Fear Mongering for the Nation

The last two nights I watched the new HBO documentary “The Weight of the Nation” and was live tweeting with the hashtag #WOTN. While the producers seemed to try and make the film appear to be compassionate toward the plight of fat people, the pre-apocalyptic language and fear mongering used by many of the people interviewed as well as the lack of a well rounded argument that looked at both sides of the issue made this documentary a fat hate fest. In the four hours of documentary only one mention of a fat person being able to be metabolically healthy was mentioned. At no point was there ever discussion on the failure rate of weight based health initiatives (95% in the first 1-2 years) or that those who “succeed” by 5 years only manage to keep 10% of their body weight off. 1 At no point was there any mention that a lifetime of weight loss attempts leads to weight cycling and weight gained as well as other health complications.2 There was huge emphasis on the rise in type 2 diabetes in children but no mention that due to the escalation in fat phobia and dieting behavior children are more likely to have an eating disorder. 3

1. Misuse of BMI Charts

The films start with the history of BMI charts, interestingly enough they use modern day BMI chart numbers with no mention of the change that occurred in the late 90s that made millions of people “overweight” and “obese” overnight. There is no mention of reality that BMI charts were never supposed to be used as a measure of health or for large populations as a whole.

2. What About the Children?

Part 3 of the series is completely dedicated to the “prevalence” of type 2 diabetes in children. No mention that the CDC does not have statistics on how many children have the disease because it is so rare.4 There is also commentary that now that the “epidemic” has started in children it is easier to take seriously than “when it was only adults or people in less valued groups.” That comment summed up the tone for the rest of the films, showing how we will help people like children who are not thought of as having their own autonomy while simultaneously deeming the lives of adults or “less valued groups” as insignificant.

3. False and Unscientific Presentations

The most egregious clips from part 1 is where they are examining the 3 different hearts at Northwestern University’s School of Medicine. They show the heart of a “normal” weight 26 year old woman and compare it to not only a 50 year old man who weighted 500 pounds but also to a fat 71 year old heart. At no point was there any mention of the significant difference between the hearts due to aging only mentioning the difference in body size. Aside from the fact that this was completely unscientific it is a perfect example of the fact that a viewer will see this clip and not think about the information that is being left out. After viewing this clip myself I saw numerous tweets about how they couldn’t believe the difference in the hearts, everyone attributing that difference to body size not age. If they were truly interested in presenting an unbiased scientific opinion, hearts from bodies of people of the same age with different weights would have been the way to go. This was not only banking on fat phobic beliefs but instilling fear of fat in viewers.

They also followed a woman who was part of a study that had its participants eat an extra 1,000 calories a day at fast food restaurants. Other than the fact that they are showing someone drastically changing their behaviors, the adverse health affects of the extra calories is completely blamed on the small amount of weight that was gained. This is only a few examples of the film that showing an unrealistic approach from science to try and prove that gaining weight not changing behaviors is related to a change in health status.

4. Promotion of Harmful Weight Control Measures

During part 2 the film followed two women who are part of the weight control registry that keeps track of people who have kept of their weight “long term,” which the registry defines as 1 year. What they showed was obsessive calorie counting, keeping food journals and excessive exercise. Watching the women explaining the obsessive behaviors that they have mastered to control their weight was one of the hardest things to watch about the films. They also promoted weight loss surgery as an option. The man that they followed to his surgery, and then did a follow up after only 6 months, had many of the life threatening complications that happen with bariatric surgery but they were down played by his affirmation that he would have done it again.

5. The Fatpocalypse is Coming!

All of the films had commentary that made it seem as though the world was going to end if we didn’t stop this “epidemic.” One commentator said that the US would be crushed by it, another said that businesses would go overseas to find a workforce (because clearly fat people are only in the US), that we wont have a workforce in the US because everyone will be fat, and that our health care costs will continue to grow until Armageddon happens. They also mentioned the overused and misplaced study that said this generations children would not live to the same age as their parents.5

6. Risks

The documentary kept talking about risks associated with “obesity” but doesn’t explain that risk does not mean cause. The confusion between correlation and causation in understanding study results is astounding when research is written about in the media.

