We suffer from a shaming epidemic.
Over the years, as a society we've shamed people for sexual choices, drug use, racialized identities, choices that aren't consistent with the rigid gender roles they've been assigned, and many many more things. In most of these cases most of us have come around to realizing that the problem isn't who people are or what they're doing, but instead a culture bent on shaming us all into conformity and/or submission.
All we have to do is look at the raging success of abstinence-only education to see the effects. My favourite anecdotal (and yes, fictional) example is in Glee where Finn believes Quinn that he impregnated her by ejaculating while they made out in a hot tub. Shaming doesn't change people or our desires, it just makes things more hidden, ill-informed and in this case, confusing.
Cue the raging, inflamed and unstoppable Obesity Epidemic Debate.
It recently came to my attention again in a Twitter discussion between Dr. Brian Goldman from CBC's White Coat, Black Art, and Melissa Travis, a writer/comedian from the States. I was writing for a deadline at the time and while feeling that I couldn't wade into this conversation with 140 characters I also knew that blogging about it would be deadly for my deadline.
Dr. Goldman re-posted an article that another doctor posted about how shaming people for being “fat” could be as effective as shaming people for smoking supposedly was:
And re-tweeted another doctor asking:
RT @kevinmd Obesity in American children and adults continues to grow. http://bit.ly/cwZDCk Why is this problem so hard to tackle?
Melissa, known on Twitter as @DrSnit, responded to these posts by pointing out that not all weight gain is a choice, and that having these conversations with doctors can be painful. Dr. Goldman agreed. Others weighed in about smoking being a behaviour, while body weight isn't. This was weeks ago now, which is a lifetime in Twitter-feed land, so I might have missed some of the dialogue here. Please feel free to wade in @WCBADoctorBrian and @DrSnit.
The premise in the first article is that being really mean to smokers saved us from one public health epidemic so why can't we just be really mean to fat people? First of all, I question the data that shaming people about smoking “worked”. We all engage in some degree of addictive behaviour. This is endemic to our culture. For an excellent read on this, check out Dr. Gabor Maté's In the Realm of Hungry Ghosts. Addiction by it's very nature is compulsive and not rationally linked to the thing itself, whatever that thing is. It doesn't make sense to me then, that shaming smokers made anyone less compulsive or addicted. Maybe they stopped being addicted to cigarettes. Maybe that was great for certain individuals. For others I'm sure that it meant picking up equally or more problematic addictions.We also socially support and prop up equally unhealthy addictions, like workaholism, to name just one, that is almost entirely driven by guilt and shame.
Also, using shaming as a tactic means that "success" is people feeling really really bad about themselves. On a purely human level, that will never be a win to me.
And now on the “Obesity” question. On a basic Public Health level, the framing of this debate in the mainstream media is completely inaccurate. The biggest factors that determine our health are NOT lifestyle choices. Ranked by Juha Mikkonen and Dennis Raphael in their new book, The Canadian Facts, here's what creates conditions for sickness or wellness in Canada right now:
1. Income and Income Distribution 2. Education 3. Unemployment and Job Security 4. Employment and Working Conditions 5. Early Childhood Development 6. Food Insecurity 7. Housing 8. Social Exclusion 9. Social Safety Network 10. Health Services 11. Aboriginal Status 12. Gender 13. Race 14. Disability
Any epidemiological study worth its salt points out that poverty is the biggest health epidemic facing us globally, and I would add to this list for many other nations around the world, war and state-sanctioned violence.
The first time I wrote publicly about my views on this ended up being the only time. In 2004 I wrote a review of the film Supersize Me (I hated it) which someone posted without my permission on New York City Indymedia and started a vile flaming war about my apparent fatness and inability to get laid. Because it was the same year I'd had my third bowel operation I was so thin at the time that one of my friends suggested I post naked pictures of myself in response. But this was besides the point. I rose above it and responded politically on Canada's Rabble. And despite many warm, lovely and astute responses, I've never written publicly on such matters again.
It's just too painful. People have made political aspects of this debate incredibly personal at the same time as blanketly and inappropriately attacking people and our body-shapes while pretending to just state objective “health” facts. And somehow people use our personal histories to discredit our political points. Yes it does hurt that the same kids who called me “blowfish” in grade five because of my chubby cheeks also frequently threatened me with violence as they spent entire days letting me know how many kids would be waiting at the gym doors to beat me up after school (p.s. if you're wondering why I never answered your Facebook message about how excited you are for my success in life, now you know). It's also infuriating, because when I look at childhood pictures, the assertions of my classmates were absurd. Some of the worst bullies were much bigger than me. But of course I didn't see that at the time. Instead I started obsessively reading up on how to develop my first eating disorder at age 11. As an aside, this is why cautionary teen fiction tales about why eating disorders are bad and dangerous don't work. Girls just scour them for tips and tactics.
Women still try to draw me into conversations with alarming frequency where we're supposed to hate on skinny women. The premises of such discussions always appall me. First, that because I'm not skinny I must hate my body. Second, that because a woman is thin, she's either way more disciplined or lucky than “us” or way more oppressed, depending who's engaging me in this conversation. Can we all please turn the gaze back at the mass marketing machines that sell us shame simultanously wrapped in fast-food drive through containers and in magical herbs that promise infinite waifishness? The shame needs to be pointed squarely back where it belongs.
At the same time as these matters play out personally all the time, that doesn't make them any less political. It probably makes them more so. Using mean and mocking images of people's bodies (as the above articles as well as every single news report on this does) individualizes social health issues as a feature of our bodies, rather than a problem of world that perpetuates the conditions of poverty and oppression I listed above.
Bullies everywhere and of every age use body-shaming as a technique. The resulting emotional pain, self-loathing and stress are really bad for our health. How is the suggestion to be “harsh” and bully people about their weight possibly legitmate public health policy, medical practice, or even remotely socially appropriate or desirable in any context?
We need solidarity, not shaming. We all have intrinsic value and deserve respect. We are all more than the sum of our parts, regardless of the substantiveness or sleekness of those parts. So to anyone waving that Obesity Epidemic Flag, either because you're genuinely concerned about people's health, or because it's the last socially-acceptable way to get your rocks off being nasty to other people, please, please, please, please STOP.