Big Fat Facts Big Fat Index

The Media

Is it okay to be fat?

This is the question posed in the Nightline debate linked to in withoutscene's posting below. The way I see it, when we ask "is it okay to be fat?", we're really asking a bunch of other questions:

  • Is a person allowed to have and maintain a body that is larger than average?
  • Is being fat a health problem?
  • Is a person with a health problem allowed to choose to not treat that problem?
  • Is fat caused by lifestyle choices?
  • Is a person in a group health plan allowed to make choices that might cause them to need more health care in the future?

When you break it down to what we're really talking about, I don't see how any rational person could conclude that it is not okay to be fat. What are your thoughts?

My Completely Unneccessary, Silly Letter to Jon Stewart: What's a Girl So Upset About?*

I know this letter is long and that's now how you're supposed to do protest letters, but I'm long-winded, people.

Jon Stewart,

Your bit with the fat suit on Monday’s show (September 14th,
2009) was distasteful, less than amusing, lazy, and sorely problematic. I know
what you were trying to do. People called you all lazy for taking three weeks
off; and since fatness is the ultimate symbol of being lazy, you got in a fat
suit. And since Jon Oliver had joked on his radio show about eating two whole
cheese steaks (or so I hear), you threw that in. Since you have a playful
relationship with Brian Williams, you took the opportunity to incorporate him.
I get that you were taunting your naysayers.  


I also get that for you it (likely) wasn’t about fat people
at all—but that’s part of the problem because it was on our backs. I know it seems initially an outlandish notion, but
you being in a fat suit and TDS using stereotypes and images of fat people the
way you did affects my every day life. I’m not saying you hate fat people or
that you are responsible for all of the derision and discrimination fat people
face—certainly not. But you are responsible for what you do, the messages you
spread, and your complicity, especially when so many people regard you as
someone well-reasoned, critically-minded, and progressive, someone who engages
in smart, sharp (if silly) comedy. Hang with me a second.


See, I am a fat person, and every day I deal with people
judging me as just some lazy fatass who doesn’t deserve a god-damn thing (aside
from a good fat-shaming, for my own good).
Fat discrimination, according to a recent study[1],
is as prevalent as race and gender discrimination in this country. I’m not just
talking about how people judge me on the street or how there is no room for
bodies like mine on TV. Fat discrimination and weight bias are prevalent in
health care, education, and employment. It affects real living, breathing
people. For instance, it affects the quality and thoroughness of care we
receive from medical professionals, and we suffer and some of us die because of

But what does this have to do with you in a fat suit? Fat suits have
been compared to blackface. Now, that’s not a historically equivalent
comparison in any way, but the the function is similar. You can put
on a fat suit and laugh with everyone else at the fat representation of you and
how gross and disgusting and wrong it is. TDS can further dehumanize fat
people by using a picture of a (faceless) bed-ridden fat person with Williams
face Photoshopped on—participating in what Charlotte Cooper calls the parade of
headless fatties—to drive home how disgusting it is to be fat. [3] And
in the process you and TDS can metaphorically masturbate stereotypes that perpetuate
the bias and discrimination we face in our every day lives—all for your joke
that really isn’t about fat people, which just means you have no regard for us
in the process.
And then you can take
that suit off and you don’t have to deal with the consequences.

Your promotion of fat stereotypes and dehumanization of fat people is part of a greater system of bias, discrimination, and dehumanization which directly affects my quality of life. It helps give people the idea that it's perfectly okay not to have any regard for us. After all, if we didn't like it, and if we had any dignity, we'd just put down the sandwich, right? If you had any sense, you might not assume fat people give up their dignity by virtue of being fat. For more a more
nuanced critique of “Fat on Film” you can visit the recent Newsweek slideshow of the same name:


This is why I’m disappointed in you and the TDS writers. I
expect better. And frankly, the best way to show your audience you haven’t
gotten lazy isn’t by telling lazy


