I’m Fatty McFatterson Mayor of Fatterworth and yes Dan (can I call you Dan?) I am pleased with the way I look. Meanwhile, I propose posters around The Hastings Center that say “If you are a bioethicist who can’t grasp the basic tenets of your field, are you pleased with your job performance?”
First of all, let’s be clear that smoking and being fat are not the same thing. Smoking is a specific behavior – every smoker smokes. Being fat is a body size and when it comes to habits and choices, fat people are as varied as any other group of people who share only a single physical characteristic.
I’m not promoting shaming smokers, but I want to be clear that shaming smokers shames people for something that they do. Shaming fat people shames people for who they are. If smokers want to continue their habit and avoid public shame, they can hide their smoking. Fat people would have to hide ourselves. Both of them may be wrong, but trying to get people to be ashamed of a specific habit is a very different than trying to get them to be ashamed of their bodies.
In an article about this [Trigger warning for fat shaming] Deb Burgard, one of my life heroes, said “For him to argue that we need more stigma, I don’t know what world he’s living in,” My sentiments exactly Deb! 386,170 negative messages about our bodies a year, but the secret to public thinness is more negative messages. Right. And yes, public thinness – let’s not fool ourselves that this is about public health. You can identify an evidence-based public health initiative because it is based on evidence and is focused on health. This is 0 for 2.
In fact, Peter Muennig’s research from Columbia found that most of the same health problems that are correlated with obesity are also correlated with being under a high degree of stress for a long period of time (for example, the stress of constant shaming and stigma). Muennig found that those who were concerned about their weight experienced more physical and mental illness than those who were ok with their size, regardless of their size. I guess being a bioethicist doesn’t include doing basic research to see if what you are recommending is likely to have the exact opposite of the intended effect?
I am lucky to know Dr. Tiffany Cvrkel, a brilliant bioethicist who works at UCLA so I immediately e-mailed her for her thoughts. She said:
I think Callahan is perhaps confused about the mission of bioethics. We are capable of doing many things to increase general public health. We can protect people from one of the leading causes of death and injury in very a straightforward way. All we have to do is forbid people from leaving their houses, for any reason. Maybe we should start a shame-based campaign?
Oh, wait. Just because we can do something doesn’t mean we should. It is the job of the bioethicist to be able to tell the difference. If Callahan thinks that shaming people for how they look is an efficient way to make them healthier — a claim that is simply empirically wrong, by the way — then he still needs an ethical argument for why that shaming is morally permissible. Simply saying “it’s for their own good” is not sufficient. I can forcibly prevent you from riding in automobiles for your own good, or from dating problematic people, or from voting for offensive political parties. Callahan is suggesting something equally ridiculous.
Suggesting that we should shame people for their own good until they hate themselves healthy thin offends me as a fat woman, as a human being, and as someone who appreciates logical, rational thought and evidence-based public health interventions. My hope is that this is the kind of thing that makes more fat people stand up and say that they’ve had enough – that the evils have finally become unsufferable, that this is not a tree and we are not kittens, that it’s time to stand up and fight back and that if they want a war on obesity, then we’ll give them one.
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