What’s Wrong with Fat? By Abigail Saguy

Hey guys!

I’ve been meaning to tell you allllll about this book I’ve recently read and absolutely loved. And, here I am, over a week later, but, alas, it’s been a crazy past couple of weeks, especially last week since we completed employee reviews at work. It took me 5 hours to fill out a self-evaluation and my direct manager, the CEO of the company, also filled one out on me so we were able to see where we’re aligned and where there are discrepancies in our perceptions and values/priorities. I think one of the greatest benefits of working at a start-up is the ability (if not push) you have to grow. I have never been more consistently uncomfortable and forced outside of my bubble than at this job. Because of this – I have grown immensely as a person and a professional.It would probably take me triple the time to learn as much at a typical corporate job where all the infrastructure is in place and where creativity is stifled due to bureaucratic protocols.

Have any of you ever done these types of reviews? I’ve previously done reviews at companies, but never found them helpful. I remember being reviewed by an HR manager, rather than my boss, and she had absolutely no idea what I did, so her basis for my review was whether I clocked in and out on time and how much overtime I did. Lame. Anyway, I’d love your input and insight.

So, back to this book I’ve been dying to share — I recently finished Dr. Abigail Saguy‘s book, What’s Wrong with Fat? and thought it did an incredible job at diving into obesity from a sociological and rhetorical perspective.

Dr. Saguy starts with helping her readers understand that obesity is a “frame” not a fact. What this means is that “obesity” is a perspective on fat whereby it (fat) is pathologized and this frame encourages us to pay attention to certain aspects of a situation while obscuring (if not overwriting) others.

The three main frames we use to view fat are: as immoral, as a medical problem and as a public health crisis. The three predominant ways to contest these frames, according to Dr. Saguy. are: fat as beautiful, fat as consistent with health (Health At Every Size(R)), and fat as a basis for (civil) rights claims. What we see above in the illustration is that when we view fat through a “problem frame” (that is assuming, falsely, that fat is inherently unhealthy & undesirable), there are three predominant “blame frames” we use: personal responsibility, society (sociocultural), and biology.

A perfect example of this would be HBO’s Weight of the Nation, which clearly frames fat as a problem by endorsing its pathology via “obesity” and deeming it a medical and public health crisis. It employed all three “blame frames” at different points in the film (i.e. it’s this person’s fault for eating too much, this person is living in a poor neighborhood and only has access to fast food so it’s society’s fault, and this person has “fat genes” so he/she is predisposed to be fat). As Dr. Saguy confirmed, however, one “blame frame” is used most predominantly in the media and in our scientific discussions (and in this “documentary”). Which do you think it is?

Personal responsibility. (Next is sociocultural and 3rd is biological).

This is incredibly interesting because it’s not the same way in other countries. For example, in France, obesity blame is placed more fairly between all three frames (though it is still framed as a problem). In the US, however, our neoliberalism – that is our desire to shift responsibility for our collective welfare from the government to the person, at an individual level – is what propels the sentiment that if one is fat (if “fat” is being framed as a problem), he or she should just pick him/herself up by the bootstraps and gain some goddarned self control.

The other thing to think about is which frame carries more monetary and cultural authority. The debate over the best way to discuss body size does not take place on an even playing field because there are huge industries and profits invested in proffering particular frames. For example, the $60B weight-loss industry is invested in society seeing corpulence as a medical and public health threat (as well as an undesirable aesthetic) that can be changed with enough will power (and consumer dollars). Confirmation biases within the media and scientific communities continue to propel this belief. The International Obesity Task Force (a lobbying group funded by pharmaceutical companies), obesity researchers and the Centers for Disease Control and Prevention are also invested and key in this blame frame.

Alternately, size-acceptance groups and activists who want to reframe corpulence as potentially parallel with health and as a civil rights issue are working with considerably less money and authority.

What I found most useful about Dr. Saguy’s approach is the language she gives us to help us understand what our diction implies and how this governs the actions we take (and the consequences we face based on the diction we tend to favor).

For example, Dr. Saguy writes: “uncritical reliance on a medical and public health crisis frame of corpulence leads us to emphasize the risks associated with overweight and obesity, while glossing over the health risks associated with ‘underweight’ or ‘normal weight,’ as well as those cases where being ‘overweight’ or ‘obese’ seems to be protective of health. This begs a social, not a medical explanation.”

To put it simply – most of us are conflating and mis-using a lot of terms, and this has real-world consequences. I can’t tell you how many times I overhear people say “obese” when they really mean “fat” (because clearly they have not measured the BMI of said “obese” person). Obese = medical definition based on BMI; same with “overweight.” Fat is a much more malleable term. However, what we so rarely realize/discuss is how fat can be protective; how obesity is not a death sentence and how normal weight and underweight could be just as easily sensationalized.

What is also incredibly intriguing about this book is Dr. Saguy‘s introduction of labelling theory which raises the question: how do our labels affect us? This is something we rarely ask: but is our obsession with obesity bad for our health?

Questions to think about:

How and why has fatness been medicalized as “obesity” in the first place?
By focusing on “obesity,” what other interpretations of fat are we shutting out?
Since there is evidence that there are health risks associated with higher body mass, with the the clearest case being Type 2 diabetes, what should our approach be? The relation is correlatory not causal – is that enough?
Why is obesity framed from a “personal responsibility” blame-frame most predominantly? Can we think of other situations where a form of self-identity is labelled as “bad” and conversion “solutions” are offered?
If there is evidence that obese patients with heart disease or diabetes have been shown to have lower mortality rates than their thinner counterparts, why is this called an “obesity paradox”? What does that assume about our perception of obesity?
What is our obsession with weight and obesity costing us?
How has our view of corpulence changed over time? how does it differ from other countries?

If you have a body, get this book. Once you start questioning your stance and presumptions about body size and health, you’ll start to unravel what is a very complicated (and perhaps insidious) web of influence and consequences. And, you’ll probably ask, as I do, if we accept the problem-frame of corpulence and its predominant blame-frame of personal responsibility – what’s next?

Thoughts?

<3,

The Cranky One

p.s. Check out Dr. Saguy‘s Facebook page here

p.p.s. you can listen to Dr. Saguy on NPR here