Legislating Weight Loss: Is Fatness a Federal Affair?

Pull up the U.S. Food and Drug Administration (FDA) homepage these days, and it looks frighteningly like the latest copy of "Glamour" or “‘O’ Magazine.” At www.fda.gov/loseweight, we're told, "You Can Lose Weight—Here's How!" followed by instructions on counting calories, setting weight-loss goals and "giving ethnic foods a try." Legislating Weight Loss: Is Fatness a Federal Affair?

By Maya Schenwar

Pull up the U.S. Food and Drug Administration (FDA) homepage these days, and it looks frighteningly like the latest copy of "Glamour" or “‘O’ Magazine.” At www.fda.gov/loseweight, we're told, "You Can Lose Weight—Here's How!" followed by instructions on counting calories, setting weight-loss goals and "giving ethnic foods a try." The goal is to combat what the FDA calls the "obesity epidemic," which supposedly claims the lives of 400,000 Americans per year. The United States Department of Agriculture (USDA) 2005 Dietary Guidelines target weight loss as America's number one health goal. The war on drugs is old news, ladies and gentlemen. It's time to rally the troops for the war on fat.

The FDA is spreading the message through a variety of obesity awareness advertisements and programs in schools and workplaces. Government intervention in weight loss doesn't stop at "educational" efforts, though. In many states, including Arkansas, Missouri, Tennessee and West Virginia, schools are required by law to weigh students each year and report their weight and Body Mass Index (BMI) to their parents, in a format much like an academic report card.

Meanwhile, at home, government health agencies claim that over 30 percent of Americans are obese, endangering their health and shortening their lives. However, many health professionals are questioning the link between body fat, illness and death.

Dr. Glenn A. Gaesser, a professor of kinesiology at the University of Virginia and author of Big Fat Lies: The Truth About Your Weight and Your Health , calls the FDA's standards for morbid obesity "arbitrary," noting that people do not die of fat.

“There are 'healthy obese' people who are in no need of 'treatment,'” he said. "Furthermore, most of the health problems of the 'unhealthy obese' (i.e., blood pressure, lipids, insulin and glucose) can be remedied by changes in diet and physical activity independent of weight loss." In his recent study, "Obesity, Health, and Metabolic Fitness," Gaesser reports that fat people are no more likely to have clogged arteries than thin people, and that body weight and BMI are not indicative of death rates. In fact, according to a study by the federal Center for Disease Control (CDC) itself, "excess" body fat does NOT claim 400,000 lives per year; people categorized as "overweight" (BMI 25-30) actually tallied 86,000 fewer deaths per year than those categorized as thin.

The rigid standards set by the government are outdated and are not based on sound science, says Peggy Howell, public affairs chair of the National Association to Advance Fat Acceptance (NAAFA). The height/weight charts that determine BMI were created in the 1970s, with only a slight revision in 1998. "I don't question the statistics that 30 percent of the American population is over a particular weight," Howell said. "I do, however, take exception to the yardstick they are using."

In April 2005, the yardstick was revised—but it hasn't gotten any longer or more flexible. Replacing the USDA's classic Food Pyramid, the new system—MyPyramid—recommends a more "personalized" approach to weight loss, advising Americans to gradually modify their food choices and exercise habits. So far, so okay. However, the program website directs users to the USDA BMI Calculator, which prescribes rigid calorie counts and recommended foods—“personalized,” apparently, means ignoring your appetite and planning your meals according to a government-regulated computer program.

Calorie-Counting Cosequences

According to MyPyramid’s creators, thinking healthy means doing your math. "Our report concludes that there is no substitute for the simple formula that 'calories in must equal calories out' in order to control weight," said FDA Deputy Commissioner Lester M. Crawford upon unveiling the government's 2005 dietary guidelines. "We're going back to basics, designing a comprehensive effort to attack obesity through an aggressive, science-based, consumer-friendly program with the simple message that 'Calories Count.'"

Yet many health professionals concur that counting calories is not the route to better health—in fact, it could mean body sabotage. Putting America on a diet won't solve its health concerns, says Gaesser, calling the USDA's 2005 Dietary Guidelines "misguided." He notes that there are no weight loss programs with a high success rate, and that dieting often ultimately leads to weight gain. Moreover, dieting—especially yo-yo dieting—can actually worsen cardiovascular health, and, Gaesser notes, the super-popular low-carb diet tends to raise cholesterol levels.

