Politics & Policy

Vogue vs. Health

When image trumps nutrition.

I’m not losing a damn pound,” proclaims actress/singer Queen Latifah. Given her spot on People’s “50 Most Beautiful People” list, why should she? As she rightly points out: “I look like America!” But in light of the recent revelations by the American Cancer Society study — attributing 20 percent of cancers in women, and 14 percent in men — to excess body weight, is that really such a good thing?

According to conventional wisdom, ours is a culture that “celebrates thinness” — a seemingly self-evident truth manifested on ubiquitous billboards, television screens, and fashion covers. Such unrealistic icons, we’re told, foster fat-phobia and undermine self-esteem.

Yet alongside such supposedly oppressive images, there exists a paradoxical attitude with subtler yet more insidious implications for public health. And that is an increasingly permissive culture of size acceptance, which robs at-risk individuals of the impetus needed to make those changes in diet and exercise that can salvage their health and save their lives.

Like a binge-and-starve eater, our schizophrenic attitudes towards body image swing from aspiring to the largely unattainable proportions of a Kate Moss, to celebrations of the largely avoidable obesity of a Star Jones. Yet while Moss is routinely vilified for glamorizing thinness, and blamed for contributing to anorexia (which affects one-tenth of one percent of the population), supersized-celebrities like Star Jones are upheld as a role model for healthy body acceptance. Jones statement, “My weight was never important to me,” is featured by Glamour magazine as a “Body-Love Breakthrough,” without a second-thought to how similar attitudes might have contributed to obesity (which affects one-third of the population).

But wait, isn’t body size determined by our genes? If some of us are simply fated to be fat, why not make the best of something we can’t change?

Researchers at California’s Lawrence Berkley National Lab recently put this proposition to test by following 35 pairs of identical twins to ascertain whether obesity, among other attributes, was largely hereditary. They found that fatness was not. ABC News featured two of these twins — John Sovocool and his brother Wayne — who, though sharing exactly the same genes, are 50 pounds apart in weight. Filming the brothers at a buffet, the cameras soon discovered why: John, the lighter twin, went for the fruit salad, while Wayne loaded up on dumplings, deep-fried seafood, barbecue pork, prime rib, and for dessert: coconut pie, melon custard, and three pieces of cheesecake.

The notion of beer bellies as our birthright is also belied by recent history: Four decades ago, just 13 percent of Americans were obese — today it’s over 30 percent. It’s doubtful our DNA has managed to mutate in so limited a period of time — so what else has changed?

The short answer: We’re eating more and moving less. But as Greg Crister explains Fatland: How Americans Became the Fattest People in the World, the underlying reasons are more complex. Among them: commodity surpluses and soaring meat production; substitution of cheap (and differently metabolized) corn syrup in junk food; the discount-marketing revolution in fast food; less Phys Ed and more vending machines in schools.

If changes in the food industry and our physical environment have abetted obesity, our culture has increasingly accommodated it. Susie Orback’s 1978 bestseller, Fat Is a Feminist Issue launched a liberation movement — exhorting women to abandon their diets for the same reasons they once burned their bras. Groups like the Body Image Task Force and the National Association to Advance Fat Acceptance sprang up to fight weight discrimination and promote “size esteem.”

The mainstream media continued to dwell on the dangers of the epidemiologically small number of the mostly white and affluent anorexics and bulimics, while heralding surveys that found a greater acceptance of overweight and obesity among African American girls as salutary signs of “self-respect.” Do such attitudes contribute to the disproportionate percentages of obesity among minorities? No one seems willing to ask — much less say. But as Crister points out, “such sidestepping denies poor minority girls a principal — if sometimes unpleasant — psychological incentive to lose weight: that of social stigma.”

Can feeling bad about being big be better for your health? Only the heartless among us can fail to sympathize with the plight of obese children, who, according to a study recently published in the Journal of the American Medical Association, rate their quality of life as low as that of pediatric cancer patients undergoing chemotherapy. To question size acceptance is not to advocate self-hatred — or condone body bigotry. But we do ourselves and our children no favors when we downplay the dangers of obesity in the interest of supposedly safeguarding self-esteem.

To find a balance between a healthy Body-Mass-Index and body image, the advice of the serenity prayer may be as good as any: “Grant us acceptance of those things we cannot change, courage to change the things we can, and the wisdom to know the difference.” We can’t change our height, our basic bone structure, or even our baseline metabolic rate. Some of us are indeed genetically pre-disposed to be a little heavier than others, or have a harder time losing weight. But very few of us are born to be obese. And we can change how much we exercise, what kind of food choices we make, and how much time we spend in front of the tube. Given the wisdom science is now uncovering, telling people to accept their fat as fate is both dishonest and disempowering.

Jennifer A. Grossman is vice president and director at the Dole Nutrition Institute.

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