Turning fat people into social outcasts

Fat celebrities are the latest victims of the UK public health establishment’s attempt to socially engineer our cultural and political environment so that the public becomes less tolerant of obesity and those the government categorises as obese. Through such nanny-state paternalism, the government seeks to ensure that people behave in ‘appropriate’ ways, as defined by itself and a coterie of public health bureaucrats and academics.

Professor Michael McMahon, author of this week’s Nuffield Health report on the influence of fat celebrities on obese people’s attitudes to weight, says fat stars are seen as role models, helping to make being overweight acceptable. Professor McMahon’s anti-fat stance epitomises the public health establishment’s increasing use of a ‘denormalisation’ campaign against fat people.

As employed by the government and the anti-obesity industry, denormalisation is a made-up word that functions as both a noun and as a verb to describe both a state in which the obese are perceived to be abnormal, aberrant, even deviant, and a series of activities designed to achieve this end.

In practice, denormalisation means that the government attempts to shame adults into changing their behaviour. For the government’s denormalisation campaign to succeed these adults must be stigmatised; that is, they will be placed apart from the rest of civilised society until and unless they learn to behave in the approved manner.

Denormalisation pushes the obese from being a health hazard to being a moral hazard, nothing less than blots on the nation’s moral landscape. The environmental approach to obesity epitomised by denormalisation is spelled out by Dr Kawshi De Silva of the Problem Gambling Foundation of New Zealand, who states: ‘The perceptions and beliefs in society about obesity can profoundly influence behaviour change and resistance to it.’

The prominent American journalist, Morton Kondracke, recently called for being fat, let alone obese, to be made as socially unacceptable as smoking. Earlier this year, a London Evening Standard columnist advocated the public ridicule of fat people eating chocolate. In some quarters, it is predicted that the language of denormalisation will soon be the main ingredient in the obesity debate.

The anti-obesity movement has accepted the argument of those, such as Australian nutritionist Dr Rosemary Stanton, who have argued that: ‘We need to learn from the successes in tobacco control in tackling the obesity epidemic.’ Clearly, the anti-obesity campaign has modelled its denormalisation campaign on the politically, if not empirically, successful tobacco denormalisation campaign. Hence, the anti-obesity lobby employs public policy tactics to denormalise the use of the food industry’s products.

There are significant downsides to the obesity denormalisation campaign. In a recent article, published in Health Promotion International, L MacLean et al express a well-founded concern regarding the stigmatisation of obese people, particularly of children. While there is much written about stigma and how it is exacerbated, these researchers point out that few, if any, guidelines exist for public health managers and practitioners who may attempt to design and implement obesity prevention programmes that minimise stigma. They examine the stigmatisation of obese people and the deeply negative consequences of this social process, and discuss how stigma is manifest in the provision of public health services.

Recently published research by CD Elliott published in the Journal of Canadian Studies is particularly insightful in demonstrating the obesity denormalisation campaign’s dangerous ambitions. Elliott is unequivocal in concluding that the obesity denormalisation campaign is central to the connection between obesity and citizenship in contemporary Western society.

This particular piece of research examines how denormalisation has connected one’s physical body to that of one’s citizenry. In tracing the evolving narrative, Elliott explains why denormalisation campaigners believe that the ideal citizen is, literally and figuratively, a ‘fit’ citizen.

The person with the larger body is quite simply categorised as a lesser citizen than his or her smaller countrymen. Elliott outlines the ways in which the fat body or ‘failed body project’ is equally positioned to that of the ‘failed citizen’. Elliott points out that the figurative concept of citizen fitness is often mistakenly conflated with the visible look of leanness.

Given that public health reports such as this week’s from Nuffield Health officially classify the majority of adults as overweight or obese, the framing of the fat body as the failed citizen is, to put it mildly, of considerable significance to both policymakers and non-policymakers alike.

We may draw several general conclusions from the denormalisation experience to date. First, the obesity denormalisation campaign represents yet another failure to address particular social problems, such as eating disorders.

Second, the fact that the denormalisation campaign has failed to work in the tobacco arena apparently means nothing to the public health establishment, which has confidently prescribed comparable denormalisation campaigns for the food, gambling and drinks industries.

Third, these campaigns dehumanise whole categories of people, which is arguably the most damning conclusion possible. Whatever one may or may not think of smoking and of smokers themselves, one unavoidable truth is that the smoker’s social status (or lack thereof) in the modern era foreshadowed the current, lowly social status of the fat person.

Fourth, the obesity denormalisation campaign is also worrisome because it wastes large sums of taxpayer money to satisfy the new Puritanism’s anti-obesity agenda.

A potentially greater worry, however, stems from the reality that this denormalisation campaign represents a new and dangerous assault on our core democratic traditions of choice about risk and lifestyle. Like so much in the ‘war on obesity’, denormalisation is a very bad prescription for supposedly good public health.

Patrick Basham and John Luik are authors, with Gio Gori, of Diet Nation: Exposing the Obesity Crusade, a Social Affairs Unit book. (Buy this book from Amazon(UK).) Patrick Basham directs the Democracy Institute and is a Cato Institute adjunct scholar. John Luik is a Democracy Institute senior fellow.

References:

Fat stars ‘make obesity normal’, BBC News, 29 June 2009

K De Silva ‘Problem gambling from here?’ PHA News 2007 10: 6-7

C D Elliott ‘Big Persons, Small Voices: On Governance, Obesity, and the Narrative of the Failed Citizen’ Journal of Canadian Studies 2007 41: 134-149

L W Green et al ‘Inferring Strategies for Disseminating Physical Activity Policies, Programs, and Practices from the Successes of Tobacco Control’ American Journal of Preventive Medicine, 2006 31: 66-81

M Kondracke Hunk Obama can help nation fight obesity epidemic, Daily News Tribune, 11 January 2009

L MacLean et al ‘Obesity, stigma and public health planning’ Health Promotion International published online on 8 January 2009

N Rafferty Say no to denormalisation, Free Society, 26 August 2008

D Sexton ‘Don’t tax fat people who scoff chocs – laugh at them’, London Evening Standard, 13 March 2009

R Stanton ‘Learning from tobacco when dealing with obesity’, Crikey, 18 April 2008