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Lonie McMichael: Medical Rhetoric and Fat

• Post 4: Lonie McMichael: Love
• Post 3: Lonie McMichael: Resistance
• Post 2: Lonie McMichael: Internalization
• Post 1: Lonie McMichael: Intro & hook's ideology of domination
• BFB introduction and dissertation abstract.


When we consider the inception and focus on the Obesity Epidemic, making fat about health instead of looks was an absolutely brilliant rhetorical move by the anti-fat industry. In the early 1990s, an anti-dieting movement started growing, emphasizing the fact that diets did not work, a fact pointed out by Laura Fraser in _Losing It_. Even a 1992 NIH (National Institutes of Health) consensus panel also found that weight-loss dieting does not work and was actually detrimental to the physical and psychological health of the individual, a statement that was later retracted and is no longer posted on the NIH consensus Website. The movement against dieting continued to expand through the early 1990s until the anti-fat community responded to this anti-dieting message with a vengeance. Researchers who had spoken out against dieting “found themselves once again underfunded” (Fraser). Another dazzling rhetorical move on the part of those making money from weight loss attempts, instead of arguing that weight-loss attempts worked the obesity researchers “raised the stakes by suggesting, with very sketchy substantiation, that obesity had become one of the nation’s biggest health problems – a “disease” (Fraser). Now, fat became about health rather than aesthetics.

By stating that obesity itself was a disease – rather than a genetic characteristic or an effect of other factors such as illness or prescription drugs – a number of groups were able to profit in some way from trying to contain that disease. Whereas beauty issues might not have appealed to certain groups, such as feminists or men, making fat about health made it a moral issue (Campos; Oliver). Oliver says that “we have created a disease out of a physical symptom that, in turn, we are unable to treat” and that “we are ascribing moral characteristics to what is largely a biological phenomenon.” This calling overweight and obesity a disease in and of itself creates a number of implications for the fat individual, implications that provide legitimacy to fat prejudice and discrimination and promote negative attitudes towards the fat individual. Whereas the proponents of Fat Acceptance believe that fat is just normal human diversity, calling fat a disease seeks to force the fat individual into a narrow ideal of what is “normal.” Since it is seen as a disease, it must be eradicated at all costs, making extreme measures such as enforced fat camps seem not so farfetched.

Moreover, the anti-fat industry, this time working through the surgeon general and other government entities, again made a smart move by calling the increase in rates of overweight and obese individuals in the U.S. an epidemic, a rhetorical move that has incredible implications for fat individuals and for attitudes about fat in this country. Oliver claims that Dietz, the director of the Division for Nutrition and Physical Activity, started the idea of an epidemic; in fact, Oliver calls Dietz “patient zero” of the epidemic. By using a PowerPoint slideshow to reveal the growing “problem,” Dietz portrayed obesity as a disease slowly engulfing the U.S. Then, in 2001, a report, actually a high profile Call to Action, from Surgeon General David Satcher, reinforced this idea by declaring that we were indeed experiencing an obesity epidemic. Mitchell and McTigue state that the word epidemic “sounds an alarm bell” to the American people since it is a term “historically reserved for describing infectious disease outbreaks.” Epidemic has two potential meanings with two significant implications: the first being a medical term implying an infectious disease that can be transmitted causing quick and imminent death and the second being a rhetorical metaphor suggesting “the rising prevalence of excess body weight as a universal problem requiring collective response.” Secondly, using the term “epidemic” makes fat about public health, not about an individual’s wellbeing, and creates an atmosphere of urgency.

These moves provide legitimacy for practicing fat prejudice as a culture since people see this as a public health crisis that must be stopped.

Another Type of Love | Lapband Approved for Lower BMIs

loniemc February 23rd, 2011 | Link | I see your point, Debra. I

I see your point, Debra. I should say that I think many people who are trying to eradicate fat truly do care about fat people. They seem to think that making people skinny is the only way to help them. And the disease concept for most people falls into that idea.

