Ugh. This is hard to read. Even a relatively balanced article by a writer I admire gets my hackles up, so I can’t fucking wait for the War on Fat to really gear up.
There’s a lot in Saletan’s article that makes me go, “Hell, yeah.” First, the fact that he acknowledges “The one thing you’re not allowed to do in a culture war is win it” (brill), and thus the relatively successful anti-smoking crusade gives way to an anti-fat one. It’s important to point that out. It’s also important to point out, which he doesn’t explicitly do, that once the War on Fat succeeds to some extent, we’ll need a new focus for the legislation of morality. What will it be then? Round two on Prohibition? An official War on Sex? War on Working Mothers? War on Immigrants? (Hey, wait…) War on Tailgating?
This is what’s scary. At this point, too many people think, “I don’t smoke, I’m not fat, I don’t drink, I don’t do drugs, I’m not a slut–and the people who are are bad! Who cares if the government makes it harder for them to be bad?” Those people will care, however, when we run out of established nasty behaviors and have to invent new ones. Anything you do that could arguably A) harm another person, especially a child or B) cost anyone other than you a dime–however indirectly–is begging to have a War declared on it. Ever yelled at your kid? Not picked up the dog crap in your yard the very second it was deposited there? Run a yellow knowing full well it would be red before you were through the intersection? Taken the subway while you had a cold? Called in sick when you weren’t? Those things could HURT OTHER PEOPLE or COST OTHER PEOPLE MONEY, you insensitive fuck! We ALL end up paying for your self-indulgence! All us good people, who never do anything that could hurt someone or cost someone else money, by which we mean EVERYONE BUT YOU!
The problem is, there’s some logical sense in the war Saletan describes. I don’t for a second believe that obesity, in and of itself, kills more people than smoking. (For the millionth time, READ PAUL CAMPOS, people!) But a sedentary lifestyle and nutrition-free diet, which often go hand in hand with obesity? Sure. Those things will make you sick. And a lot of big corporations do deserve to be taken to task for marketing potentially harmful, food-free food (especially to THE CHILDREN!). Would I weep to see McDonald’s and Kraft taken down a notch? Not so much.
But… any genuine desire to actually improve the lives of average people must be tempered with a look at the big picture. Which means asking questions like:
1. Do we actually have a responsibility to society not to get sick?
2. If so, what standard will we use to determine whose illness was preventable? Let’s say a 40-year-old non-smoker, twenty pounds overweight, is diagnosed with… umm, breast cancer. No family history, but she’s been on the pill since she was 18, ’cause she likes that consequence-free sex, and even though she passes her physical with flying colors every year, she certainly has been known to eat junk food, and she hates green vegetables. So there are a number of lifestyle choices that might be responsible for the cancer–or it might just be bad luck. Do we blame her? What about the woman who cavalierly ignores the common wisdom about sunscreen? If she gets melanoma, isn’t that her fault? Does she deserve a hospital bed that could go to someone who didn’t bring it on herself? Should I have outrageous insurance premiums because of morons like her getting payouts? What about the 16-year-old who’s too stupid not to take a ride with a friend who’s drunk? He knew better, but he got in the car anyway! Should the paramedics even bother hauling his sorry ass out of the wreck, when there are other people–good people! safety-conscious people!–who might need help at the same time?
3. Now reimagine all those scenarios just the same way, except the people involved are black and poor. Woman number one knows junk food is a much cheaper, more efficient way to fill herself up than fresh fruits and vegetables, so Cheetos give her a way bigger bang for her limited buck, and her community doesn’t really stigmatize a little excess weight; in fact, the amount she’s carrying might not be seen as “excess” at all. Woman number two knows white people make a big fuss about sunscreen, but she’s got a certain amount of built-in protection–her ancestors weren’t agonizing about SPFs in fucking Africa, were they?–so sunscreen always seemed like a ridiculous waste of money. And the kid really didn’t want to take a ride with his drunk friend, but the alternative was walking home through an extremely dangerous neighborhood. So how about those people? Do we blame them for bringing it all on themselves?
4. Speaking of which, before any liberals rush into saving people from themselves and bringing down The Man, have we given more than a passing thought to the race and class issues this brings up? On average, poor people are fatter than middle-class people, who are fatter than rich people. On average, African-Americans and Latinos are fatter than white people. Are we ready for all the ugly implications of a War on Fat, when it inevitably turns into a War on the Fat (more than it already is)? Are we ready to hear, more than ever, that fat people are ignorant, lazy and socially irresponsible–and oh hey, guess who’s fattest of all? Doesn’t that just dovetail nicely with expectations people have busted their asses to stamp out?
