Summary:
Much has been written to explain the medical aspect of obesity but little attention has been paid to understanding the sociological aspect of the epidemic. This research attempts to understand the sociological aspect of obesity by examining the socio-cultural, gender, and psycho-social effects and includes the different perceptions of the epidemic as well as what is deemed acceptable in the society we live in.
Femi Ademuwagun Independent Research with Dr. Gray
05/17/05 Final Paper
The Sociological Aspect of Obesity
ABSTRACT
Much has been written to explain the medical aspect of obesity but little attention has been paid to understanding the sociological aspect of the epidemic. This research attempts to understand the sociological aspect of obesity by examining the socio-cultural, gender, and psycho-social effects and includes the different perceptions of the epidemic as well as what is deemed acceptable in the society we live in.
In the American culture, obesity is seen as a bodily abnormality and deviance that should be corrected. Obesity has indeed become one of the most stigmatizing bodily characteristics in our culture (Brink, 1994). In the Western culture, thinness does not just mean the size of the body, but it is associated with such qualities as being healthy, attractive and in control. In contrast, a fat body is viewed as a sign of poor health, inefficiency and lack of personal will (e.g. Kissling, 1991; Ogden, 1992; Cooper, 1998). Resent research has shown that the social stigma associated with obesity can have serious consequences for an obese individual via discrimination in central fields of life such as education, health care, and employment. In relation to gender, the stigma associated with been obese is not the same for men and women. Research has clearly shown that obesity is more stigmatizing for women and obese women are discriminated against more than men because of their weight (Puhl & Brownell, 2001).
The psychosocial aspect of obesity is often overlooked. The psychosocial issues associated with obesity are usually obvious and may often stem from discrimination (conscious and subconscious) against obese people. Researchers found that lowered self-esteem was associated with being overweight in girls as young as five (Millman, 1980). As a result of depression and low self-esteem, they look more and more towards food as a means of comfort.
Based on background information, a central hypothesis was developed that obesity is an ongoing, gendered and embodied cultural process that has harmful consequences for the obese individual (e.g. Harjunen, 2002&2003). The various social implications of obesity will be explored via interviews (with obese people or former obese people) conducted and the surveys taken of people in the Boston area.
Introduction
The purpose of this paper is to study the social aspect of obesity and an individual's personal experience of being fat. I understand obesity as a socially and politically meaningful divergence that is analogous to other significant differences based on the body, for example: disability, gender, and ethnicity (ef. Cooper, 1997&1998; Young, 1990). In my research, I approach obesity as a discursive category that is created, produced and reproduced through various social practices, such as: medicine and health care system, school, religion, and the media (e.g. Foucault, 1979).
I claim that in American culture, a thin body is held as the "original", normal body; whereas obesity is viewed as a 'temporary disruption' to the balance of the body. According to our cultural understanding, an obese body is viewed as being in the process of constant transformation. The idea of a permanently fat person is unacceptable and an obese body must be standardized and normalized. The goal is to transform and return the 'original body' through exercising, dieting, and surgery, etc. This is in stark contrast with reality, since obesity is becoming more widespread and an increasing number of people are permanently fat. In this paper, I will also discuss the experiences that obese people face on a day-day basis from the point of view of an embodied fat person as seen from the interviews conducted.
Statement of the Problem
According to the National Research Council, obesity is a chronic condition defined by an excess amount body fat or adipose tissue in relation to lean body mass (National Research Council, 1989). The amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits. Body fat distribution can be estimated by skinfold measures, waist-to-hip circumference ratios, or techniques such as ultrasound, computed tomography, or magnetic resonance imaging (Stunkard & Wadden, 1993). A certain amount of body fat is necessary for storing energy, heat insulation, shock absorption, and other functions. The normal amount of body fat (expressed as percentage of body fat) is between 25-30% in women and 18-23% in men. Women with over 30% body fat and men with over 25% body fat are considered obese.
Obesity is a complex, multi-factorial chronic disease involving environmental (social and cultural), genetic, physiologic, metabolic, behavioral and psychological components that has reached epidemic proportions in the United States. The statistics show an increased rate of obesity amongst Americans now than in the past and is evident in the youth stage. "In 1966, the average BMI for a 16-year-old boy was 21.3; in 2002, it was 24.1" (National Institution of Health, 2002, p. 10). For girls the same age, the average BMI increased from 21.9 to 24.0 over the same period (National Institution of Health, 2002). The chance of becoming obese also increases steadily with age for both men and women. In the last decade, all adult age groups in both genders have experienced an increase in obesity, as shown in Tables 1.
