15 April 2012
When Fat is a Feminist Issue by Susie Orbach was first published, the response was extraordinary. Well before the so-called ‘obesity epidemic’ and at a time when eating disorders were barely on the mental health radar, Orbach wrote about ‘body image’ and eating disorders from a feminist psychoanalytic framework.
Orbach, co-founder of The Women’s Therapy Centre, London, was involved in women’s consciousness raising groups and her central theme was that “fat is about protection” – protection from gender-based stereotypes and the limited options presented to women. “Fat is a way of saying no to powerlessness and self-denial,” Orbach wrote, espousing awareness and empowerment as the alternative, from a feminist perspective.
Many women, myself included, found solace in her message. Fat had a voice and the voice was chanting for change. Contemporary feminists have countered, however, that Orbach’s original message has been translated and diluted into ‘fat acceptance’ rather than ‘fat protest’.
In feminist media studies, 30 years of sophisticated theoretical debate about eating disorders and body image issues are often reduced to complaints about lack of size diversity in the mainstream media and dismay at the emaciated state of increasingly young catwalk models.
This narrow focus, it is claimed, significantly limits the extent to which feminist cultural perspectives can respond to an increasing problem that affects large numbers of individuals, both male and female. Arguing for ‘fat acceptance’ does little to change a situation where class, gender, education and location not only contribute to who becomes overweight or obese, but also who suffers as a result.
Overweight people are targets of weight stigmatisation and prejudice. Weight bias occurs from employers, healthcare professionals, educators and even family and friends. Common to most studies that look at this phenomenon is the finding that fat women are more adversely affected by such discrimination than are men. Here are some examples:
- When participants in a study were asked to rate ‘fictitious’ male and female job candidates, males reported significantly less desire to work with a fat woman than did females; there was no comparable gender difference in desire to work with a fat man.
- A recent study showed that ‘obese’ female political candidates were evaluated more negatively overall and in terms of reliability, dependability, honesty, ability to inspire, and ability to perform a strenuous job, than were non-obese female candidates. Not only did this finding not hold for obese male candidates, but obese men were rated more positively than non-obese individuals in this study.
- In a study involving actual sales managers, employees described as ‘extremely overweight’ were more likely to be assigned to undesirable sales territories and less likely to be assigned an important or desirable region. This discrimination was stronger for fat women than for fat men.
- Longitudinal studies using large data sets (US) have demonstrated lower occupational attainment, lower hourly and lifetime earnings for fat women, even after controlling for education and socioeconomic status. This was not the case for fat men.
- Whereas roughly two thirds of adult women in the U.S. are classified as ‘overweight’ or ‘obese’, only 10% of top US female CEOs fall into these weight categories.
- In another study researchers asked college students to rate the attractiveness of prospective partners and found that men were more likely to choose sexual partners on the basis of weight than were women. Male participants rated ‘obese’ women as less attractive than women missing a limb, in a wheelchair, mentally ill or those with a sexually transmitted disease.
- Another study has found that male respondents to a personal advertisement were significantly more likely to respond to an ad in which the woman was described as being in recovery from drug addiction than one who was described as 50lb overweight.
- In perhaps one of the most disturbing studies of all, physicians were sent three hypothetical case vignettes that differed in Body Mass Index (BMI) (BMI 25, BMI 28 and BMI 32, or normal weight, overweight, obese respectively). The vignettes were either all male or all female. For those cases with a BMI of 25 (normal weight), physicians were more likely to recommend weight loss, Weight Watchers or dieting when the vignette was female and more likely to discourage dieting and encourage appearance acceptance when the vignette was male.
- And mental health professionals are not immune to discriminatory weight practices. In one study about 100 psychologists were mailed a self-description of a hypothetical female client accompanied by a fat or thin photograph. Psychologists who received the fat photograph were more likely to diagnose an eating disorder and to suggest either ‘improve body image’ or ‘increase sexual satisfaction’ as treatment goals. Female psychologists gave the fat ‘client’ a worse prognosis.
Compared to other forms of discrimination, weight discrimination is the third most prevalent cause of perceived discrimination among women in the US (after gender and age). Men are not at serious risk of discrimination until their BMI reaches 35 (well into the obese range), while women experience an increase in discrimination at BMI 27 (moderately overweight).
In fact, moderately obese women (BMI 30-35) are three times more likely than men to experience weight discrimination. The heart of the problem according to researchers at the Rudd Center for Food Policy and Obesity , Yale University, is that overweight and obesity are linked to shame and stigmatisation and this can lead to depression and discrimination. Depression and discrimination are risk factors for binge eating, and so the cycle continues.
The negative effects of weight prejudice on women have been increasingly assessed and include; poor body image, reductions in psychosocial functioning and increases in unhealthy eating behaviours, including anorexia, bulimia and binge eating disorder. According to Kelly Brownell at the Rudd Centre, “Organised efforts to reduce weight bias are needed.”
One organised effort against weight bias is the movement known as Health at Every Size (HAES®). HAES questions the relationship between fat and pathology and instead emphasises approaches to health that produce benefits independent of weight loss.
