What's Wrong With Fat? (2 page)

I was pregnant with my daughter, Claire, when I began research on this
book; my son, Jonah, was born two and a half years later. I have thus been
working on this project for their entire lives. Recently Claire and Jonah have
actively engaged in discussions with me that inform this book. I am deeply
grateful to have the opportunity to be their mother and for the sweetness and
meaning they add to my life. Finally, my husband, Dotan, makes it all possible.
He is a truly egalitarian partner who has always valued my happiness and suc
cess as much as his own. His active engagement in our family has allowed me
to throw myself into my research and writing and present my findings across
the country and abroad, while raising two young children. He has embraced
this research project as his own, always on the lookout for relevant news arti
cles and ready with suggestions for catchy book titles and covers. He is my
biggest fan, telling anyone who will listen about this research and why it is
important. I dedicate this book to him.

“Mommy, why am I fat?” Sally, a seven-year-old girl looks up at her mother with tears in her eyes, gripping the flesh around her belly. Her mother freezes, at a loss as to how to respond.
Sally is not “overweight” based on pediatric height and weight charts, but she is not far from the cutoff. And she is heavier than most of her friends, who sometimes remark on her difference from them. How should her mother respond? Should she discuss ways Sally can try to lose weight, by eating fewer treats and exercising more? Or might this convey to Sally that there is something wrong with her body or that her mother does not love her as she is? Would emphasizing weight and weight loss set Sally up for an eating disorder down the road? Sally’s mother would like to reassure her daughter, saying something like, “Oh, you’re not fat, sweetie! Your weight is perfectly normal.” And yet, this response would reinforce the idea that being fat is neither normal nor desirable, perhaps worsening Sally’s fear of gaining weight, while making life more difficult for those children who really are fat. Should her mother take another tack altogether by trying to teach Sally to accept and love her body at whatever size it is? Should she ask her if she has been teased about her weight and emphasize that it is not OK for other children to tease her (or others) about her weight?

While Sally and her mother are fictional characters, the issues they face are real. Moreover, what seems like a personal struggle over how best to talk about weight is inextricably linked with larger societal-wide debates over this issue. Reactions to a 2011 children’s book entitled
Maggie Goes on a Diet
nicely illustrate some of the divergent views on this topic. 1 As the book opens, kids at school call Maggie “fatty” and “chubby.” However, by changing her diet and exercising, Maggie loses weight, joins the soccer team, and becomes popular: “Losing the weight was not only good for Maggie’s health, Maggie was so much happier and proud of herself.” Later: “More and more people were beginning to know Maggie by name. Playing soccer gave Maggie popularity and fame.” 2 According to
Los Angeles Times
reporter Karen Kaplan, the book offers “sensible advice recommended by experts.” A commentator on an Amazon.com customer discussion board agreed, misquoting a prediction that was actually debunked years earlier, namely, that this generation of children “is NOT expected to outlive its’ parents. That’s right... If we continue this trend we will be burying our children.” 3 In fact, the discredited—but widely disseminated—back-of-the-envelope calculation to which this comment is referring had estimated that, if rates of obesity continued to increase unabated, this generation of children will die at a younger age than would their parents, not that they would die
before
their parents died. 4

However,
Maggie Goes on a Diet
also raised the ire of hundreds of commentators who warned that the book would trigger eating disorders and body-image problems and that it condoned weight-based bullying. 5 One commentator on an Amazon message board wrote: “It’s bad enough that the messages and images in the culture have co-opted most women into loathing their bodies but targeting the insecurities of young girls, vulnerable to the risk of developing an eating disorder, borders on promoting risk behaviors and attitudes that are destructive both physically and psychologically.” Another asked: “Does the book also tell ‘Maggie’ about the failure rate of all diets? The long-term affects [
sic
.
] on her body from the damage they cause? The weight you gain and gain after every single attempt?” 6
Others objected to a story line in which the solution to bullying was self-transformation through weight loss, rather than confronting the bullies: “An overweight child who reads a story like this is led to believe that she is responsible for the bullying and should lose weight to avoid it. A thin child learns that if she bullies the fat kids, they’ll go on a diet and get healthy (so, really, the bully is doing the fatty a favor; right?).”