Table 1: Obesity (BMI ≥ 30)
MenWomen
Prevalence (%)Prevalence (%)
Age (Years)1988 to 19941999 to 20001988 to 19941999 to 2000
- to 3414.124.118.525.8
- to 4421.525.225.533.9
- to 5423.230.132.438.1
- to 6427.232.933.743.1
- to 7424.133.426.938.8
- and older13.220.419.225.1
Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002.
Another survey conducted also states that "In 1999-2000, an estimated 30% of U.S adults aged 20 years and older -- nearly 59 million people -- were obese, defined as having a body mass index (BMI) of 30 or more" (National Health and Nutrition Examination Survey, 1999&2000). Body mass index is the most commonly used method for calculating whether someone weigh too much. BMI is calculated by dividing a person's body weight in kilograms by their height in meters squared (weight [kg]/height [m]2). A BMI of 20-24 is considered healthy. An adult is overweight if their BMI is 25 or higher and obese at a BMI of 30. The National Health and Nutrition Survey also stated that an estimated 15% aged 6-19 years were overweight, defined as a body mass index for age and sex at or above the 95th percentile of the CDC growth charts. There are many factors that impact a person's health risk relative to their BMI such as a waist size, smoking, the types of foods someone eats regularly, exercise, and medical conditions associated with obesity including diabetes, high blood pressure, high cholesterol, and coronary heart disease.
The rate of obesity is yet increasing and a solution must be devised considering the fact that it is the 2nd most leading cause of death within the United States under Tobacco (McGinnis, 1993). Approximately 127 million adults in the U.S. are overweight, 60 million obese, and 9 million severely obese. The number of adults who are overweight or obese has continued to increase, as shown in Table 2.
Table 2
Increasing Prevalence (%) of Overweight, Obesity, and Morbidly Obesity
Amongst U.S. Adults
OverweightObesityMorbidly Obese
BMI≥25BMI ≥30BMI≥35
- -200264.530.54.7
- -199456232.9
- -19804614.4No Data
Source:CDC, National Center for Health Statistics, National Health and
Nutrition Examination Survey. Health, United States, 2003. Flegal et. Al JAMA. 2002; 288:1723-7.
According to the American Obesity Association, more than 60 percent of Americans who are overweight or obese, have a much higher risk of developing conditions such as high blood pressure, diabetes (type 2), heart disease, stroke, gallbladder disease and cancer of the breast, prostate and colon than people of healthy weight. There is many more health risks associated with being obese that can lead to death. Given this major problem of obesity, a solution must be devised as soon as possible to limit or combat the epidemic. Families, schools, work sites, health care providers, communities, and the media must work together to prevent and reduce obesity. This is accomplished by:
- Communication-- educating, motivating, and empowering decision makers at all levels to create healthier communities.
- Action--by helping Americans balance healthy eating with regular physical activity.
- Research and Evaluation--by improving the general public's understanding of the causes, prevention, and treatment of overweight and obesity.
In the past, no one has spoken out for people with obesity. The American Obesity Association (AOA) has been formed to address obesity as a public health concern and to remove the barriers to effective treatment through vigorous advocacy and education. The role of genetics in causing obesity is being explored for the development of future drug treatments that could specifically target certain genes. Surgery is currently the most effective treatment for morbid obesity resulting in significant weight loss and accompanying health improvements. However, as the American Obesity Association pointed out, obese people experience the most disturbing type of discrimination within the medical community either from insurance providers or healthcare workers. Some health insurance providers realize the serious health effects of morbid obesity and cost benefits of its treatment. Some providers continue to deny insurance coverage, and some that once offered coverage for morbidly obesity are now excluding it (Brink, 2000). Discrimination from healthcare workers is reported to be likely due to a lack of understanding of the causes and consequences if left untreated (Puhl & Brownell, 2001). Teaching medical students about obesity management, including sensitivity training, is one strategy that may lead to improvement.
Socio-cultural, gender, and psychosocial effects also play huge roles in becoming obese and includes the different perceptions of the epidemic, as well as what is deemed acceptable in the society we live in. Studies have shown that besides health, obesity may have for example social, emotional, and psychological consequences for an individual (e.g. Zdrodowski, 1995&1996; Cooper, 1997&1998; Sarlio-Lähteenkorva, 1999). Overweight or obese individuals experience social stigmatization and discrimination from a vast majority of people especially in employment and academic situations. It is evident that in society obesity is treated as a broader issue than just a medical one. In the remainder of this paper, I will discuss the sociological aspect of the obesity epidemic from the Review of Literature to the Conclusion.
Review of Literature
Social constructionist thought sees the construction of body as a social and cultural process. This concerns all bodies, and especially those bodies that are considered somehow deviant to the norm (e.g. Foucault, 1979; Goffmann, 1968). In the American culture, obesity is seen as a bodily abnormality and deviance that should be corrected. Obesity has indeed become one of the most stigmatizing bodily characteristics in our culture (Brink, 1994).
