Wednesday, October 17, 2007

Is Fat a Moral Failure?

We tend to speak of obesity as an individual's moral failure--they eat too much, they don't exercise enough, they don't have enough self-control or willpower, they don't buy the right foods at the grocery store, they snack too often . . . ad infinitum. Now, of course it is up to the individual to make many of these choices. But constructing obesity as an individual, rather than as a social, issue makes it easy to abscond responsibility for bringing about change. For example, we could point to numerous other factors that influence obesity, such as:
  • lack of walkable cities and neighborhoods, which forces people to drive rather than walk
  • the cheapest food is often not the healthiest (due in part to government subsidies of certain commodities)
  • the diet industry, which often sells weight loss as something that should happen with no effort
  • terribly unhealthy and un-nourishing school lunches
  • availability of pop, junk food, and fast food at public schools
  • schools cutting recess and physical education
  • marketing of junk foods to children, especially via television
Looking at food issues this way, we can see how obesity is not just an individual problem, but a complex issue that has a lot of social and cultural influences, ones that we have the power to change.

I'm reading the book Conceiving Risk, Bearing Responsibility about the diagnosis of FAS. I ran across this passage that is relevant to our recent discussions about "blaming" overweight women for their pregnancy complications and also for the rise in cesarean rates.
The construction of the diagnosis of FAS reflects the emergence of an epidemiological paradigm emphasizing risk factors rooted in individual behaviors and predilections; indeed, it epitomizes our modern American tendency to locate explanations for disease at the individual—whether behavioral or biological—level rather than to see disease as the consequence of social conditions. Americans’ tendency to attribute social ills to individuals’ biology rather than to society mirrors our propensity to look for solutions to problems in medical technology, cures, treatments, and changes in individual behavior or “lifestyle.” Biologizing problems also individualizes them—taking them out of the realm of society and embedding them in the bodies of individual women, children, and men. This process of medicalization and subsequent desocialization is a powerful tool for maintaining the status quo, since it reinforces the belief that individual, not social, change is called for. (11)
Is is so much easier to blame the woman for her problems (and for the "rescuing" that she will need from herself) than to address the root causes of those problems. This is true not just for obesity-related pregnancy complications, but also for childbearing in general. From Ann Oakley's book Essays on Women, Medicine, and Health:
The fact that poverty is the biggest known risk to the health of mothers and babies is not something that most obstetricians wish to take on board....One of the biggest risk factors for the healthy survival of infants is the orientation on the part of many of the world’s governments to death—in the form or arms expenditure—rather than to life. (136)


  1. When I worked in the elementary school cafeteria last year as a lunchroom aide, I was horrified at what I saw. As I watched what those children ate on a daily basis it was as if I could see their futures played out in front of them, and it wasn't pretty. I wanted to run around with a trash can dumping all the junk into a trash can, and give them real food to eat, but of course that was impossible. Basically, I feel that culturally we are setting ourselves up for failure, and that is a very sad thing, for us and for our children.

    Thank you for this post, Rixa.

  2. How wonderful you should bring up this topic. I'm part of an organization (Health Students Taking Action Together -- HealthSTAT) and we had an anthropologist come in and speak on the topic of the evolution of the human diet. She actually said studies have been done which show babies actually learn tastes during gestation. If mom introduces a wide variety of foods while pregnant, as well as while breastfeeding, it will influence how open a child is to trying different foods. In essence, baby learns from mom what constitutes food very early on -- mom's poor food choices (for whatever reasons) could lead to the child's poor food choices later on. And I guess if mom doesn't breastfeed, that could also lead to a child making poor food decisions. It was a different spin on obesity, especially in children.

  3. Wow, I knew that some flavors came through breastmilk, but I had no idea that babies could learn different tastes prenatally! Did she give you any references to books or articles? I'd be really interested in reading about this.

  4. I've heard the same thing -- that what we eat flavors the amniotic fluid. I must've read it somewhere . .. I'll have to look through all my books.

