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In the last few weeks I have had to deal with size bias from the medical community and I have read some really hurtful comments on other sites where plus size women are choosing to be seen in public and I have considered many different ways to respond to all this discrimination, so for now the first step lies with posting final paper from my University Writing Class at Columbia.
Everyone who attends Columbia has to take this class and it help students to write academic papers, but it can also direct students find their voice and what they are passion about in life. As much as I desire to work with women who have come from domestic violence, I am feeling more and more compelled to take up this discrimination that is prevalent throughout society and always falls under the guise of "I am looking out for their health," which is ridiculous.
Within a few days I will have thyroid surgery due to two very large goiters that have formed on my thyroid that is pushing on my voicebox and my esophagus. I have a team of doctors who have spent years and years to become specialized in their field and they don't even have all the answers to why this formed or why my weight is where it is at, other than it has to do with my health. If my team of doctors is doing research, what makes you, the general public, the armchair quarterback of health tells me that you are slighting me just by looking at my size? What can you tell from my size? My blood pressure? My blood sugar? My blood work? Anything other than I am larger than normal. As the reader looks at the stats that I use in my paper, I can tell you that if any other group had to face the same stats there would be an outcry about discrimination, but size bias is the last righteous discrimination that is allowed in society, and it's too bad, because people have forgotten what they learned in elementary school that they shouldn't judge a book by its cover. Shaming doesn't work, period.
Moralizing
Obesity: Does Shaming Really Work?
I
am not sure if I can put into words how excited I was when I found out that I
was accepted to Columbia School of General Studies. Taking this great leap of
faith and moving to the New York City area, I knew that I would have to adjust
to a completely different lifestyle compared to living in a small town north of
Denver, Colorado; nevertheless, I was up for the challenge. I had made mental
notes of things people had told me who had once lived in New York City. I
anticipated the noise, the crowds, and learning to use public transportation.
One thing that I did not count on was how isolated I felt even when I was on a
bus filled with people. The isolation was not from not knowing anyone, but
because I am overweight. Numerous times in the last few months I have had a
seat open and people have refused to sit by me, many have chosen to stand. Here
I thought The Big Apple accepts everyone who comes, but I have learned
otherwise. If you are overweight, you are shunned. Once, while on a bus, I had
to stand and the bottom of my coat touched her arm, she responded as if a swarm
of flies had attacked her. I was mortified that I had caused that much
discomfort to the lady, I had to stand there and watch her over react
throughout the bus ride. There have been times that I have wanted to ask these
people who chose not to sit next to me “Are you afraid that you will catch
whatever makes me fat? I promise you, it is not like a cold, you cannot catch
it.”
I
really thought that coming out to New York City, I would not experience so much
discrimination as I did while living in the Denver area where I experienced
hostility and repulsive reactions when it came to my health care which has
caused me to delay health care rather than face more discrimination. With a
population that makes it one of the largest cities in our country, I
believed that I would blend in with the crowds; however, I was surprised how I
stood out in my alienation and isolation. How is it that in 2013, when
everything is pretty much accepted in society, people who are overweight or
obese are still judged with biased attitudes; why has this discrimination been
allowed to persist? Obesity is the last form of discrimination that society
deems acceptable and it is pervasive, it impacts every facet of the lives of those
who are overweight or obese. In their article “Bias, Discrimination, and
Obesity,” Rebecca Puhl and Kelly Brownell state, “Discrimination is harmful to
its victims in many ways and can have enduring effects. With 54% of U. S.
population … now overweight and 34% obese with the prevalence still increasing
in the United States…” (788). If half of the population is considered
overweight what motivates so many people to be so cruel and judgmental? With
statistics like this, one can see that shaming, blaming, and punishing people,
thinly disguised as helpful advice to those who struggle with their weight does
not work; instead it causes more harm.
