Tuesday, May 29, 2007

How cliches hurt us

What do the obesity epidemic, anorexia nation, and healthy eating all have in common?

They're all cliches, code phrases created by the media. And by "the media" I mean not only the Gray Lady and the Sly Network but small local newspapers, big national magazines, and--oh, yeah--those of us who write and blog about these subjects.

Each of these code phrases contains layers and levels of meaning that never get unpacked. They're like cue balls careening around a pool table, knocking all the other balls out of their way.

When you read the words "the obesity epidemic," you are, in essence, being told what to think and how to think it when it comes to the issue of overweight in America. The phrase itself shapes the way you think about it. If the language were different--if the issue was framed in another way--you might think about it differently.

And this is where I hold the media, and all of us, accountable for the superficial and slick way these deeply important subjects are framed and discarded. Each time yo say the words "the obesity epidemic," you're validating the notion that the nation is in the grip of a contagious pandemic of overweight. If that's what you truly think, you're all set. (I'd like to argue the point. But that's another post.)

But chances are it's not really what you think or what you mean to say. But each time you use that code phrase, you're buying in to someone else's conception of the dialogue. You're letting yourself be co-opted.

It's hard to unpack these code phrases. It's even harder to go against the mainstream, to question the conventional wisdom, to challenge the status quo. But more and more, I think it's crucial that we do exactly that. So next time you find one of these cliches or code phrases flying out of your mouth or tripping off your fingers, take a minute, or five, to consider what you really think. Then say it in your own words.

I'll start: I think the idea of an obesity epidemic is a sadly unimaginative construct that has little or nothing to do with reality. It's a cover for institutionalized prejudice against overweight people, a trigger for eating disorders, and a big waste of our collective time and energy.

Your turn.


mary said...

I agree with you Harriet.

For myself, I have to step outside the box and live without concern for the messages that want us to feel inferior as we are or I can not honestly ask others to! It seems that in history there have always been messages along the way telling people they are not enough and that they are broken. Even fairy tales favored beauty as if it was only outer, only fair skinned, only petite.
I suppose I could say "Oh SHUT UP you ignorant bullies!" Maybe I will.
Shall we enforce change Harriet? I'm in! We are due for a good rebellion. : )

Anonymous said...

You're oh so right Harriet. I hope that those of us interested in eating disorders learn some lessons from how disasterously awry the "public health approach to obesity" has gone. Already I've heard the phrase "eating disorder epidemic" bandied about and it creeps me out. If we're going to "raise awareness" we ougth to be clear on what we're talking about. Check this out...

Patient Educ Couns. 2007 May 21; [Epub ahead of print]
Presentation of eating disorders in the news media: What are the implications for patient diagnosis and treatment?O'hara SK, Smith KC.
Bloomberg School of Public Health, Johns Hopkins University, United States.

OBJECTIVE: Eating disorder (ED) specialists increasingly see anorexia nervosa and bulimia nervosa as complex mental illnesses with both genetic and social roots. The public, however, tends to view EDs more simply as a manifestation of personal or social problems among female, white, young women. This disconnect potentially prevents timely ED diagnosis and reinforces a stigma that limits treatment availability. We examine the presentation of EDs in daily newspapers, an important contributor to shaping public perception of EDs. METHODS: We analyze 1 year of coverage about EDs by seven daily U.S. newspapers (252 articles), focusing on the messages conveyed about epidemiology, etiology, severity and treatment. RESULTS: The highest proportion of articles about EDs (48%) ran in arts and entertainment sections. Articles primarily covered those who are female, young and white, and mentioned mainly environmental causal factors. Only 8% of patient profiles discussed treatment and recovery within a medical context. CONCLUSION: News coverage rarely presents EDs as complex medical phenomena, but rather simplifies and sensationalizes these conditions. PRACTICE IMPLICATIONS: Educators would benefit from recognizing the news media's role in shaping public perceptions of EDs in ways that differ from clinical perspectives, potentially limiting diagnosis and treatment. Three communication improvements are suggested.

PMID: 17521841 [PubMed - as supplied by publisher]

I don't think the news media is entirely to blame here. Where did they get these ideas? Plenty of ED organizations, "advocates" and treatment providers (of a certain type) actively promote the idea that EDs are primarily "a manifestation of personal or social problems" resulting from environmental causes. Once those underlying issues are discovered and resolved the eating disorder (ta da!) will be cured.

Unknown said...

You are all right on. We are part of the problem, and yet also part of the solution if we dare.

Words matter.

Harriet said...

I'm all for saying shut up to the powers that be, Mary! (Can you tell I grew up in the 1960s?) Let's make our own language and use our own words on the subject. I like "obesity hysteria" myself.

You're absolutely right, Jane. Some of the worst rhetoric about e.d.s comes from those in the field. That study was very interesting--thank you for posting it. It's probably not news to anyone reading this, alas.

Carrie Arnold said...