Marilyn Wann, a member of the NAAFA board and author of FAT! SO?: Because You Don’t Have to Apologize for Your Size, adds that the push toward weight loss actually gives nutrition and exercise a bad rap. "The categories of 'overweight' and 'obesity' are nothing but a danger to public health," Wann said. "Thin people will enjoy better health if they eat their veggies and enjoy regular physical activity. But as long as those health-enhancing habits are linked to weight-loss goals, everyone will avoid them. The average person wants to avoid punishment. When good nutrition and regular exercise are used to punish us fatties, it's a poison pill that gets in the way of everybody enjoying good health habits." Calorie-counting and prescribed diets—external monitors of “health”—can lead us to ignore our internal signals, which can help us figure out what makes our own bodies happy and healthy.

What's more, the government's overwhelming emphasis on weight loss ignores a significant weight-related problem that may well have reached "epidemic" proportions: eating disorders. On the USDA BMI calculator website, a healthy BMI is defined as "below 25"—no mention is made of the dangers of being underweight. However, American children are 222 to 1097 times more likely to have an eating disorder than Type II diabetes, according to policy analyst Radley Balko, who averaged data from the CDC and the National Institute of Mental Health.

So, why no www.fda.gov/eatingdisorders site, featuring pictures of skeletal-looking people and ads for Ensure weight-gain shakes? "You can't 'see' eating disorders, except for the extreme and relatively rare cases of anorexia," Gaesser said. "Obesity is visible twenty-four/seven—and our culture doesn't tolerate fat."

Weight Discrimination: The Acceptable Prejudice

This hardly questioned intolerance of fat—even from "official" sources like the FDA—means that fat people must deal with a lot of "official" discrimination, with few legal defenses available to them.

Weight bias isn’t just a matter of getting made fun of on the playground (though that’s a serious problem in itself). A study by the Yale Rudd Institute reports that 24 percent of nurses said they are “repulsed” by fat people, and 28 percent of teachers said that obesity is the worst thing that could happen to a person. Over all, parents give less money for the college education of their “overweight” children than their thin children. Fat discrimination plays out in hiring practices and even in wages. Studies show that most employers would rather hire a thin person than a fat one, and that highly-educated obese women tend to earn less than their “normal”-weight peers.

Sondra Solovay, adjunct professor of law at New College of California and the author of Tipping the Scales of Justice: Fighting Weight Based Discrimination, says that the government’s emphasis on weight loss stigmatizes fat people and perpetuates already-rampant discrimination.

“It makes it harder for people to be judged on their merits rather than their measurements,” Solovay said. “In practical terms it means a fat student will be more likely to drop out of school; if she survives school she will be more likely to be denied a good job; if she gets a good job she will be more likely to be denied health benefits; if she gets health benefits she will be more likely to face barriers to health care. It limits the ability of fat people to contribute fully to society which hurts our culture at large.”

It would seem that the federal government’s role in this mess would be to combat weight bias, as it has attempted with racial, gender-related and disability-related biases. However, according to the Rudd Center for Food Policy and Obesity, no national laws prevent size discrimination. In addition to the lack of laws protecting fat people’s rights, Solovay notes that few law organizations volunteer to take on weight discrimination cases. This isn’t just a right-wing thing, either:

“Fatphobia runs very deep and is especially entrenched in many ‘progressive’ communities,” Solovay said, pointing to animal rights organizations like PETA, which launched a campaign featuring “Chubby Charlie” trading cards that read, “Eat fat and you’ll be fat. Be kind to animals and to your butt and gut by avoiding fattening dairy products.” (See www.milksucks.com/milksuckers.html.)

The “Why’s” of Fatphobia

So how did the American public—from nurses to teachers to government officials to leftist activists—come to agree that “fat is bad”? It’s about early “indoctrination,” Glenn Gaesser says. Health texts in schools portray weight in the standard fashion, teaching kids that fat is a sure sign of health risks and acknowledging no evidence to the contrary.

It isn’t just about the assumptions that fat people are unhealthy or unattractive. Fatphobia is also caught up in American ideas of morality, notes Peggy Howell. “Under the guise of concern for our well-being, fat people are made to appear to be undisciplined, glutonous, and slothful, and therefore worthy of ridicule and discrimination,” she said.

This supposed morality connection may heighten anti-fat fervor in the United States, where the thread of the Puritan work ethic—and the Puritan value system—still runs through the social fabric. The idea of working toward the goal of thinness crops up in virtually all weight loss propaganda.

Obesity is even more likely to be portrayed as a moral failing when it’s linked to minorities and poor people, according to a recent study by sociologist Abigail Saguy of UCLA. As with alcohol, cigarettes and drugs, even “official sources” tend to connect fatness with lower income. Some anti-fat articles and ads claim that working mothers—not to mention single working mothers—have contributed to the “obesity epidemic” by neglecting their families’ nutritional needs. Others argue that poor folks are more apt to choose quick fixes, like fast food and candy bars, when hunger hits—feeding into the stereotype that both fat people and poor people are lazier and less sensible than their size-four friends.