The social aspect of obesity as an abnormality is a long and multi-faceted process, in which several discourses concerning the body meet. In the dominant mainstream discourse regarding obesity, for example, medicine's definition of the normal body and medical attempts to create an optimally healthy body become intertwined together with Christian-philosophical conceptions concerning morality, virtue, and moderation (Stone, 1995).
The cultural aspect of obesity as an abnormality and as a personal failure has a number of consequences both for our understanding of acceptable and unacceptable bodies, how we treat those who are labeled unacceptable and the lives of obese people themselves (Harjunen, 2003). For example, Pamela J. Brink has argued that a fat body has become one of the most stigmatizing physical characteristics in our contemporary culture (Brink, 1994). In the Western culture, thinness does not just mean the size of the body, but it is associated with such qualities as being healthy, attractive and in control. In contrast, a fat body is viewed as a sign of poor health, inefficiency and lack of personal will (Kissling, 1991; Ogden, 1992; Cooper, 1998). In other cultures (namely countries in the Middle East), however, fatness is regarded as a sign of affluence, health, and beauty. Brink (1994) further observed that this culture (Western) in which we live, obese people are stigmatized for both their physical appearance and for their assumed moral weakness.
Recent research has shown that the social stigma associated with obesity can have serious consequences for an obese individual. According to the studies conducted by Puhl and Brownell (2001), along with Brownell and Teachman (2000), obesity can often lead into serious discrimination in such central fields of life as education, health care and employment. The extent of discrimination experienced by obese people is such that obesity researchers in the United States have begun to talk about weight-based discrimination, which means that a person's weight is seen directly as the cause of discrimination.
In relation to gender, the stigma associated with been obese is not the same for men and women. Research has clearly shown that obesity is more stigmatizing for women and obese women are discriminated against more than men because of their weight (Puhl & Brownell, 2001). Some of the stigma attached to obesity relates to the cultural emphasis placed on appearance and especially women's bodies. The norms concerning appearance and body have been stricter for women than for men and also the norm of thinness has affected women more strongly (Bordo, 1991). Medical, and social discourses combined with popular media have actively promoted the view that for women, thinness is a requirement for happiness, success in personal relationships and career (Wolf, 1991). The thought of body size serving a major factor to determine one's status as partner, student, worker, or friend overwhelms many women. For example Silberstein, Striegel-Moore, and Rodin (1987) have observed that for women even imagined overweight is a significant source of feelings of shame, guilt and inadequacy. The significance of social consequences of obesity for women is underlined also in other studies such as Sirpa Sarlio-Lähteenkorva's research in which social, behavioral and health-related factors in obesity and weight-loss maintenance were studied. Sarlio-Lähteenkorva found that the motivation for dieting for women in particular is often driven more by social than health reasons (Sarlio-Lähteenkorva, 1999). Therefore, it can be argued that obese women experience a new level of stigmatization: failing to comply with the societal standards of what is perceived as the ideal appearance set for the female body.
The psychosocial aspect of obesity is often overlooked. The psychosocial issues associated with obesity are usually obvious and may often stem from discrimination (conscious and subconscious) against obese people. Many formal and informal studies have demonstrated this discrimination in all parts of society. Obese/Overweight children as young as five face discrimination about their weight that traumatizes them for a good portion of their life (Millman, 1980). Researchers found that lowered self-esteem was associated with being overweight in girls as young as 5 (Millman, 1980). As a result of depression and low self-esteem, they look more and more towards food as a means of comfort. "Don't tease girls about their weight, even in a gentle way," Dr. Leann Birch, head of the university's department of human development and family studies and a study co-author, advised in a statement (Stunkard & Wadden, 1993, p. 20). "It's clear from our study that the notion that one's weight can be a social liability emerges early on" (Stunkard, p.20). Also, food is often used as an incentive or a method to relief stress especially when one has been working hard all day. "From the psychosocial point of view, some people work hard, then they come home and use food to relieve their stress" (Stunkard & Wadden, 1993, p.22).
In the next paragraph I develop a hypothesis on what I believe is the social consequence of obesity and what I set out to prove, as seen in the methods.
Development of Hypothesis
The central hypothesis of the research and this paper is that obesity is an ongoing, gendered and embodied cultural process that has harmful consequences for the obese individual (e.g. Harjunen, 2002&2003). In the methods, I will explore the various social implications of obesity via the interviews (with obese or formerly obese people) conducted and the surveys taken of people in the Boston area.
Methods
Interviews were conducted:
Method of Interview
Type of Interview: Qualitative Interview aimed at proving my central hypothesis on the matter of obesity as stated in the previous section.
