastain’s blog post underscores the way in which scientific and popular discussions of obesity are producing new subjects of knowledge and control: the obese person. 13 That is, as the BMI categories of overweight, obese, normal, and underweight are invoked more often, people are increasingly coming to think of themselves and others as members of these different BMI categories. This is especially true for “obese” people, who are constantly reminded of their stigma. To the extent that this becomes a salient personal distinction, it may eventually become a basis for social identification as well. The “obese” may join weight-loss groups or, after failed weight-loss attempts, be drawn to fat acceptance groups. The latter seek to redefine the category of “obese” as a positive form of “fat”
identity. This social process is not unique to body size. Philosopher Ian Hacking refers to it as a
looping effect
, in which the creation of new social norms, medicalization, quantifying, and other related processes produce new categories of people, which are then reclaimed as bases for identity. 14
Ironically, such identity groups end up shoring up the category in question as a social distinction. In other words, fat rights movements make body size even more salient. This is a common quandary that identity groups face and is by no means specific to the fat rights movement. Feminist groups and queer rights activists have similarly struggled with this paradox. 15

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