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.

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.

International Women’s Day

I am preparing a talk for International Women’s Day (IWD) on fat activism. Why does it exist and why does it matter? In casting about for a way to explain this to members of the Mount Allison community, I came across this quote from Breakfast of Champions. I think it is a good one. I know that Vonnegut (1922-2007) was definitely not talking about fat activism here, but Kilgore Trout’s epitaph does speak to the important relationship between “health” and equity issues.

Fat activism is a demand for fair treatment and social inclusion. This might include recognition that a person can be healthy at any size, or the development of programs that acknowledge different cultural perspectives on nutrition and health. Like other groups who demand equitable health care, people who organize groups and develop social sites for fat people want to extend the definition of well-being beyond the physical body to the social, cultural and economic realm.  This movement, therefore, serves as a reminder to put humane treatment and equity issues at the forefront of health policy and discourse.

Read Mindy Kaling’s Book

Subtitle of this post: if you like the same stuff I like.

I like popular culture that deals with regular people and everyday concerns. So, Mindy Kaling’s new book Is Everyone Hanging Out Without Me? was a treat to read. The book is short, mostly biographical, and includes some sharp observations about beauty and the body in contemporary (North) America. For example, Kaling rightly observes that the word “fat” means so many different things to different people that it has become meaningless. She then offers a tongue-in-cheek breakdown of categories of fatness from “chubster” to “obeseotron” to explain the different types of large bodies we see (or don’t see) in popular culture. I suspect some folks on the Fat Studies listserv will have something to say about Kaling’s commentary on body size, but I see it as satire, especially because of the fun and funny critical commentary on women in popular culture that comes later in the book.

Continue reading Read Mindy Kaling’s Book

Fitness for Every Body

I’ve been working on a review article for a new journal, Fat Studies, on recent exercise DVDs for larger people. The DVDs (Yoga, Belly Dancing, Scuba) are all great – I won’t pre-empt the review here.

A drawing by Ingrid Laue for the Large as Life Fitness Program, c. 1981-2.

Instead, I’ll note that in preparation for writing the article I reviewed some new and older medical studies on the benefits of exercise for people who are defined medically as “obese.” This research, published in places like The New England Journal of Medicine and The Journal of the American Medical Association suggests that exercise, cardiovascular health and blood pressure, rather than weight and food intake, are key determinants of health.

Continue reading Fitness for Every Body

Drop Dead Diva

Drop Dead Diva is one of a handful of American television shows featuring a full-figured lead actor. The premise of the show is quite silly – Deb, a wannabe Price is Right model dies in a car accident and hits the “return” button at the Pearly Gates when the bureaucrat she meets is trying to decide where to send her. Jane is a successful attorney who gets shot in the crossfire during an altercation at her office. As Jane lies dying on an operating table Deb’s soul enters her body and – voila – Deb is now Jane – a skinny model “trapped” inside the body of a full-figured attorney.

Continue reading Drop Dead Diva