Setting: The interviews were conducted in Newton Wellesley Hospital, the Boston
College Campus and Tufts University.
When: From April 1 - April 10
Who: Five hospital patients (primarily between the ages of 30-50) recovering from obesity-related illnesses.
Who Else: Two Boston College students were interviewed; and three Tufts University students were interviewed.
How many interviewed: Ten people that were either currently suffering from obesity or who at one point were, and would like to share their experiences.
Supervision (from hospital): A close friend of my mom, Catherine Shisslak, Ph.D., a
clinical psychologist from the Department of Family and Community Medicine.
The interview was initiated with a greeting of Hey, How are you doing? And a smile.
Followed by an introduction:
"I am conducting a research study regarding the sociological effect of obesity and I would like your help. (Your responses will be held in strict confidence). My intent is to prove my central hypothesis that obesity is an ongoing, gendered and embodied cultural process that has social ramifications for the individuals affected. I would like to ask you a couple of questions and I would like to thank you in advance for your time and maybe someday we will stop the discrimination/criticism of obese people in the society we live in.
General Questions asked during the Interviews are as follows (these questions were adjusted depending on the environment):
- How old are you and where is your origin? Where do you currently reside?
- (In the hospital) What are you here for? What do you think are the causes of you illness?
- What do you think of the growing epidemic of obesity in the United States?
- How are you affected or were affected by your weight?
- Where you ever teased or bullied because of your weight?
- Have you ever experienced any type of criticism or discrimination (for example, in the health field, work force, school, etc.) because of your weight? If respondent answered in the positive, then I would proceed to ask them if they could share such an experience.
- Do you think that in society and modern culture, there is a misunderstanding on what is considered obese? Explain.
- Have you ever had any difficulty getting a job in the past because of your weight?
- The society we live in associates being heavy with disgrace and shame. In terms of gender, based on what society considers fat, coupled with its dishonorable implication, do you think that it is easier to get away with being fat as a male or a female?
- What if I told you that you can die as a result of being overweight? What are your thoughts on the fact that obesity can lead to death?
Ending Interview with "Thank you for your cooperation and stay healthy."
Method of Survey
The purpose of the survey was to increase the awareness of obesity in the Boston area and further prove my proposed hypothesis that obesity is an ongoing, gendered and embodied cultural process that has social ramification for the obese individual.
Where: Boston, MA.
When: March 7- March 20
Participants- 50 participants (adults, and college students mainly).
Assistance: My roommate Edgar James, and Pattie (volunteers at Newton-Wellesley Hospital) helped with getting people to fill out the survey.
The survey was 8 pages in length and addresses the obesity epidemic and methods in which to limit the epidemic. The survey starts out with general questions about health problems facing the United States and then focuses more on the epidemic of obesity. The survey classifies the participants' views towards obese people and then moves on to ask personal questions about the participants' status (whether they are obese). It also touches on the various factors that lead to obesity and the health risks involved while simultaneously analyzing the physical and psychosocial effect of the epidemic.
Findings
My findings come jointly from the review of literature section that is featured earlier in this paper and the survey tabulated. From the review of the literature I was able to extract facts that were pertinent to my hypotheses. Only matters pertaining directly to my hypotheses that "obesity is an ongoing, gendered, and embodied cultural process that has harmful consequences for the obese individual" are featured in this section. The following results firmly support my hypotheses:
Findings of the survey
I created a survey of people in the Boston area.
According to the survey, the general public is unaware of obesity as a major health problem that the Americans are facing (The survey proved the overall ignorance of people about obesity in the society we live in). However, when the general questions were narrowed down to the focus of obesity, people became more aware of the impact of the epidemic and how it affects their every day life (in advertising, the environment they live as seen in fast food restaurants and vending machines) and from a psychosocial perspective. They also formulated a solution of their own to help prevent the epidemic. The basic findings of the survey are as follows:
The Data shown are responses for a survey conducted in Boston, MA
The following data shows the relationship Gender, Race, Age
Socio-economic status, etc. has on Obesity
Table 1: Relationship of Gender to Body Mass Status
Femi's Result (Boston, MA)
PercentageGender
Body MassFemaleMaleGrand Total
Ideal weight45.67%54.33%100.00%
Obese76.23%23.77%100.00%
Overweight51.30%48.70%100.00%
Underweight57.51%42.49%100.00%
According to this result, more females on a grand scale were obese than
males.
Accuracy of this result will increase as more
people are surveyed approaching that of the
Population.
Nevertheless, one can say that based on
the result of this survey that the ratio of
obesity from females to males is 3:1 respectively
In the Boston Area.
