What's Wrong With Fat? (20 page)

While acknowledging that a woman in this situation has social constraints that seriously limit her choices, Pi-Sunyer concludes that someone in this situation needs greater sensitization about the risks of obesity, rather than, say, better employment and child-care options.

Sometimes, an alleged aesthetic preference for heavier women among African Americans is blamed for higher rates of obesity among African American women. For instance, a 2005 article states that “more subtle societal influences, like differences in acceptable body images among different ethnic groups, all contributed to greater obesity among women with lower incomes and those in certain ethnic groups.” 155 A 2003 news report on a
JAMA
special issue on obesity makes the same point as follows: “The mainstream media continued to dwell on the dangers of the epidemiologically small number of the mostly white and affluent anorexics and bulimics, while heralding surveys that found a greater acceptance of overweight and obesity among African American girls as salutary signs of ‘self-respect.’ Do such attitudes contribute to the disproportionate percentages of obesity among minorities? No one seems willing to ask—much less say. But as Critser points out, ‘such sidestepping denies poor minority girls a principal—if sometimes unpleasant—psychological incentive to lose weight: that of social stigma.’” 156
Note how this article invokes the “obesity epidemic” as a rationale to support increasing the stigmatization of heavy African American women. A 2003
New York Times
article discusses how Latino culinary preferences contribute to overweight among Latino children: “[Mr. Batista] says some cultural habits are simply getting the best of his people. ‘Latinos eating vegetables? Come on,’ he says, raising his hands in frustration. ‘We don’t eat vegetables. It’s rice and beans and meat. It’s very natural.’” 157

While black subculture is often blamed for higher rates of overweight and obesity among African Americans, an alleged preference for larger female bodies among black Americans is mentioned as protecting minority girls from anorexia and bulimia. Quoting a medical doctor, one article states that experts traditionally had thought that “anorexia and bulimia didn’t happen to black, Asian or Hispanic women, that they were somehow immune.... Being curvy or large was a source of pride within the African-American community.” 158 Those black (and sometimes Latina) girls who do develop eating disorders are often seen as being especially vulnerable to “white” pressures. One article describes how a black teenage girl developed bulimia because, as one of nine black students in a high school of three thousand, she was “struggling simply to be accepted. [In her words:] ‘When it came to body image, my perception of beauty was based on my white peers and images of white celebrities in the media.’” 159 Thus a mainstream diet culture is implicated in (thinness-oriented) eating disorders, while African American culture is praised as offering some cultural buffering.

Articles mentioning blacks, Latinos, or the poor are also more likely than those that do not mention these groups to discuss obesity policy solutions (37 percent versus 18 percent in the
New York Times/Newsweek
sample). I have found this same pattern in another news media sample. 160
Many of these not only address issues of access to affordable fresh fruits and vegetables but also seek to educate people considered unable to make good food and exercise choices and to change minority ethnic
cultural attitudes
about food and eating. 161 For instance, one article, describing a public health intervention in a southern black community, discusses a recipe for “low-fat catfish” developed by nutritionists as “one of a series [of new recipes] showcasing revered family recipes purged of their sins by two Auburn University nutritionists” and talks about how a leader of a public health intervention “recited a litany of virtuous eating for her largely female audience.” 162 This article identifies mothers as a crucial part of the solution, recounting how these interventions recruit minority mothers as “cheerleaders for good health,” and targets them as the preparers of food for their families: “We’re building on community talent with women who are cooking for their children and passing on behavior patterns to their children and their children’s children.” 163

WHAT’S DIFFERENT ABOUT THE UNITED STATES?

Explanations for ill health that focus on individual lifestyles are consistent with core American values of individualism and upward mobility. As political scientist Sylvia Noble Tesh has argued: “In some circles, it is chic not to smoke, to jog around the streets, to exercise in gyms, to eat low-cholesterol foods. Doing these things, or claiming to do them (“We hardly ever eat meat any more”; “I’ve started running again”), testifies to membership in the affluent classes. Such behavior means you are economically successful, or expect to be, or at least are very much like people who are. It has come to demonstrate a willingness to work to improve yourself and an eagerness to move up socially.” 164 Moreover, emphasizing personal control over illness is less threatening to economic and political vested interests than emphasizing social-cultural factors that imply a need for major changes in industrial practices, in the economy, or in the government. 165

Comparative research further suggests that conservative morality and an emphasis on individualism hold greater sway in the United States than elsewhere, including Europe and specifically in France. 166 While neoliberalism is on the rise in France, in general and in public health discourse specifically, French public intellectuals and popular opinion still tend to attribute a greater role to social factor in shaping individual trajectories. 167
Looking specifically at the case of body size, historian Peter Stearns has argued that fatness has been especially moralized in the United States compared to other nations. He specifically found that the French were less likely to treat fat as an issue of morality, compared to Americans, and treated it instead as a fashion issue. 168

Yet, Stearns published
Fat History
before the “obesity epidemic” emerged as a public health priority, raising the question: how is a country like France, where weight has historically been less moralized, framing the “obesity epidemic”? Does this greater focus on social inequalities and a lesser tendency to moralize weight specifically make the French press less likely to discuss individual contributors to and solutions for obesity and more likely to stress sociocultural determinants of obesity and collective solutions? 169 To examine this, I selected 108 news reports of obesity published in the French newspaper
Le Monde
and the French news magazine
L’Express
,
publications that are similar in style and readership to
The New York Times
and
Newsweek
,
respectively. 170

