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)