5. How do we determine who’s irresponsibly fat, and who’s just chunky? BMI? Plenty of research shows that’s way too crude an instrument to make such an important designation. I, for one, am in the “elevated risk” zone on a BMI chart, and just a few pounds shy of officially “obese.” (That recent study that showed most obese people don’t know they’re obese? Might just have a little to do with that fucking definition of it, rather than the cluelessness of fat folk.) According to a standard that some experts consider more important, however, I’m all set: my waist-to-hip ratio is well under 0.8, my waist circumference several inches below the supposed danger zone for women. Most of the fat that makes my BMI “dangerous” is keeping my femoral arteries warm, not weighing on my vital organs. And most importantly of all, despite a family history of heart disease, hypertension and diabetes, I kick ass on my physical every year: cholesterol, blood pressure and blood sugar are all top-notch. I obviously need to quit smoking, but there’s nothing in my medical profile–except my arguably arbitrary BMI rating–to suggest my weight has any adverse effects on my health.
6. In light of that, whom do we ostracize? A crucial component of the War on Smoking was making smokers pariahs. It follows that we’ll need to make fat people even more uncomfortable showing their faces in public if this is going to work. But which fat people? If I can prove my cholesterol, blood pressure and abdominal fat are all well in hand, will I get to sit in the Not Killing Myself section in a restaurant, or will I get stuck in the Costly, Costly 2 x4 section because the prevailing wisdom suggests someone with my BMI will eventually have expensive medical problems, so society shouldn’t encourage me to keep on as I am? If I’m fortunate enough for it to be the former, will I have to carry medical documents everywhere, or can they just, like, implant me with a convenient Socially Acceptable for Now chip, and later remove it if I do develop heart disease?
7. If we get rid of preventable illnesses, do we really think that means we’ll all die peacefully in our sleep at age a zillion? The mere fact of getting old means you’re far more likely to get cancer and Alzheimer’s, off the top of my head–both extremely costly and utterly miserable ways to go; I’d much prefer a heart attack, frankly.
8. Not to mention, the older you get, the more years you spend sucking social security instead of working. Scenario A: Fatty works all his life, maybe takes more sick days than his thin co-workers, sure, but then has a heart attack around age 65, which takes a week of hospitalization before it officially kills him. Scenario B: Polly Pureheart works until retirement age and, because she’s taken such good care of herself, lives 30 years beyond that, the last ten of which are spent in a nursing home with Alzheimer’s, up until she finally forgets how to swallow and kicks it. And… we’re all pissed at Fatty for costing society too much money? I call bullshit.
9. Related to that, doesn’t it follow that if we succeed in establishing any preventable illness as a massive social no-no, what we spend on preventative medicine will increase substantially? Everyone says prevention is cheaper than the cure–but is it really? Wouldn’t insurance companies be forced to cover a hell of a lot more elective doctor visits? If everyone actually started cashing in on their recommended mammograms and mole checks and whatnot, wouldn’t that get rather pricey? And wouldn’t we then be arguing about the ratio of what we spend on preventative medicine to the number of illnesses it actually catches? That guy’s thirty years old, in perfect health, with no family history of anything–why should he need a colonoscopy? That shit costs American money! And wouldn’t doctor’s offices and hospitals get even more woefully overcrowded? I mean, fuck, I spent two hours at the doctor’s office the other day, just so I could hear that my finger is healing nicely, which I already knew; I only went because the ER docs told me to, and I’m a good girl who follows directions. One and a half of those hours were spent in the waiting room, and the other thirty minutes were spent getting weighed, telling the doctor the date of my latest pap smear, etc., before he could look at my goddamned finger for ten seconds. Do we want to encourage more less-than-strictly-necessary doctor visits? If everyone really went in for preventative stuff, would we have any prayer of getting in and out of a doctor’s office in less than three days? What does that cost in lost work time?
10. Finally, where’s the fucking War on Stress? Last time I checked, stress is blamed for causing pretty much all the same things fat is blamed for. Heart disease, high blood pressure, frequent illnesses, lack of positive health habits, and maybe even, if you squint right at the statistics, cancer. Not to mention, you could argue that there is such a thing as second-hand stress–what’s the cost to society when you factor in the rudeness and verbal abuse stressed-out motherfuckers are always poisoning the air with? How well are stressed-out people treating their children? How safely do they drive? How productive are they at work? How much do they subject other people to the negative effects of their fucking coping problems? As health crises go, I’d put my money on stress being way more brutal and costly overall than fat is. So, you know, obviously we should mandate higher wages; more flexible work hours; more vacation time; more massages and naps; no changing lanes every ten seconds during rush hour and bringing the people three miles behind you to a dead stop–yes, you, asshole; reduced fares to tropical destinations; muzzles on small children in public spaces; friendly and helpful customer service representatives, and enough of them that hold times are never more than 15 seconds; bunny-petting stations in every American workplace; and kindness to fellow human beings at all times, no exceptions. That would all just be a logical investment in public health, wouldn’t it?
But maybe it’s not really public health we’re interested in when we disparage fat. Just maybe. Call me crazy.
