Archive for May 8th, 2012

May 8, 2012

the HAES files: Stereotype Management Skills for HBO Viewers

by Health At Every Size® Blog

by Deb Burgard, PhD

I don’t know what HBO’s series, The Weight of the Nation*, is going to say, but if the previews are representative, you might want to use this handy “viewers’ guide” to conserving sanity points.

Critical Thinking Skills 101

The main flaw in the traditional view is to think that if an event happens in the life of fat people, it is because they are fat.  All of us are trained to think this way, but there are some questions to ask that can help reverse the brainwashing:

“Does this happen to thin people too?

  • I eat too much.
  • My doctor tells me I have diabetes.
  • That person I was attracted to rejected me.
  • I can’t get down on the floor and play with my grandchildren.

Fat is blamed for almost anything negative that happens in life.  But thin people don’t have their fatness to blame, so when those same things happen to them, they have a whole universe of possible solutions.  Those same solutions should be available to fat people – why would we think the only solution is to turn them into thin people?

There is a version of blaming fat where the very presence of fat people in society is enough to blame them for the society’s problem.  The question to ask here is,

“If everyone was thin, would we still have this social problem?

  • There are problems with the way we produce food, and inequities in how we distribute food.
  • We are living in an environmentally unsustainable way.
  • We don’t have a functional healthcare system.
  • The baby boomers are a big demographic group who are living longer and will cost more in their final phase of life.
  • Our schools are struggling to feed, educate, and exercise our children with too few resources.
  • The demands of making a living leave little time for caring for ourselves and each other.

Blaming fatness keeps us from addressing the root causes of our problems, and is clearly unfair to fat people.  Many powerful people understand this, but find it expedient to frame a problem in terms of fat in order to bring attention to it.  They don’t think people will just attend to the real issue unless they whip up the fat panic.  Whether it is being pessimistic that people will exercise if it is not in the context of a weight-loss effort, or being pessimistic that people will care about our food environment if it is not in the context of a moral panic about fatness, the justification for whipping up the fat hatred is the same.  I say, have the courage to make your argument about the real issues and stop doing it on the backs of fat people.

Arm Yourself with the Facts

Here are some other key facts to keep in mind while you are watching:

  • The “epidemic” refers to a rise of 10-15 pounds in the average weight of US adults between 1980 and 1999.  The rise was over before most of the “obesity epidemic” rhetoric began.
  • The pictures illustrating “two-thirds of US adults are overweight or obese” are almost universally of people who represent less than 1% of the population.  People at a BMI over 50 are so rare that the CDC cannot estimate their actual prevalence in the population.  The photo that would actually represent the headline would be of someone the size of Will Smith or Tom Cruise.
  • We can re-cast public health authorities’ notion that we are “in denial” about our fat as their complaint that we are not buying into the BMI categories, which is actually a triumph of common sense, since BMI is such a lousy proxy for health, appearance, and even degree of actual fatness.  There is a fog of confusion around BMI—supposedly educated people seem to think that squaring, dividing, and converting to metric units adds more information than the height and weight data you started with.
  • The range of weights considered problematic in children was tripled in 2007 for no scientific reason, from the 95th percentile and up, to the 85th percentile and up.  This allows for dramatic statements like, “1 in 3 children in Georgia are overweight or obese,” even though pediatricians agree that even the 95th percentile and higher does not necessarily signify ill health.
  • Despite the alarm, Type II diabetes in children is so rare that the CDC has not been able to accurately estimate prevalence.  We need to focus on the lack of access to good medical care for many of these children and their families, rather than using them as poster children for public hate campaigns.

Challenging the Untested Assumption

The entire health argument for weight loss is based on a single untested assumption:

A weight-suppressed fat person has
the medical risk profile of a thin person.

Think about it.  There are no data for this, because there are so few weight-suppressed fat people who maintain weight suppression long enough to find out.  Instead, we have the illusion from medical data 6 months or a year into weight loss (which reverses with weight regain) that temporarily shows improved risk factors, like lower cholesterol or better fasting glucose levels.  If research was required to be at least 2-5 years in length, we would lose our illusion that weight loss is a solution, because neither weight loss nor health benefits last.

Fortunately, we have a more reliable way to obtain those improved medical outcomes for people who lose no weight but increase their movement levels or nutritional quality, and the physiological improvements last with the ongoing practices.

And if fat tissue loss was the key solution, why do we see no medical improvements with liposuction?

Follow the Money

When you are evaluating the claims made in the series, remember to follow the money.  Historically, every time the public appears to be getting hip to the fact that “diets don’t work,” there are massive responses from the weight cycling industry.  Their target this year is clearly communities of color and men, and their campaigns seek to shame people who are “in denial” about their weight.  One can picture the marketing execs around the table: “We got white women to hate their bodies – but we saturated that market long ago!”

Big pharma is constantly trying to create new markets, so making people who are not sick need treatment for “pre-diabetes” and “pre-hypertension” is a great money-maker.  The health insurance industry has always gotten away with discriminating against fat people and will politically get away with flouting the new healthcare law – should it survive – by charging higher premiums for the two-thirds of the country who are “overweight.”  My own profession of psychology is seeking to enshrine the current ineffective weight change interventions to make ourselves the “weight loss experts” who get the Medicare reimbursements.

All of these interests stand to lose billions of dollars if they tell the truth.  So remember, people are getting paid to hate you.

Stereotype/Stigma Management Skills

A worksheet for cultivating Stereotype Management Skills. (Please click on link at right for entire document.)

Critical thinking skills are all well and good, but there is another difficult aspect of public hate campaigns, which is of course, these are real people being obnoxious and mean to us.  We can be armed with all the facts in the world but the social reality is that it really sucks being the target of hate and bullying.  This handout provides a worksheet for cultivating Stereotype Management Skills.

When people are mean, we have to be especially careful not to blame our bodies. There is nothing about us or our bodies that deserves scorn or derision.  Take special care to honor your body and its wondrous capacities and gifts.  The problem lies outside of you and your body, with the bullies and the forces that benefit from fat hatred.

One of the most important things we can do when we are experiencing discrimination is to seek out our tribe.  This is the time to talk about what you are experiencing—in person, or on the listservs.  Also, ASDAH is preparing materials designed to help viewers understand and critique the rhetoric of WOTN documentary—to be posted soon. [Update: ASDAH’s response has now been posted: www.debatetheweight.com]

Time for a Party!

It looks like WOTN plans to hit all the major “obesity” memes, like, “this generation of children’s lifespans will be shorter than their parents,” “obesity will bankrupt our healthcare system,” and “by 2050 our entire country will be obese.”  We could not have a better opportunity to plan big parties and play Fat Hate Bingo!  HBO says we have to lose to win, but we say, all you have to lose is your hate.

* The Weight of the Nation (WOTN) is scheduled to air on HBO on May 14 & 15, 2012.

%d bloggers like this: