Health Shaming: Feminist Rhetoric is in Need of an Intervention


Cherise Charleswell I Women's Issues I Analysis I August 15th, 2013



Embarking on an honest discussion about obesity, or more specifically body image, in feminist circles is considered taboo. Traditionally, feminist rhetoric has been focused on combating "fat shaming" and speaking out against what was perceived as sexist images regarding the female body. In fact, many have pointed out the double-standard that women faced, and continue to face, when it comes to their physical appearance and physiques. In traditional mainstream media, larger - or to be blunt, fat - men are deemed acceptable, and women are to maintain svelte figures. Examples of this can be seen when one considers a number of sitcoms and even animated series' over the past generations, where the pairings had a distinctive pattern:

The Honey Mooners

All in the Family

The Jeffersons (The Willis family)

The Flinstones

Family Matters

Fresh Prince

King of Queens

Family Guy

The Simpsons

Then there are the magazines, filled with extremely thin, heroine-sheik, airbrushed, photo-shopped, and unattainable flawless bodies; projecting these false images, which bombard women and girls on a daily basis. Failure to achieve this Eurocentric standard of beauty, which is idolized by the dominant culture, is believed to cause many young women to become obsessed with their own body image; and ultimately has contributed to cases of bulimia and anorexia.1 Although many point to the reports of higher positive body image among women of color, particularly Black women 2,3, these women are not exactly immune, especially if they are fully assimilated and thus affected by the dominant culture. In fact, reports have found that, regardless of ethnic background, women who identify with and/or interact with the majority white culture are more likely to adopt "whites attitudes," adhering to the Eurocentric ideal of beauty, and will therefore be more at risk for developing eating disorders.4,5

In considering the hostile, hypocritical, and judgmental environment that women have had to cope with, feminist activities to counteract and denounce these societal issues are understandable. Anti-fat shaming campaigns and a focus on positive self-esteem and self-acceptance remain the preferred strategies to carry this out.

However, it is time to move past the customary feminist rhetoric that is merely a response to attitudes in the dominant culture, which shamefully comes across as trying to appeal to males, in order to convince them that the exponentially growing sizes of women are beautiful; and even more pathetically, to gain some sort of validation. In essence, it seems to counter the argument of self-identification and self-acceptance in feminism. A casual read through feminist magazines or visits to feminists blogs and social media sites provide evidence of this, particularly the many memes that are posted, which focus not on the contemporary and much more pressing issues that impact women (poverty, gender gap, housing, access to healthcare, violence), but on fat acceptance.



While body image issues are important, feminist rhetoric, in the interest of improving women's issues of health and well-being needs to undergo a paradigm shift. For starters, bulimia and anorexia are not the only eating disorders - there is also overeating or emotional eating. Further, it is truly time to focus attention and efforts on the worldwide epidemic of obesity, which greatly impacts women. The World Health Organization (WHO) actually defines obesity or overweight as having an abnormal or excessive fat accumulation that presents a risk to health. For those who may have skipped out or tuned out during health class or human biology courses, any of the three major macronutrients -- carbohydrates, protein, and fats-- consumed in excess, provides the body with extra calories which will be stored as adipose (fat) tissue. Thus, even those who overload on protein shakes should be aware of this fact. If the body deems those protein calories as excessive, they will be converted to and stored as fat. This propensity for fat storage is even more detrimental for women, who physiologically and as a mechanism of evolutionary biology, store more fat than men; and those with an "apple shape" body type, referred to as central adiposity, who carry the majority of their excess fat in their abdomen, are at heightened health risks. This type of fat patterning is more dangerous because the adipose tissue accumulates in the abdomen and suppresses the vital organs, while also having the propensity to leach into the bloodstream and impact the blood-lipid profile, bringing about conditions such as heart disease and stroke.

There has been an 82% increase in obesity over the last 20 years6, an alarming statistic that has led to the American Medical Association's June 2013 decision to recognize obesity as a disease. A 2012 Robert Wood Johnson Foundation report, F as in Fat: How Obesity Threatens America's Future 2012, puts the mounting epidemic into perspective. If obesity continues to increase at the current pace, adult obesity could exceed 60% in 13 states, and all states could have rates well above 44% by 2030.7

Where is the discussion about how these projections will negatively and greatly impact women in feminist discourse, which has become too politically correct, and unable to hone in on the most pressing issue - that of the health and wellbeing of women. Today, the overwhelming majority of the world population lives in areas where overweight and obesity kills more people than being underweight.