The reactions elicited by
Maggie Goes on a Diet
expose strong and divergent views in the United States today about the potential medical and social hazards of being fat and how they should be addressed, if at all.
Almost forty years ago, Canadian-born sociologist Erving Goffman talked about the way in which people use conceptual
frames
,
or definitions of situations, to organize their experiences and guide their action. 7 For instance, you might look out your window and be terrified to see a “gang member” waving a gun and screaming obscenities, causing you to fall on the floor and call the police, only to find out later that the alleged gang member was
actually
a film student acting out a scene. Framing is an unavoidable part of life. The world is too complex to be perceived in all its intricacy. If we did not frame our experiences of the phenomena we encounter, we would be overwhelmed by the sheer mass of information, or the “blooming, buzzing confusion,” in the words of William James. 8 Cognitively, we are obligated to focus on some things at the expense of others. The particular way in which events are framed often has material implications, as the example of the film student who was mistaken for a criminal demonstrates.

Later, researchers expanded Goffman’s concept of frame to examine how social movements strategically define issues in particular ways to “mobilize potential adherents and constituents, to garner bystander support, and demobilize antagonists.”9 For instance, Mothers Against Drunk Driving (MADD) reframed the misfortune of the tragic loss of a loved one as an injustice that demands an increase in the severity of penalties for drunk driving. 10 Communication scholars have used the concept of frame to show how news media reports construct and promote particular ways of framing social problems, which in turn have important implications for which solutions appear feasible and legitimate. 11

In this book, I will use the concept of framing to shed new light on contemporary debates over corpulence. Once you put down this book, you will never hear the word
obesity
the same way again. This book will show that the term
obesity
implies a medical frame and examines the material consequences of this frame. A medical frame implies that fat bodies are pathological. It has become so pervasive and taken-for-granted in the contemporary United States and elsewhere that most people do not even realize that it is a frame and that there are alternative ways of understanding fatness, as, for instance, beautiful, sexy, healthy, or a positive form of human diversity.

At this particular moment in the United States and much of the post-industrial world, fat is typically understood as a looming public health disaster. In contrast, many of the disparaging reviews of
Maggie Goes on a Diet
identify weight-based bullying, eating disorders, and body-image issues as greater social problems and assert that people of all sizes have a right to respect and dignity. In addition to examining the origins, logic, and implications of the most authoritative and powerful understandings of fat as a medical problem and public health crisis, this book also examines competing frames of fat as healthy, beautiful, or a basis for civil rights claims.
Rather than advocating for particular frames over others, I offer an explanation for the dominance of certain frames and an analysis of the social implications.

One could try to imagine a world in which fatness signified neither health nor illness but was seen as a relatively neutral form of human variation, such as, say, eye color. 12 In such a world, one would not assume that it is possible to predict how a person eats, the extent to which a person exercises, or a person’s risk of disease based on body size. Certainly abhorrence of fat is not universal. Among a tribe of Nigerian Arabs studied by anthropologist Rebecca Popenoe in the early 1990s, fat women are the epitome of female beauty, and elite young girls are fattened up for marriage.
Before stepping on a scale to be weighed, elite Nigerian Arab women leave on their shoes, jewelry, and extra clothing in the hopes of weighing
more
than last time. Nigerian love songs wax poetic about stretch marks. Simple dolls made of clay often have no arms or legs but clearly demarcated buttocks, while cloth dolls have stretch marks stitched onto their bellies. In this cultural context, thin women are considered undesirable, ugly, and sickly. 13

Reliance on particular frames can make it difficult or impossible to perceive contradictory information. Here is an example from another context: when scientists viewed the process of fertilization of a human egg by a human sperm in terms of a gendered romance of a strong, active male (sperm) and a weak, passive female (egg), they were unable to perceive the ways in which eggs actively selected and joined with sperm. 14 Today, scientists often portray fat cells like they portray fat people: bloated, greasy, flabby. This is despite research showing that fat cells play an important role in the regulation of appetite and metabolism. 15 Framing bigger bodies as obese (i.e., diseased and risky) bodies makes it difficult, if not impossible, to see these bodies as healthy or good bodies.