There are three things you can do to help fat people and
our work toward social justice. First, educate yourself on this issue. Do not
take what you think you know about fat people for granted. Put some critical
thinking into it and be willing to challenge your own assumptions. Second,
bring critical fat studies scholars or fat activists onto your show. Open a
conversation. Linda Bacon (yes, bacon, haha) is a preeminent scholar of Health
at Every Size, who has found that fat people who don’t diet and don’t lose weight can be healthier than
ones who do.[4] She has
just published a book on the subject. Kate Harding and Marianne Kirby also have
a book out called “Lessons from the Fat-o-Sphere.” Recently, scholars in the UK
have published a book called “Fat Studies in the UK” and soon the long-awaited
“Fat Studies Reader” will be out. Finally, we don’t care if you make fat jokes,
just make them funny. Make sure that you aren’t merely reinscribing harmful
stereotypes, and make sure they are the same critical quality as the rest of
your bits.





Fat Human Being, Fat Activist, and Doctoral
Student in Sociology and Women's Studies


[1] Puhl,
RM., T. Andreyeva, and KD Brownell. 2008. “Perceptions of weight
discrimination: prevalence and comparison to race and gender discrimination in
America.” International Journal of
32: 992–1000.

[2]  See the blog
“First, Do No Harm: Stories of Fat Prejudice in Health Care”: and
also the Rudd Center for Food Policy and Obesity website:


[3] For the record, I know
TDS uses Photoshop to do much more ‘horrible’ things to people’s images—but
there is a particular history of fat people’s faceless bodies being debased and
dehumanized in the media, as your colleague, Colbert, has even pointed out.
Charlotte Cooper’s piece on Headless Fatties can be found here:

[4] Linda
Bacon’s website:

*Apparently being upset about something so trivial is just silly. And after all "The joke was funny--I'm a fat person and I thought so." And "It wasn't about fat people. C'mon, they make fun of EVERYBODY on that show." "Being angry about it isn't going to solve anything." "You shouldn't let words upset you so much--we should be showing people that words can't hurt us." And, of course, "Don't we [fat people] have bigger fish to fry?"
(These are paraphrases of claims made to me from people who identify as fat-positive, size-accepting, fat-accepting individuals. Claims that I hope to have arbitrated in this here letter.)

Edited to note: I know the racial comparisons I make are problematic. I hate to rely on comparisons to racial discrimination and bias to highlight fat discrimination and bias. I am open to finding new ways to make our cause seem serious and our claims seem legitimate without using analogies to other oppressions. I try not to. But in some cases, I just haven't quite figured out how to really put things in perspective for people without using comparisons. Even if I know it is problematic.

Ye Olde Double Standard

Sorry to devolve into TMZ territory for a minute, but I was just struck by this article about Leonardo DiCaprio being asked to lose weight for a role. Imagine for a second that the article is talking about a female starlet who happens to be 30 pounds heavier than a director wants her to be. I bet we wouldn't be hearing about how she's beautiful "at any weight" and how after the shoot she will hopefully gain back to a "healthy" weight. It would either be about how rightly ashamed she is that her body displeases someone or how she foolishly chooses to love her repugnant fat body as it is. Silly women, with their misguided self-love.

Check out Kate Harding on WTTW Chicago

This segment is definitely worth a look. Kate does a great job of presenting a cool and logical argument against the war on obesity. What kills me about the concept is that the doc they had on to discuss the anti-fat side espoused a lot of good HAES principles. How can you get HAES and not get that the war should be on crappy food and sedentary lifestyles, not body size? How can you still be comparing fatness with smoking when smoking is a behavior and fat is a characteristic?

Also, does anyone have any sources for data on whether the rates of fat-correlated disease have actually risen as sharply as fatness is claimed to have increased? Because really, if one in three people is now overweight but fewer than one in three people has a heart problem or the diabetes, doesn't that prove the point right there that there are plenty of non-sick fat people out there and that the government should leave us the heck alone?

Your thoughts?

