By Wayne Roberts, Visiting Scholar
When I was a kid growing up in the “happy days” era, anyone who was the slightest bit different – I mean slightly, as in having freckles, a cowlick, glasses, a limp, a speech impediment, a twitch or accent, or being shy, skinny (me), fat, or even queasy if someone put a frog put down your sweater – was fair game to be teased, poked fun at, made the butt of practical jokes.
Today, adults who grew up in that culture have mostly outgrown such childish shaming of people who are different. Except for one case: fat people.
Common technical terms such as overweight, morbid obesity and obesity epidemic – never mind the non-technical insults – suggest arbitrary but harsh judgments are alive and well when thinking about people of different body sizes.
Katie LeBesco is one of North America’s leading scholars to subject the stereotyping and shaming of obesity to academic scrutiny, and has gained international stature for such books as Culinary Capital and Revolting Bodies.
As a guest of New College’s Global Food Equity initiative, LeBesco joined a panel of three students and activists who are well-versed in what are called fat issues to speak to a packed and lively Wilson Hall crowd on February 25.
Lebesco, a dean at Marymount Manhattan College in New York City, got her PhD in the field of communication and rhetoric. During our interview, I do a bit of a double take upon hearing of her liberal-arts credentials – they are, to me, surprising qualifications for an expert on medical and public health problems such as healthy diets and weight.
Among people concerned about the mistreatment of obesity and weight issues, my double take is called “healthism” – prejudices parading under the halo of seemingly-scientific and well-meaning assumptions about what’s healthy. Fat activists blame healthism in much the same way women’s rights activists blame sexism for blocking the door to equitable treatment of all the variations in the human family.
Though LeBesco lacks formal training in medicine or public health, she brings an understanding of loaded language and rhetoric to the table. She tells me health professionals impose “a lot of masking of moral judgments” when they classify certain people – as they did for gay people before the 1970s, and large-sized people today – as suffering from a disease.
“I’ve gained and lost a lot of weight – a hundred pounds, plus or minus – over the years, and know I can be fat and healthy,” she says. People of every size can be unhealthy, she argues, be it thin people who don’t eat enough, or people with athletic builds who take dangerous drugs or heavy people who eat too many sugary foods. “The issue is health, not body size,” she says.
LeBesco maintains her conversational tone at the lecture. Food movement leaders “threw fat people under the bus” during the 1990s, she says.
That’s an interesting way to revisit that eventful decade of political, economic and social policy, a decade commonly associated with full-on “neoliberalism.”
It was also the decade of the obesity epidemic, when 25 percent of Americans – world leaders in such matters – were reported to be overweight or obese.
In fact, the epidemic – LeBesco mimes washing her hands and cringes theatrically when using the word – was in large part due to a change in the way the World Health Organization defined “overweight” and “obese” in relation to body mass index or BMI (which measures a person’s size based on height and weight).
When I got home and followed up on this comment, I found this standard BMI measure of obesity was promoted by scientist Ancel Keys in the 1970s. Some of Keys’ arguments are now widely debated and discreetly repudiated in the latest US dietary guidelines. In his heyday, Keys was largely responsible for promoting the obsession about high-fat food and heart disease that overtook dietary thinking, before the Atkins and paleo diet crazes pushed the pendulum back.
The questionable science behind conventional thinking about obesity lends heft to LeBesco’s claim – remember, she’s a communications specialist – that public thinking about body-size issues has been framed by “moralizing or medicalizing metaphors” that resonate with Biblical language about idleness and sloth.
In LeBesco’s view, this coincided with the neo-liberal thrust of the 1990s in that obesity-baiting permitted blaming individuals’ lack of self-control, rather than inadequate government regulation, for major threats to health and well-being.
Since people of different heritages carry weight differently, it also became easier to blame people from racial minorities for their body shapes, she suggests. And also easier for many to overlook that meals based on complex carbohydrates and lean proteins are no more accessible than gym memberships and personal trainers for people on low and fixed incomes. Moreover, no one should lose sight of the impeccably well-established principles of “social determinants of health,” which confirm that at the level of population groups, it is income level, not lifestyle or genetics, that best predicts health. There is no reason for public health advocates to put that point in the background.
In other words, super-sized global corporations can be subsidized, but super-sized people should fend for themselves.
To make matters worse, LeBesco claims, campaigners for proactive government health policies – such as regulation of junk-food marketing or provision of healthy school meals – went with the current and used “the haunting specter of obesity” to super-charge their campaign.
Michelle Obama, for example, campaigns for healthy school meals under the banner of “combating an epidemic of childhood obesity” and working to end childhood obesity in one generation. Why not just say healthy school meals are good for many reasons, LeBesco asks.
LeBesco concedes fat activists have to do a “tricky tango around health issues,” since there are objective measures for risks related to visceral fat, the range of weight hips, knees and spines can handle over a lifetime.
But she insists fatness, like thinness, cannot be automatically judged as healthy or sickly, people can be “healthy at every size” and the motivation for good public health policy should be overall positive benefits, not the bogeyman of obesity.
That’s not too much to ask for. The late Dr. Sheela Basrur was my boss and friend when she served as medical officer of health for the city of Toronto, before moving on to become Ontario’s chief medical officer of health and assistant deputy minister of public health. In that capacity, she issued a 2004 report on healthy weights, modelling language that does not single out any one issue or group in the discussion of healthy public policy. Over 10 years later, it’s a shame such inclusive public-health policy isn’t more widespread.