Little Fat Man Isn’t It a Shame

by on Aug.16, 2009, under Politics

In the New York Times, David Leonhardt asks why we don’t treat fat people like we treat smokers, asking them to bear the brunt of their cost to society. It’s an inane and offensive argument on many levels. For example:

Cosgrove mentioned to me an idea that some economists favor: charging higher health-insurance premiums to anyone with a certain body-mass index. Harsh? Yes. Fair? You can see the argument. And yet it turns out that the obese already do pay something resembling their fair share of medical costs, albeit in an indirect way. Overweight workers are paid less than similarly qualified, thinner colleagues, according to research by Jay Bhattacharya and M. Kate Bundorf of Stanford. The cause isn’t entirely clear. But the size of the wage difference is roughly similar to the size of the difference in their medical costs.

Bigotry results in a wage penalty for being overweight (as it does in similar penalties for being short, or female)–and Leonhardt thinks public policy should follow from it.

The comparison to smoking is valuable, but Leonhardt gets it wrong by confusing a debilitating condition with a behavior that causes it. Cigarette taxes, whatever else they are, are not a punitive tax on people with lung cancer. So why would a smart public policy penalize, as Leonhardt proposes, “anyone with a higher body-mass index?”

Towards the end of the article, Leonhardt offers that the problem may have a social element:

The solutions to these problems are beyond the control of any individual. They involve a different sort of responsibility: civic — even political — responsibility. They depend on the kind of collective action that helped cut smoking rates nearly in half. Anyone who smoked in an elementary-school hallway today would be thrown out of the building. But if you served an obesity-inducing, federally financed meal to a kindergartner, you would fit right in. Taxes on tobacco, meanwhile, have skyrocketed. A modest tax on sodas — one of the few proposals in the various health-reform bills aimed at health, rather than health care — has struggled to get through Congress.

Again, smoking rates weren’t cut in half by ostracizing people with lung cancer, and obesity shouldn’t be attacked by shunning the fat. Most importantly, it would help to stop subsidizing the production of cheap, unhealthy food. A proposed California cigarette tax would raise revenue to fight cancer, and the costs of obesity could be fought with a soda or snack tax.

And fat people will continue to walk the earth–mostly-healthy-eating, occasionally-snacking people who remain fat. Public policy shouldn’t be designed to punish them.

Advanced reading: “Fat rights are where gay rights were at 30 or 40 years ago,” Paul Campos at Lawyers, Guns and Money.


13 Comments for this entry

  • Joshua Malbin

    I’d say the anti-high-fructose-corn-syrup movement is about where the anti-tobacco movement was at 30 or 40 years ago.

    But that Paul Campos essay strikes me as booshwah.

  • Josh K-sky

    Does booshwah mean bullshit or bourgeois?

  • Joshua Malbin

    The former.

  • Josh H. Pille

    I don’t think that you can (or should) really implement it, but the spirit behind it is understandable. If, that is, we’re willing to say that there’s a link between being a smoker and health effects, and also that being a smoker is (to some degree) a choice that one makes — then we should also be willing to say that there’s a link between being fat & health effects, and that being fat is (to some degree) a choice that one makes. So far, I don’t believe that this is controversial.

    I would assume that the degree to which “choice” and “responsibility” come into play in the two cases are pretty different, but in both cases, it’s almost certainly greater-than-zero.

    Now, I think that all of us fat, smoking, non-exercising slobs should be as entitled to free health care as all of the folks who actually take care of themselves. As Americans, we still, at least nominally, profess to certain communal, risk-sharing practices. And until I can opt out of funding your kids’ education, or funding your war, then fuck you for trying to deprive me of health care, even if I could (or in some sense maybe should) take more responsibility.

  • Josh K-sky

    Being fat is not a choice that one makes. Eating crap is.

  • Josh K-sky

    On the subject of fat-acceptance/positivity, a FB friend preferred this manifesto.

  • Joshua Malbin

    What is FB?

