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Into Obesity War
BY JANE WILSON
"I just can't bear fat bodies. 1 think there should be fat catchers, like dog catchers, to go around and put big nets over fat people and take them all someplace and get them slimmed down. And then show them what really good eating is. Because what they're doing is advertising their unhappiness and their anger or frustration for everyone to see, and 1 don't want to see it."
--Cloris Leachman, quoted in the December issue of Family Circle
As a nation, we have an obsession with slimness. The prevailing aesthetic, which dictates an essentially adolescent body shape for everyone, makes millions miserable while fattening the weight-loss business into a multibillion-dollar industry. For the obese in America, for those who are not simply a little plumper than fashion requires, but who are 30, 40, 50 or more pounds above what doctor's weight charts say they should be, getting into socially acceptable shape is a desperate undertaking.
To be found "unbearable" by those who, like Cloris Leachman, weigh 110 pounds and like to go on periodic fasts is among the least of the burdens borne by the truly fat. They are in many ways outcasts, denied jobs, threatened with dire medical warnings about the results of their supposed gluttony, lectured for their own good by anyone of "normal" weight and ridiculed behind their backs and to their faces with cruel jokes and personal remarks. To be obese is to be unable, ever, to go to a show, a movie or a concert because you can't fit into the seats, and to stay away from all but the most spaciously arranged restaurants for the same reason. To be obese in our fiercely antifat culture is to be perpetually ashamed of your own body. Cloris Leachman is right in supposing that fat people are unhappy, angry and frustrated-but these feelings, many fat people contend, are much more often the socially induced result of being fat than its cause.
So why would anyone either become or stay fat in a society where every possible motive for thinness is provided? The answer, according to a group of women in Santa Monica who call themselves, uncompromisingly, The Fat Underground, is that they have no choice-unless an intestinal by-pass operation or having one's jaws wired together or living out one's life in perpetual gnawing hunger may be seen as any kind of acceptable alternative. The Fat Underground is an offshoot of the growing Fat Liberation movement, whose cry until now has simply been "Leave Us Alone!" Since an obvious reply to this appeal would be to say, "OK-if you want to kill yourselves," a basic concern of The Fat Underground has been to examine carefully the validity of medical evidence that a fat body is, necessarily, an unhealthy and shortlived one.
The underground has also done some investigation of the side effects of reducing diets, the generally prescribed "cure" for a large body. Underground members point out that it is a well-established,.if little publicized, fact that at least 95% of those who go on reducing diets of any kind will regain any weight lost within five years or less. Of these dieters, some 90% will regain more weight than they originally lost. Nevertheless, since it is so socially painful to be fat, very few obese people are likely to accept permanent fatness as their natural condition, so even if they know the odds they repeatedly diet in hopes of being among the metamorphosed 5%. Thus large numbers of fat people are fooled all the time and, after two and a half years, there are only 20 members of The Fat Underground, 20 women who have stopped dieting, stopped hoping to be thin, and started working to change public prejudices and ignorance about fatness. Having come to the hard conclusion that their own obesity is permanent, they need also to offer one another constant support in dealing with the pain involved in such acceptance.
All the members of the Fat Underground are radical feminists and many have also participated in a radical therapy group established in Santa Monica. They are therefore committed to changing society rather than adapting themselves to it, and they are habitually skeptical of received medical and psychiatric wisdoms. The group began when a few women in the radical therapy group became aware that they felt oppressed not simply as women but as fat people. As one of their members put it, "Fat was the crisis area, the area where our identification ran highest and where we felt most strongly persecuted."
A young woman who gave only her "radical name," which is Aldebaran, met with me first as a representative of the whole group. Since she has a background in graduate chemistry, it was she who had initiated most of the medical reading and source research undertaken by The Fat Underground, using as her principal tool the Index Medicus in the Bio-Medical Library at UCLA. "I discovered there, she said, "that what doctors tell the public about obesity, and what the public therefore believes, is somewhat different from what doctors tell each other in their research papers. The first thing I discovered is that the average fat person eats no more than the average thin person. Some eat more, and then again some thin people eat enormously without ever getting fat. But the average is the same. This finding is the result of more than 20 years of research by nutritionists, and is well documented. But the popular view, sponsored by the medical popularizers, is that fat people are all gluttons who sit around scarfing up cupcakes without restraint. Fat people are seen, so to speak, as thin people gone bad.
Dull Ache of Hunger
"There is a minority of fat people who have been so heavily oppressed around their eating habits that they have reacted by becoming gluttons. But the average fat person has enough self-control to lose the 10 to 20 pounds that affluent, sedentary life adds to many people in America. Beyond that, to lose 50 or 60 pounds, to get down to the doctor's weight chart figures and stay there requires intense, prolonged hunger and much, much more exercise than is necessary for the mildly overweight. You are going to have to eat much less than the average person, forever. And you never do get used to the dull ache of hunger on a 1,000-calorie diet. You never lose the anxiety that at any moment you may lose control and go on a starvation-induced eating binge. The best you can hope for is that you will remain sufficiently alienated from your feelings, sufficiently coerced by your dread of becoming fat again, with all the pain that that will entail, that you will be able to minimize and endure the hunger. But very few can endure it indefinitely.
