PERSONAL OR POLITICAL: EXPLAINING THE PROBLEMS OF FAT PEOPLE
The philosophy of Overeatcrs Anonymous exemplifies a growing tendency to view obesity as a sign of emotional disturbance in the individual. In our psychologically oriented society it is increasingly assumed (especially about women) that we get fat because emotional disturbances drive us to cat compulsively. Frequently, the compulsion to overeat is suspected of being a substitute gratification for blocked, conflict-ridden, or unfulfilled desires (for sex or love, for example). Even where psychological explanations of obesity are not so fully articulated, they often color the images and assumptions that our society makes of fat people. And even where emotional causes are not assumed (for example, in the currently fashionable treatment mode of behavior modification, where obesity is viewed simply as the outcome of poor eating habits) it is
Personal or Political 87 still thought that the fat person's suffering and problems are individually based and self-produced. The solution lies in becoming slim. National diet organizations like Weight Watchers and Take Off Pounds Sensibly (TOPS) share not only the assumption that slenderizing is the answer, but also devote much group discussion time to the unconscious psychological problems that drive members to overeat.
This suspicion of underlying personal problems is not entirely unwarranted. Indeed, it is difficult to listen to overweight people without concluding that obesity, especially in an extreme form, is indeed often a symptom of unconscious conflicts or disturbances. Fat people themselves frequently have a psychological interpretation of their weight problems. Even if they don't go as far as Overeatcrs Anonymous in looking within for the source of their unhappiness, most feel there is somctbing wrong with being overweight and believe their fatness to be consistent with otber emotional problems they recognize. But no matter what the actual cause of obesity in any individual case, it would be difficult to be fat in our society without blaming and hating oneself, and without feeling it is a sign of something wrong. Why?
One of the appeals of Overeatcrs Anonymous and other diet organizations (including Weight Watchers and TOPS) is that they hold out the hope that a person can independently shape and create her own life. Most of us would like to believe that adherence to a certain program (such as a diet or a set of guiding life principles) will ease our troubles. Never mind that OA members arc plagued by financial stress, illness, unemployment, divorce, and children who are drug addicts: they come to believe that they alone arc responsible for the largest share of their own suffering and that they alone can achieve a solution.
This response is not without some merit. Self-improvement programs sometimes do help people fulfill their potential. And if we cannot control the larger external forces that constrain and make us unhappy, we need not abandon efforts at eliminating self-induced problems. Still, it is deeply erroneous and dangerous for people to believe that all of the causes and solutions for their
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troubles arc personal. This "illness" approach leads us inevitably to seek an ■■■dividual cure. Wc seek in vain.
Because of lire dismal failure rates of diets obesity has lately come to be viewed by the medical profession as an "incurable illness." thus conceived (whether because of psychological or physiological disturbance) obesity, like alcoholism, takes on the character of being beyond (he simple volition of the individual. Viewed in this way, obesity also becomes not quite a deliberately chosen condition, and therefore some of the guilt is removed from the individual But viewing obesity as an illness still locales the cause of the problem and the solution for it within the individual And ultimately, the view that fat people are sick or have real physical predispositions for their condition doesn't exempt them from contempt and blame, even within the health-care community itself.
Indeed, the health industry has recently depicted obesity as the prime symbol of our faulty "lifestyles." For example, Blue Cross recently ran advertisements in newspapers and magazines, and catchy spots on the radio, pointing the finger at overweight Americans for I lie high cost of health care. One full-page advertisement included an arresting sketch of an overweight man: his shirt buttons were straining, his abdomen hung sloppily over his belt. Underneath the drawing a large caption commented: "One of the reasons for the high cost of health care." Underneath the caption were graphs depicting the rise in the costs of coronary i ire units, implying that obesity was causing more heart attacks and therefore responsible for the rise in health costs. There was considerable distortion in this representation. There is no evidence that obesity is a major cause of heart attacks. And furthermore, the increase in coronary care unit costs is due less to a higher incidence of heart attacks (which have actually decreased in recent years), than to the proliferation of high-technology medical equipment and the profit-making activities of our health Industrie   The Blue Cross advertisement in question exemplifies how fat people are blamed for problems and expenses created by the structure of our medical care system and its profit orientation.
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Manic for the failure of the health system is shifted to individuals who are actually more its victims than its perpetrators.