Drop Dead Diva deserves a second look

I watched the first episode of Drop Dead Diva with the same skepticism as everyone else, and I found plenty to pick at, from the mainlining of easy cheese to the fat girl is all mousy and doesn't take care of herself thing. The second episode, however, really took me by surprise by how much it got right.

First, there's a storyline on fat discrimination in the workplace. Jane's client successfully worked at a hipster bar and then gained 50 pounds and was fired, so she sued the bar. During the course of the case, Jane's boss tries to pressure her into using the idea that fat is a disability to bolster her argument but ultimately she ends up telling him to shove it. There's a nice moment where she is giving her closing argument and discusses how the word 'fat' doesn't have to be a negative thing, just a descriptor. I mean really, when have you ever seen that on entertainment TV?

There's still a little too much talk around how Jane is fat because she likes to eat and is too tired to exercise at the end of her busy day, so not much Health at Every Size on the show, but I was so impressed by this second episode that I wouldn't be at all surprised if one day in the future she stumbles across that concept as well.

So if you can, please give the show a second chance. The writers seem to really get some of the concepts at the heart of fat acceptance and that just makes my day. Both episodes are available here. I'd love to hear what you think!

Fox News Anchor Defends Fat People?

By now I think most of you have probably heard about the NWA flight attendants who are demanding that they be allowed to wear the same "sexy" red dress as their thinner counter-parts.

And I'll give you one guess as to who thinks it's an outrage and that fat women shouldn't be allowed to be flight attendants anyway?

That's right, via Jezebel, obesity's arch-enemy, MeMe Roth, is on the warpath again. This time she's on Fox News. But there's a twist: The anchor, Stuart Varney, publicly shames her for her indulgent hatred!!

We have seen MeMe Roth and her special brand of crazy before, but this time she's got a crazy look and crazier antics than I remember. She acts like a two-year-old desperate for attention, holding up a pair of size 24 pants, laughing uncomfortably...and this guy tells just keeps on her and tells her, "That, madam, is a disgrace."

Who could've predicted that the taming of MeMe would have happened on Fox News?

(Go to Jezebel for the video. Can't imbed it at this time.)

Postscript: Granted, he goes way overboard and is out of line to say fat discrimination is "one of the most hurtful forms of discrimination," as if other forms of discrimination are somehow less hurtful. I'm pretty sure all forms of discrimination suck pretty badly. Oppression Olympics are unnecessary, sir.

Racialized, Sexualized, Dehumanized Fatness & Getting Fat Studies Totally Wrong

I caught wind of this gag-worthy article in the New Yorker--wherein the author mostly provides a lit review of people trying to solve the problem of our existence--thanks to the wonderful Susan Stinson.

First, check out the graphic. They created a fat-woman-of-color monster just for this piece! How delightful! Really, it's completely repugnant...but it's not like the New Yorker isn't famous for it's repugnant imagery.

The implication that (all) fat people are insatiable for fast food is the least of my worries about this image. It's the monster aesthetic--huge mouth, no eyes, disproportionate body, i.e. not human--and the woman-of-color harlot allusions all wrapped together that especially bother me. The dehumanization and fear-mongering is self-explanatory. The racialization is also pretty clear. The Jezebel stereotype as part of that racializaiton really stands out to me. They don't paint the fingernails of a fat-woman-of-color monster and put her in heels for nothing. The colors they choose are also telling. This cartoon from the Jim Crow Museum online comes to mind, but there are many other racist depictions that would illustrate the overtones of this image. The "threat" depicted is more than the threat of a voracious fatty, let's just say that. It's not by chance that Fat Studies scholars are thinking about how race and racial stereotypes intersect with fat and fat stereotypes. Fat gets racialized (and classed and sexually stigmatized), especially in the war on fat/against fat people, and we have to keep our eyes out for these things and be as pissed about those stereotypes and that already marginalized groups are special targets of fat hate as we are about the stereotype that frightening, selfish fatties will kill you for some damn food.

