The Role of Media and Scientific Literature in Promoting Weight Stigma Abigail C. Saguy UCLA Sociology and Gender Studies

Weight stigma and discrimination —  Heavier women are less likely to be hired, earn less

—  Parents pay less for the

education of their heavier daughters

—  Heavy women are less likely to marry, husbands earn less Health care workers regard fat patients as lazy and noncompliant

—  Too fat for insurance —  “Size profiling”

Fat stigma in medical care —  “[The doctor] waits till she puts

the speculum in and decides to start telling me about, you know, estrogen levels and, you know, obesity leads to diabetes. And, you know, I’m like, ‘okay, now, I just told this woman that my weight is not up for discussion, I’m sitting here on the table, what am I gonna do?’ …And I was—I think I went to a different place when she—I said, I can't believe this woman is actually doing this. And I can't like jump up off the table because that’s really what I wanted to do. So I just kind of went somewhere else.”

What role does obesity research and science reporting play?

Promotes public health crisis and personal responsibility framing of fat —  Framing is —  “the selection and emphasis of “some aspects of a perceived reality .... in such a way as to promote a particular problem definition” (Entman 1993: 52).

—  Cognitive and political —  Diagnostic and prognostic

—  Every frame is partial

Questions —  What social factors explain why we have we come to perceive fatness as a medical and public health crisis?

—  Who do we blame and hold responsible for the “obesity epidemic” and why?

—  What are alternative ways of understanding body weight?

—  What are the social implications of understanding body size in particular way?

Blame Frames from Chapter 3 “Blame Frames” 0.6 0.5 0.4 Individual Systemic Biological

0.3 0.2 0.1 0

Causes

Solutions

Sample: news articles over 300 words in NYT, Newsweek, 1995-2005 with “obes!” or “overweight” OR anorexi!” or “bulimi!” in the heading, lead paragraphs, or key terms, N = 332.

Medical

Public Health Crisis

Fat Rights

What’s wrong with fat

Excess weight/ fat is a medical problem.

Increasing population weights is a public health crisis.

NOTHING. Weight-based discrimination is a social justice problem

What should be done

Find medical weight loss solutions

Reduce BMI at the population level

Combat fat bias and weight-based discrimination

Master frame

Health

Health, Economics

Equal Rights

Analogies

Cancer

Epidemic

Race, gender, sexual orientation, disability

Medical frame —  Excess weight/fat is a medical problem.

—  Focus on medical weight loss solutions

—  Master frame: health —  Analogies: Cancer

Chapter 1

Medical frame: emphasis and blind spots —  “Obesity” —  Focuses on health risks associated with higher BMI —  Diabetes —  Heart disease —  Higher mortality for BMI>35

—  Ignores health benefits associated with higher BMI —  Lower mortality rates for “overweight”

—  Obesity Paradox

Normal weight

Abnormal cardiometabolic profile 24%

Normal cardiometabolic profile 76%

16 million Americans Overweight

49%

51% 36 million Americans

Obese

68%

32% 20 million Americans

Source: Rachel P. Wildman et al.,2008. “The Obese without Cardiometabolic Risk Factor Clustering and the Normal Weight with Cardiometabolic Risk Factor Clustering,” Archives of Internal Medicine 168, no. 15 (d): 1617–24.

Public health crisis frame

Chapter 1

—  “There is no doubt that obesity is an epidemic that must be stopped” –secretary of the DHHS

1998 2007

Obesity (BMI>30) Trends Among U.S. Adults No Data

<10%

10%–14%

15%–19%

20%–24%

Source: Behavioral Risk Factor Surveillance System

25%–29%

≥30%

1990

Public health crisis frame —  Analogy: Epidemic 2007

—  Implies that moving from a BMI of 29 to 30 is analogous to contracting a disease

Obesity (BMI>30) Trends Among U.S. Adults No Data

<10%

10%–14%

15%–19%

20%–24%

Source: Behavioral Risk Factor Surveillance System

25%–29%

≥30%

How does obesity research and science reporting represent the “obesity epidemic”? (From Chapter 4: Fashioning Frames)

Reporting on Special Issue of JAMA, 1999 45 Press articles that discuss "epidemic" study

0.7

35 0.6

30

Proportion of sample

Number of news articles mentioning

40

25 20 15 10 5

Press articles that do not discuss study

0.5 0.4 0.3 0.2 0.1

0 "Spread of Obesity Epidemic"

"350K Annual Obesity Deaths"

"Leptin"

Public health Physical fitness poilcy editorial and mortality

0

Label obesity "epidemic"

Matched sample of 20 research articles in 1999 special issue and 69 news reports on special issue.

Science and the News, 1999 0.8

science news

Proportion of sample

0.7

“This is getting so bad that it's going to exhaust all the resources we have in health care” – October 27 1999, Milwaukee Journal Sentinel

0.6 0.5 0.4 0.3 0.2 0.1 0

Crisis

Epidemic

War

Matched sample of 20 research articles in 1999 special issue and 69 news reports on special issue.

How do the media report on scientific debate about obesity risks? (From Chapter 4: Fashioning Frames)

Eating-to-Death vs. Fat-OK Tobacco

425,000

Obesity and Overweight

400,000

(Mokdad et al 2004)

25,815 (Flegal et al. 2005)

0

100,000

200,000

300,000

400,000

500,000

CDC estimates of excess deaths associated with overweight and tobacco in year 2000

—  The results of the “Fat-OK” study are consistent with scores of other studies

—  Despite this, the news media treats them as surprising and contested

—  This is consistent with research on confirmation bias, the tendency to privilege information that confirms one’s preconceived notions

Analyses of news coverage of the Eating-toDeath study (N=35) and Fat-OK study(N=61) Chapter 4 0.9 0.8 0.7 0.6 0.5 Eating-to-Death 0.4 0.3 0.2 0.1 0 Confirms

Surprising

Skeptics quoted

Supportive

Fat-OK

Does exposure to these frames shape attitudes? From Chapter 5

Between subject design Step 1: Random assignment of participants to conditions . News Report on “Eating To Death” study

Vs.

Step 4: Measure Dependent Variable Anti-fat Prejudice

Control

Justification – Suppression Model of Prejudice (Crandall & Eshleman, 2004)

JUSTIFY PREJUDICE

+

Health Risk Personal Responsibility

GENUINE PREJUDICE

EXPRESS PREJUDICE

-

SUPPRESS PREJUDICE Fat and Fit Diversity Genetic

-

Intensifica*on  of  an*-­‐fat  prejudice  

Saguy, Frederick, and Gruys. 2014. “Reporting Risk, Producing Prejudice: How News Reporting on Obesity Shapes Attitudes about Health Risk, Policy, and Prejudice.” Social Science and Medicine.

Medical

Public Health Crisis

Fat Rights

What’s wrong with fat

Excess weight/ fat is a medical problem.

Increasing population weights is a public health crisis.

NOTHING. Weight-based discrimination is a social justice problem

What should be done

Find medical weight loss solutions

Reduce BMI at the population level

Combat fat bias and weight-based discrimination

Master frame

Health

Health, Economics

Equal Rights

Analogies

Cancer

Epidemic

Race, gender, sexual orientation, disability

Fat Rights —  Weight-based discrimination is a social justice problem

—  We need to fight weightbased discrimination

—  Master frame: civil rights —  Analogy: Race, gender, sexual orientation, handicap

Reclaiming “fat” —  “I’m fat and its OK. It doesn’t mean that I’m stupid or ugly or lazy or selfish. I’m fat. F-A-T. It’s three little letters; what you so afraid of?” – Joy Nash in “Fat Rant”

Conclusion —  The word “obesity” implies a medical frame of fatness —  The dominance of this frame – and the public health crisis frame – can be explained by social factors

—  To speak of fatness as obesity may have negative unintended consequences

—  To combat weight-based stigma and discrimination, it may be necessary to frame fat in different ways

Discussion