  • Josh K-sky

    the book of face is long and boring
    no one can lift the damn thing

  • JBC

    Maybe this is just me being contrarian, but I thought the Campos essay was provocative, even if the analogy is obviously holey and problematic. Possibly the strongest connection is at the level of individual psychic relationship with a category of social stigmatization: it seems totally plausible to me that many lesbian and gay people living in places and times where there is very little public acceptance try as hard as they can to be straight, and most can’t do it. And yes, in a real sense the same is true for fat people trying to be thin. So I think there is a case for a fat-positive position that tries to resist the desire to normalize oneself, even though I have to say, as a fat person, I’m not there myself. An analogy with the LGBT movement might help think about building such a fat-positive politics, though I don’t find details of the analogy (e.g. BMI) helpful at all, and I doubt the analogy is useful in reverse – that is, I doubt that LGBT activists would learn much from comparing their situation with the fat-positive movement.

    That said, there’s another movement-oriented sense in which this analogy is exactly backwards. Since Stonewall, LGBT rights and recognition in the public sphere have expanded, even if inconsistently, in ways that are fraught, with contradictory growth in hate crimes in certain places, etc. On the other hand, the cause of fat acceptance seems to me to be moving backwards over the years. Body image norms for women create more impossible ideals of slenderness and youth than ever before. Fat is not only an income thing, it is becoming a class thing; while the occasional rich “fat cat” is still tolerated, in the ranks of the professional bourgeoisie particularly in “progressive” coastal and university enclaves, fat is not tolerated, while it grows at almost epidemic levels in working-class communities (more or less across the bounds of race, once you adjust a couple of generations for new immigrants). As fat becomes a working-class malady, in the immediate future I suspect it may be pathologized more, not less, and the recent media obsession with it supports that idea.

    I suppose I should just blog about this my damn self rather than filling up your comment space … sorry.

  • Joshua Malbin

    I guess, given that, I should clarify why I think the analogy is, as I said, booshwah. First, as you say, “the strongest connection is at the level of individual psychic relationship with a category of social stigmatization”. But even there the connection is weak, I think, because social stigmatization for gay people is fundamentally linked to secrecy. Self-acceptance for fat people is not linked to a big, dangerous act of self-declaration anything like coming out–which still gets people rejected, disowned, even in rare instances killed. If you’re fat everyone can already see it (unless you’re a fat person living in a thin person’s body, as Campos posits, a concept that makes no sense to me whatsoever). 30 or 40 years ago the social policing of the stigma around gayness was much more powerful than the stigma around fatness is today. You could lose your job for coming out. You could get beaten up. I have never heard of anyone getting beaten up for being fat. I suppose it may happen sometimes.

    Second, and even more importantly, the gay rights movement wasn’t just about self-acceptance or social stigma. It was and is also, vitally, about legal rights. It was illegal to be gay in most places 40 years ago. The Stonewall riot happened because the NYPD vice squad was coming in to bust everyone in a gay bar. Hell, Lawrence v. Texas was only six years ago.

    None of this is intended to put down the need for self-acceptance or social acceptance. But that’s what “fat rights” is about, so far as I understand it. It isn’t the same kind of social justice movement.

  • Josh K-sky

    First off, B’Cannon, you are encouraged to fill up our comment space. Bring your friends! None of this retreating to your own blog business.

    Second off, JM, the legal/social distinction is critical but not the end of the line. With gay writer Michael Moon, Eve Kosofsky Sedgwick wrote about correspondences between fat women and gay men:

  • Joshua Malbin

    Yeah, I’m aware of Eve Sedgwick’s writing on the subject, and I didn’t find it convincing. I kind of assume her own self-identification as both “queer” (albeit married) and fat has led her to look for relationships between the two. To me the more informative comparison is probably to second-wave feminism.

  • JBC

    I don’t think the “oppression olympics” type of comparison is ever very helpful – so certainly the interesting comparison would not be about *levels* of social or legal acceptance / equality / recognition. (There I’d argue that current developments do suggest a *new* development of something less than full legal equality for fat people – though it’s unlikely that this will ever reach levels of outright criminalization, dystopias to the contrary.)

    I don’t think there’s anything canonical about the comparison, and the emotionally cathartic identification only goes so far. Probably the most instructive part of the comparison has to do with normalization and resistance to normality.

    Also, I’m remembering a remark of Foucault’s, to the effect that the Western preoccupation with self-management shifted, historically, at a certain point from a fixation on food to a fixation on sex. I wonder if there’s a case to be made that there’s now something of a dual fixation (since there seems to be a growing fixation on managing the body in terms of food and exercise, but no less of a fixation on sex, even if notions of socially acceptable sex have shifted dramatically).

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