The article itself is less noteworthy in my opinion. I was annoyed at first sight, but tried to read through it anyway. The author's use of the word "tubby" on the second page really set the tone for me. Eventually, I skipped to the part I gave a damn about on the bottom of page 3, top of page 4 where the author talks about the Fat Studies Reader.

The author has clearly done some research. She gets it right that we prefer the word fat. She even name drops the PCA Fat Studies panels and "Fat and the Academy" run by the fatosphere's Sheana way back when. The real problems start at the middle of page 4 where Kolbert clearly misunderstands the term subversive and perhaps didn't read enough of Katie Lebesco's work to understand the quote she uses in the article. (I recommend reading Katie Lebesco's work--it's fantastic!) Then, Kolbert proceeds to mis-characterize Fat Studies, and by extension everyone in the fat movement:

In contrast to the field’s claims about itself, fat studies ends up taking some remarkably conservative positions. It effectively allies itself with McDonald’s and the rest of the processed-food industry, while opposing the sorts of groups that advocate better school-lunch programs and more public parks.

How do we "end up" despite our "claims"? By what means she does not state, but only implies. That's a terrible case of conflation, not to mention that she clearly cannot fathom why anyone would want better school lunches and more public parks other than the "obesity epidemic." IT IS THE REASON FOR ALL!!!! IF YOU DISAGREE YOU ARE FOR THE EEEEEEVIL.

Then, there's this gem:

To claim that some people are just meant to be fat is not quite the same as arguing that some people are just meant to be poor, but it comes uncomfortably close.

Um, not so much. Honestly, I don't even know what to say to that it is so ridiculous. It's like we have damned all fat people to their assumed horrible existence. Why would we do such a thing!?!? Perhaps Kolbert has read about Fat Satan.

Will Drop Dead Diva Live up to the Hype?

Like it or not, fat people have been making it onto prime time television. The Biggest Loser proved to be ratings gold, inspiring multiple seasons and a veritable franchise of products. Two more fat exploitation reality shows have hit the airwaves this season-- Dance Your Ass Off and More to Love. So Margaret Cho understands why people in the size-acceptance world might be a little skeptical about her new show Drop Dead Diva which premiers on Sunday July 12 at 9pm on Lifetime. But she thinks this show gets body acceptance right.

Thanks to CarrieP and withoutscene, I was able to attend a meet and greet on behalf of BFB with Margaret Cho and Brooke Elliot, the “plus-size” star of Drop Dead Diva. It was a fairly intimate group of bloggers, and I even got some one-on-one time with Margaret. When I asked what attracted her to this project, she told me, “This is a show for those of us who struggle to be visible. It treats body image with dignity and hope. I think it will create a new sex symbol…a new ideal.”

Drop Dead Diva is billed as a “dramedy.” Here's the set-up: Shallow, size-0 Deb and fat, brilliant attorney Jane end up at the entrance to heaven at the same time after simultaneous accidents. In a twist of fate, Deb ends up being sent back to earth, but accidentally lands in Jane's body. Comedy ensues... or does it?

The trailer doesn't exactly set this show up to be the breakthrough that it claims to be. However, both Brooke and Margaret (who plays Deb/Jane's faithful assistant) were adamant that this was not one long fat joke à la Shallow Hal. While there is some awkwardness when Deb finds herself in Jane's body, Brooke explained, it's really part of a larger journey, and one that isn't completely focused on body size. “Deb starts realizing that her life as a thin woman wasn't exactly perfect, and that maybe she has some things to learn.” Brooke went on to say that she hopes "people will receive the show in the spirit in which it was intended. This is a delicate subject that hasn't always been handled well.”

Margaret Cho has long been on record as someone who has struggled with body acceptance and eating disorders, largely due to her early experiences in Hollywood. “I would never condone or be involved with a project that was about fat jokes. The reason I took the job in the first place was because it dealt with issues of body image with such respect and grace.” She hopes that this will be a show that women, especially mothers and daughters, will watch together, and embrace seeing a "more realistic" body portrayed on screen.

