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Cleveland’s "Plain Dealer" Weighs in on Obesity Discrimination

Posted Apr 06 2010 7:43am

By Barbara Berkeley

Last Sunday, Cleveland’s major newspaper, The Plain Dealer, announced the roll out of a year-long series on obesity. I applaud The Plain Dealer for this enormous effort. Like most urban American areas, Cleveland has a significant obesity problem, but excess body size is not confined to the cities alone. The state of Ohio is one of the ten most obese states in the nation. I have long believed that our global obesity problem won’t be solved until we start to attack it on literally hundreds of fronts. Continuing to keep the topic in focus, as this series does, reminds us that being too overweight is serious and not to be ignored: an important start.

Yet in the three days since the PD launched its obesity series, all of the problems that come with addressing the issue have been on display. The difficulty is this: obesity has so many forms, so many faces, so many underlying causes that it is unlike most other societal problems. Today’s front page article illustrates the point well. Entitled, “ In Their Words: What It Feels Like to be Obese ,” the story explores the worlds of five people who have struggled with significant weight issues. Many of their comments are wonderfully insightful (and probably not unfamiliar to many of you). But the article primarily focuses on the discrimination that obese people experience.

“They are lazy or funny or a joke,” says the author. “That’s what the world tells them, but only when it happens to notice that they exist at all.”

A psychiatrist who is herself obese and is profiled in the piece says, “ It’s fascinating to be taking up so much space in a room and have people act as it you don’t exist.” She goes on to tell this story, one of many included in the article:

(She) remembers a day in her medical residency, back before she lost so much weight, when a professor began to humiliate her about her size in front of her fellow residents. 

“He just went on and on until one of my friends in residency said, ‘I feel like she’s getting raped.’ And that’s what it felt like. It was like somebody just ripping your guts open and saying, ‘You are a worthless piece of whatever’ because of the way you look.”

“We’re kind of the last bastion of discrimination,” she goes on to say, “ and nobody’s saying, ‘Hey, wait a minutes, it’s wrong.’ If you switched the word fat to black or Jewish or gay or female or any of a dozen different ways of being, it would be illegal, the stuff they’re saying.”

Unfortunately, this assertion is where the incredible complexity of the obesity problem makes itself manifest. Obese people have as many different reasons for being overweight as there are individuals. In my clinical experience, the most common reason is a broken food-processing system that becomes highly sensitive to modern foods coupled with a lack of good information about what steps to take. However, I’ve also treated people who eat to medicate themselves, people who stay heavy as a way to hide, people who punish themselves with obesity, and people who simply don’t care and just love to eat…damn the consequences.

This diversity of causation makes the discrimination argument a tough one. You can’t help being Jewish, gay, black or female, but society sees obesity as a problem that you CAN control if you want to. While those of us who understand obesity recognize the extreme practical difficulties involved, the fact that a subpopulation of obese people create their own problem allows discrimination to flourish.

And, what’s worse, the overweight are sucked into the very same belief vortex. After describing the unfair discrimination leveled against them, the article goes on to talk about how several lost weight via small changes like “eating more fruits and vegetable….smaller portions, (and) going outside to play more often.”

The article continues, “(T)here are few other things those who are…obese want you to know. For one, they take responsibility for their weight. “I am to blame for this,” (one of the group members) says. “No one forced me to eat all these bad meals. I really need to say, OK, enough is enough. I need to lose this weight so I can fit comfortably into places and I don’t need two airplane tickets…I have to discipline myself and change it. We all control our own destinies.”
In other words, the overweight person doesn’t want to be discriminated against, but then apologizes for her weakness, admitting that she could control the problem if only she tried. In fact, she believes that she wouldn’t be obese if she simply exerted a little more discipline. This is a major problem when the very core of discrimination this exact belief: that obesity is controllable with just a little will power.

What’s true? Unfortunately, all of it and none of it.

For some people, it’s a matter of getting good information and buckling down. For most, it’s a lifelong struggle to battle the addicting nature of our food supply and the over-availability of foods that we can’t process properly. For others, food has become the club they use to beat themselves with. Until underlying problems are solved, it will remain their weapon of choice. And to make matters even more complicated, there is a little of each truth in every person. Our reasons for eating are kind of like a horoscope: read any one of them and they pretty much fit you.

What I do believe with certainty is that the reasons we are overweight are much more difficult and complex than a simple lack of willpower. Whether an individual’s fat mass is due to primal mismatches in food partitioning or deeply seated emotional issues, society has to get serious about the fact that these are tough problems to control. We can’t simply continue to prescribe trivial solutions. And with experts predicting an 80% overweight and obesity rate by 2030, we’d better not be discriminating lest we find the stones aimed at ourselves.

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