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Showing posts with label obesity stakeholders. Show all posts
Showing posts with label obesity stakeholders. Show all posts

The Royal College of Physicians' patchy and cynical new year's report on obesity

The predictable new year dose of fat panic kicked off today with widespread reporting of the Royal College of Physicians' (RCP) latest missive, complete with a plethora of headless fatties from the picture archives. The RCP is a charity that represents physicians and, according to its website, "takes a wide role in public health". Action on obesity: Comprehensive care for all, by one of the RCP's working parties, states that the current response to obesity by the NHS is "patchy" and could be resolved by a number of proposed initiatives.

Reading the report is like a journey into Opposite Land. The work is well-meaning, but it exists with a framework that is profoundly problematic. For example, it is hard to disagree that current service delivery for fat people is really poor, particularly for those who undergo weight loss surgery, and that there needs to be proper auditing, quality control and monitoring of all obesity treatments.

But the report, as is typical in a medicalised discourse of fat, is entrenched in a view that regards weight loss as the universal solution to the problem of fat people and health. The authors throw about "severe complex obesity," a term they're obviously pretty proud of, coming soon to a healthcare provider near you, and bound to further medicalise and stigmatise fat people. They make the crucial mistake of failing to question the effectiveness of weight loss at all, so it's not weight loss surgery that ruins fat people's health, it's the fact that the care pathways surrounding the surgery need tweaking. This ties them up in all kinds of knots, looking for answers in the wrong places, for example suggesting that the UK needs a Michelle Obama figure to galvanise the population against obesity, even though her crusade in the US has been disastrous in re-stigmatising fat kids, and even though we've already seen Jamie Oliver screw things up over here.

The report, its press release, and subsequent reporting, reiterates the usual stale fat panic rhetoric about demographics and increasing body weight, and reproduces the inconsistencies of this argument. An estimated cost of £5 billion per year is placed on 'obesity', based on secondary reports, all of which also estimate the cost or propose costs based on irrelevant evidence (I checked their methodology). This figure is therefore a fantasy. More confusingly, Action on obesity: Comprehensive care for all criticises these costs, whilst making a prolonged case for spending more on obesity treatment, presumably because that's what puts the bread and butter in its members' tables. It's nonsense.

This report is an example of obesity research which eschews a research justice framework – more about that in posts to come – but which makes a big honking noise about being for the benefit of humanity. But work like this, cynically capitalising on new years anxiety about fat, is a load of hot air, a waste of space, that serves no one but the members of the RCP, least of all fat people.

If the RCP were really serious about fat people's health, they would be investing in health at every size research, developing fat activist communities, and pioneering projects such as medical self-advocacy, anti-discrimination work, and other low cost, low risk initiatives that have proven track records in increasing fat people's well-being. But that's just crazy talk, isn't it?

Action on obesity: Comprehensive care for all

Reporting back on the fourth and final ESRC Fat Studies and HAES Seminar

ESRC Seminar Series
Fat Studies and Health At Every Size: Bigness Beyond Obesity


Seminar Four: Researching Fat Studies and HAES: working with/as fat bodies
5-6 May 2011
Bath Royal Literary and Scientific Institution, UK


I spent a couple of days last week at the final ESRC (The Economic and Social Research Council) Fat Studies and Health At Every Size (HAES) gathering, which took place in Bath. There have been four seminars in all, stretching over about 18 months. These meetings have operated like mini conferences, and a warm and supportive community has grown up around them.

As with previous seminars, it's unfeasible to report on everything that happened, there is simply too much, so I'll just pick out a couple of the main themes.

Many of the speakers talked about autoethnography and reflexive research. Such methodologies contrast strongly with dominant research paradigms in 'obesity'. Where the latter draws upon notions of universal scientific truth and objectivity, the former disrupts such ideas by bringing the researchers themselves to the centre, by offering context, emotion, ambiguity and paradox. I particularly enjoyed Karen Throsby's presentation about her experiences researching cross-Channel swimming, which raised questions about researcher roles. Jacqui Gingras, Rachel Colls and Bethan Evans also talked about roles and ethics concerning research with and on fat people.