Moralizing
Obesity
Many
have looked at the motivating factors of what a society deems as moral or
right. Steven Pinker calls it “The Moral Instinct” where a person, or
collectively a society, deems what is morally right and what would be
considered a preference (34). The action or non-action is only one part of the
equation, the motivation behind why someone does something or does not do
something is the other part of the equation. Pinker defines moralization as, “a
psychological state that can be turned on and off like a switch, and when it is
on, a distinctive mind-set commandeers our thinking” (34). An analogy of looking at different motivations
and responses could be using reclaimed wood in a renovation: the motivation for
one family to use reclaimed wood is purely aesthetics which the wood gives to
the room. Whereas the other family uses it to show their children the
importance of using discarded wood for flooring since many forests have been
decimated by commercial logging. How
each family views the reclaimed wood would vary according to how they perceive the
value of it. The “morality switch” happens on a different level for each
family. One of the “universal moral spheres” that Pinker discusses in his
article is diet, or what people eat (55). When looking at different degrees of moralization
one can see that it is not the only law that governs a society but also peoples
personal preferences. There can be a strong punitive response in our society, regardless of the degree of moralization.
Furthermore
in their article, “The CAD Triad
Hypothesis: A Mapping Between Three Moral Emotions (Contempt, Anger, Disgust,)
and Three Moral Codes (Community Autonomy, Divinity)” Paul Rozin, Laura
Lowery, Jonathan Haidt ,and Sumino Imada state, “ individuals react emotionally
to violations, and these reactions often have long-term effects on social
relationships between violators and third parties” (574). Rozin et al. came up
with the CAD Triad which draws connections between certain emotions and their
correlations to morality (574). They categorize them into different groups that
all interact with moral judgments, but some are turned inward such as shame,
embarrassment and guilt, which they named the “self-conscious emotions” (574).
When people display these emotions it shows that they want to be included and
work towards not hurting others (Rozin et al. 574). It is the “hostility triad,”
the contempt, anger, and disgust, these emotions are linked to “other-critical”
people show these feelings when they feel superior to others in their society (Rozin
et al. 575). The group conducted
some experiments that combined American and Japanese undergraduate students,
and the students placed these emotions in correlation to community, autonomy,
and divinity (Rozin et al. 576). Rozin
et al. saw how anger was connected to autonomy or how it infringed on
individual rights (Rozin et al. 575). Contempt was connected to community and a
hierarchy of social status, and disgust was linked to divinity where this dealt
with bodily functions (Rozin et al. 575). Though there were different ethics
shown in individual rights, there was significant evidence to show communal
ethics that cross different cultures (Rozin et al. 585). Demonstration of
social structures for each society may be different, but the standards appear
the same.
When
looking at the causes that made obesity in society a moral issue, one does not
have to look too far. In her article, “Weighing Health: The Moral Burden of
Obesity”, Annemarie Jutmel looks at the chronological timeline and attitudes
towards obesity. Jutmel states, “In the early twentieth century, Wood and
Rudduck (1923) identified the slender woman as the ‘type of woman that men
should shun when choosing a life companion’” (113). Jutmel goes on to describe
the ideal woman as “sturdy,” the woman’s description however was not based upon
weight, but health (113). She compares what doctors recommended in the 1930s to
today’s standard, which is much stricter and does not allow as much weight
(114). With this in mind Jutmel states, “According to the World Health Organisation
[Sic] (2003), obesity is an epidemic of international proportions, and
overweight is now identified as a disease entity rather than a statistical
observation” (114). Changing the BMI standard, which is weight divided by
height squared and the World Health Organization declaring it as a disease,
based solely upon weight and no other health indicators contributes to how
society sees overweight people. Since the vast majority of society uses what
they see as the determining factor to judge something as “normal” or healthy it
is very easy to assume that if someone is overweight, they must not be healthy
and/or not given over to self-improvement-which can lead to virtue (119). All
of the reasoning, emotions, and judgments come from the first impression, and
yet we forget the old adage our parents and teachers taught us “don’t judge a
book by its cover.”
The
Stigma and Shame
The
prevalence of biased attitudes and the stigma with obesity includes family,
friends, public places, schools, employment, health care, renting apartments,
the court system, shopping, dining out, and of course, strangers (Puhl and
Brownell 788). They found that “28% of
teachers in one study said becoming obese is the worst thing that can happen to
a person; 24% of nurses said they are
“repulsed” by obese persons…” (788). When it came to physicians, there was a
stronger bias towards obese patients. Puhl and Brownell’s study showed that of over
400 physicians questioned, “87% believed that obese persons are indulgent, 74%
believed that they had family problems, and 32% believed that they lacked will
power” (792). When it came to children
and teens in school the statistics are heartbreaking, Puhl and Brownell state,
“Many fat kids exist on a diet of
shame and self-hatred fed to them by their teachers” (797). They also
found that, “91% of the overweight children felt ashamed of being fat, 90%
believed that teasing and humiliation from peers would stop if they lost
weight…” (796). Examining these attitudes demonstrated towards children that
are considered obese makes one pause to really consider what it must be like
for those children throughout the school year. Where do they find shelter from the barrage of criticism and hatred?
