In the 1980’s people in the healthcare industry began to notice obesity as a growing problem, but it has taken several decades for the public to catch up. According to Barry (2009), “the emergence of obesity onto the political agenda was catalyzed in part by a surgeon general’s report (U.S. Department of Health and Human Services 2001) on the topic and the extensive media coverage of the issue that followed” (p. 11). Though the problem has now saturated the public consciousness, solutions have been scattershot and increasingly polarized. On one side are people who say that weight is the problem of lazy people, and if those people would just get up off of the couch and go to the gym they would stop being a national eyesore and financial drain on society. On the other side are people who have dealt so long with body shame that they have begun campaigns toward “body positivity” which, in some cases avoids healthy solutions by saying there is no problem. Undoing the stigmatization of obesity and creating solutions which address society as a whole would lead to healthier outcomes for people who are currently obese, or in danger of becoming so….
While studies have been done to support the idea that obesity causes greater health risks and a strain on the healthcare industry (Finkelstein, 2017, p. 1), current methods for solving this problem have born little fruit. Obesity continues to rise. Because obesity is so stigmatized in our culture, most suggested solutions are punitive. It is up to those fat, lazy people to have some self-control. If they do not get to work, they will be penalized through higher insurance rates and social shaming. Shaming narratives are harmful to people who are already struggling with feelings of worthlessness- a feeling brought on by our culture’s obsession with fit and beautiful people. This is a beauty standard, by the way, that even thin people find difficult to fulfill and few people feel as though they have reached. While society, including obese and overweight people, blames the problem on individuals, people will stay caught up in the ineffective and expensive volley of diets until realistic and healthy solutions are found.
The toll that diets take is physical, emotional, and financial, with few long-term success stories. In an article on the myths surrounding obesity, Michael Hobbes (2018) says that “Since 1959, research has shown that 95 to 98 percent of attempts to lose weight fail and that two-thirds of dieters gain back more than they lost” (para. 9). Hobbes also points out that the assumption that weight and health are directly connected is false (para. 10). Many people who are fat are also fit, and a study done in 2016 “followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people” (Hobbes, 2018, para. 10). When people fail to maintain weight loss and then eventually slingshot to a higher weight, their sense of shame increases, as well. Taught that the main goal of healthier eating is to lose weight and that losing weight is the only way to decrease dire health risks, people are left with a sense of hopelessness and shame. Shame is then a catalyst for binge eating and a return to unhealthy habits. Meanwhile, they have spent money and time on yet another failed solution.
Reframing obesity as the culmination of unhealthy social norms (such as the value placed on overworking that make fast food and entertainment necessary band-aids for exhaustion) and not as a personal failing would be the first step toward positive change. Obesity is often thought of as a horrible disease brought on by poor life choices. Public policymakers use metaphors about war to mobilize people toward change, but in doing so, they negatively affect the kinds of solutions people seek. Speaking of war as a metaphor for addressing another disease, Susan Sontag (1989), in her book, AIDS and Its Metaphors says, “The metaphor implements the way particularly dreaded diseases are envisaged as an alien ‘other,’ as enemies are in modern wars; and the move from demonization of the illness to the attribution of fault to the patient is an inevitable one” (p. 99). Metaphor is a helpful tool for understanding new concepts, but giving just one metaphor to a complex issue creates its own problems.
Now that obesity is a well-established issue, it is time to move away from simple metaphors and toward a more intelligent social campaign. Pieces of this campaign would address causes for obesity from the food most promoted in commercials and available in stores to hereditary predispositions to finding beauty in all body types. Other causes of obesity, like stress, would require buy-in from the medical arena and the workplace. Employers who realize that their most effective employees will be those who are happy in their personal lives will look for ways to promote mental health, such as mental health coverage in their insurance plans. Similarly, employers have the opportunity to help their employees manage stress by checking in with them regularly about their work/life balance. Although the bottom line is a necessary focus for most businesses, that line can only improve as employees come to work more rested with clearer heads.
