What's Wrong With Fat? (18 page)

Figure 3.3:
Percentage of
New York Times
and
Newsweek
sample—on overweight/obesity compared to eating disorders—discussing specific causes

Even when an eating disorder is described as beginning with a choice (i.e., to start a diet), the choice is typically depicted as a “normal” response to cultural pressures, rather than as an irresponsible or self-indulgent behavior. For instance, an article entitled “When Weight Loss Goes Awry” describes a teenager’s anorexia as beginning with an innocent diet: “Last summer, as friends started dieting, she decided to lose five to 10 pounds.
Within a few months Amelia, now 15, was on the death-march called anorexia nervosa.” 108 In a society in which watching one’s weight is a moral obligation, Amelia is not faulted for beginning a diet. Rather, anorexia is cast as a case in which good intentions go too far. Amelia, described as “a straight-A student and cheerleader,” is quoted as saying “in a weak but determined voice from her bed at the Children’s Hospital in Denver [that she] would never want this to happen to anybody else.” 109 Anorexia is thus portrayed as something that “happens to” people, even model teenagers, rather than something people bring upon themselves. Similarly absolving anorexics from blame, another article explains that “for some kids,
innocent
-seeming behavior carries enormous risks.” 110

Considering a host of factors from “obsessive-compulsive disorder, depression, low self-esteem and anxiety” to the “‘reduce fat in your diet’ drumbeat, which can haunt children who already feel pressure—from gaunt models or each other—to be thin,” news articles do not blame the “intelligent, often highly accomplished kids [who] spiral into such destructive behavior.” 111 Many news articles point the finger at the narrow beauty standards of popular culture. For instance, discussing anorexia and bulimia, one article declares that “the apparent precipitant of these [eating] disorders seems to be an overwhelming desire to be thin, thin enough to walk down a Paris fashion runway, to act in a Hollywood movie or to dance with a leading ballet company.” 112 Yet even such blaming of mainstream cultural pressures is tempered by arguing that they only result in eating disorders among people with a biological or psychological predisposition.
For example, after noting that doctors have observed a “disturbing trend: a growing group of women in their 30’s, 40’s and 50’s who have eating disorders,” the article reassures readers that many of these newly diagnosed older women have actually had lifelong psychological problems and that “lots of people in our culture diet, [but] relatively few end up with an eating disorder.” 113

Thus, not only are individual dieters not blamed for their behavior, but also the culture of dieting is normalized: “While everyone is exposed to similar societal pressures to be thin, only a small percentage develop eating disorders. Those who succumb typically are prompted by extreme career pressures, as often happens to ballerinas, models, actresses and jockeys, or they have some underlying emotional and/or physical vulnerability.” 114
Some articles compare anorexia to alcoholism and depression, in that they are all “potentially fatal diseases that may be set off by environmental factors such as stress or trauma, but have their roots in a complex combination of genes and brain chemistry.” 115 Specifically, they note that “many kids are affected by pressure-cooker school environments and a culture of thinness promoted by magazines and music videos, but most of them don’t secretly scrape their dinner into the garbage. The environment ‘pulls the trigger,’ [... ] but it’s a child’s latent vulnerabilities that ‘load the gun.’” By stressing the complex interplay among individual factors, biological predisposition, and macro-level environmental factors, this type of reporting mitigates blame of individual anorexics and their parents.

Even more strikingly, as shown in figure 3.4, articles are much less likely to hold individuals responsible for curing eating disorders (4 percent of eating disorder sample) than for fixing overweight (56 percent of overweight sample). Articles in the eating disorders sample discuss medical interventions at least
seven times
more frequently than they mention either policy or behavioral solutions (54 percent versus 7 percent and 4 percent, respectively). In contrast, articles on overweight/obesity are more than twice as likely to discuss behavioral modification than either medical interventions (24 percent) or policy solutions (21 percent). Forty-six percent of articles on eating disorders, but no articles on overweight, discuss only medical solutions. 116

As victims of a complex illness, sufferers of eating disorders are not expected to “pull themselves up by their bootstraps.” Rather, they are depicted as needing medical intervention. For example, one article describes an anorexic 14-year-old who, despite wanting “to improve,” had failed to recover when going it alone: “It took a second hospitalization at Schneider, the following spring, before Molly could maintain a healthy weight.” 117 One article describes how a young anorexic girl was only able to recover after repeated hospitalizations because she frequently relapsed when not under direct medical supervision. 118
Such failures are not portrayed as evidence of weak will, nor are they blamed on their parents. Rather, they are used to underscore the seriousness of anorexia as a medical illness that requires medical intervention.

Figure 3.4:
Percentage of
New York Times
and
Newsweek
sample—on overweight/obesity compared to eating disorders—discussing specific solutions

Even when eating disorder articles explicitly state that individuals can cure themselves, it is almost always under the guidance of a doctor. Thus, we read about new therapies for bulimia in which specially trained nurses coach bulimics to help themselves: “Many bulimics do not need traditional psychiatric therapy. Instead, he said, patients will learn to help themselves.
‘What we’ve done is change the treatment into a self-help format,’ said Dr. Fairburn.” 119 Yet, when “self-help” for eating disorders is enacted under medical supervision, curing disordered individuals is still presented as the responsibility of an expert physician.