In
higher education the rates are not as high as in elementary and high school,
nevertheless the statistics show that “obese students were significantly less
likely to be accepted to college despite having equivalent application rates
and academic performance to non-obese peers” (Puhl and Brownell 796). Once an
obese person has employment they suffer lower wages, not as many promotions and
some have even been fired because of their weight (Puhl and Brownell 790). If this is how professional feel about obese
people, then how does the general public view obese people?
In
his article, “Disgust and perceived control in attitudes toward obese people,”
LR Vartanian defines stigma as, “an attribute that is undesirable or devalued
in a particular social context” (1302). Vartanian goes on to say that, “Weight bias exists despite the fact that
rates of overweight and obesity have increased dramatically over the past three
decades, making larger body sizes more normative” (1302). This clearly shows
that even though we have larger people today, society still sees being
overweight as being disgusting and controllable in every instance, so if people
had better self-control then they would not be overweight. The Vartanian’s study looked at what motivating factors caused the disgust the public held
towards obese people (1303). The main correlation was the belief that obese
people had control over their weight and have chosen not to do anything about
it (1303). When looking at different groups that are stigmatized today, obese
people did not fare so well. Vartanian states, “For judgments of personal
control, obese people were rated as having more control over their group
membership than did women, homosexuals, and welfare recipients, for example,
but less personal than smokers, drug addicts, and religious people” (1304). There
is no doubt that the public has moralized obesity in such a way that it is not
just how much harm can be caused by weight, but rather that there is much
condemnation associated with simply weighing more. This is not to say that there should be no consideration for
the health benefits that can come with being thinner, but the way our society
is treating the obese does not drive them to eat less, but to remove themselves
from society as much as possible.
This
leads to the emotional harm that is caused by the public’s disgust and outright
prejudice that is exhibited on a daily basis for obese people. ‘In their article, “Weight Stigmatization and
Ideological Beliefs: Relation to Psychological Functioning in Obese Adults”
Kelli Friedman, Simona Reichmann, Philip Costanzo, Arnaldo Zelli, Jamile
Ashmore, and Gerad Musante look at psychological toll that obese people face in
everyday life and what they found is that obese people are, “characterized by
others as ugly, stupid, mean, sloppy, lazy, dishonest, worried, sad,
self-indulgent, unlikable, and emotionally impaired” (907). Conversely Friedman
et al. discovered in their findings that 71% of the ninety-three participants
had a college degree and 70% were employed (908). The public perception that
obese people are lazy or stupid is unfounded yet these negative judgments,
place them at the bottom of the social structure where indifference and
alienation cohabitate with people who are heavy (Rozin et al. 575).
Living
in a community where there is a continual climate of criticism damages the
self-esteem of the obese person. In their
article, “The Influence of One’s Own Body Weight On Implicit and Explicit
Anti-Fat Bias” Marlene Schwarta, Lenny Vartanian, Brian Nosek, and Kelly
Brownell found in their studies that included participants that were under
weight to extremely obese showed that, “15% of [participants] reported that
they would be willing to give up 10 years or more of their life to not be
overweight or obese. In addition, 30% of respondents reported they would rather
be divorced than obese, 25% reported they would rather be unable to have
children than be obese, 15% reported that they would rather be severely
depressed, and 14% reported that they would rather be an alcoholic” (444). It
is mind numbing that people are willing, if they had a chance to trade years of
their lives, limit their family, or choose an addiction rather than be obese. The
public and private sector has made such an impression on the obese person, one
would think, to solve the problem just lose the weight!
