NY Times Reports on Spreading Fat Stigma Around the Globe – NYTimes.com.
Sergio Miranda admits to fat prejudice. “They take up a lot of room on the bus,” he said, making everyone annoyed and uncomfortable.
His next comment was as dismissive as it is common, according to a recent multicountry study: “I have always thought being fat was your own fault.”
The School of Human Evolution and Social Change at Arizona State University conducted a global study of 700 people in 10 countries that put its finger on the global pulse of international body image, assessing cultural attitudes towards obesity.
The study found strong negative attitudes about the overweight across all countries surveyed, and the increased level of criticism and blame directed at the overweight revealed a clear trend of globalization of fat stigmatization.
In fact, the highest stigma scores were in places that have a history of larger-bodied populations. In other words, even cultures where people have a long-standing tradition of bigger bodies are now stigmatizing their own body types, e.g. American Samoa and Puerto Rico, which Brewis speculates is attributable to ubiquitous public health campaigns intended to curb diabetes and high blood pressure – common comorbidities of obesity – are imbued with negative moral messages that put the focus on individuals over environmental and social factors associated with the rise in obesity.
Executive director of the Arizona study Alexandra Brewis described the pervasive negative perceptions about the overweight as troubling, pointing out that poor body image and low self-esteem from being stigmatized are hardly the tools needed to effect healthy changes. Dr. Stephen McGarvey of Brown University agreed:
“A public health focus on “You can change,’ or “This is your fault,’ can be very counterproductive, he said. “Stigma is serious.”
Serious enough that there are both books ( Lessons from the Fat-o-sphere: Quite dieting and Declare a Truce With Your Body) and blogs (My Big Fat Blog ) exposing how prejudice against the overweight results in opportunity and economic inequalities, and promoting more acceptance for the overweight in everything from assumptions and attitudes to product design.
Obesity stigma goes beyond negative body image – obesity is linked to lower income and shorter life spans. In fact, the New England Journal of Medicine reports that for the first time in two centuries, American children will have shorter life expectancies than their parents, due to obesity.
Clearly, the messaging about obesity is about far more than the what – it is about the how. Moralizing and stigmatizing are rarely effective strategies for inducing motivation or change. And as long as the obesity epidemic continues/worsens, our children will face foreshortened lives with more chronic disease at a cost that is high at the individual and, especially, societal level.
Maybe it’s stop moralizing and start focusing our attention and energy on the changes we need to make, individually and collectively, to dismantle what the Centers for Disease Control has dubbed our obesogenic environment – that is, characterized by the promotion of increased food intake, nonhealthful foods and physical inactivity.
A recent Pew Study suggests most people agree: 57% of respondents went so far as to say that the problem of obesity is serious enough that the government should play a significant role in reducing the incidence of obesity, especially among children. As well, celebrities like Jamie Oliver are contributing their energy and talents to the cause of promoting healthful eating, as this TED talk video demonstrates.
The government is responding, issuing the 7th edition of the Dietary Guidelines for Americans . “Obesity is a crisis we can no longer ignore,” said Secretary of the Department of Agriculture Tom Vilsack when the guidelines were released in January.
While the efforts of Mr. Oliver and the Department of Agriculture’s efforts may be effective, it is by no means certain, for the simple reason that scientists do not yet agree on the causes of obesity.
For example, in a recent New York Times article “For the Overweight, Bad Advice By The Spoonful” scientists say evidence suggests our body composition set point may be determined in utero, and a brain wired to keep weight within a +/- 30 pound window of this set point may well be more of a principle factor behind body weight than environment (high fat food, lack of exercise).
But even as the scientists debate, we see medical science pushing forward with surgical interventions which have become increasingly less invasive. Where before patients considering weight loss surgery were limited to very invasive surgeries such as the RNY gastric bypass, today LAP-BAND is widely available as a laparoscopic procedure that takes 20 minutes and results 50% or more of excess weight loss in the first year. Nonsurgical solutions such as the gastric pacemaker are also being tested.
Considering the risks that a BMI> 30 poses, these innovations may an essential front on the war against obesity. Diabetes is the leading cause of kidney failure, is a major cause of heart disease and stroke and according to the CDC is the 7th leading cause of death. Revolutions in noninvasive procedures such as LAP BAND and the new gastric plication offer people an opportunity to lose dangerous excess weight before they reach the stage of obesity and its related chronic conditions. And we can all agree, there’s no shame in that.