I found that the French news reports are as likely as American news reports to emphasize individual causes of overweight/obesity (46 compared to 39 percent, a difference that is not statistically significant).
However, an emphasis on individual blame dominates U.S. news framing, while being more equally balanced by other frames in French news reporting. That is, while American articles are almost 50 percent more likely to mention individual compared to sociocultural contributors to weight, the French articles mention sociocultural factors as frequently as individual factors. This is because the French news reports are more likely than the American ones to discuss sociocultural contributors to overweight/obesity (47 versus 27 percent) and to discuss government policy solutions (44 versus 21 percent). In contrast, the American reports are more likely to emphasize individual-level solutions. The French news sample is also somewhat more likely to discuss biological determinants of weight (25 versus 15 percent). These patterns are shown in figure 3.6 below. The overall pattern is that, as expected, the American news media are more likely than their French counterparts to frame body size as a choice, rather than as influenced by forces beyond personal control.

Specifically, the French articles are more likely than the American articles to blame the food industry for contributing to obesity, particularly among children. Thus one article in
L’Express
affirms that the “proliferation of advertisements for products targeted at children have a direct effect on the development of obesity in France. Therefore it is necessary to manage such advertising.” 171 Another French article similarly condemns the food industry for contributing to childhood obesity and not acting to reverse the trend: “We know that obesity is multifactorial. There is no single nutrient that is guilty, no single type of food singly responsible, and no unique behavior to proscribe. But must we abstain [from action] based on the pretext that it is complicated, as the lobbies claim? Whether they represent biscuits, sugar, vending machines, fast food restaurants, cookies, soda or the food industry, they all say: ‘It is not only me. Do not penalize me.’ Of course. But if we listen to all of them and sanction none of them, we will stay on the same course for a long time.” 172

Figure 3.6:
Percentage of U.S. and French news sample discussing specific causes and solutions for
obesity and overweight.

Many of the French news articles specifically blame American fast-food restaurants and processed snack foods for expanding French waistlines: “The McDonald’s food chain, a symbol of ‘bad food’ (
malbouffe
)... is at the center of these critiques on this side of the Atlantic.... Makers of soda, including especially Coca-Cola and PepsiCo, the latter which also owns Frito-Lay, are also in the hot seat.” 173 Unbridled capitalism and corporate greed is a common theme in French critiques of the United States. Obesity provides another opportunity to strike this cord. The French press is also more likely than the American press to discuss policy solutions, which may be related to greater support for state intervention in France, compared to the United States. 174

There is no reason to believe that sociocultural factors are objectively more to blame for increasing body weights in France than in the United States. In fact, given the more extensive social safety net and lower levels of social inequality in France compared to the United States, the opposite is a distinct possibility. Rather, it seems that the French press is more likely to emphasize social factors because such considerations are more accessible in French cultural and political traditions. Similarly, there is no reason to believe that individual-level solutions would be more effective in the United States or that policy solutions would be more effective in France.
Rather, this difference in attention probably echoes
general
patterns in how social problems are addressed differently in each nation, with the U.S. press focusing more on individual autonomy and the French press envisaging a larger role for the state.

In addition to different national cultural lenses regarding personal responsibility and the role of government, there are well-documented differences in U.S. and French approaches to food and eating, which are reflected in news media reporting on this issue. Americans often eat alone, over a computer, in a car, or while running crosstown. 175 In many corporations, there is suspicion of people who take leisurely lunch breaks; they are seen as lazy. I have often heard American business people who have collaborated with French people criticize their long lunch breaks as evidence of a weak work ethic. Indeed, a common American expression for being inattentive or indolent is saying that someone is “out to lunch.” American school children are typically given a meager twenty minutes for lunch. Typical cafeteria food includes pizza and corn dogs. Despite expressed consternation about childhood obesity, there is no federal mission to develop students’ palette or to teach appreciation of food, although there have been some local efforts made in this direction. A growing slow food movement notwithstanding, the dominant American approach is to treat food as fuel.

Sociologist Barry Glassner has argued that, in general, Americans believe that “the worth of a meal lies principally in what it lacks. The less sugar, salt, fat, calories, carbs, preservatives, additives, or other suspect stuff, the better the meal.” Glassner contrasts an American “gospel of naught” with a French emphasis on pleasure. 176 Thus, when one study asked 1,281 respondents from France, Japan, Belgium, and the United States what words they associated with chocolate cake, the French chose “celebration,” while the Americans chose “guilt.” Asked about heavy cream, the French chose “whipped,” while the Americans picked “unhealthy.” 177 Reflecting these cultural differences, the American news sample is also more likely, compared to the French news sample, to discuss low-fat (12 versus 2 percent), low-carbohydrate (12 versus 2 percent), and low-calorie diets (10 versus 1 percent). In contrast, the French news sample is more likely to talk about
adding
“healthy” foods to the diet (17 versus 11 percent). In bemoaning the decline of French food culture, the focus is as much on a way of eating (i.e., slowly, over several courses, with others) as on particular foods consumed.