My problem with these phrases is the original coining of them. Because they are not based on science. The studies showing the "rise in obesity" are actually done on only 3,000 people- in a nation with a population of 300 million. And anorexia nation or eating disorder epidemic. Though the numbers of eating disorders *on the whole* have been rising, the number of cases of AN have actually remained constant since the 1950s or so. There is much more disordered eating, even the pathological type, but not AN.

In an interesting sidenote, the class I'm going to be teaching at Hopkins in the fall focuses on "Typhoid Mary." Why the quotation marks? Because it's a person- her name is Mary Mallon. She was way more than just "Typhoid Mary." I do that as a matter of respect for her. And it's the same with using "obesity epidemic." If I use it, I try to use quotations to set it off, show that maybe it ain't so.

Thanks for the thought-provoking post.

Anonymous said...

I would never say the term "obesity epidemic" unless I was arguing with someone in an attempt to establish the falsity of the concept. I think that my daughters are appropriately doubtful about the truth of the concept as well. But "healthy eating" is a struggle. I try to tell them that all types of foods can be part of healthy diet, but they seem to be unable to think of cookies as "healthy" or veggies as "unhealthy." I hate to mention the tainted spinach, but sometimes I do; that, to me, was unhealthy food!

Moby Dick said...

The Obesity Epidemic makes people think and talk about Obesity, and that is good. The more attention that fighting obesity gets, the better it will be for the obese.

Harriet said...

Dear Spidey,

"Fighting obesity"--by which people usually mean dieting, so-called healthy eating, etc.--actually creates more overweight and eating disorders. 98 percent of those who diet gain back the weight plus more, making it perhaps the single least effective technique possible; the fact that dieting is still touted as not just a physical but moral imperative reflects the money to be made off weight loss plans and our institutionalized prejudice against overweight.

A recent study looked at weight, age, and mortality, and concluded that your best chance of dying early is to be TOO THIN. People whose weights put them into the overweight or mildly obese category lived longer than those of "normal" or "too thin" weights--most likely because having a nutritional reserve is a GOOD thing.

As for the "obesity epidemic"--what's changed over the last 30 years are the standards by which we measure overweight and obesity. Each time the criteria for being considered overweight is moved (as it has been repeatedly over this period of time), more people suddenly fall into the "overweight" or "obese" category. You can see the same mechanism at work in the cholesterol "debate." Numbers that used to be considered just fine are now grounds for medication. Hmmm--I wonder who benefits from two-thirds of the country being on cholesterol medication???

I think you might want to educate yourself on this subject. But thanks for writing.

Anonymous said...

Great post!

It's crazymaking to me how so few seem to recognize that the rhetoric of the "war on obesity" increases the stigmatization of fat people and is counterproductive (at least as far as weight & health are concerned -- for "obesity" researchers and the diet-pharmaceutical-medical industry, it's a cash cow).

And, of course, the "war on obesity" and "obesity epidemic" language also end up increasing disordered eating. Bariatric surgery, which is being widely promoted as a "treatment" for "obesity," actually creates a surgically induced eating disorder.

Did you know that the term "morbid obesity" was actually invented by bariatric physician Howard Payne in the 1950s to justify his "weight loss" surgery? (Per J. Eric Oliver's "Fat Politics" -- an excellent book.) In other words, the term was invented as a marketing strategy. Death was verbally linked with "obesity" in order to portray "obesity" as a killer disease. And, I suspect, to frighten people into undergoing -- or recommending -- such surgery.

Harriet said...

Hi Peggy,

No, I didn't know that. But I guess I'm not surprised. So many of the terms and phrases that inform our dialogue and consciousness are marketing strategies or sound bites. Thank you for opening my eyes to that one!

Anonymous said...

Another thing with "morbid" obesity labelling is that "morbid" is supposed to be a medical term that means illness or malaise, not "deadly". But how many of the general public know that? How many health professionals even know that? More twisted language.

Trying to explain to someone that the "obesity epidemic" is based on faulty statistics is a huge headache. It's hard to get beyond the inherent fear of fat and conventional thinking about the alleged behaviour of fat people and so on. It's even worse when "obesity experts" use that emotive language in their proclamations. Professor Paul Zimmett said at the most recent Conference On What To Do With The Fat People (or "World Obesity Summit" or whatever it's called) said that obesity is a "scourge" and a "plague". Now there's a man you can rely on for objective scientific thinking. He is of course on the scientific advisory board of a pharmaceutical company that is developing a diet pill, only that's an unpublicised fact.

Thank you for a great post. Language is powerful.

Harriet said...

Have you read Paul Campos' book The Obesity Myth? It's great. Of course it troubles me that while he was researching and writing it he lost like 100 pounds . . . but it's still a great book.

Language IS powerful. More than people really know. Keep on telling the truth.

Faith said...

Harriet -

This is an excellent and thought provoking post. I never thought about the terms in quite that way and I'm so, so glad you pointed it out to me. I promise to never use the phrase again.


Harriet said...

You're welcome, Faith. We all learn from one another. Come back and teach me something sometime, OK?