The writer and creator of the show, Josh Berman (who has written for CSI and Bones) had a real-life inspiration for the show. According to Margaret, he was significantly impacted by his grandmother, who in his words “was as wide as she was tall,” but never let her size interfere with living life to the fullest.

While I believe that the writers and stars of the show have the best of intentions, I did lament to the panel that this show required a gimmick to get a fat woman center stage...after all, this is the metaphorical “skinny woman trapped in a fat woman's body”--the mantra of dieting women everywhere. I would much rather see a show where the lead is a fat woman (in a fat woman’s body) who is empowered, happy and successful; that would be a true breakthrough. Brooke agreed, and said that she too--especially as a fat actress--hoped that this might be a launching pad for more diverse shows featuring fat women.

I guess the proof will be in the pudding. I'll be watching on Sunday, for better or worse, and hope to be pleasantly surprised.

MeMe Roth is Made of Crazy

Look at this poor woman. Doesn't it look like maybe she needs a big ol' fat hug? I concur.

The thing I like about MeMe Roth is that she is such an easy target. She wears her hatred and her bigotry on her sleeve, has no good advice to give, and 99% of the time comes across to even fat-phobic reporters as bat sh*t crazypants. Aside from the fact that she is all about the fat hatred, there are two things I don't like about MeMe:

1. She gets a lot of attention from the media for her anti-fat blather
2. I am starting to really feel sorry for her

I mean, how could you not? She's so delusional! She insists she's not anorexic, in fact says she's "never been on a diet", but then in the next breath talks about how she doesn't eat breakfast, forces herself to work out before eating during the day, and finally admits that, the day of the interview, which occurred at 3:30 PM, she hadn't eaten at all! Sounds like disordered eating to me.

The article says her (fat) family finds her crusade to be hurtful, so I can imagine that family get-togethers are probably strained and uncomfortable for everyone involved. On second thought, I really feel sorry for her kids. MeMe comes across as so cold and controlled that I can't imagine she's all that warm of a mom. Not to mention what hell it must be to grow up in a house where no one eats. I hope I'm wrong about that, but I bet I'm not.

She just seems so intensely unhappy, so rigid, so devoid of joy that I can't help but feel empathy about the lifetime of hurtful experiences she must have gone through to get to this place. That woman does NOT like herself. Not even a little bit. Sure, I absolutely hate everything she stands for and most of the time I really wish she would just stuff a sock in it, but the sad little fat girl inside me recognizes that the sad little fat girl inside her really just needs some love. I hope one day she finally gets it.

Thanks Jenny!

Logic? What's that?

Okay you're telling me that people who are fat in middle age and then lose weight have a higher risk for health problems when they're old? And it doesn't occur to you that the weight loss itself could be causing the health problems? Aren't you, like, a scientist? Cause and effect? Ring any bells?

Thanks Jean!

Fat and global warming

When I first read this article I had an odd sense of déjà vu. Then I realized why: it's not a new story! Not only that, but every time this subject has come up, the same people seem to be behind it. Ian Roberts wrote the original diatribe in 2007, he and Dr. Phil Edwards wrote a letter to the Lancet in 2008 with the same message, and now they've published a study along these same lines. The thing is, all of their research is based on the same faulty assumptions: that fat people consume more energy by eating and driving more. Even this new "study" draws conclusions based on these assumptions. For instance:

Since it can be assumed that energy expenditure is approximately balanced by energy intake, it follows that total food energy consumption increases as BMI increases.

So, we're going to assume that each step up the BMI ladder means more food consumption? There have been studies to refute this, but even if you disregard them and assume that I, with a BMI of 60+ eat THREE TIMES THE VOLUME OF FOOD as a person with a BMI of 20, what about the one in four people in the UK who are on a constant diet? What about the 45 million Americans who go on diets each year? Some of those folks must be fat, yes? So right there you can see it's ridiculous to assume that every fat person eats more than someone with a lower BMI. If it were true, the diet industry would crumble.

