Obesity: A New Bias that Doesn't Measure Up
To Begin
In the pride of social progress, it is easy to overlook the forms of discrimination based on physical appearance that still linger with us today. Over two hundred years have passed since our nations’ founding. Over these centuries, American has witnessed the evolution of cherished ideals such as “freedom” and “equality” within our nation’s social context. Rights have been expanded across different skin colors and genders. Tolerance has slowly but surely crept into the places where the shadows of prejudice once loomed. We have become increasingly accepting of the wide spectrum of variety human life comes in: the myriad of religions, ethnicities, sexual preferences and political beliefs that color our diversity.
Stigmas related to weight are tolerated in current American society to the point we are hardly aware of them. Children grow up with indexes of derogatory nicknames: chubby, fat-so, piggie, pudgey… the list goes on and on, depending upon the creativity of the child. Fat people are the punch line of physical comedy— just turn on any episode of America’s Funniest Videos. When you are in line for food, you make assumptions regardless if the person in front of you orders the same exact thing you have on your tray. If he are larger, suddenly their choice of a supersized McFlurry seems a little easier to judge. Of course he would ask for extra m&ms on top.
When does stigma cross the line of comedy and become a deeply detrimental prejudice?
Or perhaps it is already there?
When does stigma cross the line of comedy and become a deeply detrimental prejudice?
Or perhaps it is already there?
This anti-obesity attitude is evident across the globe, even where heavier figures were once symbols of beauty and wealth. There is a battle of prejudice without and within our own borders, and it is not without its casualties. Public prejudices make us uncomfortable; professional prejudices hurt our livelihoods. Discrimination can affect employment, legal rights, and even a person’s medical care. This all-to-tolerated discrimination against obese people needs to be addressed and legally curtailed before the consequences in people's medical and professional lives become any more severe. The side effects of this malignant discrimination are real and deadly. they are so devastating, perhaps, because this anti-obesity mindset so widely tolerated here in America.
The Problem
Anti–Obese discrimination is not limited to the American public. The New York Time’s recently published a front-page article entitled “Fat Stigma is Spreading Around the Globe, Study Says.” This report detailed how Dr. Alexandra Brewis, executive director of the school of Human Evolution and Social Change at Arizona State University and her colleagues studied 700 people from 10 countries (including America, Tanzania, Mexico, and England among others). Using true-false questions, they surveyed the acceptance of statements such as “People are overweight because they are just lazy” and “Some people are fated to be obese” (Parker-Pope). To Brewis’s surprise, these responses were strong not only in westernized countries, but all over the globe.
“Stigma is serious,” said Stephen McGarvey, a professor of community health at Brown University. It declares that obese people are personal failures, slaves to their lack of will power. Public health campaigns in many countries target the individual, rather than acknowledging that obesity can be a product of socioeconomic status (Parker-Pope). McGarvey noted that sometimes the medical industry can do more hurt than help, often creating negative images of obese patients in the name of curbing growing rates of diabetes and other weight-linked diseases.
These abstract biases can translate into medical practice discrimination. The Rudd Center for Food Policy and Obesity conducted a survey of 620 primary care doctors in the United States for a recent case study. They found that medical professionals, charged with the duty to help people take up the path to better health, openly described their obese patients as “awkward, unattractive, ugly and unlikely to comply with treatment” (Puhl). National Association to Advance Fat Acceptance, or NAAFA has conducted similar research. In a survey of 400 American doctors, they found “1 out of 3 listed obesity as a condition to which they respond negativity, ranked only behind drug addiction, alcoholism, and mental illness” and that “obesity was associated with noncompliance, hostility, dishonesty and poor hygiene.” The same resource sites that in a survey of 2,449 overweight and obese women (who frequently experience higher levels of bias than males of the same BMI), that 69% perceived the above biases from doctors. Another 52% said these incidents of palpable prejudge happened on a recurring basis (Puhl). These people are intensely aware of the biases society- and even their personal doctors- greet them with.
This view of obesity as a personal failure creates a positive feedback loop of poor mental and physical health. In the New York Times online article “For Obese People, Prejudice in Plain Sight,” Dr. Peter A. Muennig, assistant professor of Health Policy at Columbia University, explains “Stigma and prejudice are intensely stressful.” People who received bias from those they need to trust most, in this case professional doctors, are deeply affected. “Many fat people sidestep such judgments by simply avoiding doctor visits, whether for routine checkups, preventive screenings or urgent health problems” (Brown). The more severe a patient’s case of obesity- the more visible bias they receive. Yet these are the very people who need treatment and medical guidance the most. Doctors respect these patients less, and as a result the care they offer- in terms of time spent with the patient and information shared with them- generally decreases, says Dr. Mary Huizinga from John Hopkins School of Medicine (Brown). This creates a positive feedback loop- a cycle in which the stimulus reinforces a result that feeds back into the original stimulus. Here, the stress fat stigma causes obese people reinforce the unhealthy behaviors that influence obesity.
