By Kathryn West
“At 419 lbs, the 23-year-old stay-at-home mom was feeling good about being out of the house that day to take in the fresh air and get some exercise. That was, until a truck of young men pulled up and began harassing her. ‘You fat blimp!’ one yelled. ‘You whale!’ said another. ‘You fat ass bitch!’ the men shouted as they pelted her with empty soda cans and other debris from inside their vehicle.” -Jennifer Craig, from tolerance.org.
Our society is obsessed with physical image. It is no longer enough to be intelligent, successful and funny; we must be intelligent, successful, funny and thin. However, the true “obesity crisis” lies deep within this façade of merely large figures. The above testimonial describes one particular moment in Jennifer Craig’s life that has affected her confidence to ever leave her house and is a glimpse of the public humiliation which the obese face on a daily basis. Our country is currently embarking on its most prejudiced and discriminatory era against the obese, and consequently, the obese are now experiencing social inequalities similar to those of various civil rights issues of the past. Specifically, the clinically obese are currently discriminated against in the workplace, in education, and in healthcare.
Weight discrimination in employment, education and healthcare seems to persist because of a belief that people are to blame and are responsible for their obesity. For example, in healthcare-related insurance policies, insurance companies use a “fault-based paradigm” to justify their refusal to cover weight-related procedures. As Jennifer Craig explains in her personal accounts of dealing with obesity, “it almost seems to be an acceptable prejudice…people think you can’t change your race or your skin color, but you can change being fat.” The problem with this prejudiced attitude is that there is a difference between someone who is ten pounds overweight, someone who is obese, and someone who is morbidly obese. The American Obesity Association defines an obese person as one who weighs an additional 20% more than their ideal body weight. On the other hand, morbid or clinical obesity is defined as someone weighing 50-100% or 100 pounds more than their ideal body weight. When morbidly obese, controlling the intake of food is no longer as simple as pushing a plate of food away; moreover, recent research suggests there is a definite genetic component involved in morbid obesity.
The “obesity crisis” has hit our society hardest in the most recent decades; according to the Surgeon General, it is estimated that adolescent obesity has tripled in the last two decades alone. In response to this increasing growth rate of obesity in the US, current research has found significant leads in determining a genetic component involved in obesity. In an article published in 2005 by the American Diabetes Association, Dr. Andrea Baessler and associates found “a substantial heritable component to the risk for obesity; specifically, 50-70% of the variation in BMI [body mass index] may be attributable to genetic factors.” More specifically, Baessler et al. have pinpointed a certain growth hormone called ghrelin that may contribute to a predisposition for obesity. The ghrelin hormone is occasionally administered to cancer patients because it is found to increase appetite and food intake. This research study discovered that the entire ghrelin system is impaired in some obese patients. Subsequent twin studies from the University of Pennsylvania in Philadelphia, the Psykologisk Institut in Copenhagen and the University of Texas Health Science Center at Houston have also supported this idea of a genetic component involved in obesity. The researchers of one particular twin study found that not only was there an association between the weight of an adopted child to their biological parents (which was expected), but there was not an association between the weight of a child to their adoptive parents. This twin study suggests that if obesity was merely an environmentally-acquired condition, a child whose adopted parents are obese would raise an obese child. But this is not the case.
Another example that suggests a genetic component involved in obesity is the very controversial gastric bypass surgery. The Roux-en-Y Gastric Bypass (the most common method) calls for a connection between the small intestine and a separated portion of the main chamber of the stomach. Immediately after this painful surgery, the new stomach chamber holds only one ounce of food, but eventually stretches to hold four to eight ounces. The reason the gastric bypass operation is successful is because of a genetic predisposition to obesity. If obesity was merely environmental, one’s body would not be able to maintain such a high weight eating only a few ounces of food for each meal; this low amount would starve the average person. As explained in the Maine Medical Center’s pamphlet for potential patients interested in the operation, physicians are aware of this genetic component and therefore carefully screen their patients before approving them for gastric bypass surgery–that is, they assess whether the patient’s condition is life threatening and whether they may require surgery for survival. If they do not meet the strict requirements that suggest a genetic component involved a physician will not perform the operation.
Other research studies seek to ascertain where and how our obesity stereotypes originate. One particular research study run by Dr. Kelly Brownell, a professor at Rutgers University, measured participants’ feelings towards obese people when placed in two different subject groups: one group was informed that behavioral factors caused obesity “such as overeating and lack of exercise,” while the other group was told that genetic factors caused obesity. To Brownell and her colleagues’ dismay, the “genetic” group was not less biased than the “behavioral” group towards obese people—that is, although the genetic group believed obesity is not something one can control, they still exhibited negative attitudes towards the obese. The same researchers tried to change their respondents’ biases and evoke sympathetic feelings by creating a story of an obese woman’s personal battle with obesity: the results were similar. Such findings force researchers to question why people are inherently prejudiced towards the obese—and many people blame the media.
