If HBO ran a miniseries called "Health of the Nation," seriously, would anyone watch? An extensively-researched documentary pointing out our many failures to wash our hands, floss, eat well, exercise more and, um, maybe watch less TV -- how well do you think that would go over?
But with the cable network's debut this week of Weight of the Nation (WOTN), a multi-part documentary with accompanying book, websites and government-hosted conference, America has settled in on the national couch. Like ancient Romans in the Colosseum, expect them to stick around to the end to see who survives and who gets torn apart. After all, on even the cheapest bleacher seat or rattiest futon, you're still a notch above the Other, those hapless schlemiels in the arena.
In Rome, the stadium fodder tended to be slaves or Christians or baited animals. In WOTN, they're fat people. And not just fat but, given the nature of health economics in this country, likely to be poor and people of color, too. I write in advance of the debut, but we've all seen enough "obesity crisis" coverage to know that the lens won't capture many of the people who can shell out for HBO subscriptions, unless they're the expert talking heads.
I shudder to imagine how this will intensify the already rabid prejudice against fat people in this country. Of course, the producers claim to be all about concern for fat people and redressing the many harms obesity supposedly causes, but as author and attorney Michele Simon writes elsewhere on The Huffington Post, the program's misguided attention to weight rather than health "... ensures the focus stays on the individual instead of the food industry" (or other concerns, I add). "What do you think when you see a fat person? That it's their fault, they just need to eat better and exercise more." (There. I just spared a bunch of folks having to write that last bit themselves in the comments.) And along with Big Food, there are plenty of targets WOTN could legitimately take on, like unequal access to health care, discrimination and the extra stressors of poverty that might impair Americans' health. But, like the taxpayer-supported agencies that helped fund it, the series simply reinforces the blame and the "if-they-only-tried-harder" stigma.
Whatever remedies the show proposes won't work, so long as they aim to change the shape of 100 million or more Americans. How many diets do we have to try, how many miles do we have to log, before we realize that these just don't result in sustained weight loss for the majority of people? Still, we plow on with talk of "moderate" diets (which don't work any better than extreme diets) and "educating" Americans that they're fat. Proponents may think they mean well by deploring the size and appearance of roughly half our nation, but it's easier to rail about fat than it is to examine the commercial and class motives that create the real health and wellness divides we live (and die) with.
The real message of all the hand-wringing is not that obesity is a risk for health and the GDP. It's that fat is a cultural signifier: Just as swarthy skin and accents marked the lower classes 100 years ago, today we identify the Other by waistlines and thigh bulges. And that's what you'll be seeing on HBO this week.
To justify this exercise in prejudice, you'll hear a string of familiar-sounding "solutions" born from the same biases, myths, and false cause-effect constructs that already give us terrible obesity-based medicine and public policy. Many will rely on the self-serving pretension that there's a sort of fat-brain myopia out there that keeps fat adults from knowing they're considered too big (with the false implication that education leads to downsizing). When it comes to children, the fat-brain myopia premise assumes we can rail against obesity but somehow shield kids from internalizing the deep disdain for fat (and prevent inevitable increases in bullying and in body shame that follows, for fat and thin kids alike).
The first three of the HBO series' four sections (as quoted here from the documentary's website) rely entirely on such self-justifying myths. Only in the final section does the documentary appear to begin examining the many non-weight-related issues that may affect the health of our society:
"... CONSEQUENCES, examines the scope of the obesity epidemic and explores the serious health consequences of being overweight or obese."
Actually, that so many are "obese" is a matter of semantics and a function of how we choose to define obesity (which has little to do with health). The real consequence of being "overweight," or of moderate "obesity," as defined on government BMI charts, may just be that you live longer. (This is according to the CDC, which in defiance of its own data, is hosting this week's WOTN hand-wringing conference.)
"... CHOICES, offers viewers the skinny on fat..." [oh, what a tired phrase!] "... revealing what science has shown about how to lose weight, maintain weight loss and prevent weight gain."
In fact, what science has shown on these questions is that most people cannnot maintain weight loss even when sticking to diets and exercise programs. That fact should surprise no one and is readily explained by biological mechanisms that resist sustained weight loss. The one well-established fact about attempts to reduce is that they will more likely result in weight gain than sustained loss. (Seven prospective studies of dieting behavior indicate this; none show the opposite!)
"... CHILDREN IN CRISIS, documents the damage obesity is doing to our nation's children. Through individual stories, this film describes how the strong forces at work in our society are causing children to consume too many calories and expend too little energy; tackling subjects from school lunches to the decline of physical education, the demise of school recess and the marketing of unhealthy food to children."
If the latter are problems, why not train the lens on the food companies that profit from those school lunches? Why not divert the billions of public dollars wasted on fruitless and stigmatizing anti-obesity expenditures to more spending on phys ed, sidewalks, and playgrounds? Why not help kids of all sizes make good health choices? When the focus is on weight, it's not obesity that damages our children but fear mongering about their bodies that puts them at risk -- for eating disorders, discrimination, sedentariness, and lifelong discomfort in their bodies.
The fourth section:
"... CHALLENGES, examines the major driving forces causing the obesity epidemic, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the strong influence of the food and beverage industry."
The problem with these influences is not that they make people fat (thin people are subject to the ravages of biology and the food industry too); it's their health impact.
Fat may or may not hurt you, but fat stigma sure will, and Weight of the Nation bids to worsen it immeasurably. It's a wild, crowd-baying mob frenzy disguised in a white lab coat. Don't watch it.
The solution? If it's health we're concerned about, let's talk about health -- not weight. From my book, Health at Every Size:
"The only way to solve the "weight problem" is to stop making weight a problem ... The real enemy is weight stigma, for it is the stigmatization and fear of fat that causes the damage and deflects attention from true threats to our health and well-being."
By focusing on health, we can address real health concerns, giving both fat and thin people the support they deserve and avoiding stigmatizing people and worsening the problem.
For more information on shifting the focus to health -- not weight -- check out the Health at Every Size movement, consider the peer-reviewed evidence which demands a shift in medicine and public policy, or read my book, Health at Every Size: The Surprising Truth About Your Weight. Marilyn Wann's critique appears in the Exhibitionist (SF Weekly's blog) and The Association for Size Diversity and Health, an organization for professionals committed to changing the paradigm, provides a more detailed debunking of WOTN, including Dr. Deb Burgard's guide to stereotype management for the people who will be victimized by this WOTN-inspired onslaught.
For more by Linda Bacon, Ph.D., MA, MA, click here.
For more on personal health, click here.
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