Swiss Pharmacy

THE FATTENING OF AMERICA: FIGHTING CULTURAL PREJUDICE

It would be one thing, from a health perspective, if weight were a reliable indicator of health. But it isn't. Some of the unhealthiest people I know are very thin, and some of the healthiest people I know sport at least twenty or more "extra" pounds. Some of my thin friends have the most terrible eating habits, consuming enormous quantities of the worst that the junk food industry offers. They smoke cigarettes, drink alcohol, and engage in other high-risk behaviors. In fact, they can't gain weight because their bodies are struggling just to stay alive. And some of my heavier friends watch their diets with the vigilance of a mother eagle, and their faces glow with an inner health their thin friends should envy. No, the scale is not always a measure of health status.

But we aren't convinced. We cover up our weight with stylish clothes, hats, long hair, baggy pants, or any other device we hope will take the emphasis off our expanding waistlines, because we know we'll be harshly judged if it shows.

An article in the Executive Health Report spoke eloquently on the pain of being overweight, stating that "obese persons in the United States are subject to 'intense prejudice and discrimination,' beginning early in childhood and lasting for life."

"If you tell me that I cannot have that, that I cannot ever have that, it's the end."

ETTA

How did weight get to be such an emotional issue? When we look back just a few centuries into the works of some of the great artists, we see a concept of beauty that would do well for us today. Round-faced, round-bodied women. Full-chested men who stuck out hefty anteriors with a savoir faire that only a society that boasts of bigness could appreciate. Most of the artists whose works have endured through the ages featured women carrying at least twenty-five to thirty pounds more than we consider ideal. As a matter of fact, the women in Greek sculpture tended to be just a little hippy, according to our taste. But in those times, portliness was associated with prosperity. The woman or man whose figure was more round than angular could afford more and better food. Body shape wasn't so much a fashion statement as a barometer of status.

Just which fashion designer decided for the rest of the world that slim is in and plump is dumpy? We can't be sure who first birthed the idea that "you can't be too rich or too thin," but let's accept our share of the responsibility. We've all said it, although if we thought about it for longer than a second or two, we'd see the utter foolishness of it. I don't know if one can be too rich but I do know we can be too thin.

Body size and shape is such a complicated issue for us, especially if weight is indeed a health challenge and not just some vain obsession to lose five pounds. But even if our weight is a health issue and not a case of vanity, it still carries emotional and spiritual baggage unlike any other health condition. If we develop gallstones or a lung disease, if our knees go bad, or some other "invisible" ailment overtakes us, we can simply hide it or accommodate it and go on with our lives. We certainly don't feel shame or disgust.

Weight is different. We shake our fists at the scales. We whimper about our clothing size. We suck in our gut to try to conform to the image we've cast in our minds. In short, we do everything we can to look like what we are not and be what we will never be—the reincarnation of Twiggy or Arnold Schwarzenegger. This wouldn't be so painful if our culture didn't agree with us. Just try to accept the few extra pounds that sculpt your figure, and buy a size larger, and you invite the scorn of every passerby who weighs just a little less.

One author wrote:

Numerous studies have documented the stigmatization of obese persons in more areas of social functioning. Children as young as six years describe obese children as "lazy, dirty, stupid, ugly, cheats, and liars." As they grow older, obese persons find they are less likely to be admitted to prestigious schools, to enter desirable professions, to receive equal pay for their work and respectful treatment by their doctors. Of all conditions for which a person may be stigmatized in our culture, the stigmatized overweight may be the most debilitating. . . . Furthermore, the stigma of overweight has two aspects: stigmatization of the appearance of the body and the stigmatization of the character of the person for the moral failure of not controlling one's weight.

Some years ago I stepped out of a radio station with a well-known talk show host. With her frosted hair, her size-10 pantsuit, and her polished nails, she looked as if she had stepped right off Rodeo Drive. As we pushed open the door, two overweight women walked by. My host took one look at them and said, "Isn't that disgusting? Just look at them! Why don't they do something about that?"

My heart went out to those two women. After working with obese people over the years and watching their frustration explode into fury at bodies that simply won't cooperate with the very best efforts, I surmised that these women possibly had done everything they knew to keep the scale under control, but with little success.

"I did what was politically correct and I still gained weight."

ETTA

Obesity is seldom a case of overindulgence. It may simply be that an obese person's body works differently from a "normal" person's body, and the obese person hasn't been taught how to compensate for his or her own unique health needs.

Unfortunately, many doctors who should know better feel free to chastise their obese patients as they would a willful child. Pat spoke of her humiliation: "I don't go to the doctor my family uses because he's into: 'It's your fault.'" I asked Pat if she felt like an overweight object with her doctor. She grimaced and replied, "They give you that little look that says, 'How could you?' They make you feel uncomfortable."

Samantha nearly burst into tears when we discussed her doctor visits. "One time I had an inner ear infection and went to see the doctor four times before he would actually look at my ear," she said. hen I finally crawled in (I had lost my equilibrium), he decided it wasn't my weight after all. One doctor tweaked my knee and said, ''When are you going to do something about this?' I hadn't even asked him about weight; I went in for something else."

Samantha then talked about the doctors who performed her stomach bypass surgery. "When they couldn't figure out why I regained the weight [after the surgery], they tried to talk me into intestinal bypass surgery, and I refused. I found out later that many people die from that surgery, but the doctors don't care. We're just fat people. We really don't matter to them."

Whether or not Samantha's perception is a true reflection of the medical community's attitude is irrelevant; her experience is a thread running through discussions I have with almost all of my obese clients. Their doctors don't show compassion; they show judgment.

One author, writing in the Medical World News, said that "many doctors in the health field are insensitive to fat people since it is very hard to help them. They lose their empathy and compassion which grows out of the thought from days past where obesity was viewed as an addiction or 'gluttony' . . . Physicians need to be more understanding. . . ."

Those of us who are not obese can't even imagine this type of demeaning attitude from professionals we're told to trust. But let's face it: Our culture discriminates against fat people in their work, in their social lives, in their medical treatment, in every part of their lives.

Pat told of one incident so casually that I almost didn't catch the tears in her voice as she related it. "One time someone harassed me going down the highway. These two teenagers cut me off and stopped in the middle of the highway. And I had my son in the car."

"Did you feel that was because of how you look?" I asked.

She nodded her head. "Oh, yes. They were making comments and teasing me."

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