Fat Chance The line between health and shame is becoming increasingly thin

That we obsess about fat is evident. We have only to note our $60.5 billion weight loss industry in the United States, the 179,000 weight loss surgeries performed every year, or the annual BMI (Body Mass Index) report cards that many states, including my own Pennsylvania, send home for all K-12 children. Or we could turn to our First Lady Michelle Obama’s Let’s Move campaign, launched in 2010 to “combat the epidemic of childhood obesity” because the “security of our nation is at stake.” She even appeared—twice!—on the long-running television show The Biggest Loser, working out with Bob Harper in the White House, demonstrating how to do jumping pushups. “Michelle Obama is what no excuses is all about” he intoned, suggesting that those participants who collapse, cry, or vomit in their failed attempts to lose weight are, indeed, losers.

It’s not just a U.S. obsession, either. Last summer Harvard University announced it had received a $350 million dollar gift, its largest ever, from the Morningside Group, a relatively new philanthropic group funded by a wealthy Hong Kong family; the New York Times explained that the “pandemic” of obesity was one of the problems its donation was intended to address. And a recent blog noted the “countless opportunities for weight management companies” globally, from North and South America to Asia, Europe and the Middle East. The World Health Organization even has a new name for it—“globesity,” short for the “global obesity epidemic.”

Why we obsess so about weight, however, is not so evident. The obvious answer, of course, is health.  Most of us have heard the statistic about obesity causing an additional 300,000 deaths per year in the United States. This “fact” turns out to be less conclusive than it appears, though as early as 2005, the Centers for Disease Control and Prevention published a study that called into dispute the 300,000 figure, estimating the deaths linked to obesity at a much-lower 112,000 per year. Even more startling, in 2013, the Journal of the American Medical Association published a large scale review and meta-analysis of all the studies done to date on health risks related to body mass index. The results? It turns out that the “most healthy” weight category in terms of morbidity and mortality is overweight. The group of people classified as “obese level one” show no difference in health compared to the “normal” weight people. Health risks rise for people in the categories of underweight and very obese. Significantly, however, there are no movements to identify “thinness” as a disease—a symptom, perhaps, of anorexia or malnutrition, but not a disease in and of itself.[1]

And it turns out that the individual studies which garner headlines about the grave health risks of obesity often don’t say exactly that. Usually they show a link between metabolic problems—diabetes, blood pressure, cholesterol—and a poor diet and physical inactivity. Sometimes those two factors, a poor diet and physical inactivity, correlate with obesity, but not always. This means not only that we fail to identify those thinner folks who nevertheless might be at health risk, but we also emphasize weight loss, which has a 95 percent failure rate, rather than more physical activity and healthier eating habits. Why then would doctors continue to tout weight loss? Well, that might be because, as Abigail Saguy explains in her book What’s Wrong With Fat?, most doctors educate themselves through the same newspapers that “lay” people read, the same ones that carry the sensationalized headlines, the incomplete stories, and the close up photos of fat people without their faces shown—otherwise known as “headless fatties.”[2]

Or, it could be that physicians continue to tout weight loss, and most people continue to believe in the assertions about fatness and ill health, because of what my students call “hegemony,” or “capitalism.” It is difficult not to laugh when they start spitting out these phrases, often strung together quickly as one word, as in hegemonicwhitepatriarchalcapitalism or, conversely, voiced slowly and with great difficulty, usually with a hard “g,” as in heg e mon ee. Nevertheless, they may be on to something. That $60.5 billion industry is not simply an abstract accounting—it is real money that moves from the hands of individual consumers into the coffers of big industry, who profit tremendously from the insatiable desire for a different body and the endless cycling of weight lost and weight gained. When one reads about the kickbacks that doctors receive from pharmaceutical and surgical supply companies, the medical journal articles and studies ghostwritten by Big Pharmacy, and the fact that organizations like the World Health Organization base their policy on recommendations from the International Obesity Task Force, whose members are “obesity experts” (in other words, bariatric surgeons, weight loss industry representatives, and more pharmaceutical representatives) it is difficult to ignore the possibility that what we know about fat is being shaped to benefit a particular sector of our world economy. It is not even that much of a stretch to consider the possibility that we are all like Mildred in Ray Bradbury’s 1953 novel Farenheit 451, “thin as a praying mantis from dieting” so bombarded with nonsense advertisements and tv stories of family drama and romantic explosions on her “parlor walls” (Bradbury’s prescient vision of flat screen tvs) that she is completely distracted from the war and tyranny that surrounds her; in addition to the endless drone of ads and nonsensical shows like from the Biggest Loser, Ruby, Heavy, and Extreme Makeover: Weight Loss Edition that fill our parlor walls, we also get tantalizing pop-ups on our computer screens listing “5 foods to avoid to lose belly fat,” countless magazine covers of women wearing pants many sizes too big—or, conversely, stuffed into a bikini too small, front page stories on cities who challenge all their residents to take part in a collective weight loss effort, and serious offers for Weight Watchers and Overeaters Anonymous at our workplaces. Who benefits when we gaze incessantly at the fat on our bellies, thighs and upper arms—squandering our energy and money—rather than turning our attention squarely to the problems of tremendous income inequality, violence in our neighborhoods, endless wars and war profiteering, water scarcity, and global climate change? Who gets to make decisions about those issues while the masses are fixated on reducing their size?

