What's Wrong With Fat? (6 page)

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Authors: Abigail C. Saguy

Tags: #Health & Fitness, #Medicine, #Public Health, #Social Sciences, #Health Care

BOOK: What's Wrong With Fat?
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I draw on Bourdieu’s concept of
field
,
or a semiautonomous social space with its own rules, to explain why certain people and organizations develop specific frames. For instance, most of the leading obesity “experts” run weight-loss clinics, which may make it difficult for them to consider the possibility that weight-loss diets are counterproductive. In contrast, most fat acceptance activists are extremely fat women with firsthand experience with weight-based discrimination and a long history of unsuccessful weight-loss diets. This may make them more likely, than thinner people or people without a history of unsuccessful diets, to focus on weight-based discrimination and to question the emphasis on diets. The concept of a
fat field
also helps explain why certain people and organizations have more credibility and influence than others based on the amount of economic, cultural, and bodily capital they possess. 102
Whereas, several economically powerful and culturally authoritative groups and individuals, including the IOTF, Hoffman-La Roche pharmaceuticals, and the Centers for Disease Control and Prevention (CDC), are promoting a public health crisis frame, advocates of the fat rights frame possess relatively fewer economic and cultural resources. Yet, by drawing on the symbolically powerful theme of equal rights, the fat rights movement is able to exert more influence than one might expect.

MY PERSONAL STORY

People often ask me how I came to work on this topic. I typically explain that this topic builds on long-standing intellectual interests I have in the issues of framing, gender, and social movements. “Yes, yes,” my interlocutors say, conveying with their bored expression that this is not what they meant. They want to know if I have a personal stake in this issue. They don’t see me as fat and are therefore puzzled by my interest in this topic. Some ask if I lost a large amount of weight. I do not have such a dramatic tale to tell. My adult BMI has always been in the “normal weight” category. As a result, I have never suffered weight-based discrimination or stigma. In fact, I have benefited from
thin privilege
(as well as white and middle-class privilege), in that people tend to attribute positive traits to me and other thin people solely because of our body weight. Because of my relative thinness, I am often unfairly considered a more objective, and thus more credible, commentator on debates over fatness than if I were fat, in that people assume that I have no personal axe to grind. (That a thin person might be equally biased regarding the subject, but in another direction, is rarely taken into account. In this sense, thinness in our culture is what sociologists call an “unmarked category.”)

Yet, exposure to pervasive cultural messages that women can never be thin enough has nonetheless contributed to difficult personal struggles with eating and body image at different points in my life. In this respect, my story is similar to that of many women (and men, who struggle with pressures to be muscular). To the extent that the war on obesity is about convincing us that fatness is a pathology that we need to fight in ourselves and in others, it affects many of us on a very personal level. I also have a personal stake as a mother of two young children whose weight has hovered around the 85th percentile for their sex and age (the current cutoff for “overweight”). Like the mother of “Sally” described at the beginning of this chapter, I have struggled with how best to speak to my children about body weight. I am keenly aware that fat kids are often targets of bullying and, like many parents, I want to protect my children from pain. 103 Yet, I also worry that emphasizing the importance of thinness may lead to problems with self-esteem, body image, and even eating disorders down the road. I worry that, by reinforcing the thin-is-good messages that my children will tease others who are heavier than they, thereby contributing to intolerance, hatred, and pain for other people’s children.

PLAN OF THE BOOK

The rest of this book includes five additional chapters, including the conclusion. Drawing on analyses of key texts, interviews with scientists and activists, and participant observation in fat acceptance meetings and online forums, chapter 2, “Problem Frames,” examines three ways that fatness is framed as a problem, including: (1) the immorality frame, in which fatness is seen as a moral problem; (2) the medical frame, in which fatness is viewed as a medical problem; and (3) a public health crisis frame, in which corpulence is viewed as a public health crisis. I also discuss three different ways in which fatness has been framed as
not
a problem, including: (1) a health at every size frame, according to which corpulence is potentially compatible with health; (2) a beauty frame, in which fatness is seen as beautiful; and (3) a fat rights frame, according to which weight-based discrimination, not fatness itself, is the problem. This chapter examines in detail the internal logic of each of these frames, as well as how the groups and individuals promoting each frame are situated within a larger fat field, in terms of their economic and political power. This discussion is crucial for understanding why certain voices are heard loud and clear, while others are muffled.

Chapter 3, “Blame Frames,” then examines the main ways in which blame and responsibility for a perceived obesity epidemic are typically framed, including as resulting from bad individual choices, sociocultural factors, or genetics/biology. As in chapter 2, I provide both a detailed discussion of the internal logic of each of these frames, as well as the relative power of their advocates. Drawing on a comparison of 261 articles on overweight or obesity and 70 U.S. news articles on eating disorders—
all published in
The New York Times
and
Newsweek
between 1995 and 2005—this chapter examines the extent to which there is greater tendency to evoke a personal responsibility frame when discussing obesity than when discussing other issues. I show that U.S. news reports are more likely to blame people for being “too fat” than for having eating disorders that lead them to be “too thin.” Drawing on a comparison of these U.S. articles with 108 French news reports on obesity, this chapter further examines the extent to which an emphasis on personal responsibility is especially pronounced in the United States. I show that, while the U.S. news media stress individual responsibility for obesity, the French news reports tend to emphasize sociocultural and individual factors more equally.

