Practically the minute President Obama announced Regina M. Benjamin, a zaftig doctor who also has an M.B.A. and is the recipient of a MacArthur "genius grant," as a nominee for the post of Surgeon General, the criticism started.
The attacks were vicious—Michael Karolchyk, owner of a Denver "anti-gym," told Fox News' Neil Cavuto, "Obesity is the No. 1 issue facing our country in terms of the health and wellness, and she has shown not that she was born this way, not that she woke up one day and was obese. She has shown through being lazy, and making poor food choices, that she's obese."
"This is totally disgusting to have some one so big to be advocating health," wrote one YouTube commenter.
The anger about Benjamin wasn't the only example of vitriol hurled at the overweight. Cintra Wilson, style columnist for The New York Times, recently wrote a column so disdainful of JCPenney's plus-size mannequins that the Times' ombsbudman later wrote that he could read "a virtual sneer" coming through her prose. A NEWSWEEK post about Glamour’s recent plus-size model (in fact, a normal-sized woman with a bit of a belly roll) had several commenters lashing out at the positive reaction the model was receiving. "This model issue is being used as a smoke screen to justify self-destructive lifestyle that cost me more money in health care costs," one wrote. Heath guru MeMe Roth has made a career crusading against obesity, and made waves when she suggested that American Idol contestant Jordin Sparks needed to lose weight. (That MeMe Roth is considered something of an extremist doesn't stop the media attention) Virtually any news article about weight that is posted online garners a slew of comments from readers expressing disgust that people let their weight get so out of control. The specific target may change, but the words stay the same: Self-destructive. Disgusting. Disgraceful. Shameful. While the debate rages on about obesity and the best ways to deal with it, the attitudes Americans have toward those with extra pounds are only getting nastier. Just why do Americans hate fat people so much?
Fat bias is nothing new. "Public outrage at other people's obesity has a lot to do with America from the turn of the 20th century to about World War I," says Deborah Levine, assistant professor of health policy and management at Providence College. The rise of fat hatred is often seen as connected to the changing American workplace; in the early 20th century, companies began to offer snacks to employees, white-collar jobs became more prominent, and fewer people exercised. As thinness became rarer, says Peter N. Stearns, author of Fat History: Bodies and Beauty in the Modern West and professor of history at George Mason University, it was more prized, and conversely, fatness was more maligned.
At the same time, people also paid a lot of attention to President Taft's girth; while Taft was large, he wasn't all that much heavier than earlier presidents. Newspapers questioned how his weight would affect diplomacy and solicited the funniest "fat Taft" joke. "This [period] is also when you get ready-to-wear clothing," says Levine. "For the first time, [people were] buying clothes in a certain size, and that encourages a comparison amongst other people." Actuarial tables began to connect weight and shorter lifespan, and cookbooks published around World War I targeted the overweight. "There was that idea that people who were overweight were hoarding resources needed for the war effort," Levine says. She adds that early concerns were that overweight American men would not be able to compete globally, participate in international business, or win wars.
Fatness has always been seen as a slight on the American character. Ours is a nation that values hard work and discipline, and it's hard for us to accept that weight could be not just a struggle of will, even when the bulk of the research—and often our own personal experience—shows that the factors leading to weight gain are much more than just simple gluttony. "There's this general perception that weight can be controlled if you have enough willpower, that it's just about calories in and calories out," says Dr. Glen Gaesser, professor of exercise and wellness at Arizona State University and author of BigFat Lies: The Truth About Your Weight and Your Health, and that perception leads the nonfat to believe that the overweight are not just unhealthy, but weak and lazy. Even though research suggests that there is a genetic propensity for obesity, and even though some obese people are technically healthier than their skinnier counterparts, the perception remains "[that] it's a failure to control ourselves. It violates everything we have learned about self control from a very young age," says Gaesser.
In a country that still prides itself on its Puritanical ideals, the fat self is the "bad self," the epitome of greed, gluttony, and sloth. "There's a widespread belief that fat is controllable," says Linda Bacon, author of Health at Every Size: The Surprising Truth About Your Weight. "So then it's unlike a disability where you can have compassion; now you can blame the individual and attribute all kinds of mean qualities to them. Then consider the thinner people that are always watching what they eat carefully—fat people are symbols of what they can become if they weren't so virtuous."
But considering that the U.S. has already become a size XL nation—66 percent of adults over 20 are considered overweight or obese, according to the Centers for Disease Control—why does the stigma, and the anger, remain?