This tendency is compounded by the fact that in America obesity is correlated with poverty: it is many times more prevalent among the poor than the rich and is associated with downward mobility.1 As a "lifestyle" problem it is easy to see why obesity-is a product of poverty: inexpensive convenience foods are the most fattening, and we have to be relatively wealthy to eat a high-protein diet or have the time and resources to cook healthy low-calorie meals. Access to pleasant physical exercise and athletic activities is increasingly expensive. As Overeaters Anonymous illustrates, eating is often used to dull the pain and soothe the frustrations of difficult life circumstances. While financially poor overweight people might logically be seen as the victims of social conditions that make a healthy lifestyle improbable, instead they are blamed for driving up the cost of health care and using up too many resources. It is a case of blaming the victim.
It is precisely in the area of "lifestyle" illnesses (alcoholism, drug addition, and now "food abuse") that traditional American medicine has been least successful. These illnesses are often caused by chronic stressful life conditions and therefore don't lend themselves well to treatment by the high-technology, high-proiit. acute intervention medical care preferred by physicians and the health industries. Since they arc unresponsive and unattractive to medical practice, these "lifestyle" illnesses and their treatment have largely been left to nonmedical sclfhelp organizations, which have consequently received uncharacteristic endorsement by the medical profession.
Although obesity is viewed as an illness, most medical insurance excludes treatment for obesity unless diabetes or hypertension are involved. Thus fat patients are unattractive to physicians, except those who specialize in weight reduction and have worked out a mode of "treatment" (usually a weekly allotment of questionable drugs) that allows them to sec patients in large enough volume to compensate for the relatively small fee that can be collected for each visit. It is a treatment mode well designed for
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the constraints of a noninsnrcd condition
Clearly, in its extreme form, obesity is deleterious to health. But for most people (especially women) it is concern about physical appearance, and not health, that motivates dieting. Yet few diets achieve long-term weight loss. Only about 10 percent of the patients in supervised weight-reduction programs maintain their original losses for as long as one year; after two years the percentage drops to 6 percent, then lower.2 And there is little health benefit in the activities of most dieters who repeatedly lose and regain weight, a stress on the body that is itself probably more unhealthy than staying overweight. Furthermore, if one considers the methods that many people use to lose weight (taking amphetamines, fasting), it becomes clear that the health motive is obviously not uppermost in the minds of dieters.
These destructive methods, moreover, are often used by women who arc either not overweight at all, or only slightly so, and who certainly arc not fat enough to be jeopardizing their health (most studies suggest a person needs to be 20 percent over the "ideal" for their weight to have demonstrable effects on their health) And several experts have noted that while obesity is correlated with hypertension, and therefore indirectly with corona ry heart disease, there is little evidence that obesity causes hypertension and heart disease. ** The important point is that our common attitudes and practices with regard to obesity cannot be reasonably explained on the basis of medical considerations.
There is another explanation—fane that NAAFA lias repeatedly pointed out: fat people meet with subtle and flagrant dis-eriinination in all areas of life. And discrimination against fat people most dramatically affects groups already disadvantaged: women and the poor. One well-known study4 of college admission ■ t<   indicated thai overweight girls ha\c only one-third the chance of being admitted to prestigious colleges as slim girls with otherwise identical records. (Teenage boys are not nearly so verely penalized for being overweight—an indication of how «omen are punished more than men for being overweight.) In pointing to such examples of discrimination, NAAFA calls
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1 attention to social and political factors rather than to individual
I self-destructiveness as responsible for the suffering experienced by
I fal people When NAAFA members talk about "coming out of
I the closet" in the organization and becoming comfortable about
I acknowledging that they are fat and discussing it, they are conv
I paring themselves to members of other oppressed groups, lake
I black and gay people in earlier liberation movements, NAAFA
I has adopted political terminology and slogans that proclaim its
I members' differences from others in a neutral or positive way and
I in a maimer that disputes the majority's view of normalcy.
I NAAFA uses the word fat rather than obese or overweight just
I as blacks rejected the word Negro and gay was substituted for
I homosexual. In all these cases, the motive was to discard a label
I that had been applied by the oppressive majority and to use
I instead a name originating from the minority group itself. I Nor is NAAFA alone. Recent lawsuits have begun to question
I the legality of weight criteria for employment or membership.
I These suits revolve around the civil rights and health status of fat
I people. It is possible that recent federal legislation requiring em-
I ploymcnt of the physically handicapped in order to qualify for
I federal funding (Rehabilitation Act of 1973) may have relevance
I for charges of discrimination by fat people. There is still debate
I about whether fat people are protected by this legislation. Most
I employers justify firing or failing to hire a fat person with the
I argument that he or she is physically unable to do the work of a
I thin person. Most employers also take the position that although
I they are not physically fit foi the job, fal people are not truly I        handicapped" because their problem is voluntary. It is around
I these contentions that future debates about discrimination will
I revolve.