Table 2: Relationship of Race to Body Mass Status
PercentageBody Mass
RaceIdeal weightObeseOverweightUnderweightGrand Total
Asian52.53%0.00%17.90%29.57%100.00%
Black (non-Hispanic)30.03%17.41%52.56%0.00%100.00%
Hispanic16.59%11.66%45.29%26.46%100.00%
Other0.00%0.00%0.00%100.00%100.00%
White (non-Hispanic)49.14%0.00%22.36%28.50%100.00%
Based on the result of this survey, we can say that obesity and
Overweight is prevalent the most in blacks followed by Hispanics.
For the 50 people surveyed, obesity and overweight is present the least in whites
And Asians.
This thus correlated with that examine by The National Center for Health Statistics who took a survey on a much grander scale.
Table 3: Relationship of Age to Body Mass Index Status
Body Mass18-3435-4445-5455-6465+Grand Total
Ideal weight48.91%4.13%26.52%0.00%20.43%100.00%
Obese0.00%6.49%44.16%49.35%0.00%100.00%
Overweight27.04%26.79%32.65%13.52%0.00%100.00%
Underweight32.66%13.01%13.01%9.25%32.08%100.00%
Based on the results of this survey, obesity is directly proportional to age.
This may be attributed to the fact that younger people (are healthier as indicated
by a large percentage at their ideal weight) engage in more physical activities than older people.
However, when the age approaches 70 or so, decay of the individual
occurs and most of the body soils die out causing a weight loss.
Because of this, at a very old age, the individual is increasingly underweight.
Table 4: Relationship of employment Status to Body Mass Status
PercentageBody Mass
EmploymentIdeal weightObeseOverweightUnderweightGrand Total
A stay home parent39.47%0.00%60.53%0.00%100.00%
Full time22.18%12.43%40.73%24.67%100.00%
Homemaker11.54%0.00%0.00%88.46%100.00%
Part time46.40%0.00%21.60%32.00%100.00%
Retired51.65%0.00%0.00%48.35%100.00%
Student48.04%0.00%32.02%19.94%100.00%
Unemployed0.00%100.00%0.00%0.00%100.00%
The result of the above data shows that you don't have to be financially well-off
to become obese.
Obesity does not vary proportional to wealth or employment status.
In fact if you group the data into two categories (employment and unemployment),
A person is more likely to be obese if he is unemployed.
Employment keeps people both mentally and physically occupied and thus, enabling
Them to burn excess fat. However, there are other factors, such as genetics, environmental (ex. the accessibility of fast food restaurants), and etc. that contribute to an individual being obese.
Table 5: Relationship of Physical Activity to Body Mass Status
PercentageBody Mass
Physical ActivityIdeal weightObeseOverweightUnderweightGrand Total
- -4 times a week47.61%0.00%26.20%26.20%100.00%
- -4 times a month0.00%0.00%100.00%0.00%100.00%
- -7 times a week29.84%0.00%14.10%56.07%100.00%
less than once a month0.00%11.90%88.10%0.00%100.00%
Never17.21%59.02%23.77%0.00%100.00%
Once a week49.53%0.00%28.35%22.12%100.00%
Based on the result of the survey, an individual is less likely to become obese
as physical activity is enhanced.
According to the above data, people that exercise on a more frequent basis are
less likely to become obese.
Exercising can also bolster the body mass index as fat mass is converted to muscle mass.
As a result being overweight or obese based solely on the Body Mass Index (BMI >25)
can be due to an increase in muscle mass (more muscle than fat).
"Muscle weighs more than fat."
Findings of the Interview
Newton Wellesley Hospital
1) Patient's name: Pam (diagnosed with heart attack)
Pam is 33 years old and 244 pounds (height of 5'6 and 49% body fat). Pam gave me a very detailed experience (Pam's story) about the social and psychological aspect associated with been obese which, in turn proved very helpful in confirming my hypothesis.
Pam's story: Pam was raised on a farm in Texas until she was 10 years old. She had an active childhood there, waterskiing, riding motorcycles, and of course tending of chores. She then took an interest in gymnastics and was a fairly good gymnast. The drastic change in weight occurred when she hit puberty. She then started gaining weight (a good portion was muscle) due to been an athlete and in fact weighed much more than all the girls and most of the guys. Since this day on her social life went downhill. Her gymnastic coach would tell her to constantly loose 8 pounds before the next meet. Her dad would also constantly comment on her weight by saying stuff like "If you were a skinny little girl, I will give you all the ice cream and candy you want" (to punish her for been heavy). Also, she would receive such remarks from guys at the Fire Station when she walked closer to them stating, "she's not a babe, she's fat." She constantly suffered from low self-esteem and depression based on the societal stigmatization; she proceeded to loose weight at the age of 12. She further stated that loosing weight is a very difficult task. "It's not as easy as people think." She tried all sort of dieting usually some form of starvation and would loose the weight (of which a lot was muscle), lower her metabolism and then put on more weight (with a larger percentage of that weight being fat). She also states that her weight problem also affected her job status. She was declined from a couple of jobs because she was obese.