However, I still think the people behind these moves, the ones who are instigating the moral panic, are in it for the money. Time and time again, I find that to be true. The more I study how the obesity epidemic came about, the more evidence I find that the anti-fat industry, primarily pharmaceutical companies, are funding it. For instance, Dietz reportedly has connections to Roche Laboratories (Xenical) and Knoll Pharmaceuticals (Meridia).

strawberry February 23rd, 2011 | Link | There's the big question -

There's the big question - are the moneymakers also taken in by the rhetoric they propagate or do they realize how much of a scam they're involved in?
Here's something I'd like to know - what's in the obesity epidemic scare that makes profits for medical insurance companies? It would seem that they ought to be natural antagonists to big Pharma and to weight loss surgery.
Debra, I hope you don't mind, I just had to chuckle at your "many diseases are just downright unappealing" comment. Is there a list of appealing diseases somewhere?
I'm surely not the first to notice this, but doesn't William Dietz provide some support to the idea that names influence career choices? (Yes I know there's a pronunciation difference.)

osxgirl's picture
February 24th, 2011 | Link | Strawberry - The profit for

Strawberry -

The profit for insurance companies is in charging more for those who are designated as obese. Some may also just deny coverage - insurance companies look for excuses to deny coverage to all but the young and (statistically) most healthy.

As to why they assume that denying coverage to the obese will save them money/increase profits: you have to look at how the obesity crisis has changed the way that deaths get classified. When someone who is not obese dies, the cause of death will be indicated as whatever is really discovered to have killed them. When someone who is obese dies, these days it is very likely the cause will be determined to be obesity, regardless of what the real underlying cause was. Any medical problem experienced by someone who is obese is likely to be blamed partially or fully on his/her obesity. These decisions skew the statistics on how much obesity costs the medical industry. And in turn, the insurance companies use these facts to justify much higher premiums for those who are designated as obese, or to drop those they think will cost more money and therefore cut into profits.

And, of course, the lower the threshold for obesity, the more people insurance companies can lump into the higher premium brackets with no real increase in treatment costs statistically.

richie79's picture
February 24th, 2011 | Link | Strawberry, I would suspect

"There's the big question - are the moneymakers also taken in by the rhetoric they propagate or do they realize how much of a scam they're involved in?"

Strawberry, I would suspect that whilst those lower down the 'food chain' (local officials, newspapers etc) either genuinely believe they're 'helping' fat people (evn as in some cases they marginalise and discriminate against them) or have simply jumped on the latest 'trendy' bandwagon for their own reasons (career advancement etc) without fully understanding it, those at the top are acutely aware of the benefits to be had from deliberately problematising and stigmatising what was once considered a natural human variation.

For me the main driver of the moral panic has been the media. Their news and current affairs agenda is heavily influenced by the rich and powerful, who invariably benefit from actively diverting public attention from their misdeeds and shortcomings through an artificial focus on an imaginary social issue and construction through repetition of a scapegoat class on which to pin the world's ills. Big Pharma wins too, by exaggerating the risks to a point where they can justify releasing dangerous drugs and surgeries whose benefits are claimed to outweigh their harm, and by charging national healthcare providers a small fortune for the illusory promise of long-term savings.

Moreover, whilst I would put the local public health officials etc into the former category, I am certain that the major pressure groups and charities (often the same thing) who are driving Government policy on obesity have become aware of the extent to which they rely on the perpetuation of the notion of multiple public health crises to justify their existence and funding streams, especially against a background of rising life expectancy, falling morbidity and the general perception that yesterday's big issues (smoking, infectious disease, poor sanitation etc) have largely been dealt with, in turn requiring the identification of new threats.

On the whole I'm inclined to agree with Lonie's assessment of the process. I certainly recall a much more sympathetic and tolerant climate toward size diversity in the mid to late 1990s, before it was redefined as an issue of national, rather than individual, concern requiring collective 'solutions'. The misconception that fat people can and moreover should strive to be thin as some sort of social duty remains central and is responsible for the level of hatred and prejudice against those considered to be 'shirking' it.

"What is right is not always popular and what is popular is not always right" - Albert Einstein

loniemc February 24th, 2011 | Link | You all have given me some

You all have given me some really good stuff to think about.

Debra, you're right -- we need proof. Unfortunately, without an investigative reporter we probably will not find it. We can look at the connections, however. What we do know is that the IOTF (Int'l Obesity Task Force) is behind the change in definitions for overweight and obesity, which is the instigation of "the obesity epidemic." And we know Dietz is associated with IOTF. We also know the IOTF is funded primarily by pharmaceutical companies (see Obesity task force linked to WHO takes “millions” from drug firms for connections to Dietz and funding info). The IOTF is behind a lot of research that is being used to justify the war on fat today. I have not tracked down every article and every move behind the epidemic. Yet, of those I have tracked down, they always lead to a pretty strong connection with pharmaceuticals.

loniemc February 24th, 2011 | Link | One other point, though the

One other point, though the primary rhetoric may come from money makers, our society took to it like fire to dry kindling. These moves are feeding a societal prejudice already present, not creating prejudice out of thin air.

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