Wednesday, October 6, 2010

Fat Activism

This is an issue which concerns me, brought to mind most recently by this (ABA) article concerning a suit brought by the Equal Employment Opportunities Commission on behalf of the estate of a deceased obese woman.  The claim is that she was fired on grounds of obesity, and it seems to want  obesity to be or become a protected grounds of discrimination, or recognised as a disability.

The reason this concerns me is that i'm very conflicted by the issue.  On the one hand, there is clearly an ongoing cultural and societal disapproval of even moderate excess weight, which is exacerbated in the case of the obese.  This disapproval is not accountable for on terms of things like health concerns, but rather seems to be prejudice.  So this is bad and we should try to consider ways to eliminate it.

On the other hand, attempts to do things like getting obesity recognised as a disability, or as a grounds on which employers cannot legitimately discriminate, seems to be pushing too far in the other direction.  There are significant and ongoing physical and psychological health concerns with being overweight, which are unlikely to be assisted by vindication (probably the wrong word in this context) of one's overweight status through  classification as a disability.

Part of the difficulty is that there are such a wide range of factors pushing people to become overweight and to stay that way.  The diversity of the causes makes it hard to differentiate between those who are strongly genetically predisposed to weight gain, those who gain weight in resposne to things like medication, and those who simply systematically make harmful lifestyle choices leading to weight gain.  The latter seem justifiably criticisable in ways the former two do not, but how do we tell the circumstances of any particular individual?

Further, how do we tell when being overweight is actually unhealthy.  At the high end of the overweight scale (obesity and morbid obesity) it is clearly unhealthy, and very much so, but being moderately overweight is far less determinately linked to health concerns.  Can we simply scale our criticism to the size of the person being criticised?  A corrolary to this is that thinness is often taken as evidence of health, which obscures the fact that people of average weight can be as unhealthy as the overweight, and it may be even more difficult for them as it is not visibly diagnosable.  Think of people who (at least claim to) guzzle junk food without putting on weight.  They may well be severely lacking in micronutrients, have a terrible fat/muscle ratio, without displaying this through weight alone.  Then there is the inadequacy of BMI as a measure of health.  This is, at least, a procedural point.  People need to stop pretending BMI is useful in determining the health of an individual.  It gives you a good idea of the state of society as a whole, but on the individual level, it tells you nothing useful.  An example:  It doesn't differentiate between the significantly overweight non-exerciser and the muscular athlete, as it measures each in a ratio of weight to height, without regard for composition.

It seems to me that what is needed is a clear delineation between harmful prejudice and helpful concern.  I am not, however, sure that there is such a distinction available, let alone that it has successfully been made.  There is much to think about with this, and I would love to get a clearer idea of the state of the debate.

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