BINGE-EATING DISORDER: A NEED FOR SELF-CONTROL

Binge-eating disorder is categorized in the DSM-IV as an “Eating Disorder—Not Otherwise Specified,” an umbrella category for various eating disorders that do not meet the precise criteria for either anorexia or bulimia. The American Psychiatric Association (APA) provides a “provisional diagnosis” of binge-eating disorder as bingeing without compensatory purging and/or extreme dietary constraint. 120 This “provisional diagnosis” signals that binge-eating disorder is being seriously considered as requiring its own diagnostic category in the DSM-V (expected in May 2013), while also providing clinical researchers with shared criteria for studying the disorder. Binge eating is likely to become the object of more public discussions, as it gains more attention from clinicians.

Articles that discuss binge-eating disorder in detail draw upon frames typical of
both
thinness-oriented eating disorders articles and of articles on overweight, underscoring the extent to which this condition straddles the symbolic space between usually polarized conceptions of body size.
Ultimately, however, binge-eating disorder is more firmly situated within an “overeating” frame, depicting sufferers as needing “self-control” more than medical assistance. For instance, in an account of her personal struggle with binge-eating disorder, reporter Jane Brody writes: “My despair was profound, and one night in the midst of a binge I became suicidal. I had lost control of my eating; it was controlling me, and I couldn’t go on living that way.” 121 A psychologist helped Brody resist suicide but “was not able to help me stop bingeing. That was something I would have to do on my own.” As with victims with eating disorders, this binge eater is presented as needing help from a doctor or therapist, but ultimately, as with overweight, it is suggested that she needs to control overeating on her own.

Two articles that discuss binge-eating disorder argue that the most important reason binge-eating disorder needs to be taken seriously is because it makes it more difficult to
succeed at weight loss
.
In other words, the concern with achieving a “normal weight”—which also dominates discussions of overweight—seems to trump more general concerns about eating disorders as psychological problems. One article explains: “The importance of binge eating disorder is that people who fit these criteria do worse than others in weight management programs.” 122 By focusing on the importance of weight-loss, these articles obscure or downplay the psychiatric symptoms experienced by binge eaters, which have been shown to have negative health effects independent of body size. 123 Another article draws upon binge-eating disorder’s relationship to overweight in order to depict it as a
public
health risk: “Because of the disorder’s close link with obesity... it’s a major public-health burden,” a theme that was never encountered in discussions of anorexia or bulimia. 124

Further, while feminist authors have identified binge eating and compulsive overeating as serious “eating problems,” which—like anorexia and bulimia—often “begin as ways women numb pain and cope with violations of their bodies” and are “a logical response to injustices,” this news sample describes individuals with binge-eating disorder as “overeaters” who have an “ordinary, if unfortunate, human behavior,” and a few articles express concern that binge-eating disorder has been “invented” by greedy drug companies. 125 For instance, the following article quotes an eating disorders researcher who says: “‘Outside North America, it’s basically a laugh.... No one thinks it’s a serious condition.... These are overeaters.’” 126 In other words, there is resistance to giving binge-eating disorder the status of a full-fledged eating disorder like anorexia or bulimia, for which outside forces of biology or cultural pressures—rather than individual choices—are to blame.

In sum, the comparison with eating disorders suggests that, in the contemporary U.S. society in which thinness is highly prized, news articles are less likely to moralistically blame individuals for disordered eating that leads to thinness than they are to blame them for being too fat. It seems that the association of heavier bodies with gluttony and sloth and of thinner bodies with discipline and responsibility favors framing anorexics and bulimics as victims of cultural and biological forces beyond their control, while blaming the obese for their weight. Such frames, in turn, reinforce the original stereotypes that fuel them. This sample of news articles tends to deny binge-eating disorder, in which sufferers eat large quantities of food and tend to be heavier, the status of a “real” eating disorder, reframing it instead as ordinary and blameworthy overeating.
In other words, the news media’s tendency to present obesity as a moral issue of personal responsibility is not merely a generic feature of news reporting. Rather, fatness as an issue lends itself to moralizing in a way that other issues do not.

RACE, CLASS, GENDER

Historically, in the United States, the association, especially among women, of fatness with the poor and people of color and of thinness with elite whites has largely driven the negative moral valence of fatness. 127 My news media analysis suggests that this remains true today. The
Newsweek
and
The New York Times
sample discussed above was also, on average, more likely to discuss nonwhites, compared to whites, and the poor, compared to the middle class, in the context of overweight and obesity, while focusing on affluent white women and girls, rather than on the poor or people of color, in the context of anorexia and bulimia. 128 These patterns in reporting may reinforce the image of white middle-class girls and women as victims and of poor minorities as ignorant or willfully defiant of health guidelines.