Oscar-winning actress and comedian, Monique, made headlines this year when she unveiled her dramatic 80-pound weight loss, which she contributed to a change of diet and increased physical activity. While previously declaring and making a tag line that "Skinny women are evil" (skinny being inclusive of healthy-sized women who were not overweight) and hosting a pageant called Monique's "Fat Chance," she shared that she had to lose the weight due to medical conditions and the realization that she wanted to be here to meet her babies' babies. Due to her former stance, she has been accused of abandoning her core message, or as explained by Nomalanga, social commentator and editor of Your Black World, " Monique needs to acknowledge that her old message was destructive, instead of trying to pretend that the women she told that being obese was "beautiful" are fools and did not realize that she jumped ship ."8

Obesity itself is considered a cormorbidity or contributing risk factor for a plethora of chronic diseases: Type 2 diabetes, cardiovascular disease, and some cancers; which the CDC has declared are among the leading causes of preventable death9 Also, obesity is linked to an increase risk of recurrence of breast cancer .10,11,12 All of these chronic diseases are associated with lowered quality of life, reduced mobility, and premature death; particularly if left untreated or improperly treated. Treatment should actually be referred to as disease maintenance; and this, along with care for complications of disease, are associated with high health care costs, and of course those without access to health insurance or a means to afford astronomical health expenses, and thus without health care, are left without proper treatment. Due to the gender pay gap, the limited availability of financial resources in female-led single families, and other conditions within a built environment that impact women; particularly minority women, as they are often without access to those critical health care resources, and thus suffer higher rates of mortality. In essence, women make up a great percentage of those who are basically left to die because they are unable to shoulder the cost of treatment. While campaigning for the 2008 Presidential election and to later garner support for the passing of the Affordable Care Act, which goes into effect in October of this year, President Obama often alluded to his mother's death from cancer, as well as the role that being an uninsured single mother lacking available financial resources played in her early demise.

Thus, when looking at the harsh realities linking social determinants of health, obesity, and reduced health and wellbeing, feminist theorists familiar with the effects of intersectionality, should add to and expand upon this needed conversation on "health shaming" within feminism, and how the pre-occupation with the topic of body image and counteracting a Eurocentric ideal of beauty takes away from needed dialogue on the many intersections that affect the health of women. The reality is that those who are obese are more likely to be malnourished, obtaining the bulk of their caloric intake from processed foods, fats, and fiber-less carbohydrates. Social feminists and Ecofeminists should certainly realize that the relationship between the body size, food availability, food consumption, and health & well-being, represent a social justice issue.

Rather than hampering over the issue of body image and filling their pages with redundant memes and persuasive images, feminist bloggers, magazines, and theorists should focus on this issue of obesity, and more importantly women and children's access to nutritional food. For instance, there would be a great benefit in forming coalitions with public health specialists and other social organizations as they champion health policies that will benefit women, such as the highly debated US Farm bill13, which allocates funding for the Supplemental Nutritional Assistance Program (SNAP). Further, feminist critiques should point out the counterproductive nature of these programs and the fact that they do not live up to the title "nutritional," in that they may be used at fast food restaurants to purchase non-nutritional foods and food-like substances, rather than adhering to the traditional food stamp program's focus on providing nutritional staple foods. Essentially, the overlooked fact is that food, which is meant to nourish and sustain our bodies and prevent illness, is now the leading catalyst for major health problems. Remaining silent on these issues essentially allows corporate profit to guide politics and consequently negatively impact women and their families; particularly single women-led families, which operate on limited incomes and will be more likely to use subsidized programs.

In understanding how obesity has negatively impacted their communities, women of color, and particularly Black women, have attempted to shift the focus of discussion away from body image and body size. A 2012 Washington Post-Kaiser Family Foundation report, based on a poll comparing weight and self-esteem against each other, found that Black women, who were heavier than their white counterparts, reported significantly higher levels of self esteem, which correlates to positive body image.14 This suggests that Black women do not need the reinforcement of fat acceptance propaganda to make them feel better about themselves and more accepting of their bodies. Meanwhile, they suffer from some of the highest rates of obesity and, consequentially, have the highest rates of many chronic diseases. Of course, these health disparities are mimicked in other populations of color. For example,

African American women have the highest rates of being overweight or obese compared to other groups in the U.S., with 4 out 5 African American women overweight or obese. In 2010, according to the CDC, African American women were 70% more likely to be obese than Non-Hispanic White Women.15 One in 4 African-American women older than 55 has diabetes. African-Americans also have high rates of at least two of diabetes' most serious complications: amputation (such as having a toe or foot removed) and kidney failure16 1 in 10 Latinos has Type 2 Diabetes, and Latinas are 17 times more likely to die from diabetes than non-Hispanic white women17 1 in 8 (13.2%) of Native Americans ages 18 or older has diabetes, 1 in 3 (almost 30%) of Native Americans has hypertension, and they are twice as likely to die from these diseases as whites, which can be partially attributed to the fact that 1 in 3 are uninsured.18

Black women food and social activists have formed organizations and are adopting urban farming practices to help counteract the alarming rates of obesity. Once again, women in these communities have never adhered to or felt the need to openly protest body image issues tied to the Eurocentric ideal of a waif-thin woman. Due to cultural differences, that argument and the overall objection against fat shaming have been dominated by Caucasian women. Thus, the organizations led by Black women and other women of color, which look at this issue from a social justice standpoint, include: The BLK Project, Growing Power, and the People's Grocery.

