Tag Archives: fatphobia

Imagining a Body-Positive Future

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Laurie and Debbie say:

Anna North’s recent article in Vox, “The past, present, and future of body image in America,” is an interesting experience for the two of us to read. We have recently completed an academic article, on submission to a special issue of Fat Studies, which is surprisingly similar in its scope and outlook to North’s piece. Assuming it gets accepted, we’ll share that here when it is published in 2022; meanwhile, North’s piece is a different trek over much of the same ground, well named as “the past, present and future of body image.”

North’s conventional journalistic opener quotes a directly affected person (in this case, Elena Ariza, now 21, talking about her experiences with body-shaming as a Latino student in a predominantly white California middle-school and high school.

bullying over weight and appearance is far from a thing of the past. In some ways, it might be worse now: The sheer number of images young people have to deal with every day has multiplied a thousandfold, and those images are often manipulated with Photoshop or filters that create a homogeneous appearance that’s unattainable for many people. “They manipulate your features to become Eurocentricized,” Reanna A. Shanti Bhagwandeen, a freshman at Bates College, told Vox. “It gets rid of, I guess, me.”

Meanwhile, many young people today say the term “body positivity” has been coopted by thin, white, or light-skinned celebrities and influencers — the same people whose looks have been held up as the beauty ideal for generations. What’s more, some of those influencers celebrate features once stereotypically associated with Black women, like full lips, even as Black women themselves remain discriminated against for their appearance.

She goes on to discuss the Facebook/Instagram issues which Debbie wrote about here last week, and later some of the public reaction to the leaked documents.

young people and educators say what’s needed most at this particular stage in the body image wars are guides to help people navigate the torrent of information they now get about their appearance. Teens and kids especially need regular education about “social media and what healthy relationships look like, and what body image means,” Pascale Saintonge Austin, who oversees the Just Ask Me peer education program at the New York nonprofit Children’s Aid, told Vox. “There just needs to be more of a conversation with our young people.”

North then takes us back into a very brief history of the roles of thin-ness and fatness in earlier centuries in Europe, and a somewhat deeper dive into the history of the fat acceptance movement. She is scrupulously careful to keep reminding her readers of the links between fatphobia and racism:

[In the early 1970s,] Black writers and activists were also linking weight discrimination and racism, as Briana Dominici notes at Zenerations. “I’m a woman,” welfare activist Johnnie Tillmon wrote in 1972. “I’m a Black woman. I’m a poor woman. I’m a fat woman. I’m a middle-aged woman. In this country, if you’re any one of those things you count less as a human being.”

“If you are a fat Black person, particularly a fat Black woman, you are more likely to receive worse medical care, you’re more likely to be discriminated against at your job,” [Sabrina] Strings [author of Fearing the Black Body: The Racial Origins of Fat Phobia] said. “There are all these ways in which having more than one identity characteristic that Americans deem to be coarse will put you in a position for facing greater amounts and different forms of oppression.”

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In the last ten years, North recounts, things have begun to change:

Nothing happened overnight — in 2012, when writer and influencer Gabi Gregg posed in a “fatkini” and wrote about it for xoJane, the image of a size 18 woman proudly modeling swimwear was still unusual enough to go viral. And swimwear options for women Gregg’s size were still few and far between. The winds of change were blowing, however, as companies realized they could make money selling to the millions of American consumers who were being ignored or alienated by ultra-skinny models and restrictive size ranges.

In 2016, Sports Illustrated put its first plus-size model, Ashley Graham, on the cover. In 2019, brands like American Eagle and Anthropologie began expanding their sizing. The rise of direct-to-consumer brands advertising on Instagram also meant a wider array of sizes and a more diverse group of models appearing in customers’ feeds.

As both our forthcoming article and North are very aware, social media, of course, is a major driver of all the different things that are going on at the same time:

Maybe the biggest difference between the media environment today and in the ’80s or ’90s is that there’s just more now, of everything. Growing up, magazines were dominated by super-skinny models, but “you could take a break,” Austin said. “There was no Facebook or anything like that,” and “it’s not like you had Netflix or DVR.”

Today, by contrast, “it’s so much information,” Austin said. That information can include body-positive messages, but it also, increasingly, includes images of people who have had plastic surgery or use filters or Photoshop to look a certain way. “Everything is so enhanced,” Austin said.

And North and the two of us end on very similar positive notes. While the problem remains huge and the damage being done every day is real, nonetheless there are new kinds of paths through and resources to draw on:

In the wake of revelations about Instagram’s impact on young people, Congress has shown an appetite for increased regulation of social media platforms. Frances Haugen, the former Facebook employee who helped bring the company’s internal research to light, has suggested a number of reforms, including increasing congressional oversight, greater scrutiny into Facebook’s algorithms, and increasing the minimum age for users from 13 to 17.