Along with environmental, hereditary and social factors, a focus on healthy eating and exercise still holds a big place in a move toward a healthier society. Transcribed from a symposium given in Aukland, New Zealand on obesity, Teresa O’Connor (2007) quotes Paul Campos saying, “The ‘obesity problem’ could be eliminated by not framing it as a problem. Health at every size is what we should focus on” (p. 13). When thinness stops being the goal, thin and fat people are free to focus on things that will add quality to their lives. Additionally, the polarization found in the body shaming and the body positivity camps could dissolve, and those people could unite under the reality that everyone is valuable and responsible for their own health. Solutions in this direction include making gyms more financially accessible to everyone, creating more spaces outdoors that will allow people to exercise, and promoting a lifestyle of healthy movement instead of an often futile battle for a bikini body.
To change our bodies, we must change our minds. Berg (2016) says that while “prejudice plays a significant role in policy attitudes… promoters of comprehensive environmental health policies may need to include prejudice reduction measures in their efforts” (p. 138). Focusing on both health and body positivity is possible. Even now, social media sites are full of plus-sized models who are not only pictured wearing fashionable clothes but often post photos of the healthy food they are eating, and photos of themselves working out. On these accounts, there are no before and after images in sight, because they choose to focus on getting healthy and not changing how they look to suit social norms. Other media could use this perspective, as well. Movies which utilize overweight actresses who play complex roles and live healthy lifestyles, ads showing overweight people using everyday products that have nothing to do with dieting, all of these would add to a more inclusive public narrative.
Just as the reality of the obesity “epidemic” took decades to sink into popular understanding, appropriate attitudes and effective action will take a long time to implement. The diet industry, as well as fast food chains around the country, would take a huge blow if the social consciousness shifted toward real health. While it seems as though the impact on them would only be negative, these companies have the opportunity to step out front and become leaders in a more holistic health movement. Even now, fast food restaurants are adding healthier options to their menu, as well as caloric information so that consumers can make more educated choices. The world of diet pills, meal replacement plans, specialty cookbooks, and before and after magazine ads would require the most creativity to stay solvent. But maybe the diet industry needs to die for people to move away from the psychological crutch of that next miracle pill. Is it possible for this very misunderstood issue to move away from unhealthy extremes? Only when we focus more on physical and mental wellness for everyone and less on the shape and size of bodies will we begin to move together toward a healthier nation.
Barry, C. L., Brescoll, V. L., Brownell, K. D., & Schlesinger, M. (2009). Obesity metaphors: how beliefs about the causes of obesity affect support for public policy. Milbank Quarterly, 87(1), 7-47. doi:10.1111/j.1468-0009.2009.00546.x
Berg, M. B., Lin, L., Hollar, S. M., Walker, S. N., & Erickson, L. E. (2016). The relationship between weight-based prejudice and attitudes towards obesity-reducing public policies. Analyses Of Social Issues And Public Policy, 16 (1), 125-142. doi:10.1111/asap. 12113
Finkelstein, E., Trogdon, J., Cohen, J., Dietz, W. (2017) Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Affairs. Retrieved from https:// www.healthaffairs.org/doi/10.1377/hlthaff.28.5.w822
Hobbes, M. (2018, September 19). Everything you know about obesity is wrong. Retrieved from https://highline.huffingtonpost.com/articles/en/everything-you-know-about-obesity- is-wrong/
O’Connor, T. (2007). Deconstructing the ‘obesity epidemic’. Kai Tiaki Nursing New Zealand, 13(10), 12-13. Retrieved from http://search.ebscohost.com.proxy- library.ashford.edu/login.aspx?direct=true&db=ccm&AN=105922710&site=eds- live&scope=site
Sontag, S. (1989). AIDS and its metaphors. New York: Farrar, Straus & Giroux.