It turns out that the individual studies which garner headlines about the grave health risks of obesity often don’t say exactly that.

Of course, this sounds a lot like a conspiracy theory, one of those grand-designed plans by a secret elite, an argument I’ll leave to Michael Moore. Perhaps, indeed, it is the other way around. Rather than the elite not being held responsible for their actions because we are so consumed with self-loathing, it might be that fat people do get blamed for problems that have nothing to do with their bodies. This process of deflecting responsibility certainly has a long history.  In Ancient Greek religion a slave, criminal, or disabled person—known as a pharmakos—was ritualistically exiled or tortured when disaster hit, a kind of purification rite. In South India, the Pariahs were a tribe feared for sorcery—and were largely considered untouchables. The Bible refers to the scapegoat in Leviticus, literally one of two goats significant for the Day of Atonement, i.e. Yom Kippur; one was to be sacrificed, and one was to be expelled into the wilderness, symbolically carrying the sins of the people on its back. We certainly know how cultures identify and persecute scapegoats in more modern times. Throughout Europe the Jews served as typical scapegoats during countless pogroms, culminating in Hitler’s reign. In the 1950s, Senator McCarthy led the charge against the “enemies from within”—Communists and homosexuals—who threatened to topple the nation. Immigrants are often an easy scapegoat; one can simply think of the billions of dollars spent on a double layer wall separating Mexico and the United States, or, closer to my home, former Hazelton, Pennsylvania, Mayor Lou Barletta whose anti-immigration activism carried him into the House of Representatives.[8] Our most easily identified scapegoats are African Americans, blamed for everything from our national deficit (the welfare queens) to the death of cities (a culture of poverty) to crime and violence (the dangerous black male.) One of the very first films screened at the White House, occupied by President Woodrow Wilson, was D.W. Griffith’s 1915 Birth of a Nation, a particularly forceful example of this kind of racial scapegoating. Set in post Civil War, Reconstruction-era America, black men (many played by white men in blackface) are represented as out of control, physically aggressive and sexually violent, threatening white women and the virtue of America in general. The savior in Griffith’s film? The Ku Klux Klan, whose raids and lynchings suppress the danger posed by black men, bringing order back to the nation. Despite protests by the National Association to Advance Colored People, the film went on to great commercial and critical success. Today the film is infamous as one of the most powerful racist texts in U.S. history, not only because of its representations of African Americans but also because of its twisted plot that portrays white people (and thus the nation) as threatened by the very existence of blacks.