The next interview done with Bob further confirmed that obesity is gendered. Bob was 32 and 6 feet tall weighing about 260 pounds.
2) In contrast to Pam, Bob was more accepted in society and didn't experience as much criticism. He would occasionally be looked down on but overall he got along well with most people. He also didn't have as much difficulty getting a job. However, he was still teased as a youth by his classmates and friends because of his weight and suffered from depression. As he grew older his torment started fading away.
Three more interviews were conducted at Newton-Wellesley Hospital. The results from the interviews conducted with Bonnie, Carol, and Whitney served as further evidence of the connection of socioeconomic status, psychosocial, and gender to obesity; and that it is an ongoing, and embodied cultural process. Bonnie took a stab at the American culture and spoke about the causes of her obesity, while in unison with my research, verifying the connection of socioeconomic status to obesity as the survey conducted shows. "The problem with anyone who may have a weight problem is the fact that high carb foods are cheap compared to high protein foods... go to any restaurant and what do they serve... small portions of protein loaded with huge portions of fries, pasta and other high carb foods to fill up the plates..." This indicates and as seen from the survey results that poorer people or those of lower socioeconomic status are more likely to be obese than wealthier and more affluent folks. The interview conducted with Whitney further proved that obesity is an ongoing, gendered, and embodied cultural process. Whitney experienced a lot of discrimination from childhood till now because of her weight. She articulated the criticism and discrimination she had to face as an obese female in the American culture. "Obesity is a huge problem in America. And I have to admit I am even though it is a slap in the face." "I didn't go through years of law school to find it difficult to obtain a job because of my weight even with all my credentials. America is such a male dominated country and I bet men don't worry about their weight on a consistent basis than females." Whitney also further confirmed the psychosocial role in her obesity. "I have eaten emotionally since childhood, and there wasn't much exercise involved." Her obesity stems from emotional eating that is due to the depression she experienced since childhood. The next interviewee, Carol, also stated that the main reason for her obesity is due to emotional eating. "There is the "high" you get off eating sugar, and when you are down, you want to medicate yourself to feel better - eating a candy bar." She continues by saying "some have no emotional eating problems, which is wonderful! Some of us do, and it is up to each of us as individuals to find out what makes ourselves tick." It appears that Carol is very eager in finding a solution to her emotional eating and ultimately her obesity. Carol also confirmed the claim that socioeconomic status is related to obesity. When asked if she agrees that poorer people are more likely to be obese, she replies: I think another poster hit another nail on the head - carbohydrate rich foods are cheaper, and easier - and more widely acceptable as "healthy" foods. I definitely agree that lower income folks tend to be larger because of the less expensive foods that are very filling (pasta and potatoes). Also advertising in the USA is geared toward cars, junk food, and prescription drugs!" In other words she believes that advertising promotes unhealthy eating and thus increases the prevalence of obesity in the United States. Thus, these interviews show that obesity is an ongoing, embodied, cultural process.
Boston College
I also interviewed 2 good friends (Katie and Rob) of mine currently attending Boston College. Their response to some of my questions is as follows:
Katie (21 years old) was at one point obese and every experience she had was solely negative. She spoke about the effect been obese had on her social life. It was extreme difficult for Katie to make friends growing up. "The one girl that I considered a friend ended up betraying me and she would make negative remarks about my weight. She would say things like I can never attract the opposite sex if I tried." She continues by saying: "Too many expectations are placed upon females in the American culture to meet an 'unrealistic model' like stature and if they don't meet the requirements they have to suffer the consequences (depression, low self-esteem, etc). Meeting the standard is very hard to do. It's hard to be that thin. I had to go through surgery in order to be at normal weight, and what a relief!" Being obese was the worst experience she had to undergo. "I would rather go blind than be fat. I'd rather have both legs cut off than be fat. I don't want to ever experience the immense depression and pain I had to go through because I was fat" (Katie).
In the interview (Instant Messenger conversation, April, 4, 2005) conducted with Rob who is currently obese, he gave some very interesting about what its like to be obese and how he deals with it. Rob was and he is still being made fun of because of his weight. Given these conditions, he resides to food as a means of comfort to release stress and to get past the constant teasing. When asked how he copes with his weight Rob says "It wasn't hard especially when I like to eat. I always have room. Food is what keeps me going." Also when asked if he was aware that he can die an early death because of his weight, he gave a quite interesting response.
