Tomorrow: Historical Perspectives on Obesity Stigma

Tomorrow afternoon I’m speaking at the Canadian Obesity Student Meeting (COSM) in Waterloo, Ontario. My talk, “Historical Perspectives on Obesity Stigma” examines how the problems that we associate with obesity have shifted over time, from religious (sin) to moral (poor character) to health issues. Obesity’s history means that, when we try to engage the public in a conversation about weight and health, we’re working against a deeply ingrained cultural belief that what you see on the outside is a reflection of who someone is on the inside. Looking at this cultural history, I believe, helps us to better understand the depth of obesity stigma in the contemporary context. People experience their health, fat or thin, not with discreet dividing lines between medical and social settings, but immersed in a culture that is fascinated with better managing the body.

The details:

When: 4:00pm on June 18, 2014
Where: In the Lecture Hall at St. Paul’s University, University of Waterloo
Who: The talk is intended for graduate students in the health sciences, so my focus will be on how historical literature on obesity helps us to think about contemporary clinical health practices. But, everyone welcome.
Why: Because social scientists and scientists should talk to each other!

Check out the full program, including lots of panels on obesity stigma.

‘New’ Research Confirms Long-Term Weight Loss Impossible: CBC Health News

The findings of a research study can often be distilled to an amazing headline. And when that research is on a popular health topic like superfoods or cancer research, it can draw a lot of interest. But popular health reporting has drawn critiques from academics for presenting individual studies out of context, misleading and confusing the public about what is and isn’t healthy. Blaming the media isn’t really my game, since health consumers are also complicit in this game of seeking out new and (sometimes) untested solutions, like cleanses, for old problems, like feeling fat. I do, however, feel compelled to comment on the historical dimensions of a story that appeared yesterday on CBC outlets about the potential for long-term weight loss, “Obesity Research Confirms Long-Term Weight-Loss Almost Impossible”:

Medical Science Reporter Kelly Crowe explains new research suggests long-term weight loss is statistically unlikely. Only 5 to 10 % of people who try to lose weight will ultimately succeed. Crowe writes that “[o]ur biology taunts us, by making short-term weight loss fairly easy. But the weight creeps back, usually after about a year, and it keeps coming back until the original weight is regained or worse.” While the tone of this bothers me (“worse” makes it sound like being fat is a huge threat), Crowe goes on to quote the author of the study, Traci Mann of the University of Minnesota, who explains that it is possible to be obese and healthy. “You should still eat right, you should still exercise, doing healthy stuff is still healthy…it just doesn’t make you thin,” explains Mann. The story also hints that this is a bit of an open secret among obesity researchers who either don’t accept or refuse to acknowledge this data. So, other than the fact that the story is accompanied by a “headless fatty” image and makes being fat seem like a horrible fate, this article is a bit of a win for health at every size believers. It reminds people that health isn’t determined by weight, and also, kind of, sort of, calls out obesity scientists for their denial of the numerous studies suggesting long-term weight-loss is difficult and unlikely.

But, but, but…this data about the ineffectiveness of dieting has been around since the early 1970s. Fat Power: Whatever You Weight is Right (1970) by Llewellyn Louderback, is the first book to provide an overview of medical research on the question of fat and health. Arguing that fat people are socially and economically discriminated against in the United States, Louderback expressed disdain for medical professionals. “Advising a fat person to see his physician,” he claimed, was akin to “telling a mouse to go see a cat.” Louderback’s frustration stemmed from his own failed attempts at weight loss. Despite the polemical tone, Fat Power is based on a comprehensive analysis of medical studies up to 1960 that showed that long-term weight loss is unlikely and also that dieting was itself unhealthy and could contribute to malnutrition, further weight gain and heart damage. His point, of course, was that social and cultural distaste for fatness had influenced medical approaches to fatness, and scientists were irrationally tenacious in their pursuit of a “cure” for obesity. Sounds familiar, right?