In concordance with a number of other societal factors, Brownell claims the media has managed to create a relatively limited and notorious stereotype of the obese person: lazy, unmotivated and uncontrolled. On the contrary, according to tolerance.org, their attractive and slimmer counterparts evoke feelings of skill, popularity, intelligence and happiness. Especially within the last couple of years with the popularity of reality television, the number of weight-related and beauty-based programs has increased. In one season last year, six television programs aired directly relating to physical appearance: The Biggest Loser, The Contender, Sports Illustrated Swimsuit Competition, America’s Next Top Model, Extreme Makeover, and Fat Actress. If it is not a reality-based weight loss show, then it is one of many sitcoms that hire underweight and beautiful actresses for lead roles and overweight actresses for side-kick roles. The message the media sends is clear: thin is good, fat is bad. In a study cited in the Journal of College Student Development, Christie Befort explains that the problem with these messages in Western societies is that we are expected to attain the level of thinness portrayed on television—the television is what we aspire to become. Although this sort of aspiration is somewhat expected in our society, it is still highly problematic considering that the body which we are trying to attain has been getting thinner every year, and subsequently, the attitudes towards those who cannot attain such beauty worsen.
Similar attitudes concerning the obese in the media were illustrated in the recent documentary Super Size Me . One man was interviewed regarding his views about obesity and how well protected he believes the issue is. The man, a chronic smoker, went out for a business dinner with some colleagues, one of whom was obese. When the man tried to light a cigarette, the obese woman hassled him about the effects smoking has on his health. In the interview segment of the film, the man was outraged that an obese woman had the audacity to harass him about his health choices while she was stuffing her face at the dinner table. This particular interview sent forth the message that obese people are too well-protected, and we ought to be able to bluntly voice our prejudices towards overweight individuals.
Whether or not the media is to blame, psychologists have been able to prove that we have an inherent, unconscious prejudice towards the obese through a specific test called the Implicit Associations Test. The Implicit Associations Test (IAT) was created as a means of measuring our unconscious roots of feelings and emotions. Today the IAT is used to measure a number of unconscious biases including racism, sexism, ageism, and, of course, weight bias. (An online version of this test is available https://implicit.harvard.edu/implicit/demo/selectatest.html ). The test requires the respondent to answer the questions in a timely fashion, without too much thought or analysis—it is actually expected that you answer a certain number of questions incorrectly to prove that you have not spent too much time thinking about each question. The test then asks the respondent to pair two concepts-for example, fat and bad or thin and good. However, as the test develops, the associations between concepts become more difficult and this is when the IAT measures your inclinations towards biased responses. It is much easier for a weight-biased person to associate fat and bad than it is to associate fat and good, even though both of these associations are between words which have no inherent equivalency. In other words, the IAT measures the ease with which we formulate and accept certain illogical claims. As the automatic preferences for whites versus blacks, men versus women, and elite versus poor are declining, the preference for thin versus fat people remains one of the strongest subconscious associations in our society today. Consequently, it comes as no surprise that this automatic preference affects the three major public institutions in our society–the workplace, education and healthcare.
The workplace is one institution in which obese people are faced with incredible displays of discrimination. Within the workplace, there are at least two avenues for weight-discrimination: the hiring process and wage earning inequity. Dr. Mark Roehling, assistant professor at Western Michigan University’s Haworth College of Business, says that weight discrimination “is much more prevalent in the hiring process than bias against race or gender.” Again, it is the idea that people are to blame for their obesity that supports managers’ reluctance to hire overweight employees. Roehling states that employers are also unwilling to hire obese people because of higher medical insurance costs. In a blog concerning attractiveness on Career Builder’s website, some employers try to mask their prejudice by stating “it is the appearance of confidence they find attractive, not the presence of physical beauty.” However, this argument does not hold merit when most applicants’ testimonies claim their resumes and even telephone interviews seem to highly impress the employer until they finally meet in person.
The other way in which the occupation institution has discriminated against overweight employees is through an inequality in wage earnings. There is a strong, inverse stair-step association between an obese person’s physical weight and his/her salary compared to his/her “normal-sized” counterparts—(stair-step association implies that as “x” [weight] increases, there is a subsequent incremental change in “y” [wages]). For example, one study on tolerance.org states that mildly obese white women earned 5.9% less than their normal weight employees, and that statistic jumps to 24.1% less for morbidly obese white women. A similar study found that the average starting salary for obese MBA graduates was $3000 less than for non-obese graduates.
