originally posted in:Secular Sevens
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[quote]Unhappy with the slow pace of public health efforts to curb America’s stubborn obesity epidemic, a prominent bioethicist is proposing a new push for what he says is an “edgier strategy” to promote weight loss: ginning up social stigma.
Daniel Callahan, a senior research scholar and president emeritus of The Hastings Center, put out a new paper this week calling for a renewed emphasis on social pressure against heavy people -- what some may call fat-shaming -- including public posters that would pose questions like this:
“If you are overweight or obese, are you pleased with the way that you look?”
Callahan outlined a strategy that applauds efforts to boost education, promote public health awareness of obesity and curb marketing of unhealthy foods to children.
But, he added, those plans could do with a dose of shame if there’s any hope of repairing a nation where more than a third of adults and 17 percent of kids are obese.
“Safe and slow incrementalism that strives never to stigmatize obesity has not and cannot do the necessary work,” wrote Callahan in a Hastings Center Report from the nonprofit bioethics think tank.
Weight-acceptance advocates and doctors who treat obesity reacted swiftly to the plan proposed by Callahan, a trim 82-year-old.
“For him to argue that we need more stigma, I don’t know what world he’s living in,” said Deb Burgard, a California psychologist specializing in eating disorders and a member of the advisory board for the National Association to Advance Fat Acceptance.
“He must not have any contact with actual free-range fat people,” she added.
That view is shared by Dr. Tom Inge, an expert in childhood obesity at the Cincinnati Children’s Hospital Medical Center.
“No amount of teasing, probing questions about what they wish they could do, or medications seem to help,” Inge said. “So if one is proposing to help them by more stigmatization, that would seem at once both antithetical and unethical.”[/quote]One of my friends, knowing that I am interested in bioethics, sent me this, so I will just copy my response here:
[quote] This is an absolutely abhorrent and unethical idea on both the theoretical and practical levels.
Firstly, to shame another person's body is to act as though their body is an instrument for your own desires, not the sole and exclusive possession of the person themselves. As was pointed out in the article, body and person are inseparable; it is impossible to attack one without attacking the other. I am the only one who gets to care what happens with my body, period. The mentality from which body fascism stems is the same one that spawned the stigmatization of healthy expressions of sexuality in people other than married heterosexual couples, and also has the lovely track record of tacitly lending credibility to -blam!- apologists by legitimating the view that bodies can justly be used for another person's means. It is disgusting and entirely antithetical to the ideals of medicine that place the patient and their own autonomy at the center of any bioethical issue.
Even if we were to accept that "fatness" was a problem, however, it is entirely clear that shame is not the answer. Our culture already stigmatizes those without a culturally determined "ideal" body, particularly women, enough, and to think that overweight people do not already experience significant social pressure and stigma is ignorant. The bioethicist's statements also seem to overlook completely the non-trivial issues of mental health problems resultant of body shame, which can be just as unhealthy and dangerous as obesity.
Besides that, though, stigmatization has very rarely proved to be an effective way to combat complex health problems like obesity. Stigmatizing premarital sex has done nothing to combat STD rates and unwanted pregnancy; education and public health programs have been far more effective. Similarly, stigmatizing mental health issues only makes matters worse. This last point is especially noteworthy because the stigmatization of fatness frequently leads to mental health problems in the shamed. Anybody who has ever had a mental health issue like depression - resultant of body image problems or not - can tell you that it makes staying healthy much harder. Eating disorders - another common result of social stigma against body size - also make maintaining a healthy body weight difficult. If people truly wanted to "help" people who want to lose weight, they would not begin doing so with shame, as such is almost guaranteed to make the issue harder to tackle.
So no, I do not agree with this article. I think it is a terrible way to try to combat a problem that is likely exaggerated by unrealistic cultural standards of beauty, and it implies that somebody else has a right and responsibility to make decisions about my body, which is not the case. If we really wanted to help promote healthy bodies in our society, we would begin by eliminating the shame that is responsible for so many body image problems that lead to unhealthy habits, fix the insidious problem of food deserts and lack of access to healthy food, fund ways for people in every area of the country to have safe and affordable access to health care and recreational facilities, implement better educational programs based on the idea that there are many different (and equally valid) ways to have a healthy body, and reform our culture's notions about consumption. But this would be hard, and take a lot of money, and it's far easier to sit back, laugh at fat people, and make reasons for ourselves to feel like we're doing a good thing by stigmatizing people who are already stigmatized enough, which is why most people choose it.[/quote]
What are your thoughts?
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Edited by dr0cx: 1/24/2013 9:33:10 PMYou stole my thoughts, in that stigmatizing individuals leads to mental issues. Aggressively assaulting someone's already fragile self image will most certainly lead to depression problems. I want to believe that Daniel Callahan is hoping that the shaming will lead to suicide, fat people culling their own herd. This shit pisses me off. People like this look at an obese person and judge them instantly. She's not hot enough, he's a couch potato, they must eat a ton and do nothing but watch TV. These people have no idea if or how that person is trying to get healthy. They have no clue if they suffer from a thyroid or some other ailment. They think it is easy to simply stop eating so damned much and exercise for at least an hour a day. Part of the problem is our diet. We eat food that is bad for us because it is what we can afford. When our monthly food budget forces us to decide between a month on canned food, budget meats, and other cheap ingredients, or a weeks worth of healthy foods from a whole foods market, we tend to go with what we can afford. What about the activity side of the equation? We work at least 8 hours a day at "Some Corporation", few of which provide an onsite exercise facility, calculate in a commute, help children with homework, get children to sports practice and or boyscouts or other extracurricular activities, and before you fucking know it 9:30 PM is ticking off and you haven't had a moment to yourself. What we need is cooperation between employers and the health of their workers. A [url=http://www.cdc.gov/workplacehealthpromotion/businesscase/benefits/productivity.html]healthy workforce is more productive[/url], so employers should hire onsite certified conditioning and nutrition experts while maintaining a fitness facility, or if that isn't possible subsidize memberships to gyms, or even subsidize products like [url=http://www.fitbit.com/]fitbit [/url]. Employers with onsite cafeterias should lower food prices and serve a higher % of healthy foods while leaving the burgers, fries, and pizza at normal prices. But mostly, that 15 minute smoke break you get every 4 hours should be converted to a 15 minute walking break every 2 hours. Given that activity and healthy eating improves workforce productivity, reduces turnover, and saves money from insurance plans, it is an investment that returns. Frankly, it is stupid not to. EDIT: Then there is the "how do we eat" question. For the most part, we eat when we are hungry, bored, or participating in some social venue where eating is encouraged. Over the deacdes "marketing" has shown that larger portions are more desirable, and a plate with no empty space is preferred. What portion of the layman actually knows how often they should eat, what they should be eating, and what the portion size ought to be? I doubt it is a significant portion. The ignorant should be educated, not shamed. EDIT2: This topic rustled my jimmies.