The Plan
There are many values to be considered in the construction of an effective policy that will combat weight-based discrimination. The previously mentioned organization NAAFA supports the mission principles of the Health at Every Size policy (referred to in short as HAES). This policy’s goal shifts the evaluation of health from the focus on an individual’s weight, and instead to their overall physical, mental, and emotional health. These categories of health and happiness, NAAFA states, are vital for a person of any body shape or size.
The General Principles of HAES are verbatim, as follows: “accepting and respecting the diversity of body shapes and sizes; recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional and intellectual aspects; promoting all aspects of health and wellbeing for people of all sizes; promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite and pleasure; promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss” (NAAFA.org). The National Association to Advance Fat Acceptance isn’t arguing that weight should be overlooked in the treatment of obesity, but that it shouldn’t be the only facet of a patient’s welfare that doctors evaluate.
The NAAFA also provides a “Health Care Bill of Rights,” that first and foremost cites the right to “have a policy in the health care system against discriminating practice base on weight, size or health status.” A policy that adheres to the values asserted by HAES and fulfills the specifications dictated in the NAAFA Bill of Rights Article One should be implemented into medical care legislation. Weight should not be the only part of a patient’s health assessed at a check-up, nor should it prevent them from getting the medical care required for that individual’s unique health circumstances.
Like other anti-discrimination policies that prevent biases on the basis of race, age or sex, it should be implemented on a national level by the Congressional branch of our government. All medical professionals should be required to abide by a code stating their perceptions of a patient on the bias of weight will not affect their treatment of said patient. It should be as integral a part of their professional mindset as the Hippocratic Oath. Such a policy ensures formal legislature protection against discrimination for obese patients.
The Practicality and Advantages
As a country, we already have measures in place to prevent discrimination on other facets of personal appearance, such as gender, age, and race. Decades ago, we fought prejudices that stated a person’s worth was reflected by the color of the skin. Laws, such as the series of Civil Rights Acts based between 1961 and 1964 prevented that ethnocentric stigma from translating into professional practices and social behavior. Similarly, ageism has been tackled by legislation such as the Age Discrimination Act of 1975, and sexism has been battled by documents as recent as Lilly Ledbetter Fair Pay Act of 2009. Yet to date, “no federal legislation protects the civil rights of fat workers, and only one state, Michigan, bans discrimination on the basis of weight” (Brown).
Michigan’s Elliot-Larsen Civil Rights Act of 1976 was the first piece of legislation to take strides against weight discrimination. It includes height and weight in the list of factors (such as gender, age, marital status, color and nation of origin) that cannot be used to disqualify an individual from hiring or promotion (Act 453 of 1976). This Act was implemented over thirty-five years ago, and yet no other state has followed Michigan’s effective and progressive model. The Act has been used with increasing frequency against employers who make it a company initiative to target ‘unhealthy behaviors’ and those who practice them within the workplace (e.i. excessive weight and weight gain) (Egan). Outside Michigan, an obese person must turn to the U.S. Americans with Disabilities Act, under which obesity must be claimed as a physical disability to receive any legislative protection. The American Government, in short, has no protection against weight based prejudice in the medical or professional arenas (Egan).
All fights against discrimination are unfinished fights. Yet, codifying the disapproval of these biases has slowly but surely affected the social climate of our nation. By creating legislation that bars a certain prejudice, we start change in the social current— a certain tolerance for discrimination is in effect damned up. Not perfectly, but at least legally. This type of anti-discriminatory policy has historically acted as a foothold for fighting social prejudices, and a legal protective stronghold for those who have been victimized by prejudice in the past.
In Conclusion
You wouldn’t use the N***** word jokingly in public discuss; you wouldn’t objectify woman on a popular media source like the television or radio; you wouldn’t deny an elderly person medical care because of your reluctance to touch them- not without expecting at least some social or legal repercussions. It is time we extend this same level of protection and acceptance to obese citizens. No society is perfect, ours especially. Though founded on the principles of equality and freedom, the USA has often failed to attain these lofty ideals. But as a nation we have struggled towards them, and continue to struggle forth today.