To estimate the GHG emissions due to car travel by each population, we assumed that all individuals with BMI < 30 kg/m2 use an average small car (e.g. Ford Fiesta) and that individuals with BMI 30 kg/m2 use a car with more internal space (e.g. Ford Galaxy). The Ford Fiesta weighs 1530 kg and produces 147 gCO2 per km, whereas the Ford Galaxy weighs 2415 kg and produces 197 gCO2 per km.

So for the purposes of this study, we're just going to *assume* that all of the skinny folks drive tiny cars and all of the fat folks drive bigger cars. What about all of the skinny SUV drivers? What about the fat folks who drive hybrids or smaller, more fuel-efficient cars? What about all of the poorer fat people who don't even have their own car and instead take public transportation?

The increase in energy expenditure with increasing body weight should prevent further weight gain in a negative feedback loop but with rising BMI people are likely to move less, particularly those who are substantially overweight

Of course this part ignores the active fat people and imagines that all skinny people are active. It also incorrectly assumes (again) that the amount of walking a person does correlates somehow with their BMI. Furthermore, when I was digging for info I came across this article that states that driving might be better for the planet than walking anyway.

So Dr. Phil Edwards and Ian Roberts, here's some advice: no matter how many times you interpret and reinterpret these data, you're still starting off with a bunch of flawed, unproven assumptions that, despite the moderate media interest, add up to nothing more than fat-bashing, sizeist nonsense. Your "research" is focusing attention on fat people instead of the actual changes that need to be made to stop global warming. Do the planet a favor and kindly knock it off.

Thanks to DC and Marilyn for the tip

United Airlines and the upside of anger

So I was asked to give a comment yesterday on United Airlines' new policy to charge fat people double to fly on their planes. When the article came out the thing that struck me the most was how my response, which I had thought of as calm and rational, was being portrayed as "anger" and that I was "hitting out" against United. My first thought was "But wait...I'm not angry!" The more I thought about it though, the more I realized maybe I should be.

What United is doing here (and what the rest of the airlines have already done) is basically scapegoating fat people for the fact that there's no room in their tiny airplane seats. Air travel for most people is not a very comfortable or cheap way to go and if they can get us all focused on the specter of a fat person's fat encroaching on the armrest then we won't even think about how seventeen inches isn't really enough personal space for us to be comfortable sitting next to any stranger, even a thin one. Not to mention that by making the seats so small, the airlines are guaranteeing that a higher percentage of their passengers will not be able to fit into them and will then have to pay for two seats. It's like the BMI effect when a bajillion people became overweight overnight. These terrible fat people wouldn't be such a problem if the seats were at least made to fit average-sized adults.

An aside:

So okay, maybe it's not realistic to expect airlines to rip out all of the tiny seats and put in a bunch of average-sized seats. But would it be too much to ask them to put in a couple of rows of larger seats for larger folks? Sure, maybe they could even charge a little more for them, but there should be coach fare seats that fat people can fit into, no? Not everyone can afford two seats or first class seats. By putting in a row or two of plus sized seats, they can not only ensure that fat people are accomodated comfortably, they could also make sure no thin people ever have to put up with sitting next to them (egads!).

End aside.

Anyway, back to the scapegoating. Is it really logical and/or possible that fat people on planes are that much of a problem for United? According to their own press release, they got 700 complaints last year about fat people encroaching on thin peoples' space. 700...that sounds like quite a few complaints until you look at the other number in the article: 3000 flights a day. A DAY. Even if we take a seriously conservative estimate and say there are only 50 people on each flight, that means that 150,000 folks fly United every day. That's 54,750,000 people a year. So 700 of those people, or 0.00001% of the people who flew last year, had a complaint about fat people. I wonder how many people complained about delays or ticket prices. I wonder how many had something to say about lack of leg room or the terrible airline food. I'm willing to bet that any one of these things scored more than 700 complaints from United's customers, but to change them would cost the company money. Announcing a fat people policy, on the other hand, gets them free publicity, goodwill from the fat-hating public, and some extra fares paid by fat folks who now have no choice.