It is hard to imagine similar conversations happening at, say, amongst stakeholders at an obesity conference where fat people are made absent, abject, and anonymous, and where fat is automatically framed as pathology in need of professional intervention. What is remarkable about these conversations is that they took place at an interdisciplinary level and were points of contact across considerable academic difference, where tensions were able to be contained and addressed to some extent. Even better, these seminars have been open to non-academics, you know, normal people, and although some academic jargon was unavoidable, discussions emerged between people with very different experiences of and approaches to fat. Best of all, people of all sizes instigate the conversations. More mainstream obesity stakeholders would do well to stop what they're doing and listen to this dialogue.

Another seminar strand was devoted to alternative ways of presenting and conceptualising research and fat. Emma Rich, the main organiser of this seminar, invited a number of local artists and performers to showcase their work. Although few were working principally around fat or Health At Every Size, and were concerned more generally with the body, it was clear that there are exciting possibilities for fat and HAES praxis. Perhaps Vikki Chalklin came closest to this with her performance that included material from research interviews.

For me, these seminars have been much more than a series of presentations and discussions. I have experienced them as very freeing, as places of collective intellectual and political engagement, and of a scholarship that feels full of life, community and exciting potential. In 21st century Western academia these are really precious moments! My colleague and friend Bill Savage/Dr R. White has said that the ESRC Fat Studies and Health At Every Size seminars have forever spoiled us, and that other academic gatherings might be good, but they would never be as welcoming and stimulating as the ESRC experience! These seminars have been places where participants can see how things might be if we could talk about fat without having always to start at a 101-level defensive justification to hostile spectators. Having the freedom to think, speak, take risks and be heard in a gentle atmosphere has been wonderful, one of the best experiences of my academic career.

It's sad that this round of seminars has ended, although there will be some post-seminar projects, which are currently being discussed, and there may well be other Fat Studies conferences and seminars in the UK, as well as online activites. Keep your fingers crossed.

Meanwhile, deep thanks to Bethan Evans, the principle investigator, who had the idea of the seminar series and who wrote the successful funding application. Thanks also to my colleagues who organised the seminars, and to everyone who participated and supported them. And thanks to Lucy Aphramor, who closed the final seminar with an impromptu rendition of a beautifully vulnerable, funny and wavery-voiced verse from a HAES song. It really was the perfect ending.

Further information about the seminars

Government Support for Fat Studies and HAES in the UK

Reporting back on the first ESRC Fat Studies and HAES Seminar

Reporting back on the second ESRC Fat Studies and HAES Seminar

Reporting back on the third ESRC Fat Studies and HAES Seminar

ESRC Fat Studies and Health At Every Size

Fat, Sex Work, Rescue Industries

I'm very interested when other areas of critical engagement and struggle have crossovers with fat activism. I know this is controversial in terms of fat, which is seen by many as a choice and a triviality, but it fits with the earliest fat activist analyses of oppression (not that I think challenging oppression is all there is to fat activism). For example, Judith Stein's pithy two-page mimeographed introduction to fat activism places fat within a matrix of oppression and calls on fat activists to challenge other forms of oppression too. Sometimes this is lost, fat activism has been criticised for its racism, for example, but I think the idea that no one is free until everyone is free is good to bear in mind.

This week I had the pleasure of spending some time with Laura Agustìn. If you have never read Laura's book Sex at the Margins: Migration, Labour Markets and the Rescue Industry, which she authored in 2007, you must hurry and get a copy now; likewise read her blog, The Naked Anthropologist.

Although Laura is part of a wider movement, for me her book was a paradigm-changer which enabled me to recognise more deeply the agency of people who migrate and sell sex, what selling sex looks like, and how this is thwarted by the rescue industry. Laura's work has helped me unpick hyperbolic rhetoric concerning trafficking discourse, and I am grateful for her rational approach to sex work, particularly in her methodology of sex work research. It also enabled me to reconsider my own personal relationship to sex work and to connect with fat sex workers.