It’s too soon to tell whether such reforms will pass or whether they’ll have a meaningful impact on the kinds of messages young people get about their bodies. But in the meantime, young people themselves are navigating the confusing sea of contemporary body image discourse, offering guidance and inspiration for others along the way.

Ariza’s advice is to “unfollow accounts that make you feel like you need to compare yourself or you need to change,” she said. “Follow people who are going to influence you to go on a 30-minute walk or read a new book or go visit this exhibit.”

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Although she never says it in so many words, North’s article implies that she believes, as we do, that nothing can change if we can’t imagine it changing–and if we aren’t willing to work to convert our imagined future into reality.

All photographs (c) 1994, Laurie Toby Edison, from Women En Large: Images of Fat Nudes.

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Various Thoughts about Medical Racism

America's History of Medical Misogynoir, with stylized images ofo women with skin tones ranging from very dark to very light
picture from DocumentWomen

Debbie says:

I listen to a lot of podcasts, many of them about race and racism issues, but the idea for this post came from The Allusionist, which is about words. Host Helen Zaltzman interviewed Moya Bailey, who coined the term “misogynoir” when she was doing work on racism in the medical community. As part of the conversation, Bailey relates the story of Dr. Susan Moore, a Black physician who died of COVID-19 in 2020. Despite her profession, Dr. Moore received woefully inadequate treatment for the virus because she was perceived as a “drug-seeker,” undoubtedly because of the color of her skin.

Examples like Dr. Wood’s are legion; perhaps more is to be gained from looking at the theory and practice of medical racism than the horror stories. This brings me to two things I’ve learned recently from Pod Save the People. First, race correction. When I heard the term, I thought (naively), “Wow! Sounds like a way to do evidence-based work on the medical issues that disproportionately affect the Black and Brown communities. I couldn’t have been more wrong.

Race correction, which is in use today, is the misuse of what author Cathy O’Neil calls “weapons of math destruction” against the health of (especially) Black people. Jacque Smith and Cassie Spodak wrote about it for CNN.

The New England Journal of Medicine article “Hidden in Plain Sight” [link requires registration] includes a partial list of 13 medical equations that use race correction. Take the Vaginal Birth After Cesarean calculator, for example. Doctors use this calculator to predict the likelihood of a successful vaginal delivery after a prior C-section. If you are Black or Hispanic, your score is adjusted to show a lower chance of success. That means your doctor is more likely to encourage another C-section, which could put you at risk for blood loss, infection and a longer recovery period.

[Dr. Samuel] Cartwright, the racist doctor from the 1800s, also developed his own version of a tool called the spirometer to measure lung capacity. Doctors still use spirometers today, and most include a race correction for Black patients to account for their supposedly shallower breaths.

Turns out, second-year medical student Carina Seah wryly told CNN, math is as racist as the people who make it.

On a somewhat more encouraging note, Pod Save the People also hosted Dr. James Wood, a Black orthopedic surgeon. I was especially pleased to hear Dr. Wood address fatphobia and medical bias against fat people in the context of medical racism:

And there’s bias against obese patients because patients who are very obese– everybody wants to blame whatever disease that is on the body habitus. But there’s new study and new research now on obesity that’s talking about people in their best body. I see people who are obese by any standard.

They walk in, their BMI, 38-40. But then their best body, these are the same people that can run five miles. They can hike. They can ride bikes at 20-30 miles, in great shape. It just big people, doing their best body. So being able to really have people understand this and respect this is something else that’s coming on new in the future.

So people who’ve been fat shamed and other things like that– and this is happening. It has happened to doctor’s office where they walk in and say, well, you’re too fat. I can’t take care of you. Or you’re too fat, you’ve got to do that, so you could take care of your diabetes or your hypertension or your arthritis in the joints. Being more cognizant of what the conversation is now about obesity would be very helpful as well, just as an example.

I’m not sure what research Dr. Wood is citing on this “best body” concept, and I will keep looking. In the interim, it was genuinely exciting to hear a medical professional talking about medical bias and using terms like “fat shamed,” which I tend only to hear in body image circles.

I’ll close with a comment from Moya Bailey which applies both to misogynoir and medical racism:

“I’m hoping that this is perhaps the flourishing before the end. If we talk about it a lot now, perhaps that means we’ll get to a place where we can actually transform and get rid of it.”

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