Canadian researchers Janet Polivy and Peter Herman, of the University of Toronto, also published a pioneering study on the limitations of dieting. Breaking the Diet Habit (1983) suggests that weight-loss programs are ineffective and may contribute to many of the long term health problems attributed to obesity. Dieting, Polivy and Herman’s research showed, could lead to complications such as gallstones, low blood pressure, muscular aching, abdominal pain, kidney stones, anaemia, headache, cardiac problems and depression. Where Polivy and Herman departed from earlier research was in their claim that “stable, lifelong overweight is probably the natural and optimally healthy state for many people.”

More recent research, which I’ve talked about on this blog and this one, has also called into question the relationship between obesity and health. In short, this research has been out there for over forty years. So, why do we think it is “new” and exciting that another study has called the effectiveness of dieting into question? Part of the reason is surely a combination of cultural amnesia and the unbelievable volume of available information on dieting and obesity. But my research suggests it is more than this. People don’t want to give up on the dream of being thin, and they don’t want to let go of their belief that being fat is a moral or personal failing. So much of our culture’s approach to the body is grounded in the belief that health is visible, i.e. that you can see what wellness looks like from the outside. Calling this into question is scary because it challenges our reasons for eating well and exercising. It also undermines numerous scientific research programs and the health and beauty industries that are built on the assumption that if we all eat right and commit to exercise, slenderness will follow. But we can’t, as a society, seem to get it right and tend to blame individuals for their “failure” to lose weight.

I’m not a conspiracy theorist, nor am I a health scientist, I’m someone who has studied the impact of obesity stigma and the persistent dream of slenderness on Canadian women. My research speaks to the social and cultural experience of fatness, to the impact of the long-standing tension between the goal of being thin and the lack of concrete scientific information about how to achieve a slender body. If health is really the goal, then Crowe’s article and Mann’s study, show that we need to continue to push to detach the concept of wellness from personal appearance. I’m gratified there is another study by an established scholar that complicates our understanding between diet-exercise-weight-health and frustrated/optimistic about the possibilities for a shift in popular perception of this issue.

Canadian Bulletin of Medical History, Issue 30.1

An image from one of my projects is featured on the cover of the current issue of the Canadian Bulletin of Medical History (30.1). It is an illustration by Dr. Ingrid Laue who was the editor of “The Bolster, ” the newsletter of Vancouver fat acceptance organization Large as Life (LAL). LAL was active in Vancouver between c. 1981-1985. The group organized fitness classes, swimming nights and fashion shows for fat women only. About 120 women were members over the years, and “The Bolster” had 500 subscribers.

Bolster Cover March 1983

Laue used clip art to put together this cover. What makes it special is that the two foremost figures, the woman in black and the golfer, have been enlarged by hand. Laue wanted the images to reflect women who were actually “ample.” Since it was not easy to find clip-art of large women she instead added to the images herself.

The desire to enlarge clip-art to make bodies larger is indicative of the erasure of images of fat women in contemporary culture. Fat bodies aren’t a part of the stock images stored, photocopied, cut and pasted into documents to illustrate fashion, parenthood, childhood and work. Large-sized clothing is rarely stored in archives, displayed or studied by fashion historians. And, beyond greeting cards and post cards poking fun at fat people, it is still rare to see large bodies displayed as art in contemporary society.

Laue’s images also help us to see that women respond to images of beauty and health in unexpected ways. Rather than use an image of a smaller woman or no images at all, she chose to enlarge and sketch images herself. This, to me, is a modest example of the ways that women talk back to popular culture and body norms. Laue and other members of LAL were not willing to accept the erasure of fat women from popular culture and so they chose to create images of women, as well as social sites and services (aerobics and dance classes, clothing swaps), for fat women.

When we talk about popular culture, in this case I’m talking about the media, beauty and fashion industries, we tend to assume that women are the victims of the monolithic and uncreative images of femininity presented in mass media. But Laue’s images are a reminder of the creative responses women have to culture. And, they are also a reminder of women’s desire to expand our culture’s understanding of beauty to include different shapes and sizes.