7. Fake Compassion

The film was very conflicted with its point of view on how we should feel about fat people. Not only did they say that we should know that people are fat outside of their own control, but many of the fat people who were interviewed said that it was their own fault or that they could change their body if they tried. The idea that they want us to see fat people as helpless while also giving “choices” on how fat people can lose weight is asinine. They are trying to appear to be compassionate and create less fat stigma when that is exactly what they are doing.

8. Structural Changes

There is a lot of time dedicated to the prevalence of poverty and body size in the films. How in low income areas there are no outdoor spaces for people to move their body, that they are often located in fresh food deserts (lies) and how junk food is the most affordable food available. All of this creates the idea that they don’t want to place the blame on people living in those areas while also presenting misleading information. The top suggestions given were creating safe outdoor spaces and access to affordable fresh foods. They also tried to tackle the prevalence of fast food restaurants in low income areas but didn’t mention a recent study that showed more middle income people eat fast food than people who live in poverty.6

9. The Food Industry

While talking about the amount of junk food in stores they also try to engage the food industry referring to it as something similar to the smoking industry. Many suggestions of reforming the food industry are not sustainable for the population of our country. Organic fresh foods, grass fed beef etc would not be possible with the amount of land we have and the population of the people we need to feed. As it is we have people that starve every day, stores like Trader Joe’s and Whole Foods throwing out blemished foods because they don’t look good enough for their shelves. One commentator even made the suggestion that they should be required to make less food each year so that people would be forced to eat fewer calories. All of these suggestions mean someone completely more sinister than just trying to make people thin because if this were to actually happen people would die. We would need a smaller population for these suggestions to actually work and they would be created by the lack of food available for the current population. Also, none of the suggestions given would actually make the population as a whole thinner or make it so that fat people didn’t exist.

10. Conflict of Interest

Many of the contributors in the film as well as the National Institute of Health, the Institute of Medicine and the Center for Disease Control, all sponsors of the documentary, have possible conflicts of interest with people in their organizations who get money from companies that bank on fat bodies being pathologized. The NIH specifically had a panel that recently was called out for having conflicts of interest with the makers of Lap-Band.7 A few of the contributors of the documentary have been on this panel and every person who spoke in the film has a job that depends on fat bodies being considered diseased.

Final Thoughts

While the documentary banks on the normal ignorance surrounding weight and health, I found the worst parts to be the way they used scare tactics and misleading information. The length of the documentary was almost excruciating to sit through aside from the information being presented, they probably could have cut the time in half if they didn’t repeat half of the information numerous times in what I am assuming they hope will make people remember everything that they talked about.

One of the short films titled “Stigma: The Human Cost of Obesity” talks about weight stigma, but even in that portion the stigma is completely blamed on the weight of the person, as you can see with the title of the clip, not on society or fat phobia. In the clip Rebecca Puhl says how we need to not make this a fight against fat people but against “obesity.” The problem is that when you live in a fat body that science doesn’t know how to make thin you really are waging war against people.

Some more reading,

Bread and Circus (Hold the Bread):Weight of the Nation Deserves an Imperial Thumbs Down by Linda Bacon, Ph.D., MA, MA

Weight of the Nation Serves Up More Fat Shaming by Marilyn Wann

Debate the Weight: Deconstructing HBO’s The Weight of the Nation by ASDAH

the HAES files: Stereotype Management Skills for HBO Viewers by Deb Burgard, PhD

the HAES files: Top 10 Reasons to Be Concerned About “The Weight of the Nation” Documentary by Fall Ferguson, JD, MA

1. Do 95% of Dieters Really Fail – Dances With Fat

2. Weight Cycling, Weight Gain, and Risk of Hypertension in Women 

3. Incidence and Age-Specific Presentation of Restrictive Eating Disorders in Children 

4. Children and Diabetes – See Difficulty Detecting Type 2 Among Children

5. the HAES files: the cockroach effect

6. Fat Food’s Biggest Consumer: Not the Poor but the Middle Class

7. Health Guideline Panels Struggle with Conflicts of Interest