What's Wrong With Fat? (19 page)

Indeed, there is evidence that white middle-class women and girls are more likely than poorer women and girls, women and girls of color, or boys or men to be diagnosed with anorexia or bulimia, also referred to as “thinness-oriented eating disorders,” although this may partially reflect biases in diagnosis. 129 In contrast, rates of binge-eating disorder, which are often associated with higher body weight, are similar among black women, white women, and white men, with some scholars finding recurrent binge eating to be more common among black women than among white women. 130

These demographic trends have been evoked in debates over the relative urgency of eating disorders as compared to overweight and obesity. While fat acceptance activists and eating disorder specialists have expressed concern that discussions of the danger of obesity will trigger eating disorders, those advocating for greater attention to obesity have dismissed these concerns as class biased. For instance, Greg Critser, author of
Fat Land
,
argues that the news media have given disproportionate attention to anorexia because they are biased toward problems that affect the white upper middle class. Quoting a physician who treats overweight and obese girls at Children’s Hospital in downtown L.A., Critser writes: “For every one affluent white anorexic you create by ‘overemphasizing’ obesity, you foster ten obese poor girls by downplaying the severity of the [overweight] issue.” 131 Quoting Judith Stern, Critser adds, “We’ve got to stop [talking about anorexia] and get on with the real problem.” 132 In an interview with me, obesity researcher James Hill similarly says: “Not to sound cruel about it, but one problem [obesity] is a huge problem for society. The other problem [anorexia] is a smaller problem.” Similarly, in an interview with me, obesity researcher Walter Willett says: “The problem of overweight and obesity is a hundred times more of a problem than the problem of anorexia, if we look at morbidity and mortality.”

This is directly related to the fact that overweight and obesity have been defined broadly to include anyone with a BMI over 25 or 30, respectively, regardless of body composition or health status, while anorexia has been defined quite narrowly. Specifically, the APA defines anorexia as the refusal to maintain body weight at or above a minimally “normal weight” for age and height (85 percent of “expected” weight), fear of gaining weight or becoming “fat,” denial of the gravity of one’s low body weight, and, in post-menarchal females, amenorrhea. 133 The APA defines bulimia as recurrent episodes of binge eating (eating extremely large amounts of food in one sitting), followed by “inappropriate compensatory” purging (i.e., by vomiting and/or talking laxatives), and an undue influence of body shape in self-evaluation. 134 Fat rights activists and health at every size scholars argue that a better comparison is between the prevalence of eating disorders and type 2 diabetes, pointing out that rates of the former among U.S. children is roughly nine times higher than the latter. 135

The following news article plays up stereotypes of anorexics as elite white girls. It describes how 10-year-old Katherine, growing up in the wealthy suburbs of Richmond Virginia,, had been diagnosed with anorexia and how her parents, in their desperation to help their daughter, promised they would buy her a pony if she would only eat. After two months of inpatient treatment at a children’s hospital in a nearby town, during which she was homeschooled, Katherine recovered and became “an avid horsewoman, sometimes riding five or six times a week.” 136 When Katherine says she is hungry, her mother “has been known to drop everything and whip up a three-course meal,” comments the article approvingly. 137

In contrast, another news article describes how a poor black single mother lost custody of her son, Terrell, after months of fighting neglect charges related to his body weight. He had gained weight after being released from an inpatient weight-loss program and his mother protested that she could not “watch him 24 hours a day..., hold his hand, take him to the Y, make him eat salad” or buy the food recommended by Terrell’s doctors while working at her time-consuming minimum-wage job. 138 These two articles drive home the way in which an ideology of total motherhood puts moral pressure on mothers to protect their children from medical risk in a social context in which different mothers have unequal resources at their disposal to live up to these expectations. 139 In these articles, a white, wealthy anorexic girl is treated as a victim of a terrible illness beyond her and her parents’ control, while a black, poor, obese boy is described as having a health problem that may be the result of parental neglect.

Discussions of obesity are also racialized, in that they tend to point blame at sedentary activities, such as television-watching as opposed to reading, that are associated with lower income or less formal education and more common among African Americans. 140 Similarly, fast food and cheap industrialized “junk food” are cited as examples of poor food choices, rather than, say, imported Brie cheese or premium ice cream. For instance, a
New York Times
editorial opines: “With more two-income families and single-parent households, more children eat at cheap fast-food outlets, where sugary drinks and high-calorie choices in enormous portions abound.” 141
The focus on behaviors associated with the poor and ethnic minorities is typical of earlier moral crusades against alcohol, which targeted immigrants, and the drug wars, which have focused on drugs like crack cocaine that have been consumed disproportionately by poor minorities, rather than the drugs like powder cocaine that are consumed by the affluent. 142 In other words, even when race and class are not explicitly mentioned, these discussions are imbued with racial and class overtones. A
New York Times
editorial recognizes and resists this tendency by arguing that expensive high-caloric foods (and their elite consumers) should not get special treatment: “Another penny or two of tax on fast food is really a tax on the poor... if potato chips are taxed,
crème brûlée
should be too. Anybody who buys Camembert can afford an extra nickel for a childhood obesity prevention program.” 143

Discussion of the risks of “dual-working parents,” in which “parents” rely on packaged foods or takeout to feed their families, obscures the fact that it is specifically working women who are expected to be at home cooking nutritious meals. 144 An advertisement running in newspapers in the summer of 2005 makes this explicit, blaming “30 years of feminist careers,” for a host of social ills including “an epidemic of childhood obesity and diabetes”: “With most mothers working, too few adults and children eat balanced, nutritious, portion-controlled home-cooked meals.” This advertisement echoes earlier discussions by 1830s crusader Sylvester Graham, among others, of food excesses “within the home, at table, by women.” 145 In that working-class women and women of color often have no choice but to work, these discussions are racialized as well.