Fat Stigma is real, global, and intensely hurtful. In its potency fat stigma is akin to racism and sexism. In its interference with health care it is downright deadly. The fact that a personal bias is affecting another’s personal health should not and cannot be tolerated within our society any longer. For these reasons and many others it is imperative that the popular tolerance of discriminating against overweight people be tackled on the legislative policy level. Weight can no longer be the only standard of health, as outlined by the NAAFA’s HAES initiative. Similarly, legal protection against discrimination based on any and all aspects of physical appearance needs to be put in place. The alternative— allowing our fellow citizens to suffer injustice based on physical appearance in silence— is no longer acceptable. It is time to square our shoulders and confront the obesity bias. As legislative policy emerges, hopefully a more accepting cultural mindset will as well.
Our current social attitude is over two hundred years in the making; we are still a work in progress. Let us not hesitate to take the next steps necessary to create a healthier social climate for everyone, regardless of shape and size.
Bibliography
Bacon, Linda. "Health At Everysize." NAAFA.org. National Association to Advance Fat Acceptance. Web. 11 Apr. 2011. <http://www.naafaonline.com/dev2/education/haes.html>.
Brown, Harriet. "For Obese People, Prejudice in Plain Sight." Editorial. New York Times. 15 Mar. 2010. Web. 05 Apr. 2011. <http://www.nytimes.com/2010/03/16/health/16essa.html?_r=1&scp=1&sq=for%20obese%20people,%20prejudice%20in%20plain%20sight&st=cse>.
Egan, Paul. "Bosses Want a Say in What We Weigh." Fett and Fields P.C.: Michigan Employment Law Attornies. The Detroit News, 8 Oct. 2006. Web. 15 Apr. 2011. <http://www.fettlaw.com/In-The-News/Bosses-want-a-say-in-what-we-weigh.shtml>.
"Elliot-Larsen Civil Rights Act: Act 453 of 1976." Michigan Legislature: Michigan Compiled Laws Complete Through PA 14 of 2011. Michigan Legislature, 2009. Web. 15 Apr. 2011. <http://www.legislature.mi.gov/%28S%28niw3egmsf4lcy4453yg1c055%29%29/mileg.aspx?page=getobject&objectname=mcl-act-453-of-1976&highlight=>.
"Health Care Bill of Rights." NAAFA.org. National Association to Advance Fat Acceptance, 2008. Web. <http://www.naafaonline.com/dev2/education/brochures/Healthcare_Bill_of_Rights--EDITED.pdf>.
Parker-Pope, Tara. "Fat Bias Worse for Women." Editorial. The New York Times. The New York Times, 31 Mar. 2008. Web. 14 Apr. 2011. <http://well.blogs.nytimes.com/2008/03/31/fat-bias-worse-for-women/>.
Parker-Pope, Tara. "Fat Stigma Is Fast Spreading Around the Globe." New York Times. 30 Mar. 2011. Web. 08 Apr. 2011. <http://feeds.nytimes.com/click.phdo?i=49fd60f9c84ff360bba3545c271540cf>.
Puhl. "Healthcare Issues." NAAFA.org. National Association to Advance Fat Acceptance, 2008. Web. 08 Apr. 2011. <http://www.naafaonline.com/dev2/the_issues/health.html>.
--------------------------------------------------------------------------------------------------------------------------------------
Obesity Essay: Revision Reflection
I really struggle with grammar and sentence structure in all my writing assignments. I poured over every draft of this one, weeding out errors that might distract the reader. I took care to really make sure my "small scale editing" made the essay clearer and better focused. Typos are truly my worst Achilles heel, and I did not want to loose the impact of my writing because of them.
I found that I really didn't like my conclusion after turning in my essay the first time around. So began my "large scale revisions." The conclusion was very redundant, and because of this I felt the ideas were worn out and flat. So I shifted several of the ideas in my action step into my conclusion and removed anything that seemed devoid of significance. I rearranged my sentences on pen and paper then tried them out in several new orders. In this final version, I feel the last few paragraphs are as effective as they have ever been.
I think the skills I have come to most value during this course and through the many drafts of this essay are my organizational ones. I've learned the importance of strong topic sentences as focal points for each paragraph. I've come to understand how essential transitions are for the flow of a piece. My last hurdle was adding in good tight theses- which I've found are a lot easier to construct in the middle of revision. At this point in the process my ideas were still malleable enough to be changed, but on the whole cohesive and coherent. I had to tighten up my ideas, and I feel my thesis reflects that now. This is my favorite essay, and after all the effort that went into it, I am proud to showcase it here.