I As we have seen, being fat is not a "voluntary" condition to the
I cxlenl that most people think The medical profession now views
I obesity as relatively "incurable " There is also increasing evidence
I that some people have body types that arc constitutionally more
I cfficicnl at storing fat than others. These people gain weight
I rating the same diet and engaging in the same physical activities
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that would cause others to lose weight.5 So far the argument that obesity is an involuntary condition has not been used a great deal in discrimination suits, because few fat people want to define themselves as physically handicapped and are therefore unlikely to seek protection under the Federal Rehabilitation Act More often, the argument for equal employment opportunity has rested on the claim that fat people arc just as competent in work as
thinner people. .
One administrator in charge of enforcing federal fair-employment practices and affirmative action admitted that most employers can circumvent these legal requirements Few admit that they refuse jobs because of weight—even though this obviously happens routinely. Most overweight people, in his experience, do not even challenge weight standards and simply don't apply to be a receptionist or a worker where "front-desk appearance" is one of the criteria.
But even this administrator 'who seemed genuinely sympathetic) told a revealing anecdote. He reported with amusement an incident involving a "big black woman" who filed a complaint with his office. She felt she had been rejected as a file clerk because she was black. When he called the employer to investigate the complaint he learned that the employer had brought her back to the filing area and "she got stuck between the cabinets, trapping the employer in there. She became hysterical and started screaming."
Despite ridiculing the client in this story, the administrator explained that his commission generally took the view that obesity could be considered a physical handicap and therefore come under protective legislation. In order to decide whether obesitj was a physical handicap in individual cases he would ask a doctor to state whether a person might safely lose a certain amount of weight in a time period satisfacton to an employer, or if the v. eight problem was immutable, permanent.
More recent charges of discrimination in weight requirements have been coupled with claims of sex discrimination. One stewardess sued her former employer. Continental Airlines, for firing
Personal or Political 93 her because she exceeded the weight limit.6 Initially, a judgment was found in her favor, holding that the weight standards were unconstitutional sex discrimination. This was argued, presumably, because male flight attendants were not subject to the same sanctions. A federal judge ruled subsequently, however, that federal sex discrimination laws do not forbid employers to set appearance standards. Airlines could therefore legally suspend or fire fat stewardesses as long as they treat overweight male flight attendants similarly.
Despite this ruling, the case raises fundamental questions about the legal aspects of weight requirements. It is obvious that since women are evaluated more than men on the basis of physical appearance, so do they encounter greater employment discrimination if they are fat. This point is critical because it raises the possibility for another important source for politicizing attitudes about weight, namely the women's liberation movement. Because of its size and power, the women's movement could potentially bring a political analysis of weight problems to the widest possible audience in the United States. Even more than NAAFA or the litigation about discrimination, the women's movement is in an excellent position to encourage people to examine how women and men arc deeply injured and oppressed by the feelings and attitudes we have about getting or being overweight. But interestingly, the women's movement has been remarkably silent on the issue of weight, even though it has denounced the oppressiveness of other kinds of beauty standards. Indeed, it is puzzling that the pressure to be stylishly thin and the toll this takes on women has received practically no attention, save from a small number of radical feminists and lesbians who consider the issue as derivative of the more general social, political, and psychological subordination of women.
Like NAAFA, these radical feminists address the social isolation and psychological oppression of fat women, yet unlike NAAFA (which asks only that fat people be allowed to participate fully in society as it currently exists), the feminists argue that "fat oppression" is part of the larger problem of sexism in our society.
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Such an argument appeared in a lesbian newsletter article entitled "Looksism as Social Control":
Looksism encompasses sexism, ageism, racism and other forms of discrimination that nullify peoples' consciousness. We are in the era of packaging. The aesthetics of human beauty are the aesthetics of packaging, when the contents are secondary to the package for the purpose of successful saleability. Fat oppression is the clearest example of how society programs our aesthetics. The measure of their success is that we don't even know we're programmed. . .. Looksism is an infinitely vital psychological weapon of the ruling elite; it manipulates what we spend our time thinking about. If one is worrying about her appearance, she has that much less energy to concentrate on her deprivations and natural survival instincts.7
Radical feminists and NAAFA make very different assumptions about the causes and solution of the problem. Radical feminists aim for a more basic transformation of the society while the heterosexual relationships formed in NAAFA are often quite traditional. But both are interested in how fat people experience discrimination not only in employment and public services but also how they arc excluded from social life and sexual relationships. Both NAAFA and radical feminists have pointed out the relationship between the self-hatred of fat people and social structures and institutions (for example, the media and the medical profession} that promote or exploit the vulnerabilities of fat women, and both groups recognize a need for consciousness raising as well as political action.
