The United States is now the fattest country in the world. In July 2007, the Centers for Disease Control and Prevention (CDC) reported that more than 60 percent of U.S. adults and 25 percent of children were overweight or obese, making obesity one of the major health challenges facing the nation. From a medical perspective, those individuals likely to experience health problems as a direct result of excess weight are considered overweight. Obese is the term for individuals who are overweight to the point that their lives will be cut short as a direct result of excessive fat, whereas morbidly obese is reserved for those more than 100 pounds overweight or whose body mass index (BMI), a measure of height and weight, exceeds 40.
Over the past several decades, cultural eating patterns changed such that more Americans dine outside of the home more frequently, eating foods containing significantly higher calories, saturated fats, and cholesterol. Americans are quite literally stuffing themselves to death. Somewhat opportunistically, a billion-dollar diet and exercise industry exists to help the obese shed pounds and inches. Because this weight loss is elusive at best and temporary for most, the weight loss industry thrives on repeat business, those searching for the weight loss miracle cure.
Associated with obesity are many health risks, including heart disease, hypertension, and diabetes. Adult onset (Type II) diabetes is increasing at an alarming rate, coinciding with expanding waistlines. In addition to overt health risks, obesity strains the health care system with medical interventions, both surgical and pharmaceutical, at great cost to individuals and insurance companies. Some interventions, such as the weight loss drug Fen-Phen, promised miracles but produced devastating, even deadly outcomes.
In response to the rising tide of obesity, grassroots movements have had some success in reducing Americans’ girth. Following a public outcry, many schools have removed candy and soda machines, packaged foods require nutrition labels, exercise facilities are more readily available in workplaces, and many fast food restaurants now offer more health-conscious meal alternatives.
In addition to the health risks linked to obesity, excessive body weight relates to a host of social-psychological problems, ranging from weight discrimination to social isolation and diminished self-esteem. Three areas of research address different aspects of obesity, and excessive weight more generally, as a social and social-psychological problem: the cultural emphasis on thinness, weight discrimination, and self-esteem problems.
Obesity and Culture of Thinness
A large body of research shows a linkage between the recent increase in eating disorders, especially in girls and young women, and the cultural emphasis on thinness. The desire to achieve the cultural thinness norm, in conjunction with the fear of deviation, leads individuals to strive for thinness, causing an array of devastating eating disorders, including obesity. An individual’s deviation from the idealized image of physical thinness may provoke others to judge and condemn individual behavior, resulting in embarrassment, severe isolation, or alienation. While attempting to adhere to the norm of thinness, many people get caught in a vicious cycle of short-lived weight loss followed by weight gain.
While both men and women are obese, women receive most of the social condemnation of obesity (although rates of eating disorders among men are growing). For this reason, researchers study the media and other cultural products as explanations for the pressures exerted on women. Of particular interest is the representation of women on television, in the movies, and in advertisements. Generally speaking, the size of women in the media has been shrinking as real women have grown heavier. One example of cultural variation over the past 55 years is the White Rock mineral girl, who was 5 feet 4 inches tall and weighed 140 pounds in 1950, while today she is 5 feet 10 inches tall and weighs 110 pounds. Similarly, 1950s actress and sex symbol Marilyn Monroe wore a size 12 dress, while contemporary supermodel Kate Moss is a mere size 4. The White Rock mineral girl and Kate Moss are indicative of a literally shrinking media woman.
By holding up an image of female perfection— such as slenderness, daintiness, or demureness— the media insinuates that women who fall short of that perfection are somehow lacking. Print ads, magazines, television programming, and movies exemplify this, as does merchandising toward females of all ages. The “feminine failing” not only jeopardizes a woman’s happiness but also questions her femininity.
Much research on women’s obsession with weight assumes that all women and girls are equally affected by the culture of thinness, but some evidence suggests that not all women are affected similarly. Compared to black females, white women are under significantly greater social pressure to be thin, so that the rates of eating disorders are higher among white women than among women of color.
When it comes to obesity specifically, however, the rates are higher among African Americans and other minorities than among whites. A number of factors contribute to the prevalence of obesity among the poor and disenfranchised, including the cost of food, with fast food and fattening snacks being relatively inexpensive while healthier options are more expensive. Additionally, it takes time and resources to maintain a healthy lifestyle.
Not only is flagrant weight discrimination pervasive in many areas of social life, but overweight people comprise one of the few remaining groups still openly ridiculed with little public condemnation for such action. In the past 15 years, numerous lawsuits have attempted to identify obesity as a civil rights issue, citing cases of discriminatory hiring and firing practices, housing violations, and a lack of access to mandatory safety devices and public transit. Some of these challenges have been successful. However, because no federal laws currently prohibit discrimination against the obese, weight-based discrimination continues to flourish.
Perhaps the most widely accepted form of weight-based discrimination comes in the form of workplace prejudice, insensitivity, and inequity. The loss of livelihood may be blatant; examples range from the aerobics teacher fired because she did not meet the “image” of an aerobics instructor to flight attendant applicants not hired because of their size. Less cited is institutional discrimination, flourishing from stereotypes held about obesity as a perceived disability.
Research shows that obese women earn 12 percent less than non-obese women. Obese men do not face the same wage penalty as women but do tend to be underrepresented and paid less than non-obese men in managerial and professional occupations. Estimated time for an overweight person to find a new job is an average of 3 weeks longer than non-obese job seekers.
Discriminatory attitudes among health care professionals may affect clinical judgments and deter obese persons from seeking care. Many health professionals associate obesity with poor hygiene, hostility, and dishonesty, believing that obese patients are lazy and self-indulgent, lacking self-control. These biases negatively impact medical judgments and practices, such that physicians report discussing weight loss programs with obese patients less than half as often as discussing weight loss programs for mildly obese persons. The National Health Interview Survey reports that obesity is associated with decreased preventative care measures such as breast examinations and gynecological examinations.
Growing research evidence reveals that the obese are more socially isolated than others. For example, both adults and children consistently rank obese children as least likable when compared not only with non-obese children, but also with children with various physical handicaps and disfigurements. This social distancing makes it more difficult for the obese to develop relationships, thus further increasing social isolation and decreasing self-esteem.
Obesity and Self-Esteem
Repeatedly, physical appearance links integrally to self-esteem, most notably among adolescents but also among the population at large. Sixty percent of adolescents, females in particular, report lower self-worth because of their appearance. As social animals, humans tend to define themselves by the attitudes of, and their interaction with, others. As such, the obese often suffer from lower self-esteem and a negative self-image, creating heightened levels of psychological distress with the result that those who are overweight are at risk not only of a host of physical problems and ailments but also of ridicule, social isolation, and discrimination.
The social pressure on Western females to literally buy into the culture of thinness is overwhelming. Women are constantly vigilant, their self-esteem hanging on the determination of whether adherence to social norms has been satisfied, allowing escape from condemnation. For some, this escape is elusive, causing self-esteem to plummet.
- Bruch, Hilde. 1957. The Importance of Overweight. New York: Norton.
- Critser, Greg. 2003. Fat Land: How Americans Became the Fattest People in the World. Boston: Houghton Mifflin.
- Dowling, Colette. 1988. Perfect Women: Hidden Fears of Inadequacy and the Drive to Perform. New York: Simon & Schuster.
- Kilbourne, Jean. 1995. Slim Hopes: Advertising and the Obsession with Thinness. Northampton, MA: Media Education Foundation.
- Pipher, Mary. 2005. Reviving Ophelia: Saving the Selves of Adolescent Girls. New York: Riverhead.
- Wolf, Naomi. 1991. The Beauty Myth. New York: HarperPerennial.
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