In the opening chapters of American author Sarai Walker’s novel Dietland, the reader gets an uncomfortable insight into what it means to be fat. Plum, the heroine of the novel, grows up in a world where it is easier to hide away.
She is sure that the rubbernecks who are laughing and taking photographs of her family’s house have come to ridicule her. It comes as a shock when she learns they are in fact intrigued by the history of the house and the famous actress who once lived there.
he sense of shame that comes with being overweight is something Walker understands well. In her twenties she worked for a time in girly magazines and was the only fat girl in the office, and one of the few in an industry where body image ruled. Later, while doing her PhD in London, she discovered the world of fat studies, where academics were reframing the debate about obesity. The Health at Every Size movement was gaining traction, with the belief that everyone had a right to be comfortable in their own bodies.
For Walker, it was one of the defining periods of her life.
‘I think since the late-19th century, fat people have been dehumanised and demonised and talked about as if they are lazy and stupid and gluttonous,’ she says.
‘There’s a long, long history of talking about fat people in a very negative way, and I think that this contemporary obesity rhetoric just feeds into that and sometimes tries to lend legitimacy to what is really bigotry.’
For doctors, the problem of how to tackle obesity is fraught. It’s often not as easy as telling people to just eat less and exercise more. Obesity is a problem that affects not only western countries but also the developing world, as middle class wealth increases, and diets and lifestyles change. The World Health Organisation says the worldwide rate of obesity has more than doubled since 1980.
A media guide was recently launched in Sydney by Obesity Australia, encouraging better use of language and media images when talking about the issue. The organisation argues that obesity should be recognised as a disease or a chronic condition and not framed as an aesthetic issue. Shaming people does little to change their habits.
Dr Amanda Salis, is a scientist with the Boden Institute at the University of Sydney. The institute is conducting clinical trials into what works and doesn’t work when it comes to weight loss. Salis understands how hard losing weight can be for many people, and she spoke at the media guide launch.
‘One of the primary things that needs to change is the attitude … if the doctor still thinks that it’s the patient’s fault and that they are gluttonous, lazy et cetera, and they are useless because they can’t stick to the regime and lose weight, then those underlying attitudes will come out in body language,’ she says.
Salis speaks from experience. By her own admission, she ‘used to be a fatty’ in early adulthood before losing the weight over a number of years.
‘I was 93 kilos, my body mass index was 35, which the World Health Organisation would call severely obese,’ she says.
‘I remember going into the doctors and I had a blister on my foot that was looking a bit infected and I thought I might go in there and get some antibiotics or an ointment or something, but instead I went in there and I got a lecture, and that lecture involved telling me about all the health implications of being obese.
‘It finished with my doctor saying, “‘I mean, look at yourself, you’re obese!”‘ And that word was like a slap. It’s the absolutely worst word that I could have heard. It just had the opposite effect of what the doctor was hoping to achieve.’
Salis says that 60 per cent of adults in Australia have a body mass index that puts them in the overweight or obese range. While a lucky few can be metabolically healthy while carrying extra weight, for most the health consequences—such as diabetes, cardiovascular disease, obesity related cancers and joint stress—will catch up with them, if not immediately then further down the track. It is crucial people lose weight, but there needs to be a deeper discussion on how to best help people do that.
However, Walker is sceptical that most comments aimed at fat people have anything to do with health at all, arguing they are just part of our cultural obsession with body image.
‘Any time somebody is confronted with the idea that fat is okay or fat can be beautiful or fat people can be healthy, someone immediately responds with, “‘Fat is unhealthy, you’re going to get all of these horrible diseases,”” she says.