One can only imagine my surprise, then, when I came across the 2012 Emmy-nominated, documentary entitled Weight of a Nation. Produced by HBO and the Institute of Medicine, the four-part film “confronts the nation’s obesity epidemic.” “To win, we have to lose,” the trailer for the documentary reads. It is quite astonishing that the filmmakers would entitle their film with a wordplay on Birth of a Nation, considering the extent to which black people in that film are presented as less than fully human, primitive, dangerous, in need of control and civilizing by white people. But perhaps it should not be so astonishing—it is just an updated pariah who threatens to contaminate the nation. Set to music with an insistent, pounding beat, the trailer for the film strings one formidable comment about the dangers of fatness after another, all spoken by experts wearing suits and ties or medical scrubs. “Obesity is the biggest threat to the health, welfare, and future of our nation.” “It’s not only about our health, it’s about the well being of the United States as a nation.” “The weight of the nation is out of control.” “If we don’t take this an urgent national priority, we are all going to pay a really serious price.” Interspersed are images of junk food, grocery stores, fat children being treated at physician’s offices or laying around playing video games. Fat adults sit perched precariously on folding chairs; as the camera pans in on them they relay their difficulties losing weight, their medical problems, and their dashed hopes. “I want to think there is something better for me,” a young fat white woman laments. Black cutouts of fat people scroll across the screen, each eventually revealing itself to be the image of a “real,” but unnamed fat person. Finally, the camera focuses on an image of the U.S. Capitol Building and the Washington monument, while a thin white man in a suit explains, “If we don’t take this as an urgent national priority, we are all going to pay a really serious price.” This is followed by a thin woman in medical scrubs who says, in an urgent tone, the background music stopping, “OBESITY WILL CRUSH THE NATION IN OBLIVION.”

When listening to all this I was initially struck by the missing “to.” Shouldn’t she have said, “Obesity will crush the nation into oblivion”? That, of course, is one of those distracting thoughts that one gets when studying popular culture, particularly, I have found, when the material is as distressing as this documentary is. For I would argue that this was not a slip-up by the filmmakers who may not have known about the content of Birth of a Nation (though what filmmakers would be ignorant of this movie?), but rather a deliberate connection made to the story of a degenerate type who threatens the very existence of the nation. We now have a new scapegoat for an anxious nation: fat people.

It is not that hating fat is new. Antipathy toward “excess” body flesh runs deep. In 1817, the eminent French scientist Georges Cuvier made a name for himself in his “Extrait d’observations faites sur le cadaver d’une femme connue à Paris et à Londres sous le nom de Vénus Hottentotte” (Observations made on the cadaver of the woman known in Paris and London as the Venus Hottentot), his report on the Khoikhoi woman who was given the name Sara Baartman by her Danish slavetraders. Paraded around as a spectacle and oddity and prostituted in England and France before her death in 1815, Cuvier’s report, although it did conclude that she was indeed human, also classified her body parts, characteristic by characteristic, as clearly inferior to Europeans and low on the scale of civilization.  Crucially important to our understanding of the contemporary frenzy against fatness is the realization that it was not just her skin color (black) and her genitals (elongated, compared to European women) that were “proof” of her inferiority, but also her “excess” body fat—on her buttocks, her knees, her thighs. Fat was a sign of what the famous 19th-century criminologist Cesare Lombroso would call the “stigmata of degeneration,” the sign that either one was already lower on the scale of civilization or that one harbored atavistic traits that could emerge at any point, leading one into a life of crime, prostitution, and violence. A real citizen was not fat. To be sure, in the 19th century there was a greater desire for a certain level of body fat; it demonstrated that one was a fertile and hearty, neither starving nor a victim of the many wasting diseases that flourished in that time period. There was even a certain level of respect given to the “fat cat,” the wealthy man whose girth demonstrated his prosperity. But once transformations in health care, work lives (office work was less physically tiring than farm work, as was factory work, even if it was physically dangerous), and transportation (foods could be moved more easily into cold areas during the winter months)—once, in other words, it was not just the wealthy who could be fat—weight obsession really gained traction. William Banting, the mid-19th century British businessman whose diet tract “Letter on Corpulence” was a best-seller in both Europe and the United States, called obesity a “parasite of barnacles” and a “crying evil.” By the early 20th century, an American physician Dr. Leonard Williams called fat women “repulsive sights, degrading alike to their sex and civilization.” And the author of Girth Control, For Womanly Beauty, Manly Strength, Health, and a Long Life for Everybody (1923), a wildly popular dieting book by Henry Finck reminded readers that they were “modern British and American citizens” whose “standards of good looks are different from those of Hottentots, Moors and Turks.” In other words, good, white citizens were not fat. [3]