Another aside:

And United, don't give me that crap about how your industry is struggling and these evil fat people are putting such a strain on your resources by taking up two seats and not paying extra for them. First of all, didn't you just get a giant government bailout? What exactly did you do with that money? I know you didn't improve your planes because they're just as uncomfortable as they have always been. I know you didn't lower ticket prices because it still costs an arm and a leg to fly anywhere. I know you didn't use it to continue to pay your valuable employees because you're still laying people off. So what the hell? Isn't it time to examine why you keep running out of cash instead of blaming and double-charging your passengers?

End aside.

So yes, I'm a little angry. I'm tired of the airline industry and the fashion industry and the media telling me that the problem is me and my body and that I should just change and everything will be okay. My body is not the problem! Your complete denial that there is any body type other than model-thin is the problem. Your focus on doing things more and more cheaply so you can make more money is the problem. I am not an anomaly. I am not "other". I am a valid member of the human race and I don't deserve to be excluded or asked to pay more for the same goods and services as thin people. I and the millions like me deserve to be considered when you're building a new airplane or designing a new clothing line for the masses. We are the masses! Stop acting like we don't or shouldn't exist. We're here, baby. One way or another, you're going to have to deal with us.

That is all.


According to this article, studying ten people for three days is enough to generalize about the behavior and activity level of an entire segment of the fat population.

While I appreciate that the researchers doing the study seem to have reached the same conclusion that every HAES proponent has known for years, it annoys me that Reuters is choosing to frame the results as "big fat fatties are totally lying when they say they have healthy habits!" instead of "habits are better indicators of health than weight or size". Arg.

They should call the article "Ten very obese adults almost completely sedentary." That's some news there.

They want our brains!!!

Zombies? No, obesity doctors.

You read that right. Though they want in our brains, rather than eating them up. But part of me thinks they’d eat our brains if it’d “cure our obesity”—after all, it’s for our health!

On Tuesday Nightline covered a story about a woman, Carol, who agreed to be the second person in the U.S. to undergo “the most radical treatment ever devised for obesity,” a treatment called Deep Brain Stimulation. Basically, surgeons drill into her brain and carefully poke around, sending electric currents into her brain until they identify the part that controls her hunger, feeling of satiation, etc. And then they implant “two brain pacemakers” into her chest that will send those same electric currents to her brain. TWO!!! The currents are supposed to keep her, it seems, feeling full enough—meaning they are sending volts into her brain to simulate a feeling “just below [the] threshold of nausea.” According to one surgeon, this will “readjust her weight thermostat so that she can metabolize better and potentially eat less, if that’s what it takes.” Eventually they will have to dial it up a notch to keep her feeling full.

I respect this woman’s right to do this, but I do not respect the doctors/researchers’ endeavor to perform it, nor am I very satisfied with Nightline’s coverage. Martin Bashir doesn’t ask the tough questions, evaluate the risks of this radical procedure or the assumptions it’s based on, or even present more than a flittering critical thought throughout this report. It’s not that Bashir seems all that gung-ho about it, but in the end it is just another booga-booga-OMGtehFats puff piece, rather than an investigative report.

I tend to be long-winded, so I decided to at least organize my long-windedness and post a list of my the top of my head.

1. The contention that “obesity is the most painful problem in the world.” Now, I took that out of context. The actual quote is, “For Carol Poe, obesity is the most painful problem in the world.” If she said this and she feels it’s her biggest problem, I feel really bad for her and what she must go through...not that she’d be the only one who thinks being fat is The_Worst_Thing_Evar ™. We all know that people would rather die than be obeeeeese (or “overweight” or even a little fat); fatness is many people’s greatest fear. But this segment only reinforces the idea that it’s the worst thing that could happen to a person and that we should all be very, very afraid of the fats. The same news show would likely do a story on how young girls are so afraid of fat and not see the connection between girls’ fear of fat and their own reporting.