It
is important to understand what the government deems as overweight and obese. Taking
an example a person who is five-foot five inches and weighs 150 pounds is
considered overweight with a BMI of 25 according to the National Heart, Lung,
and Blood Institute’s website and if
that same person weight 180 pounds then they are considered obese with a BMI
of 30,(“NHLBI, Obesity Guidelines”). Many
maybe surprised by these guidelines. Nevertheless, according to the article
“Attempting to Lose Weight” Judy Kruger, Debora Gaulusk, Mary Serdula, and
Debora Jones state that, “The current national preoccupation with weight loss
and dieting is demonstrated by the fact that American now spend $33 billion
annually on related products and services” (402). Though, Linda Bacon and Lucy
Aphramor state in their article, “Weight Science: Evaluation the Evidence for a
Paradigm Shift” that, it is close to $58.6 billion that Americans spend on
weight loss (1). In addition Kruger et al. found in their study that, “31% of
U.S. adult were currently trying to lose weight” (Kruger et al. 404).
There
are considerable differences in the statistics comparing men and women in their
weight loss and discrimination on the job concerning obesity. There is a gender
gap which shows that almost 40% of women have tried to lose weight; whereas
close to 25% of men have tried to lose weight (Kruger et al 403). Puhl and
Brownell also saw that obese women were punished more when it came to
employment through less wages and lack of promotions, however obese men do not
get penalized with their wages as much (790). That may be one of the motivating
factors in why women are more likely to try to lose weight than men, since they
experience a greater degree of discrimination, but women also have a greater
since of negative body images. Women are also more likely to try multiple
approaches to losing weight in comparison to men that include: exercise, lower
the calorie consumption, diet pills, fasting and taking laxatives (Kruger et al
404). Kruger et al. found one of the main problems associated with not losing
weight, being a lack of success (404). Americans are spending billions of
dollars are trying to find a solution; so maybe it is not as easy as it looks
when losing weight.
No
One is Exempt from Fat Shaming
People who have
careers that are in the media not only deal with “Hollywood’s” version of what
a beauty looks like, but face scorn and cruelty on a public level. In his
article, “The Cricket: A critic’s fat jokes aren’t funny or unique” Sean Means
calls fellow film critic from the New
York Observer, Rex Reed a jerk for calling Melissa McCarthy, comedian and
actress ”tractor sized” and a “female hippo” while critiquing her latest movie.
Many came out in support of McCarthy, including her cousin Jenny McCarthy.
After the backlash, Reed stated that he was trying to bring “awareness to
obesity” (The Cricket:). Once again the superior mentality of one person who
does not even have the star power that Melissa McCarthy does, feels the need to
express his “concern” about obesity? Reed when on to say, “The real problem is
that his attitude toward McCarthy—and most overweight people—is not an
aberration. It’s [a] standard for many of the people who decide how movies get
made in Hollywood” (The Cricket:). Outright bullying does not only occur on the
playground any longer.
However
JoNel Aleccia, from NBC News reports
how one female anchor in La Crosse, Wisconsin decided to take on her
email bullying viewer who wrote that she was too fat to be on TV and not a good
role model (Too fat for TV?). Aleccia quotes Livingston and went on air with her
reply to Kenneth Krause, who sent the email, “You can call me fat, and yes, even
obese on a doctor’s chart” she
said—but then she lashed out at the viewer for contributing to a culture of
bad-mouthing and bullying” (Too fat for TV?). Livingston has received
tons of support for encouraging children not to be bullied. Livingston ended
her response with these words, “…the cruel words of one are nothing compared to
the shouts of many” (Too fat for TV?). Livingston made it clear that she never
mentioned that young girls should follow in her footsteps when it comes to her
body size (Too fat for TV?). Once again, here is someone who feels superior and
does not back down when he is interviewed by the press; he even offers
Livingston some pointers if she wants to lose weight (Too fat for TV?). There are
two issues at hand, one that being slender equates to being healthy, which has
not been proven and secondly, using shame as a motivation tool does not work;
if anything it only makes the problems worse. When has shaming anyone worked?
Is
Anyone Trying to Make a Difference?
One company is trying to make a
difference, Dove, Inc. In her article, “Performing Beauty: Dove’s “Real Beauty”
Campaign” Jennifer Millard discusses what western society deems as beautiful
and how Dove is trying to bring in “realism” by using women of all ages and
sizes to advertise their products (148).