I live in Stratford, close to where the 2012 Olympics will be held. There are discredited reports that major sporting events result in an increase in trafficking and that evening Laura had been invited to be an expert presenter at a meeting at Waltham Forest council which was concerned with this possibility. Waltham Forest is one of the five London boroughs that is connected to the Olympics, though I live in Newham. So on Wednesday I took her to have a look at the Olympic site, and also on a mini-tour of Stratford's more obvious brothels, its sex shop and red light area, active and present long before the Olympics were announced in 2005, and just another part of the area. Fun!

I won't go on too much about the council meeting, which took place in the very formal Chamber. I'm sure minutes will be available in due course if you want to find out more about what was said in detail. Briefly, two police officers working for the Met's anti-trafficking department stated their case, as did four people who work with sex workers and migrant people, including a nun, and two medics. Varying ideological positions on sex work were represented though all could be described as 'rescue industry'. Laura spoke, and people from the council recorded and questioned the speakers. The idea that the Olympics will result in an increase in trafficking was immediately dismissed as soon as evidence to the contrary was produced. So the meeting ended up being an arena for people to state their positions and argue for their own legitimacy. No conclusion was reached, the Chair resolved to have more meetings, though this may be in question because there are local government elections looming. As an observer, I think councillors were expecting one thing but ended up having their minds blown by having to consider alternative paradigms.


As an observer, I found the meeting really interesting in a dull, committee type way. What intrigued me were the crossovers in the way that fat is presented in policymaking. Obviously there were no out sex workers present to offer their expert testimony, just as there are never autonomous fat people present during similar meetings of obesity stakeholders, it's as though the concept Nothing about us without us never existed. These gatherings are about professional management of perceived problematic populations, where there is a moral and medicalised discourse concerning embodiment, and where 'helping' is a euphemism for 'control', and where people routinely rely on duff 'evidence.' In these contexts, sex workers/fat people are talked about, made pitiful, framed as service users, are absent and Othered. Even the language has parallels: 'prostitution' sounds a lot like 'obesity' to me, 'trafficking' is as much a neologism as 'bariatric,' and 'sex work' could be seen as analogous to 'fat'. Professionals pump themselves up as essential to the discourse, medics especially so, yet it's clear that the rescuers need their fodder more than sex workers or fat people need them, for example, what do you do with massively resourced anti-trafficking units when there are no trafficked people?

Of course there are differences between the way that fat and sex work is framed in contexts such as this meeting I went to with Laura. I think fat people are far less organised than sex workers – not that fat people and sex workers are necessarily mutually exclusive groups – partly because shame is much more present. Issues concerning criminalisation and migration are also different.

Despite these differences, acknowledging common ground can be very illuminating. I would love to see broader analyses of how helping industries further marginalise their apparent constituents, for example.

What was exciting about the meeting in Waltham Forest was the way that Laura's testimony was paradigm-shifting for many people in the room. I have experienced this when I start talking about fat with people, or at least in those situations where people are more able to move beyond clichés. It's clear that many people are hungry for more complex and human ways of thinking about things that have been overstated through moral panics, and that trite accounts of trafficked women or obesity epidemics are not enough, and that ethical, grassroots ways of understanding may be possible.

Agustìn, L.M. (2007) Sex at the Margins: Migration, Labour Markets and the Rescue Industry. London: Zed Books.

Yale's Plagiarism of Headless Fatties

In 2007 I published a piece of writing on my website (yes, pre-blog) in which I identified and described the phenomenon of the headless fatty. I was the first person to do this.

This concept hit a nerve and took off, much to my pleasure, it felt as though I had given people a way of describing one of the ways in which media makes fat people abject, and also a way of critiquing and laughing at that stereotype, thus reducing its power to hurt. References to headless fatties turned up all over the place.

It was rare that I was ever credited for this invention. For the most part I wouldn't expect to be, headless fatty has become part of fat activism's language and theoretical framework, it's just a thing that some people know about now. Ideas come from somewhere, but it would be exhausting to have to cite and reference every single thing that we know and believe in everyday conversation, for example.