2. The doctors’ treatment of “obesity” as though fatness is a disease like Parkinson’s. Fatness is not a disease, people. Yet doctors think that since Deep Brain Stimulation worked on Parkinson’s (not sure how accurate that is) they can and should save the world from fat people—and fat people from themselves—using DBS.

3. That’s right, we can’t control ourselves, so they’ve gotta go into our brains and do it themselves. See how much work we make them do? If this procedure “works” (whatever that means), there may be a time when any “obese” person who doesn’t subject themselves to DBS and “brain pacemakers” will be seen as both socially and personally irresponsible. If so, at the same time we will still be lamented for our inability to control ourselves of our insatiable need for instant gratification. A judgment all based on weight.

4. The “Fat Carol” to “Ideal Carol” digital transformation. Really? Like fat people don’t see enough of this on weight loss commercials. The fact that “before” and “after” pictures have become a staple in our culture is evidence that we have some real problems. When we set up any kind of “ideal” body shape/size, we have a problem.

5. This segment addresses nothing about health. No mention of measures of her health before or after. No mention of health other than the cursory mention of her mental health/anguish regarding her fatness and the implication that she is a compulsive eater paired the idea that her compulsive eating is what’s at the root of her “fat problem.” After all, they wouldn’t need in our brains if we could control ourselves. You wanna bet people still come away form the segment assuming this will improve her health? What happens if this woman actually ends up malnourished? This implant is manipulating signals sent to her brain about what her body needs; it completely suppresses any chance she would have of listening to her bodily cues regarding hunger and nourishment.

6. According to the segment, this woman is 230lbs. I think a simple WTF covers this.

7. Surgeon guy: “For some it may seem radical that electrodes should be put in the brain, that someone should be doing brain surgery for obesity. But I think we’ve gotten through that.”
Me: Uh, no we have NOT.

8. This is not scientific, at least not in the sense that we can deduce anything whatsoever. (Though the fact that they know so much about the brain is pretty friggin cool, if scary.) There is no control group. She’s just one woman, and she’s doing things in addition to getting the DBS implants that might affect the outcome. Not to mention the possible placebo effects of something as serious as brain surgery. And on top of all this, we have just seen a snapshot of her experience. We in no way know what the future holds for her or whether eating less would make her thin or even “overweight.” And yet people will assume. And we will continue to suffer from their poor assumptions because when you are addressing OMGtehFatness you don't have to think critically, ask tough questions or give an accurate portrayal of risks and benefits.

Finally, I have been really trying to create “action steps” lately...but on this one I am not seeing a clear path. I did tweet Nightline a piece or two of my mind, not that they paid any attention. Maybe we should suggest that Nightline do a segment on weight discrimination and prejudice in health care and the real health consequences of both, or a segment on HAES. Any suggestions?

More info on this from Sandy Szwarc at Junkfood Science

Solid TV Report on Fat Health Care

DebraSY pointed me to a great report from the Kansas City Fox affiliate on fat health care. The story is surprisingly good, and it's available in video form - definitely worth a look.

The narrative here comes from Ann Pei, whose sister Joyce was denied proper care due to her size.

Studies have found health professionals spend less time with obese patients and view them as less likable and more emotional. Young doctors claim medical school are addressing the issue.

"They always taught us to confront our own biases, not just about obesity, but all chronic health conditions. Confront your biases. That helps you meet the patients where they are," says Dr. Veronica Anwuri with Saint Luke's Medical Group.

Debra also notes that Laurie Todd, the first person interviewed in the piece, has started a group called Stay the Course KC "dedicated to bringing out fat people who have isolated themselves, and getting them reinvolved in the community and with one another."

This is a really straightforward piece overall and I'm most impressed at the lack of negativity here. It's handled with careful consideration and yet drives the point home nicely. Good stuff.

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