To fight obesity, we demonize the obese
Gina Kolata the New York Times
October 29, 2006
First we said they were ruining their health with their bad habit, and they should just quit.
Then we said they were repulsive and we didn't want to be around them. Then we said they were costing us loads of money -- maybe they should pay extra taxes. Other Americans, after all, do not share their dissolute ways.
Cigarette smokers? No, the obese.
Last week the list of ills attributable to obesity grew: Fat people cause global warming.
This latest contribution to the obesity debate comes in an article in The Engineering Economist that calculates how much extra gasoline is used to transport Americans now that they have grown fatter. The answer, it said, is 1 billion gallons a year.
Their conclusion is in the same vein as a letter published last year in The American Journal of Public Health. Its authors, from the U.S. Centers for Disease Control and Prevention, did a sort of back-of-the-envelope calculation of how much extra fuel airlines spend hauling around fatter Americans. The answer, they wrote, based on the extra 10 pounds the average American gained in the 1990s, is 350 million gallons, which means an extra 3.8 million tons of carbon dioxide.
"People are out scouring the landscape for things that make obese people look bad," said Dr. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale.
And is that a bad thing? Dr. Sheldon H. Jacobson, author of the first study, doesn't think so. "We felt that beyond public health, being overweight has many other socioeconomic implications," he said.
The idea of using economic incentives to help people shed pounds comes up in the periodic calls for taxes on junk food. Martin B. Schmidt, an economist at the College of William and Mary, suggests a tax on food bought at drive-through windows. Describing his theory in a recent Op-Ed article in The New York Times, Schmidt said people would expend more calories if they had to get out of their cars to pick up their food.
"We tax cigarettes in part because of their health cost," he wrote. "Similarly, the individual's decision to lead a sedentary lifestyle will end up costing taxpayers."
Dr. Eric Oliver, a political scientist at the University of Chicago, said his first instinct was to laugh at the gas and drive-through arguments. But such claims often get wide attention, he says, and take on a life of their own. "This is like, let's find another reason to scapegoat fat people," Oliver says.
At an annual meeting of the Obesity Society, one talk correlated obesity with deaths in car accidents, and another correlated obesity with suicides. Oliver, who attended, said no one in the crowd of at least 200 questioned whether the correlations were really cause and effect. "The funny thing was that everyone took it seriously," he said.
Katherine Flegal of the U.S. Centers for Disease Control and Prevention also wryly cautions against being quick to link cause and effect. "Yes, obesity is to blame for all the evils of modern life, except somehow, weirdly, it is not killing people enough," she said. "In fact that's why there are all these fat people around. They just won't die."
The message in the blame-obesity approach, said Dr. James Marone, a political-science professor at Brown University, is that it is so important to persuade fat people to lose weight that common sense disappears. "Anything we can say to persuade you, we will say," Marone added.
So is it working?
It doesn't seem to be. Fat people are more reviled than ever, researchers find, even as more people become fat. When smokers and heavy drinkers turned pariah, rates of smoking and drinking went down. Won't fat people, in time, follow suit?
Research suggests that the stigma of being fat leads to more eating, not less. And if reducing the stigma suggests a solution, that's not working either.
"One hypothesis about getting rid of stigma is having more contact with the stigmatized group," Brownell says. But with obesity, the stigma seems to be growing along with the national girth.
He cites a famous study in the 1960s in which children were shown drawings of children with and without disabilities, as well as a drawing of a fat child. Who, they were asked, would you want for your friend? The fat child was picked last.
Recently, three researchers have repeated the study, this time with college students. Once again, almost no one, not even fat people, liked the fat person. "Obesity was highly stigmatized," wrote the researchers, Janet D. Latner of the University of Canterbury in New Zealand, Albert J. Stunkard of the University of Pennsylvania and G. Terence Wilson of Rutgers University, in the July 2005 issue of Obesity Research.
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