Yet, just as there is something missing in the philosophy of OA and other organizations that treat obesity as a personal problem, so there is something absent in arguments that are made from purely political positions. Although NAAFA members and radical feminists correctly point to oppressive standards of beauty and acceptability in our society as the ultimate source of the problem,
Personal or Poliliail $ they occasionally lack insight into their own self-defeating tendencies and unrealistic expectations.
Consider the argument made in "Fat Dykes Don't Make It," published in Lesbian Tide. The author criticizes the lesbian community for being almost as oppressive to fat women as the conventional heterosexual culture. Although she explains that she didn't expect a "ticker-tape parade" when she came out as a lesbian, her outrage with slender lesbians for being reluctant to pick a fat woman as a sexual partner strikes an unrealistic note. Is her lack of sexual relationships merely the product of looksism?
I came out and nobody cared. I didn't exactly expect a ticker-tape parade, but this is ridiculous. 1 finally got the guts to admit that I love women, wrote an explanatory letter to my mother, announced to my friends that I had done the thing that I spent my life avoiding, and all I got was a couple "Right-On's" and a few cans of diet soda. No one turns on to a fat lesbian. It's not fashionable
. .. Your hot-shot alternative life-styles and "different" aesthetics are lies. Women seem to think of me as a sister-eunuch. I'm not alone in feeling this; there is a whole community, and we all feel this. Our heads are fine, our bodies do not exist.
. . . The only coverages, magazine ever gave a fat woman was Rosalyn Drexler at Duke University on a rice diet. Amazon Quarterly did an interview with a woman who was fat until she came out, then she "got her shit together" and lost weight. The implication is that we can't have our shit together and still be fat. Coming out was seen as the Lesbian Way to Stay Forever Thin.
I might even be able to find some humor in the situation if it was not so personally oppressive. We have here this wonderful community of politically correct sisters, who all hate looksism and look as tough as they please. Nobody considers wearing make-up or using a depilatory. Facial hair is OK
96   Such a Pretty Face here Everyone fights a daily battle to overcome ageism is it that you just need to have your fascism laid out for you? For this I left Philadelphia? I'm tired of people telling me how much they love my head and how they think I'm truly beautiful and then going home with someone else. . .
Similarly, while most NAAFA members recognize the disadvantages of being fat and don't fool themselves about what NAAFA can and can't do for their lives, some occasionally place full blame on society for their suffering. They have overlooked how their own lack of self-esteem and their willingness to be victimized have also contributed to their difficulties. In a few cases, the stories of pride and the confidence that fat is beautiful gained through NAAFA have a shallow, unconvincing ring.
Ultimately, one cannot thoroughly disentangle personal and political sources of suffering. The two reproduce each other in the course of life experiences. Yet one can more logically make the argument that low self-esteem in fat women follows their shabby treatment rather than precedes it. As several social liberation movements have repeatedly demonstrated, a person who is treated like an inferior or a slave may ultimately develop a self-destructive slave mentality. The .solution is to do away with slavery rather than blame the individual for self-destructive behavior. At the same time, the women's movement has also taught us that while we must identify and transform the external forces that injure our lives, so must wc look inside ourselves for how wc yield to these forces or use them against our own advantage. Taken alone, a political or a psychological explanation and analysis of why fat people suffer seems unconvincing and oversimplified. Only by studying the intricate connection between them can we comprehend why fat people suffer so much.
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LIVING WITH ONF.SK LIAS
A FAT PLRSON
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Wc have begun by concentrating nn the fat person's outward life, on her marginal position in a world of "normals," We turn now to the inner life of being fat, to the thoughts and feelings the fat individual has about herself, even when she is alone. For since we are self-conscious and self-reflective beings we have relationships noi only with others hut also with ourselves. We scrutinize our own actions, give internal explanations of who and what we are, and evaluate ourselves in constant internal dialogue,
Of course, our inner voices, too, speak from the perspective of the social world we live in. Sometimes they represent the view of society and sometimes the view of significant individuals in our lives. The conversations we have with ourselves about how we are doing therefore have much to do with what we think or know the
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