The emphasis on breast-feeding as an antidote for obesity, despite a lack of compelling scientific evidence for this claim, further advances an obligation to “total motherhood.” 146 For instance, a
Chicago Sun-Times
article cites breast-feeding as the first “step to fitness”: “It’s far easier to prevent childhood obesity than treat it. And the time to start is infancy. Breast-fed babies are 22 percent less likely to become overweight adolescents than bottle-fed babies, according to a study reported in the
Journal of the American Medical Association
.
Bottle-feeding parents might make their babies finish the bottle even when the kids feel full, the researchers found.
Also, breast-fed babies have lower levels of insulin, which promotes fat storage.” 147 Given lower rates of breast-feeding among African Americans, which have been partly attributed to a rejection of a legacy in which enslaved black women were forced to nurse their masters’ children, the emphasis on breast-feeding further casts black mothers as bad mothers. 148, 149

Moreover, as is shown in figure 3.5, news reports are more likely to invoke a personal responsibility, as well as sociocultural (and specifically cultural) but not biological, frame when the poor and/or ethnic minorities are discussed, compared to when these groups are not discussed. Specifically, among articles mentioning blacks, Latinos, or the poor, 54 percent discussed individual choices, 43 percent mentioned sociocultural factors, and 17 percent mentioned cultural factors, compared to 38, 26, and 4 percent, respectively, among the articles not mentioning these demographic groups.
In contrast, 15 percent of articles mentioning these groups and 20 percent of articles not mentioning these groups discussed biological factors, a difference that is not statistically significant, meaning it could be the product of chance. I found the same pattern, in which articles mentioning the poor, blacks, or Latinos were also more likely to discuss individual blame and sociocultural factors (but not biological factors), in a different news media sample. 150

Figure 3.5:
Percentage of
New York Times
and
Newsweek
sample discussing specific causes and solutions for obesity and overweight depending on whether blacks, Latinos, or poor are discussed

One article portrays as absurd a lawsuit brought by two black-girl plaintiffs from the Bronx against McDonald’s, arguing that it was the plaintiffs’ own fault for “gorging themselves so wantonly.” The word
wanton
refers to lewd or bawdy behavior and is clearly moralizing. Similarly, the word
gorge
means to consume greedily, thus conjuring up gluttony. The account of these girls’ unchecked desire for cheap and fattening food echoes stereotypes of black women as having insatiable sexual appetites. 151 This article dismisses the idea that these girls could really not have known “about the nutritional shortcomings of fast food” and says that “if that’s really true, they should consider a lawsuit against their parents for endangering the welfare of their children rather than a suit against McDonald’s.” 152 This article thus rejects the idea that McDonald’s has any responsibility to produce nutritional food, heaping full blame onto the girls and their parents.
This is consistent with an ideology of “total motherhood,” in which mothers are held responsible for any harm that may befall their children as well as a broader tradition of denigrating black mothers as bad mothers. 153

If cultural factors are more likely to be mentioned when blacks, Latinos, or the poor are cited, it is because minority ethnic culture is often being blamed. For instance, one article, discussing the higher rate of overweight among minorities in inner cities, quotes a news source who acknowledges that “it is easier and less expensive to eat fast food and very difficult to find, in some of these neighborhoods, appropriate foods, fruits and vegetables at a reasonable price.” 154 But the article then shifts to a focus on ethnic culture, quoting an activist who says that, in the end, “ ‘it will take a culture change’ to reverse the trend.... ‘Eating healthy is synonymous with whiteness for some of these kids,’ [an activist] says. ‘They’ll be like, “Salmon? That’s white people food.” ’ ” In contrast, “black people food” is assumed to be “unhealthy” foods. Thus, ethnic minorities are depicted as backward or ignorant and as needing to be educated in proper food choices and preparation, thus reproducing stereotypes based on race as well as body size.

Similarly, many of the obesity researchers I interviewed evoked a contrast between weight-conscious and health-conscious elites and poor minorities who do not care about their weight or health. For instance, Xavier Pi-Sunyer, who is a medical doctor at St. Luke’s Hospital, runs his own weight-loss clinic, is on the board of Weight Watchers Inc., and is a past president of North American Association for the Study of Obesity (NAASO), says that “the average American... eats three cheeseburgers and a big order of French fries and a two-liter milkshake twice a week.” He vehemently rejects the idea that the contemporary United States is a weight-obsessed society, saying that “the average American doesn’t care [about their weight].” He acknowledges that many of the “Barnard girls” [women attending the elite Barnard University in New York City] are obsessed with weight for “cosmetic reasons” but contrasts this to the “average American woman [who gains] weight with each pregnancy and [ends] up [after] four kids, fifty pounds heavier... because nobody alerts her to the fact that this may happen and it may not be good for her to end up fifteen-twenty years later fifty pounds heavier.” Later in the interview, he says:

Now a lot of the obesity problem in America or more of it is in the minority groups and more in the poorer groups, and it may be that they have other priorities. You know, some woman who’s living in the housing projects and has no husband and is trying to take care of four kids and is now off welfare and has to work and has all kinds of problems. For her, diet is not [a priority]. In fact, food is the one pleasurable thing she can afford, so it’s not a high priority in their lives. I’m not saying they’re wrong, but I’m saying I don’t think they’re really connected to the idea that, that, you know, they need to lose twenty-five pounds, and so they don’t try it.