"Some doctors and nutritionists, who do not have a vested interest in making a lot of money from weight loss programs, will admit the degree of hunger that must be borne by obese dieters. Yet psychiatrists and psychologists still insist that any eating beyond what is necessary to be slim is 'emotional.' The problems of a fat person on a diet around food are not emotional but physical-the physical pains of hunger."
Aldebaran's weight since she stopped dieting has remained constant at 60 pounds more than the charts say it should be for a woman of her height and build. She says she eats moderately, has no more trouble with eating binges and her blood pressure, when she has it checked at work, is normal. When she has it checked by a doctor it is high--because, she says, she is then in a stress situation.
Aldebaran told about a community of 1,700 Italian immigrants, living in the town of Roseto in Pennsylvania, whom she had read about in the Journal of the American Medical Assn., and also in a book called "Fat Power" by Llewellyn Louderback. These Rosetans are notably fat as a group and cheerfully consume large quantities of high-calorie, high-cholesterol Italian foods. Yet they enjoy remarkably good general health, dying from heart disease at about one-third of the national toll, and being afflicted with diabetes at only a quarter of the rate of the population at large. Teams of researchers from the University of Oklahoma investigated the Rosetans three times, in 1962, 1964 and 1967, but could find no explanation for the low incidence of supposedly obesity-related disease among their number. One researcher did suggest that "contentment" might have something to do with it.
"It seems", commented Aldebaran, "that the Rosetans liked themselves a lot and thought it was pretty neat that they were so fat. They felt no anxiety or stress about it and didn't find it undesirable. But when the fat children of these fat parents went into the mainstream of American society, and went on diets, they began to suffer from obesity-related diseases at the same rate as the rest of the population."
"It does appear", she said, "that fat people are particularly susceptible to heart disease and strokes, that they tend to have high blood pressure and to suffer from kidney disorders and metabolic problems such as diabetes, together with a whole range of psychological ills ranging from depression to 'bad self-image'. I don't think it's necessary even to talk about the origins of the psychological problems. But the medical difficulties do bear a lot of examination. Statistics on the health of fat people are most often based on fat subjects found in medical settings, where it is unlikely that they will have avoided either subjection to dieting or feelings of intense anxiety about their health. Such fat patients, who have been sufficiently serious about weight loss to have consulted a doctor, are people under stress who may have gone on and off diets repeatedly, each time losing weight only to regain it again. The dangers of such a procedure have been known for more than a decade."
At this point Aldebaran produced a copy of a 1966 U.S. Public Health Services Report on "Obesity and Health" and read the following extract: "Repeatedly losing and gaining weight may be more harmful than maintenance of a steady weight at a high level. For example, it has been shown that serum cholesterol levels are elevated during periods of weight gain, thus increasing the risk of deposition. We have no evidence to show that once cholesterol has been deposited it can be removed by weight reduction. It is possible that a patient whose weight has fluctuated up and down a number of times has been subjected to more atherogenic stress than a patient with stable though excessive weight...If an animal has once been obese and then has been repeatedly reduced it will have a shorter life expectancy than an animal which has never been reduced.
"We feel", she went on, "that any doctor who knows this information about serum cholesterol levels--and he most certainly should know it--and who tells a fat person who has dieted many times before to make yet another. doomed attempt at reduction is, in effect, saying, 'Go kill yourself.' It simply has not been profitable for bariatricians to face up to the contradictions in their approach to obesity, to the stupidity, for example, of their mystified use of the term 'overeating.' Perhaps that's why they never put out more than the first edition of something called 'The Journal of Bariatrics'. They have refused to learn from their own failure rate, but just go on saying, 'Go on a diet' with the unspoken thought, 'Perhaps a miracle will happen for you.' On a purely practical level, the worst problem that a fat person can have with doctors is that any physician can say, 'This fat person is not healthy enough to work at such and such a job' and there is no appeal. We can be routinely denied a civil right because a doctor says we shouldn't have it until we reduce the size of our body. The doctors, you see, are backed by a multibillion-dollar industry, and by national prejudice."
The future of The Fat Underground does not include any large-scale plans to recruit. They have learned that it maybe a long and difficult process for a new member to come to terms emotionally with the idea that her own obesity is probably genetic in origin, and is permanent. "Most fat women's feelings about fat are so dreadful," said Aldebaran, "that they have really 'numbed out' in that area--they can accept incredible insults without reacting. But when they start to get in touch with the numbed feelings it is excruciatingly painful--so we have needed to have constant support groups to help us stop feeling wretched about ourselves, to stop feeling worthless and ugly."
At a recent weekly meeting of the Fat Underground there was some good cheer in that a feminist newspaper in Denver had written, out of the blue, to offer moral support and suggests that the Underground might help to produce a special issue of the paper on the oppression of fat women by society at large, with particular attention paid to the role of the medical profession. But then they heard that a woman author, whose new book contained several expressions of aesthetic disgust at fat bodies, had been unwittingly invited to speak to some members of their own feminist group. There was anger in the room.
Obese Americans are, some contend, the scapegoats of a guiltily well-fed nation. The Fat Underground is working to reestablish the lost distinction between gluttony as a sin of self-indulgence and fatness as a natural characterisic which, like unusual height or above-average intelligence, occurs in proportion of the population.
The underground has a motto--"Fat people of the world, unite! You have nothing to lose!"