In addition to problem frames—different ways of framing corpulence as a problem or not—there are competing
blame
frames. Thus, some people blame obesity on bad personal lifestyles (a personal responsibility blame frame), while others blame the food industry, urban planning, or poverty (a sociocultural blame frame), and others see it as primarily determined by genetics or other biological factors (a biological blame frame). There are heated debates over what is to blame for rising rates of obesity, and yet collectively, these debates serve to reinforce the
problem
frame of fatness as a medical issue and public health crisis.

There have been a lot of books written about the causes of obesity or of the “obesity epidemic.” This book turns that question on its head by asking what obesity, as a frame, causes. In other words, this book examines the social implications of understanding fatness as a medical health risk, disease, and public health crisis. To do this, it is necessary to understand where these frames come from, what their internal logic is, and how and why have they come to dominate our understanding of fatness. The medical and public health crisis frames make it difficult to think of fatness in other terms, such as, for instance, an ascribed characteristic and a form of human diversity that should be valued. To demonstrate this, this book also examines the origins, internal logic, supporters, and very different social implications of other kinds of fat frames, including those that cast fat as beautiful, healthy, and as a basis for rights claims.

LANGUAGE CHOICE AND DEFINITIONS

Before going further, let me specify my use of terms. In the spirit of the budding fat studies subfield, I use the terms
fat
and
fatness
as neutral descriptors, not as derogatory terms.” 16 I sometimes use the word
corpulence
as another neutral term for bigger bodies. This is an imperfect solution. Given the extent to which fatness has been condemned and pathologized over the past century, it is impossible to choose a truly neutral word for
fat
. Despite protestations that
fat
is not a four-letter word, it is still treated as such, so that some schools forbid its use along with other “dirty” words. 17 And some people find the term
corpulence
derogatory as well. Terms like
plus-size, voluptuous, plump,
and
Rubenesque
refer exclusively to women and
plus-size
excludes women too large for plus-size clothing. Moreover, some argue that these terms function as euphemisms, suggesting that the truth is so distasteful that it needs to be masked. 18 The terms
overweight
and
obese
explicitly affirm a specific interpretation of bigger bodies as
medical problems
.
I use these terms when discussing how others have framed bigger bodies as indicative of disease or health risk. Sometimes I place these terms in scare quotes or refer to people “who would be categorized as overweight (or obese)” as a way to signal a critical distance from these categories, while simultaneously acknowledging that they have real social implications. Even when I do not use scare quotes, this critical distance should be assumed.

Webster’s New World Dictionary
defines
obese
as “very fat, stout, corpulent,” while the
Merriam Webster
online dictionary defines it as “having excessive body fat.” 19 In contrast, the official public health category
obesity
includes people who do not look especially fat, because it does not differentiate body weight coming from fat, muscle, or bone. Specifically, among adults, one is obese if one has a body mass index (BMI) of 30 or greater.
(BMI is calculated as weight in kilograms divided by height in meters squared and thus does not measure fat mass or percentage.) Based on current definitions, a woman of average height (5’4”) would be obese at 175 pounds, and a man of average height (5’10”) would be obese at 209 pounds.
This is a very new and contested way of measuring obesity. As recently as 1995, the World Health Organization (WHO) issued a report warning that one cannot measure obesity based on BMI since obesity is “the degree of fat storage associated with clearly elevated health risks” and BMI does not measure fat mass or percentage. 20 This concern was disregarded, however, in a subsequent WHO report, widely circulated in 1998 and formally published in 2000. 21