Millard states that Dove realized they need to do something, “after commissioning
a global report on beauty found that of the 3,200 women surveyed from ten
countries only 2 percent considered themselves beautiful (Ectocff et al. 2004)”
(147). In a society where beauty is so desirable and even looked at as
powerful, this statistic reflects the culmination of societal pressure,
advertising, and what a negative self-worth can do to women. Dove decided they
did not like that statistic and chose a very daring campaign, to use “normal”
women, who are not models and to not retouch the pictures (Millard 148). Millard writes, “Supporters congratulate Dove
for promoting broader definitions of beauty (Neff 2004), growing its brand in a
positive way (Prior 2004), putting older and bigger women in the spotlight…”
(148). The response has been very encouraging, they even won two awards for the
campaign. Millard interviewed different women who looked at the Dove Campaign
and some of the responses were quite candid. One young mom who was trying to
lose her baby weight stated, “The Dove model,
who is carrying more than fifteen extra pounds, helps Tanya feel better about
the way she looks” (157). Seeing others out there they can look at their bodies
and see beauty and not just the extra lines or weight. In fact PRNewswire
website shows that “When girls feel bad about their looks more than 70 percent
age 15-17 avoid normal daily activities such as attending school, going to the
doctor, or even giving their opinion” (Negative Feelings About Their Looks). In
their report about the Dove Campaign they state, “More than 50 percent of women
strongly wish that the next generation learns to eat healthily instead of
dieting” (Negative Feelings About Their Looks). So where do we go from here?
What
does healthy look like?
Throughout
this paper, it has been demonstrated that shaming, humiliation, isolating, and
judging people merely on the basis of weight alone is not only wrong, but
harmful. The physiological effects that it causes from children through
adulthood have greater implications than a BMI number that is too high. That
being said, children with Type II diabetes and high blood pressure need to be
treated and if weight is a part of the problem it cannot be singled out,
instead encouraging healthy eating and behaviors will have a greater impact
than just the number on the scales. Bacon and Aphamor state:
Concern
has arisen that this weight focused paradigm is not only ineffective at
producing thinner, healthier bodies, but also damaging, contributing to food
and body preoccupation, repeated cycles of weight loss and regain, distraction
from other personal health goals and wider health determinants, reduced
self-esteem, eating disorders, other health decrement, and weight stigmatization
and discrimination. (1)
Bacon
and Aphramor discuss the benefits of a “Trans-disciplinary movement called
Health at Every Size” (HAES) (1). This program works with all eating disorders
and is designed to promote healthy behaviors where weight loss is not the
determining factor (1). In fact, they go on to state that research shows,
“one-third to two thirds of the weight is regained within one year [after
weight loss], and almost all is regained within five years” (Bacon and Aphramor
5). Just reducing calorie intake alone does guarantee long lasting results when
it comes to weight loss. HAES offers three distinct ways that addresses health
rather than weight: “1) encourages body acceptance as opposed to weight loss or
weight maintenance; 2) supports reliance on internal regulatory processes, such
as hunger and satiety, as opposed to encouraging cognitively-imposed dietary
restriction; and 3) supports active embodiment as opposed to encouraging
structured exercise” (Bacon and Aphramor 6). This is a completely different way
of looking at food, especially for people who have dieted throughout the years.
People learn about nutrition, comfort eating, appetite, and the difference
between immediate satiety and delayed gratification (Bacon and Aphramor 7).
People also learn how to incorporate activity into their daily lives which they
enjoy, as well as relaxation, art, and volunteering which aid in the
psychological empowerment of obese people (Bacon and Aphramor 8). Finally,
those in the healthcare business need to realize that aiding the chronic stress
that obese people deal with on a daily basis not only inhibits weight loss, but
has been linked to hypertension, diabetes, and heart disease (Bacon and
Aphramor 8). However, having a positive body image has shown to lower weight and
other health issues (Bacon and Aphramor 6). The focus must change from looking
at the scales or BMI profiling to looking at the whole person, their socioeconomic
situation, activity level, depression, and other illnesses or medicines that
could be contributing to their overall health. For Bacon and Aphramor state,
“if shame were effective motivation there wouldn’t be many fat people” (7).
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