  5. The points you make, and excellent ones they are, are all about *health*, which apply equally to all people, thin and fat. Why then is the question not, "Is lack of health a moral failure?" Fat is not synomous with ill health. Yet, even when fat people are healthy, the question is *still* "Is fat a moral failure?", but the underlying issues are no longer the ones you listed.

    I support health. I don't support the war on obesity. Rixa, I'd like to know what you think about The Obesity Myth and similar books. Also this. And this.

  6. Agreed, Linda. I was using obesity as a jumping point--that's why I chose the title. But yes, it's so true, unfortunately, that we equate being overweight with being unhealthy. And while some larger people are in poor health, there are lots of skinny & unhealthy people too!

    Our assumptions about body type and health stem largely from socioeconomic markers. When healthy, abundant food was only something that the upper and middle classes could afford, the idealized body (especially female) was plump and well-rounded. As food became less expensive relative to income, wealth become more synonymous with thinness. Of course this is a big generalization but I'd hazard that it's not too far off for Western countries.

    Thanks for those to read!

  7. We often run into the issue that healthy food is more expensive. We can barely afford groceries, since my husband is still finishing college and I am mostly staying at home with the baby. It's so frustrating how expensive organic food, or foods that are made of whole ingredients can be. It's hard not to buy the high fructose corn syrup, hydrogenated oil, dye-filled foods when they are always the cheapest. My husband and I discuss this all the time--no wonder so many people in our country (fat or skinny) are in poor health. We know many, many people who drown themselves in diet Coke and fill their kids with nothing but pop-tarts and Chef Boyardee because they don't know any better. Even healthy food, like yogurt, is made of HFCS and dyes at the regular grocery...It's almost like our food industry is poisoning us. But not many people seem to notice or care. They medicate their hyperactive children, give steroids and creams for their eczema, and fill them with antibiotics when they are constantly ill. I marvel over the thought that if we only had whole, chemical-free foods widely available our entire society would be much more happy and healthy.

  8. Yes, the cost of organic food is quite high. Plus I live in an area where it simply isn't available in stores, unless I drive at least 40 minutes each way and then spend way too much money. I buy a lot of bulk foods, many through a whole/organic foods buying group that I belong to. (It's through United Natural Foods, which is the distributor to most natural/organic/health food stores in the US). All of my dry goods staples I get in bulk and either put in dry pack cans or in sealed Mylar pouches so they will keep long-term. You can also put dry goods in 5 gallon plastic food-grade buckets, add an oxygen absorber, and seal the lid shut. Or in any PETE plastic bottle, glass jar that has a rubber seal on the metal lid such as spaghetti sauce jars, etc.(Hint: you can get 5 gallon buckets at Walmart for free: go to the cake decorating dept and ask for their empty frosting buckets).

    My mom gave me a wheat grinder several years ago, so I grind my own wheat for making bread. I've started buying meat in bulk: right now I am working through 1/4 cow and 1/2 lamb that are in my freezer. It requires some investment upfront, but the overall price per pound is generally much less than you'd pay in stores.

    Anyway growing your own food is a way to really reduce expenses in the summer. I really would like to have a garden but we're always gone overseas working during the summer, so I've had to put that off. And of course you need a place to grow things, which doesn't apply to apartment dwellers!

    I have found a creative way to get organic produce inexpensively: I am the pick-up person for an organic CSA. I drive out to the farm (8 miles away), pick up the shares of everyone who lives in my town, and organize it all on my front porch every week. Local CSA members then pick up the food from my house later in the afternoon. In exchange, my share was 1/2 price (normal price is around $380 for 6 months of veggies). Even better, for the 3 months that I was gone over the summer (there is another pick-up person in town, and we switch off) someone else bought my share, so I ended up with almost entirely free food, in exchange for picking up the vegetables once a week! Not bad!

  9. I loved the idea of a CSA, but the one we joined this summer was a TOTAL waste of money. Arrggh! We will have to figure out a better way next year because I am certainly not going through that person again next year.

  10. That's too bad your CSA wasn't a good experience. What did you not like about it?


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