Why I’m not surprised by the Geoffrey Miller Twitter controversy

Earlier this week Geoffrey Miller, a Stanford-educated NYU lecturer with a permanent appointment at the University of New Mexico, tweeted the following:

“Dear obese PhD applicants: if you didn’t have the willpower to stop eating carbs, you won’t have the willpower to do a dissertation #truth”

Miller subsequently deleted the tweet, apologized, and has since said it was part of a research project. His actions caught the attention of Jezebel and media commentator Jay Rosen who rightly criticized Miller for “fat shaming.”

Fat shaming is a relatively new way of describing the longstanding social stigma attached to being overweight. In the 1960s and 1970s some activists referred to this as fat oppression, and more recently health studies scholars have referred to it as obesity stigma. What these terms are describing is the assumption that fatness is an indicator that a person is weak, lacks willpower, has a poor knowledge of nutrition and is undisciplined.

I’m not surprised by Miller’s tweet because fat shaming has been a part of our (Canadian/American and “Western”) body culture for hundreds of years, if not longer. It is a reflection of the our deep-rooted belief in “mind over matter,” i.e. that a rational person should be able to control their bodies and their will. Slenderness, conversely, is taken as a sign of discipline and self-control. These broad generalizations about fat/thin are reflected in media representations, diet culture, and public policies which seek to curb the so-called “obesity epidemic.”

More than this, though, I’m not surprised by Miller’s tweet because there is plenty of evidence that weight has been used as criteria for admission to universities in the last forty years. I conducted interviews with fat activists in Canada, two of whom were told they needed to lose weight in order to get into nursing school (c. 1970s). Bill Fabrey, the founder of the National Association to Advance Fat Acceptance, has said that he started the organization, in part, when he discovered his girlfriend was rejected by Cornell University based on her weight (c. 1960s). More recently (c. 1990s), research has suggested that obese people are less likely to be accepted to elite colleges and universities.

Universities are just one social institution among many – gyms, health clinics, bars, clothing stores – where fat people may face shaming and stigma. Regardless of whether or not it is an experiment, Miller’s tweet reveals the #truth about our fat phobic culture. Concern about obesity is currently couched in terms of the health of larger people, but it is also often about aesthetic and moral disapprobation of larger bodies.

Ethics of “Obesity Epidemic” to be Examined at International Workshop

A group of 20 international experts on obesity will gather in Kitchener-Waterloo on the weekend of October 20-21, to share insights into the social and cultural dimensions of obesity in Canada. Attendees will reflect on the ethical and equity issues that arise in the treatment of people deemed obese.

“As the obesity epidemic and critical responses to it reach the 10-year mark, this planning meeting brings together scholars whose work expands upon and complicates understanding of fatness and the obesity epidemic in the Canadian context,” says Wendy Mitchinson, Canada Research Chair in Gender and Medical History at the University of Waterloo and co-organizer of the conference.

One participant, Michael Gard of Australia’s Southern Cross University, examines Canadian weight statistics during the last thirty years, and questions whether the rhetoric of “crisis” is warranted at all given the recent plateau in obesity rates.

Other experts will examine obesity stigma, a problem that may deter people from seeking medical care, and isolate them in social situations. Obesity stigma is defined as the negative treatment and discrimination experienced by people who are considered “fat”. Other visiting scholars include:

• Charlene Elliott (University of Calgary) who asks who is “responsible” for childhood obesity, and considers the implications of government programs aimed at youth.

• Deborah McPhail (University of Manitoba) looks at obesity stigma in working class and poor populations, specifically in rural areas

• Gerry Kasten (Public Health Dietician) and Lawrence Mroz (University of British Columbia) who focus on eating and body management practices in gay male communities.

• Jenny Ellison (Mount Allison University) who will talk about critical responses to obesity stigma by Canadian and American “fat activists.”

As well as critical perspectives, participants will hear innovative suggestions from scholars like LeAnne Petherick (University of Manitoba) and Natalie Beausoleil (Memorial University of Newfoundland), who explore new modes for obesity education that would promote self-esteem and healthy body image in children.

Organizers of the workshop received funding from the Canadian Institutes of Health Research (CIHR) for work in the area of health ethics. The work done at the meeting will result in a published collection of articles.

For more information, contact me.