Money is tied to the obesity panic in an even more direct way, according to Marilyn Wann, who points to a profit-driven motive for the war on fat. “In the government, public health officials have a monetary interest in pointing fingers at two thirds of the population, because they get huge funding streams to combat dread 'obesity,'" Wann said, adding that government researchers are often paid consultants for weight-loss companies like Weight Watchers, or for pharmaceutical companies that develop diet drugs.

Fighting Fatphobia

With most of America—including many left-leaners—stuck in fatphobe gear, starting up a successful movement against legal weight discrimination may seem next to impossible.

Luckily, there are plenty of folks who don’t feel that way—and luckily, some of them are influential psychologists and doctors. Claudia Clark, who heads the Association for Size Diversity and Health at Bowling Green State University, promotes a philosophy of “Health At Every Size” (HAES). Her organization provides info about nutrition and exercise, holding that becoming healthier is about lifestyle changes, not body size makeovers.

“Naturally, there are things that are necessary to control,” she said. “The spread of actual disease that really is a threat to life needs to be controlled. We HAES professionals have seen sufficient evidence in the research literature that body size and weight are not in that category.”

HAES-minded psychologists and doctors hope to spread the word to other health professionals. It’s slow going, Clark says, but more doctors are becoming open to treating large patients without including weight loss in their prescriptions. She notes that more funding for medical research on the subject—such as Glenn Gaesser’s studies on weight and heart risk—could make a big difference in how professionals view fat.

But will this research sway the federal government toward a health policy that doesn’t resemble a swimsuit competition? So far, activists have mostly concentrated on the more realistic goal of state-based advocacy. Weight-based discrimination is now illegal in San Francisco, Santa Cruz, Washington DC and the state of Michigan, according to Peggy Howell.

It’s a start. It’s important to keep thinking big, though, Solovay says; as long as national policy advocates weight loss and ignores weight-based discrimination, smaller-scale policies are a lot less successful.

“These laws are good, but I would much rather see something federal so that protections from discrimination were universal and easier to enforce,” Solovay said. “Right now discrimination that is illegal in San Francisco is perfectly legal on the other side of the Bay Bridge.”

Fat Activism and Fun

However, on both sides of the bridge, there’s a lot of resistance going on that doesn’t involve banging on Congress’s doors. In San Francisco and beyond, bands, dance troupes, and radical cheerleading squads are cropping up that specifically target issues of weight discrimination.
In Wann’s words, “Fat is punk rock!”

The band Creamy Goodness, headed by Max Airborne who also co-edits the zine, “Size Queen,” infuses its lyrics with straight-up fat pride:

Fat Girl can't live out no Clark Kent lies
Girdles, corsets, vertical stripes, there is no disguise
She's omnipresent, she's an omnivore
You know you can't hide from Fat Girl

Lots of folks aren’t hiding from Fat Girl, these days… they’re seeking her out at Big Burlesque, the Original Fat Bottom Revenue, a San Francisco erotic dance club where, as the San Francisco Bay Guardian puts it, “audiences get teased and pleased by ladies whose corsets runneth over.”

Flashing some ample flesh may not seem a direct challenge to the upsurge of federal weight management. However, Cherry Midnight, a former dancer at Big Burlesque and a Bod Squad Fat Power cheerleader who co-edits “Size Queen,” says that working to combat fat bias at a personal, ground-up level is just as important as demanding official rights; societal values and fashions aren’t dictated by the government.

“There is no one road to social change, especially for unpopular causes that have big money on the other side,” Midnight said, pointing to the pharmaceutical and diet industries, which have a keen interest in maintaining the super-thin ideal. “That is serious opposition. You gotta use the law, you need to have fun, you need to build a culture you want and actively create the world you want to live in.”

This culture may begin as a counterculture—“fat communities” have begun cropping up in recent years, providing a space for fat people to be openly happy in their bodies outside the bounds of public disapproval. NOLOSE, a group for fat lesbians, holds conferences and retreats where members share their experiences, eat together, and even go to the pool—an activity that some of the women had never participated in before joining.

NOLOSE is made up of writers, activists, performance artists, lawyers, doctors, academics, sex workers, dildo vendors, filmmakers, dancers—all tackling fatphobia from different fronts, said Devra Polack, the organization’s outreach coordinator. A positive attitude doesn’t hurt either.

“Fat people rule!” Polack said. “It’s in our jeans.”

Take that, FDA.