Call it a case of self-loathing. "A lot of people struggle themselves with their weight, and the same people that tend to get very angry at themselves for not being able to manage their weight are more likely to be biased against the obese," says Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at Yale University. "I think that some of this is that anger is confusion between the anger that we have at ourselves and projecting that out onto other people." Her research indicates that younger women, who are under the most pressure to be thin and who are also the most likely to be self-critical, are the most likely to feel negatively toward fat people.
As many women's magazines' cover lines note, losing the last five pounds can be a challenge. So why don't we have more compassion for people struggling to lose the first 50, 60, or 100? Some of it has to do with the psychological phenomenon known as the fundamental attribution error, a basic belief that whatever problems befall us personally are the result of difficult circumstances, while the same problems in other people are the result of their bad choices. Miss a goal at work? It's because the vendor was unreliable, and because your manager isn't giving you enough support, and because the power outage last week cut into premium sales time. That jerk next to you? He blew his quota because he's a bad planner, and because he spent too much time taking personal calls.
The same can be true of weight: "From working with so many people struggling with their weight, I've seen it many times," says Andrew Geier, a postdoctoral fellow in the psychology department at Yale University. "They believe they're overweight due to a myriad of circumstances: as soon as my son goes to college, I'll have time to cook healthier meals; when my husband's shifts change at work, I can get to the gym sooner.…" But other people? They're overweight because they don't have the discipline to do the hard work and take off the weight, and that lack of discipline is an affront to our own hard work. (Never mind that weight loss is incredibly difficult to attain: Geier notes that even the most rigorous behavioral programs result in at most about a 12.5 percent decrease in weight, which would take a 350-pound man to a slimmer, but not svelte, 306 pounds).
But why do the rest of us care so much? What is it about fat people that makes us so mad? As it turns out, we kind of like it. "People actually enjoy feeling angry," says Ryan Martin, associate professor of psychology at the University of Wisconsin, Green Bay, who cites studies done on people's emotions. "It makes them feel powerful, it makes them feel greater control, and they appreciate it for that reason." And with fat people designated as acceptable targets of rage—and with the prevalence of fat people in our lives, both in the malls and on the news—it's easy to find a target for some soul-clearing, ego-boosting ranting.
And it may be, that like those World War I-era cookbook writers, we feel that obese people are robbing us of resources, whether it's space in a row of airline seats or our hard-earned tax dollars. Think of health care: when president Obama made reforming health care a priority, it led to an increased focus on obesity as a contributor to health-care costs. A recent article in Health Affairs, a public-policy journal, reported that obesity costs $147 billion a year, mainly in insurance premiums and taxes. At the same time, obesity-related diseases such as type 2 diabetes have spiked, and, while diabetes can be treated, treatment is expensive. So the overweight, some people argue, are costing all of us money while refusing to alter the behavior that has put them in their predicament in the first place (i.e., overeating and not exercising).
The reality is much more complicated. It's a fallacy to conflate the unhealthy action—overeating and not exercising—with the unhealthy appearance, says Schwartz: some overweight people run marathons; eat only organic, vegetarian fare; and have clean bills of health. Even so, yelling at the overweight to put down the doughnut is far from productive. "People are less likely to seek out healthy behaviors when they're criticized by friends, family, doctors, and others," says Schwartz. "If people tell you that you're disgusting or a slob enough times, you soon start to believe it." In fact, fat outrage might actually make health-care costs higher. In a study published in the 2005 issue of the Journal of Health Politics, Policy and Law, Abigail Saguy and Brian Riley found that many overweight people decide not to get help for medical conditions that are more treatable and more risky than obesity because they don't want to deal with their doctor's harassment about their weight. (For instance, a study from the University of North Carolina found that obese women are less likely to receive cervical exams than their thinner counterparts, in part because they worry about being embarrassed or belittled by the doctor because of their weight.)
The bubbling rage against fat people in America has put researchers like Levine in a difficult position. On the one hand, she says, she wants to ensure that obesity is taken seriously as a medical problem, and pointing out the costs associated with obesity-related illnesses helps illustrate the severity of the situation. On the other hand, she says, doing so could increase the animosity people have toward the overweight, many of whom may already live healthy lives or may be working hard to make heathier choices.
"The idea is to fight obesity and not obese people," she says, and then pauses. "But it's very hard for many people to disentangle the two."