Fast forward to the beginning of the 21st century, and we can see all these ideas in full circulation. Fat Americans certainly are not good citizens; indeed, they threaten to “crush the nation in[to] oblivion.” Fat is abject, as Julia Kristeva would say, a form of grossness that needs to be constantly invoked and then expelled in order for us to have a sense of who is a good citizen. Popular celebrities often display the substance of fat itself in order to prove how gross it is. Oprah Winfrey brought a whole wagon of fatty-like substances onto the stage to represent the weight she had lost; more recently Dr. Oz paraded through the tv audience with a swath of bloody fat hanging between his hands. He would walk up closely to the heavy women in the audience, all of whom were wearing tight, revealing spandex for this special episode, dangling the fat in front of their faces. The women would squirm and grimace, giggle and even start crying. This grossness, he seemed to be saying, is what you are if you are fat. You are not fully human, you are an abject danger. Morgan Spurlock evoked the “abject” particularly well in his hit documentary SuperSize Me, interspersing his detailed exhortations about the dangers of a fast food diet with close ups of him vomiting and even images of a fat man, mouth dangling open, after a gastric bypass. The film lingers over the images of the surgery, instruments poking around in the fat, precious yards of intestines pulled inch by inch from his gut. My students all groan and cover their eyes during this part of the film; some have even had to leave the room.

This grossness, he seemed to be saying, is what you are if you are fat. You are not fully human, you are an abject danger.

The women mocked with fat dangling in front of their faces; the man given such little respect that we see him in full pornographic display during a surgery: in other words, one does not deserve to be treated well, with respect and dignity and full rights, if one is fat. This line of reasoning should also make us pause when we consider the fact that people of color and poor people tend to be fatter than white people and wealthier people. Might discrimination against fat people be a coded way to discriminate against poor people and people of color? And we do know that fat people are discriminated against in every aspect—in education, in medical settings, in interpersonal relationships, in employment. A “professional” appearance is often a masked way for an employer to say “no fat people allowed.” The discrimination adds up so much that, as Paul Ernsberger has shown, fat children will experience downward mobility compared to their parents. Not, as he points out, because the fat children are lazy, or less smart, or more sickly than their parents—but because they will be systematically discriminated against throughout their lives, from the time they are small children.[4]

It is only in a context where fat means so much that a recent New York Times article on the African-American activist Al Sharpton would even make sense. The article, “A Slimmed-Down Sharpton Savors an Expanded Profile,” elaborated on the extent to which Sharpton had transformed himself from a radical social justice activist to a mainstay of the Presidential administration. “From an overweight Brooklyn firebrand clad in track suits and draped in medallions, Mr. Sharpton has transformed himself into the White House’s civil rights leader of choice, an incessantly televised pundit, and even a poster child for a strict diet of salad and juice,” the article read. And then the authors quote Sharpton himself: “I always knew under those 300 pounds and track suits was a refined, slim, dignified man.” No longer an out-of-control Black radical, he is now a “refined, slim, dignified man.” None of this, it is important to note, has anything to do with health. It is about Sharpton shedding those atavistic traits, becoming, literally, fit for citizenship.

The next time, then, that someone invokes the health dangers of fatness or the threat of the “obesity epidemic” to our national security, we should ask ourselves the extent to which our ideology is getting in the way of clear thinking. How else do we explain the ineffective at best, fatal at worst “obesity cures” that cost $60 billion a year, even when we have clear evidence that the health implications regarding fatness are far from conclusive? How else do we understand the ritualistic torment of fat people on shows like The Biggest Loser? Or the fact that PETA could call the mocking of fat people in its ads “light-hearted?” How else do we rationalize the discrimination and stigma that fat people face? Might our obsession with fat essentially be about the desire to identify some group as the pariah, the scapegoat, the less civilized ones who deserves to be punished and blamed?

Works cited: 

[1] Katherine Flegal, et al, “Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis” The Journal of the American Medical Association, January 2, 2013—Vol 309, No. 1, 71-82.

[2] Abigail Saguy, What’s Wrong With Fat?, (New York: Oxford University Press, 2013).

[3] Amy Erdman Farrell. Fat Shame: Stigma and the Fat Body in American Culture. (New York: New York University Press, 2011.)

[4] Paul Ernsberger, “Does Social Class Explain the Connection Between Weight and Health?” in Esther Rothblum and Sondra Solovay, The Fat Studies Reader, (New York: New York University Press, 2009): 25-36.