Proponents of HAES advocate the practice of size acceptance; listening to the bodies internal signals of hunger and satiety; engaging in pleasurable and meaningful physical activity rather than exercising for weight loss; and accessing size-friendly health care environments. These practices are healthy for people of all sizes, genders, ages, levels of education and income. They are neither stigmatising nor pathologising.
Feminist therapy approaches
There are a wide range of therapeutic approaches used and useful in the area of eating disorders and disordered eating. Counselling approaches compatible with a feminist theoretical perspective are found in psychodynamic, systemic, narrative, cognitive and mindfulness based therapies.
Feminist practitioners working within these therapeutic styles share a core idea: the personal is political. This ‘mantra’ of the feminist movement recognises that people with eating disorders are both shaped by the political environment in which they live and contribute to it. In this way feminist therapy can be seen as ‘an act of political resistance’.
Traditional ‘evidence based’ therapies for eating disorders, particularly those evolving from the medical/biological models of aetiology, tend to separate the personal from the social and political domains.
For example, eating disorders are the result of self-hatred and low self-esteem; eating disorders arise from negative thoughts and irrational core-beliefs; eating disorders are the result of sexual, emotional or physical abuse; or, eating disorders are associated with underlying personality disorders.
These formulations don’t include more recent theories associating, in particular anorexia, with structural or hormonal brain abnormalities. In contrast, feminist theories that attempt to explain the aetiology of eating disorders do not deny the aforementioned associations, but additionally attend to the social context that provides the unsanitary conditions in which these vulnerabilities can thrive.
Objectification theory, for example, proposes that self-objectification and the internalisation of cultural ideals of beauty can lead to a range of negative psychological consequences.
Women, taking an observer’s perspective of their own bodies, view their bodies as objects to be evaluated. Research has shown that women who self-objectify their bodies are more likely to experience disordered eating, body dissatisfaction, appearance anxiety, decreased self-esteem, depressed mood and even decreased cognitive performance as the result of a disruption of focused attention.
There is some empirical support for the notion that the more women subscribe to feminist attitudes, the less likely they are to evaluate themselves primarily on the basis of physical appearance. Marika Tiggerman from Flinders University, Adelaide, found that while middle-aged women with feminist attitudes had less concern about their weight, feminist attitudes did not affect the younger women in her study in the same way. Perhaps this generational difference points towards the diminishing influence of feminist thought on post- feminist women.
Nevertheless, research and clinical experience do suggest that feminist attitudes may help women develop a critical perspective and voice which they can use to struggle against the oppression they face in the body domain.
An important component of feminism that may be critical for counteracting the effects of societal objectification is empowerment.
Empowerment can be defined as having control over one’s life and influencing the organisational and societal structures in which one lives. Empowerment programs for girls (when introduced into the school curriculum) have demonstrated some success in influencing body image and eating attitudes in early to middle adolescence. And studies with college students have found that the more powerless a sample of undergraduate women felt, the more likely they were to have body image and eating disturbances.
The feminist approach to dealing with body image dissatisfaction and disordered eating involves consciousness raising and education (empowerment). It involves challenging myths about beauty and dieting and addressing weight and appearance discrimination.
Discussing these issues in group settings (rather than individual therapeutic settings) may be particularly empowering, as groups embody the cultural and social context of women’s lives. And part of this process involves thinking of ways to participate in challenging systems ‘out there’, rather than, as therapies focused on ‘individual change’ would suggest, learning acceptance within those systems.
An obvious problem with Cognitive Behaviour Therapy (CBT), the ‘gold standard’ for treatment in eating disorders, is that it locates within the thought processes of individuals – deemed ‘irrational’- sociocultural beliefs about weight, shape and eating behaviour.
Fed Up? Is a feminist agency in Melbourne, Australia, providing education, health promotion, small group programs and activist opportunities to the general community, those with eating and body image issues, health professionals and others. This agency has developed, in part, as a counterpoint to existing community based organisations that operate within the dominant biomedical paradigm.
Important principles of Fed Up? include; recognising the central role of socio-political and cultural contexts in the aetiology, maintenance and recovery from disordered eating and body image dissatisfaction, emphasising the role of gender, race and age in these contexts, locating support and change agents within the community, actively working for social change and empowering women to challenge the existing systems that promote discrimination and self-hatred. If you are Fed Up? sign on.
Dr Naomi Crafti is a member of the Australian Psychological Society College of Counselling Psychology, with over 20 years experience working in the area of eating disorders, body image and weight discrimination. While an academic at Swinburne University Naomi developed, evaluated and supervised the Mindful Moderate Eating Group (M-MEG) program at the Swinburne Psychology Clinic and trained more than 50 psychologists to run this program.
Naomi began working as the Community Development/Education Officer at Eating Disorders Victoria in 2009 and has only recently left this position to start her own consultancy, Fed Up?. In this role Naomi enjoys the opportunity to speak with and educate a wide variety of people about understanding and managing eating disorders, enhancing self-esteem, developing a positive body image and celebrating diversity. Naomi is a member of the Association for Size, Diversity and Health (ASDAH) and promotes Health at Every Size (HAES®) as a sustainable paradigm for living a less stressful life.
Naomi presented a workshop titled ‘Is fat still a feminist issue? at the 2011 Feminist Futures Conference, in Melbourne, Australia, which inspired this article. She can be contacted at firstname.lastname@example.org.