Brown's examination of fat stigma won't be entirely new to anyone who's been following the issue, but it's worth reiterating some of her most important points. One study showed that doctors had less respect for obese patients, meaning they spent less time with them and gave them less information. In another study, over half of doctors called obese patients "awkward, unattractive, ugly, and unlikely to comply with treatment." In addition to suffering indirectly because of doctor bias, obese people also feel the health effects of stigma in the form of chronic stress, which "can lead to high blood pressure, diabetes and other medical ills, many of them (surprise!) associated with obesity." And in the world of work, there's this disturbing anecdote:
"As soon as I shook the interviewer's hand, I knew she would not hire me," Ms. Brown said. "She gave me a look of utter disdain, and made a big deal about whether we should take the stairs or ride the elevator to the room where we were going to talk. During the actual interview, she would not even look at me and kept looking to the side." Ms. Brown, 36, who now works as an assistant dean at a college near Chicago, said she never even got a "No thank you" letter after the interview.
Despite Brown's examination of the negative effects of stigma, some commenters on the Times Well Blog still think you can shame people thin. Writes Jules,
Question: Do we need to make obesity LESS socially acceptable to improve the health of the nation and the budget?
Pretty? No. Nice? Not particularly. But what's a more powerful trigger to get people take responsibility for themselves than the pressure of others?
Telling people to eat more vegetables and take the stairs is not working.
Of course, since many obese people already eat vegetables and take the stairs, weight loss isn't always a matter of "getting people to take responsibility for themselves." And the idea that all fat people are irresponsible is just one more form of stigma. In fact, some argue that the shame-them-for-their-own good argument made by Jules and others is really just a cover. Commenter Nancy likens fat prejudice to homophobia:
At the root of it lies the bigotry of disgust. Gays and lesbians face it - those who hate them are often hung up on their personal disgust with their sex lives (never mind that straight sex can be viewed in the same way). Fat people face it - those who hate them are often hung up on their disgust for their bodies (never mind that nobody's body is perfect).
A new TMZ post about Gabourey Sidibe illustrates this concept perfectly. The post itself does an unsurprisingly poor job explaining fat acceptance: "Gabourey Sidibe might have a weight problem, but it doesn't mean she's unhealthy ... this according to the National Association to Advance Fat Acceptance (NAAFA). Yes, that's a real group." But what's really telling is a comment by one Mr. Creosote, who calls Sidibe "offensively fat." Those who would shame fat people can claim they're doing some sort of public service, but frequently, they're just expressing their own "offended" sensibilities. There's no reason for doctors to care if a patient is "attractive," except for a culturally conditioned desire for everyone to conform to a certain body type. Those who don't do so frequently find themselves discriminated against, not for their own good, but because deviations from the beauty norm provoke a strong emotional reaction. And the solution to this reaction isn't for fat people to lose weight — it's for everyone else to examine the basis of a prejudice that's really not about health.