In addition, I do not want to turn headless fatty into a commodity in order to force recognition for myself. I am against the copyrighting of the terms of fat activism, The Association for Size Diversity and Health claimed 'Health At Every Size' as a Registered Trademark last year. To me this is both a neoliberal act that regards activism as a market, and a colonial act where ownership of a formerly free-floating concept now lies within the US. ASDAH took this step to prevent weight loss corporations from appropriating the term, but asserted themselves undemocratically as the rightful owners, and themselves transformed the concept into a commodity by claiming it.

Because I can prove I invented the term 'headless fatty' I am not concerned with anyone buying or selling it, nobody can take this intellectual property from me. Or so I thought!

This week I was very interested to read a news story in which Dr Rebecca Puhl talks about certain kinds of media images of fat people. Shaming the obese - with photos like these - isn’t working appeared in The Globe and Mail, a national Canadian newspaper, and was syndicated widely, including by many fat activists who really should know better. In the article, Puhl says that she describes images where fat people's heads are cut out of the frame as "the headless stomach." The article goes on to say that such images shame "the obese" and finishes with the claim: "We need to fight obesity, not obese individuals." Yeah, yeah, I know.

Puhl is Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. She is also a Research Scientist. This means that, in a formal presentation such as, for example, an interview with a national newspaper, she would know that ideas come from somewhere and she would also have the skills to search for and cite or reference those ideas. A simple Google search would reveal that I originated 'headless fatty', for example. Perhaps, like many people in the US, she thought that because I live in a different country I either wouldn't know that she had done this, or that it somehow didn't count.

Whether or not Puhl searched for its origins is moot. Instead, what she did, in conjunction with the newspaper's reporter and editors, was take my concept and imply it was she who thought of it without any fact-checking. As well as demonstrating arrogance, this is plagiarism and, as Puhl will know, within academia it is a very serious offence. By substituting the neutral-sounding 'scientific' term 'stomach', she made the concept more palatable for an assumed audience of people, perhaps including herself, who get the vapours when the words 'fat' or 'fatty' are used.

You could argue that language is not important here, what matters is the article's message of non-shaming. But the reclamation of the words 'fat,' and more recently 'fatty,' are a fundament of fat liberation. It is really important that they are able to be uttered without shame. Ironically, in seeking to reduce shame against fat people, this article adds to it, and don't get me started on the assertion that obesity needs fighting.

It feels risky speaking truth to power in this way, bang goes any remote possibility of a nice, cosy, well-paid postdoctoral research fellowship in New Haven! But I feel angry about Puhl's plagiarism of my idea, and it is not up to her who, judging by online photographs, is not a fat woman, to decide what language is and is not appropriate to describe fat experience.

The Rudd Center consistently takes a conservative view of fat politics. I am not the first to have spoken out about their problematic approach. Disability rights activists would recognise the organisation as a typical example of a charitable approach that:
  • Diminishes the unruly voices and lived experiences of the constituency it has nominated itself to serve in favour of its own appropriated version of that reality – which is inevitably really weird
  • Benefits from high status and impressive financial rewards
  • Appears to be the neutral propagator of knowledge about its constituency, removed from power politics
  • Trades on dehumanising pity for its constituents
  • Is an organisation 'for' rather than 'by' or 'of', and likes to retain that power
  • Needs its constituency of fat/disabled people more than they need it
I am for a pluralistic, multifaceted movement that supports the rights and autonomy of all people everywhere, including fat people. There is room in the movement for all kinds of fat activisms. Yet I've had enough of The Rudd Center's 'kindly' version of fat politics, which actively undermines the acceptability of fat activism. In their world those of us at grassroots level are too abrasive and hotheaded to be allowed access to high level descision-making, we must be protected from it in some way, though not removed so far away that they can't appropriate a juicy concept whenever they choose. This is an issue of power and its misuse. Instead they should be doing their own work, defining their own concepts, not riding on the back of fat activists like me, who are very far removed from Yale's privileged corridors.

Picard, A. (2011) 'Shaming the obese - with photos like these - isn’t working ' [Online]. Toronto: Globe and Mail. Available: http://www.theglobeandmail.com/life/health/andre-picard/shaming-the-obese---with-photos-like-these---isnt-working/article1883947/ [Accessed 8 February 2011].
 

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