Education is the second institution in which weight discrimination is affecting obese people–specifically obese children. The two ways in which overweight individuals are discriminated against within the educational system are through the treatment of educators and peers toward the obese subject, and through the unequal distribution of resources which assist young people with college. It should come as no surprise that overweight children are discriminated against by their peers. One particular study cited by the American Obesity Association found that an overweight child was considered the least desirable option as a friend among four other “handicapped” individuals: a child in crutches, a child in a wheelchair, a child with an amputated hand, and a child with a facial disfigurement. However, Brownell states that what is more surprising is that there is similar prejudice against overweight children among their teachers: “28% of teachers in one study said that becoming obese is the worst thing that can happen to a person.” Perhaps this is the basis for studies like Christie Befort’s, which show that overweight children are also less likely to receive attention from teachers. These statistics illustrate the educational and emotional disadvantages overweight children have in succeeding. Unfortunately, these children’s disadvantages don’t improve as they near their college careers.
The National Education Association has confirmed that overweight teens are less likely to attend college regardless of the fact that, on average, overweight students achieve higher standardized test scores. There are a plethora of studies demonstrating the various factors that contibute to this unfortunate reality. One factor resides within the universities themselves: according to tolerance.org “university faculty members are more likely to refuse to draft letters of recommendation for overweight students.” Unfortunately, another important factor in determining overweight students’ likelihood to attend college resides within the home. A number of studies, including one by Brownell, have shown that parents do not financially support their overweight children as much as they do their normal-sized children. The American Association of Obesity claims that this statistic remained strong even when controlled for the parent’s education, income, ethnicity and family size.
The third social institution which discriminates against the overweight population is the healthcare system. In this institution, there are two major ways in which overweight individuals are again at a disadvantage: through physicians’ care, and through the obese individual’s reluctance to visit healthcare providers or their embarrassment when they finally do. Doctors in both mental and physical healthcare facilities are likely to allow their prejudice stereotypes to interfere with diagnoses and treatments. For example, Brownell found that in mental healthcare facilities, psychologists are more likely to assign negative symptoms—the withdrawal of normal psychological characteristics—to overweight patients than to their normal-weight counterparts. Within physical healthcare facilities, physicians admitted being ambivalent about discussing weight management with their obese patients and claimed they didn’t intervene as much as they should. Perhaps physicians’ and nurses’ inadequate care for the obese stems from their prejudiced thoughts towards these patients: Brownell’s study found that 24% of nurses said they were “repulsed” by obese people and 17% of physicians were reluctant to provide pelvic exams for obese women. Therefore, it is safe to say that the prejudice and discrimination experienced within healthcare facilities has a direct effect on one’s likelihood of ever returning to a hospital.
The second factor contributing to inadequate healthcare for the obese is their low confidence in visiting a physician in the first place. To continue with the example of obese women obtaining pelvic exams, studies show that the heavier a woman is, the less likely she is to have her regular exams. More specifically, Brownell’s study discovered that “32% of women with BMI over 27 and 55% of women with BMI over 35 delayed or canceled visits because they knew they would be weighed.” These women canceled their appointments due to embarrassment about their weight, but these same exams are meant to promote good health and can save lives. Under no circumstances should any individual ever feel so intimidated about their identity that they are hesitant to visit their own healthcare providers and attend to their own medical well-being.
There is no question that the “obesity crisis” is a cause for concern. The weight of the average American continues to increase each year: according to the Surgeon General, in 1999, 61% of adults in the US were overweight or obese. However, while our society is starting to pay more attention to how obesity occurs and to helping the obese get healthier, we are ignoring the ways in which we have permitted their disability to affect their everyday lives within the institutions that we as a society are supposed to rely on. There is no other group that is currently suffering as much as the obese are while their suffering is actually acknowledged and accepted by society. There are currently three laws on record that prohibit size or weight discrimination. However, Miriam Berg of the Council of Size and Weight Discrimination believes the first step in reform is not passing laws, but getting society to abandon their negative prejudices towards the obese. Our society needs to be presented with an alternate perspective on obesity—one that is not based on body-image, but is based instead upon social equality within the occupational, educational and healthcare institutions of this country.
About the Author:
Kathryn West grew up in Edina, Minnesota. She is currently majoring in Sociology with a minor in Psychology and Cinema-Television and will graduate in May 2006. After graduation, Kathryn plans to take a year to travel the world teaching English and experiencing new cultures. Eventually, she hopes to work in the documentary film industry where she can combine her passion for social sciences and political issues into a career.
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