"Yes, but you could die crossing the street. You could get run over by a bus. This plane could crash. Terrorists could hijack it. Think about all the people on diets who were killed on Sept. 11. Deprivation-and for what? You have to enjoy life because you don't know when it will end. I enjoy eating and I don't enjoy exercising and I don't mind being as big as I am and that's all there is to it. I used to feel bad about it, especially when I was younger, but now I realize that it is not my problem-it's other people's problem. If you don't like the way I look then it's your problem" (Rob).
Tufts University
Three more interviews were conducted at Tufts University. People interviewed were between the ages of 18-21. Tosin, Tamara, and Stanley were interviewed from Tufts University and their responses demonstrated the societal stigma associated with obesity. Tosin was formerly obese and she describes her experience as an obese individual. Her obesity started when she was a teenager. Ever since then she was referred to as "lazy," "dirty," "stupid," and "ugly." "I was never this fat in my native country, Nigeria; as a matter of fact, I was pretty thin." In other word, the American culture promotes obesity by means of advertising, fast food restaurants, etc. than most other cultures. The modern Western diet consists largely of over-processed, fatty foods manufactured by the ever-expanding food industry. Our 20th-century Western lifestyle--with its highly processed foods, chemicals, pollution, stress, industrialization, and social structure--is triggering and exacerbating the body's instinct to prepare for and defend against famine. And the growth of the fast food industry has made an abundance of high-fat, inexpensive meals widely available. Tamara, who is from Trinidad, also had a similar experience as Tosin. Her weight gain occurred when she moved to the United States at the age of 13. Stanley, who is current obese, stated that he was always 'chubby' as a child and was put on diet by his mom at the age of 7. "My mother had me on diets since I was about 7 ...so yo-yo-ing has been a big part of my whole life..." He also suffered from discrimination ever since he was a child and was afraid what other people think of him. "I have been afraid to speak up or out when I did not like something, for fear that my opinion doesn't count. I still struggle with this daily...I am afraid people think I am stupid." This demonstrates the harmful consequences that obesity has towards the obese individual and their psyche. Stanley looked more and more towards food to help him cope with stress, and discrimination. As seen from the review of Literature section relating to the psychosocial aspect of obesity, obese people themselves may attribute their weight to a tendency to view food as a source of comfort--a friend who can help them cope--in times of stress, anger, depression, and loneliness.
Discussion/Conclusion
I have attempted to show how obesity is being discursively and on the level of social practices produced as a condescending position. The social stigma associated with obesity and other discriminating social practices systematically marginalize and mark the obese person as different. As noted in the review of Literature section, there are certain physiological and emotional reasons that contribute to the vast majority of obese individuals, but yet, our American society and other societies similar to it, do not recognize that many obese individuals are not that way because they choose to be. Thus, our society tends to label obesity as a deviant behavior and obese persons are (often) victims of employment and other discrimination and are penalized for their condition despite many federal and state laws and policies.
Based on my findings, it is safe to say that an obese person's bodily base of subjectivity is constantly under suspicion and threat. The obese individual's embodied experiences as a fat person is being effectively denied or ignored (based on survey), and thus unaccepted by society. Obese persons clearly comprise a stigmatized group in the United States today. Obese persons are viewed as physically unattractive and undesirable, and as responsible for their weight due to some characteristic flaw or "blemish," such as laziness, gluttony, or a lack of self-control. There is growing criticism of those people who weigh more than the average. From the results of the survey and interviews, the obese person experiences discrimination and status loss, which in turn may have harmful consequences for their life chances, including their psychological, economic, and physical well-being.
The data collected from the survey evaluated whether members of purportedly stigmatized groups suffer from disadvantaged life chances due to discrimination. Rather, "discrimination" is invoked as a post-hoc explanation when members of a socially devalued group show a disadvantage in an important life domain. Furthermore, the results of the survey showed that obese persons have lower levels of education, earnings and occupational status than normal weight persons. This disadvantage typically is attributed to "bias" or "discrimination" even when no direct measures of such experiences were obtained. It was also concluded from the results of the survey that obese persons belonging to social strata where obesity is less common and acceptable may be more likely to experience discrimination. As seen from survey, whites, the highly educated, and those with richer economic resources are less likely to be obese. They also are more likely to value thinness, diet, and exercise, and to hold more negative attitudes toward obese persons (Goffmann, 1968).