Overall, there is a relationship between class, race, food, gender, culture, and health which cannot be overemphasized. Feminist analytics would be more beneficial if it focused on these dynamics and fostered discussions on this topic and the need to stage an intervention to combat feminist "health shaming." Feminist rhetoric, which critiques socio-cultural norms and gender relations, should not assume that it is above scrutiny. Even more importantly, this scrutiny should be done internally. Perhaps, in the face of the current epidemic, it is time to reevaluate the feminist status quo and messaging of unwavering fat acceptance; and instead advance the conversation to not only include the promotion of healthier and leaner bodies, but to acknowledge the correlation between obesity and the pressing global social issues of food justice and health access. Doing so will begin the process of addressing the problem, which has disproportionately negative impacts on the very groups already facing hardship. Daring to speak about this taboo topic will help to open discussion about the other myriad problems caused by the agribusiness industry, such as the raising of hormone-filled livestock, or looking at the manufacturing sector and its production of hydrogenated and high fructose foods, to the issues with food labeling and aggressive marketing strategies that target adolescents; and finally turning our attention to health policies and cultural norms that support poor health choices.

In closing, here is the reality - obesity is not a female-specific issue, as men worldwide are also showing higher rates of obesity; however, women still maintain slightly higher rates and are burdened by a number of barriers, such as poverty, diminished wages, decreased mobility, and a lack of food options which greatly contribute to their obesity. Also, in their traditional roles, women have held more control over family food choices, and thus play an instrumental role in the prevention of childhood obesity, which has life-long consequences. The end goal should not be the transformation of our bodies into toothpick frames, for those who are extremely skinny are also likely suffering from malnourishment, but instead should move past vanity and aesthetics and focus on health and well being, and the need for equal access to the resources that make healthier lifestyles possible.

Feminist messaging is correct in that women should love themselves, but we should also love ourselves enough to take care of our bodies, our health, our well-being, and our overall quality of life.



References

King, N. (1994). College women: Reflections on recurring themes and a discussion of the treatment process and setting. In B. Kinoy (Ed.), Eating Disorders: new directions in treatment and recovery (pp.122-131). New York: Columbia University Press.

Gore SV. (1999). African-American womens perceptions of weight: paradigm shift for advanced practice. Holistic Nursing Practices, 13, 71-9.

Hesse-Biber SN, Howling SA, Leavy P, Lovejoy M. (2004). Racial identity and the development of body image issues among African American adolsecent girls. The Quality Report. 9(1):49-79.

Crago M., Shisslak, C. M. & Estes, L. S. (1996). Eating disturbances among American minority groups: A review. International Journal of Eating Disorders, 19, 239-248.

Greenwood, D. N., Dal Cin, S. (2012). Ethnicity and body consciousness: Black and white American women's negotiation of media ideals and others' approval. Psychology of Popular Media Culture. Advance online publication. doi: 10.1037/a0029411

Lim SS, Vos T, Flaxman AD, et al. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. 380(9859): 2224-22260. doi:10.1016/S0140-6736(12)61766-8

Centers for Disease Control and Prevention. (1998). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Retrieved from: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf

Nomanlanga (2013). Monique's 80 pound weight-loss Is a betrayal of overweight Black Women. Healthy Black woman. Retrieved from: http://www.healthyblackwoman.com/nomalanga-moniques-80-pound-weight-loss-is-a-betrayal-of-overweight-black-women/

Levi J, Segal L, St. Laurent R, Lang A, Rayburn J. (2012). F as in Fat: How Obesity Threatens America's Future 2012. Trust for America's Health/Robert Wood Johnson Foundation. Retrieved from: http://www.rwjf.org/content/dam/farm/reports/reports/2012/rwjf401318

Molnar A. (2012). Obese and overweight women face increased risk of recurrence of most common type of breast cancer. National Cancer Institute (NIH). Retrieved from: http://www.eurekalert.org/pub_releases/2012-08/w-oao082212.php

Templeton, D. (2012). Breast cancer recurrence, death linked to obesity, study finds. Pittsburgh-Post Gazette. Retrieved from: http://www.post-gazette.com/stories/news/health/breast-cancer-recurrence-death-linked-to-obesity-study-finds-650813/#ixzz2bMtvpmh4

Ligible, J. (2011). Obesity and breast cancer. Oncology.25(11):994-1000.

Wiseman J, Nixon R. (2013).House Republicans push through farm bill, without food stamps. New York Times. Retrieved from http://www.nytimes.com/2013/07/12/us/politics/house-bill-would-split-farm-and-food-stamp-programs.html?pagewanted=all&_r=0

Washington Post-Kaiser Family Foundation poll of black women in America. Washington Post (2012) from: http://www.washingtonpost.com/wp-srv/special/nation/black-women-in-america/

Centers for Disease Control and Prevention. Obesity and African Americans: Health United States, 2011. Table 74. (2012). Retrieved from http://www.cdc.gov/nchs/data/hus/hus11.pdf

Women's Health. US Department of Health & Human Services. Diabetes: Minority women's health. (2010) Retreived from http://www.womenshealth.gov/minority-health/african-americans/diabetes.cfm

Office of Women's Health. US Department of Health & Human Services. Diabetes: Minority women's health. (2010) Retreived from http://womenshealth.gov/minority-health/latinas/diabetes.html

American Kidney Fund. Native Americans (2008). Retrieved from http://www.kidneyfund.org/kidney-health/are-you-at-risk/native-americans.html