What's Wrong With Fat? (26 page)

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Authors: Abigail C. Saguy

Tags: #Health & Fitness, #Medicine, #Public Health, #Social Sciences, #Health Care

BOOK: What's Wrong With Fat?
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Compared to participants who had read the control articles, participants who read either the news reports framing fatness as a public health crisis or those framing it as an issue of personal responsibility were more likely to agree that it was unhealthy to be fat. In contrast, compared to the control group, those who read either the articles advancing a health at every size or those promoting a fat rights frame were significantly
less
likely to say that they thought being fat was medically dangerous. As shown in figure 5.1, agreement with a series of question about whether it is unhealthy to be fat ranged from 6.1 for those who read the fat rights articles to 8 for those who read the personal responsibility articles. 11 In sum, these results suggest that exposure to different news media accounts shifts attitudes about health risk, at least in the short term.

Figure 5.1:
Attitudes about whether it is unhealthy to be fat by experimental group, Experiment 2.

Another way in which we measured attitudes about weight and health was by showing respondents computer-generated images of women in bikinis at various body sizes and asking them whether they thought it was possible to be healthy at that size. They could respond either “yes” or “no.”
We found striking differences for the image of a woman with a BMI of about 34 (at the top of the “obese 1” category). In Experiment 1, only 27 percent of the participants who read the personal responsibility and public health crisis articles agreed that this woman could be healthy, compared to 65 percent of those having read the health and any size and fat rights articles.

Testing the effect of these frames separately and comparing them to a control, in Experiment 2, provided additional insights. Only 36 percent of people who read the personal responsibility articles and a mere 15 percent of those who read the public health crisis articles agreed that the woman could be healthy. In comparison, a whopping 82 percent of those having read the fat rights articles said that it was possible to be healthy at that weight. Those having read the health at every size and control articles fell in the middle at 59 and 57 percent, respectively. The lack of effect of the health at every size frame is puzzling and suggests that this position, while questioning that it is not necessarily unhealthy to be fat, does not present fatness as
good
. In contrast, the fat rights frame’s more radical claim to fatness as positive seems to shift attitudes more.

ANTI-FAT BIAS, DISCRIMINATION AND CELEBRATION
OF BODY SIZE DIVERSITY

Fat rights activists and health at every size advocates worry that a medical and public health crisis framing of fat will worsen weight-based stigma and discrimination. Our experiments provide empirical support for this concern. We used a variety of different attitudinal measures, including many developed by other researchers, to capture the expression of anti-fat bias and discrimination. 12 We also measured support for body diversity by asking relative agreement with three statements: (1) “People should embrace the idea that ‘big is beautiful’”; (2) “We should celebrate fatness and the diversity in people’s body size”; and (3) “It is morally wrong to pressure fat people to lose weight if they don’t want to.” As with the other attitudinal measures, respondents were asked whether they agreed with each of these statements, on a scale of 1 to 9, where 1 represented strongly disagree and 9 represented strongly agree.

In Experiments 3 and 4, we asked participants to read either a news report on the Eating-to-Death study, on the Fat-OK study, or a control article about cancer mortality that made no reference to body weight. The news report on the Eating-to-Death study framed fatness as a public health crisis: “Obesity is near to overtaking smoking as the No. 1 cause of death in the United States, government researchers said on Tuesday, and other research shows that its adverse health effects could soon wipe out many recent improvements in health.” 13 It also stressed personal responsibility by referring to the Department of Health and Human Service public relations campaign “emphasizing that people do not need to shake up their lives to lose weight, but can take small steps like walking to work sometimes or taking the stairs instead of the elevator.”

In contrast, the news report on the Fat-OK study offered a weak health at every size frame, in that it tentatively challenged the idea that carrying a “modest amount” of extra weight is unhealthy. The article noted that “the study was conducted by highly respected statisticians and epidemiologists with no visible axes to grind at two federal agencies” and said it looked like “the most authoritative analysis yet of the relationship between mortality and the ‘body mass index.’” However, it also referred to the study’s findings as “perplexing,” said it cannot be considered definitive, and cautioned that “slightly pudgy individuals would be wise not to take the findings as a license to overindulge.” The control article reported about an “amazing statistic” showing that cancer had overtaken heart disease as the leading killer of Americans under age 85. It made no mention of body size, eating, or physical activity. 14

Because news reports on the Fat-OK article offered a weak health at every size frame at best, in the next three experiments (5–7), we replaced the Fat-OK study with a slightly edited entry from fat activist Kate Harding’s website, which contained a stronger message of fat rights and the idea that one can be healthy at every size. This article declared that “weight itself is not a health problem, except in the most extreme cases” and cited health benefits to being “fat.” It affirmed that “poor nutrition and a sedentary lifestyle
do
cause health problems” but emphasized that this is true “in
people of all sizes”
(emphasis in the original) and that “diets don’t work” and “themselves cause health problems.” It concluded by affirming that “human beings deserve to be treated with dignity and respect” and that “shaming the fatties for being ‘unhealthy’ doesn’t help.”

With the exception of Experiment 4, those participants in all experiments who read one or more articles promoting a personal responsibility frame or public health crisis frame expressed more anti-fat prejudice, compared to those in the control group or having read articles developing a health at every size or fat rights position. Experiments 1 and 2 further showed that those who were exposed to a personal responsibility or public health crisis frame were more likely to agree that it is justified to discriminate on the basis of body size in employment. Moreover, we found that people who read articles advancing a personal responsibility frame or public health crisis frame were
less
likely to express support for size diversity. 15
These results are illustrated in figures 5.2 through 5.5.

Figure 5.2:
Expression of anti-fat prejudice, Experiment 3.

Figure 5.3:
Expression of anti-fat prejudice, Experiment 5–7.

These results are consistent with research by other scholars showing that people are more willing to express prejudice against fat people when they believe that higher body mass results from a lack of willpower. 16 Social psychologists Chris Crandall and Amy Eshelman explain these results in reference to what they label a Justification-Suppression Model. According to this model, most people have some level of genuine prejudice. However, different social and individual factors affect the extent to which this prejudice is experienced and expressed. Some factors, such as exposure to social norms emphasizing that prejudice is unacceptable, tend to suppress the expression of prejudice. In contrast, other factors, exposure to the idea that body size is under personal control, tend to justify prejudice, enabling one to express it. 17

Figure 5.4:
Expression of anti-fat prejudice, discrimination, and celebration of body size diversity, Experiment 1.

Figure 5.5:
Expression of anti-fat prejudice, discrimination, and celebration of body size diversity, Experiment 2.

Pushing attitudes toward greater tolerance proved more difficult. In Experiments 3 through 7, those respondents who read the fat rights article did not differ significantly from the control group in the extent to which they expressed anti-fat prejudice. In Experiment 1, compared to those who read articles framing fat as a public health crisis and issue of personal responsibility, those who read health at every size and fat rights articles expressed less fat prejudice and discrimination and more support for the idea that body size diversity should be celebrated. However, when in Experiment 2 we measured the effect of each frame separately and compared it to a control group, we found that only the fat rights articles—but not the health at every size frame—significantly reduced the expression of anti-fat prejudice, while significantly increasing support for body size diversity. 18 Neither the health at every size nor the fat rights articles reduced approval of weight-based discrimination, compared to the control group.

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