On the basis of the interviews conducted, the experiences of those interviewed proved that obesity is an ongoing, gendered and embodied cultural process that has harmful social ramifications associated with it. The interviews conducted generally explored individuals' own perceptions that they have been treated in a discriminatory manner. As seen in the interview of Pam and Bob, the male was more accepted in society than the female, which in effect correlates to the gendered section of my proof. Moreover, definitions of physical attractiveness are more closely tied to thinness for women than men (Bordo, 1991). The interviews conducted also demonstrated cultural ties to the prevalence of obesity. As seen from the interview conducted with Tosin and Tamara, obesity was less common in their native country. Their obesity stemmed from being engrossed in the American culture that promotes unhealthy eating by means of advertising and fast food restaurants (highly accessible). Also, the perception that one has been treated unfairly due to an enduring personal attribute may be sufficient to prevent that person from pursuing important and necessary life goals (Harjunen, 2003) as seen from the interview conducted with Stanley. Stanley was afraid of speaking up when he did not like something or felt uneasy about a particular issue, for the fear that his opinion doesn't count. Stanley felt held back to achieve his goals and make a difference because of his physical appearance and the fact that no one will take him seriously. Moreover, obese persons who believe that their health care providers look down upon them may avoid seeking care; this reaction is potentially dangerous given that obese individuals are at an elevated risk for many health conditions and are in particular need of sensitive health care providers (Harjunen, 2003). Other people interviewed weight problems stemmed from emotional eating. Whitney and Carol's weight problems came from eating emotionally since childhood, in which they look more and more towards food as a means of comfort in times of distress.
Overall, the interviews conducted examine reports of both major discrimination (such as being passed over for a job promotion) and day-to-day interpersonal discrimination (such as being treated rudely). Indicators of major discrimination reveal the ways that enduring, socially structured patterns of exclusion and rejection shape social and economic life (Puhl & Brownell, 2001). Major discrimination was seen primarily in the interview conducted with Whitney who graduated from law school but yet finds it difficult to obtain a job because of her weight. The majority of the findings obtained were due to interpersonal discrimination; even minor slights can produce considerable distress. It was thus concluded, from the findings that the interpersonal and social consequences of obesity are most acute for those who are white, young, female, and of a high socioeconomic status (Puhl & Brownell, 2001). Overall, the people interviewed were discriminated as a direct consequence of their weight.
Embodiment and embodied subjectivity have become the most important concepts within my findings. If the body is understood as the foundation of subjectivity and identity, my question is how is the embodied subjectivity and identity negotiated and what is the nature of embodied experience for an individual whose body is by the dominant cultural understanding seen as unstable and temporary, that constantly faces demands to change and is generally understood as physically, socially, morally and aesthetically unacceptable by the society's standards. What choices are there available? These questions clearly require further exploration.
REFERENCES
- Bordo, S. (1993). Unbearable weight: Feminism, Western culture and the body. Berkeley: University of California Press.
- Brink, P. J. (1994). "Stigma and obesity." Clinical Nursing Research, 3(4), pp. 291-293.
- Brownell, K. and Teachman, B. (2000). "Implicit anti-bias among health professionals: Is anyone immune"" International Journal of Obesity, 2000/25. pp. 1525-1531.
- Cooper, C. (1999). Fat and proud. The politics of size. London: Women's Press.
- Foucault, M. (1979). Discipline and punish. Harmondsworth: Penguin.
- Goffman, E. (1968). Stigma: Notes on the management of spoiled identity. Harmondsworth: Penguin.
- Harjunen, H. (2003) "Exploring obesity through the social model of disability." In Kristiansen and Traustadóttir (eds.) Gender and Disability Research in the Nordic Countries (pp. 200-222). Lund, Sweden: Student literature (in press).
- Kissling, E. A. (1991). "One size does not fit all: Or how I learned to stop dieting and love the body." Quest, 43, 135-147.
- Millman, M. (1980). Such a pretty Face: Being fat in America. New York: Norton&Co.
- National Institutes of Health. (2002). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, Maryland: Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute.
- National Research Council. (1989). Diet and health: implications for reducing chronic disease risk. Washington, DC: National Academy Press.
- Puhl, R., & Brownell, K. (2001). "Bias, discrimination, and obesity." Obesity Research, 9, 778-805 (http://www.obesityresearch.org/cgi/content/full/9/12/788).
- Sarlio-Lähteenkorva, S. (1999). "Losing weight for life? Social, behavioral and health-related factors in obesity and weight-loss maintenance." Publications in Public Health, 171. Department of Public Health, University of Helsinki.
- Silberstein, L.R, Striegel-Moore, R.H. & Judith, R. (1987). "Feeling Fat. A Woman's Shame." In: Block Lewis, Helen (ed.) The Role of Shame in the Symptom Formation, (pp.89-108). London, Lawrence Erlbaum Associates.
- Stone, S. (1995). "The myth of bodily perfection." Disability&Society. 10(4), 413-424.
- Stunkard, A.J, & Wadden T.A. (Eds.). (1993). Obesity: theory and therapy, Second Edition. New York: Raven Press.
- Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press.
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