Medical research on the health risks of obesity and news media reporting on such research have each played a crucial role in framing fatness as a medical problem and public health crisis and in assigning blame and responsibly for this perceived problem. Drawing on two different paired samples of scientific studies of obesity and news reporting on those studies, chapter 4, “Fashioning Frames,” examines the respective roles played by scientific research and the news media in framing fat and assessing blame and responsibility for the “obesity epidemic.” It further examines how the news media evaluate the credibility of specific claims and the scientists and activists making those claims.

Chapter 5, “Frames’ Effects,” examines the material impact that different fat frames have on how public policies are formulated, what forms of political action are possible, and on individual attitudes. To get at the latter, this chapter draws on the results of several experimental studies that test how exposure to different fat frames, as communicated in news reports, affects people’s attitudes about weight-based discrimination and stigma, obesity policies, weight-related health risk, and the value of size diversity.
It further draws on interviews and the secondary literature to discuss the real impact these various frames are having in the world. The conclusion teases out theoretical and material implications of this study.

CH
APTER 2:
PROBLEM FRAMES

Obesity is a disease. Obesity is an epidemic. Obesity is a public health crisis. “Obesity” is a frame.

Obesity, that is, an understanding of fatness as a medical problem, is the dominant way of understanding fatness in the contemporary United States and Europe. And yet, this has not always been the case and is not true everywhere. In other times and places, fatness is widely regarded as beautiful and healthy. And it was not until quite recently in the United States, at the middle of the twentieth century, that fatness came to be viewed as a medical problem and even later—at the end of the twentieth century—as a public health crisis. Today, in the United States, a small but vocal group of activists, clinicians, and researchers are attempting to reframe fat as healthy, beautiful, and/or as a basis for group identity and rights. This chapter examines the origins and internal logic of these frames, as well as the relative influence of the people and associations promoting them. This is essential for comprehending both the stakes and the outcome of contemporary debates over fatness.

The medical frame is one of several different ways of establishing why fatness constitutes a problem. I refer to this as a
problem frame
,
which I distinguish from the
blame frames
discussed in the next chapter. Problem frames are the different ways in which fat is framed as a problem or as
not
a problem. In addition to a medical frame, these include an
immorality frame
,
in which fatness is seen as a moral problem, and
a public health crisis frame
, in which corpulence is viewed as a public health crisis affecting the nation and justifying government intervention. I also identify three problem frames that refute the notion of fatness as a problem, including the health at every size frame, according to which corpulence is potentially compatible with health; the beauty frame, in which fatness is seen as beautiful; and a fat rights frame, according to which weight-based discrimination, not fatness itself, is the problem. 1

Table 2.1 provides an overview of the six problem frames discussed in this chapter, showing what each frame implies about:
what
(if anything) is wrong with fatness, what should be done, associated analogies, key supporters, the gender of proponents, and the
master frame
on which the particular problem frame draws. 2 The equal rights master frame is a classic example of a master frame. The U.S. civil rights movement, women’s movement, gay rights movement, and disability movement all draw on an “equal rights” master frame, which first became prominent in the southern black freedom movement of the 1950s. 3 Indeed, a small but vocal fat rights movement is currently trying to extend the equal rights master frame to body size by likening weight-based discrimination to racial, gender, or sexual orientation discrimination. In contrast, as we will see, the medical, public health crisis, and health at every size frames all draw on a master frame of health. These frames are not exhaustive; one could identify additional problem frames and subframes. 4 Yet these six frames capture many of the important cleavages in contemporary debates over fatness.

TABLE 2.1

CREDIBILITY STRUGGLES IN THE FAT FIELD

Presenting these different frames in a neat five-by-five table obscures the fact that these different frames are not competing on an equal playing field.

The frames, and the people and institutions advancing them, vary widely in their influence and power. To illustrate this, it is helpful to draw upon Bourdieu’s concept of
field
,
a semiautonomous social space with its own rules such as the political, academic, artistic, and journalistic fields. People and institutions compete for distinction and influence within specific fields, based on that field’s rules and associated forms of capital. In addition to
economic capital
,
which refers to monetary resources, there is
symbolic capital,
which is based on honor, prestige, or recognition. Two specific forms of symbolic capital include
social capital
,
or the actual or potential resources linked to social networks, and
cultural capital
,
the knowledge, skills (including “soft skills”), and education that give a person advantages in a given society. 5 Specific institutions, groups, and individuals vary in the amount and kind of capital they possess, providing incentives either to shore up or to challenge the rules governing who has influence and power within a field. For instance, when U.S. civil rights and women’s groups challenged the role of “old boys’ networks” to confer status and privilege, they contested the legitimacy of a specific form of social capital that favors white men and disadvantages women and ethnic minorities.

Building on Bourdieu’s concept of field, we can conceptualize a
fat field,
in which the meaning of fat is contested. Organized around a topic, rather than a single institution, a fat field can nonetheless be conceptualized as a semiautonomous field with its own rules and forms of relevant capital.
Below, is a visual representation of some of the key players in the fat field, mapped on a matrix, in which the y-axis represents the volume of capital possessed by each institution, company, industry, or group of individuals and the x-axis shows the relative balance between cultural and economic power or capital. In a traditional matrix analysis, the position of actors would be determined based on careful calculations of actual capital. 6 In contrast, the figure below should be taken as sensitizing, rather than as empirically exact. It provides a visual representation of the relative power of key interest groups that is grounded in my knowledge of how these different groups vary by their economic and cultural capital. In the interest of simplicity and readability, this figure only shows a few key players who feature prominently in this chapter and makes no claims to be exhaustive.
Those higher on the vertical axis possess more capital of any kind. Those further to the left possess a greater proportion of symbolic, compared to economic, capital. In contrast, those further to the right possess a greater proportion of economic, relative to symbolic, capital.

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