In a segment from the 2010 documentary Fat, Sick & Nearly Dead, Dr. Joel Fuhrman states that “It wouldn’t be so terrible if people were well-educated and well-informed, they didn’t have to die and they could make that choice if they want to commit suicide with food” (Cross). This dichotomy is maintained throughout the film, presenting “obesity” as either the result of nutritional illiteracy or a suicidal abdication of responsibility for the self. Watching and learning from the documentary is thus potentially healing and curative, while a failure to act on the new knowledge and presumably lose weight represents a decision to die. Fat is presented as the antithesis of not just health, but also of a sentient and rational being.
Mainstream discussions about the rise of “epidemic obesity” frequently neglect to mention the ties between mental health and weight. This persists despite widespread evidence that psychiatric medications can induce changes in appetite and cause both weight gain and loss. Similarly ignored is how food often provides respite and relief, preventing more immediate harm for those who use comfort foods to cope with distressing symptoms of psychiatric disorders. Even outside of discussions about psychiatric diagnoses the well-documented links between weight and psychological well-being clearly emphasize that the physical and mental dimensions of health are not easily separated. Stress that arises from experiences of weight stigma in healthcare settings, for example, has been found to contribute to heightened cortisol levels and inflammation (Fruh et al. 483), making weight gain more likely and weight loss more difficult.
When topics related to mental health are invoked in conversations around “obesity,” they frequently arise in comparisons that impart existing stigma against specific psychiatric conditions upon fat people. Fatness as a suicidal state of being is one example, but even more commonplace are descriptions of “obesity” as the result of food addiction, drawing connections to substance use disorders that present fat people as experiencing a diminished capacity for self-control. Consider, for example, Dr. Neal Barnard’s description in Super Size Me (2004) of giving Naloxone to “a real chocolate addict, a person just shovelling it in,” describing them as suddenly “[losing] much of their interest in chocolate” and exercising restraint (Spurlock). Or, to return to Fed Up, we can examine the phrasing used by Dr. David Kessler when he describes how modern food landscapes mean “our brains are constantly getting hijacked” (Soechtig), a statement that may not explicitly reference addiction but plays upon a similar sense of a mind that is no longer entirely rational or controlled.
Presentations of fat people as mindlessly gluttonous or as embarking on a determined death march help to justify both anti-fatness and the neoliberal responsibilization of health. These comparisons convert “obesity” from a physical disease entity (itself a contentious categorization) to a sign of profound mental illness. They further obscure important discussions around the effects that mental distress may have on an individual’s weight, focusing more on attributing negative stereotypes about people with depression, suicidal ideation, and/or substance use issues to fat people than on carefully considering how different experiences of stigma and oppression may be mutually constitutive and reinforcing. While psychiatric stigma is used to compound existing anti-fat stigma, the solutions to the problem of fat embodiment are presented as being within the control of the individual, requiring re-education and rehabilitation. Failure to comply is presumed to result in death, and that death is presented as a suicidal choice rather than the complex result of various forces that cannot be easily or exclusively attributed to individual failure.
These are not the only ways we can imagine or frame the links between body weight and mental health. Though we disagree on some fronts, Lauren Berlant has argued for considering “obesity as an effect of people’s attachment to life,” highlighting how “eating provides a kind of rest for the exhausted self, an interruption of being good, conscious, and intentional that feels like a relief” (26). Berlant’s argument draws attention to how pleasurable acts of consumption (both in the immediate example of food and other forms of consumption that have similarly been problematized) represent forms of resilience and resistance to the wear and tear of capitalist societies. This does not preclude discussion of the harm that may be incurred from such consumption, but rather rejects the urge to pathologize and demonize the behaviors people engage in that may be harmful in some senses, but lifesaving in others. As Berlant writes, “the pleasure people take in ‘letting themselves go’ might be a pleasure that’s both for and against health” (28).
Works Cited
Berlant, Lauren. “Risky Bigness: On Obesity, Eating, and the Ambiguity of Health.” Against Health, edited by Anna Kirkland & Jonathan Metzl, pp. 26-39. NYU Press, 2010.
Cross, Joe, director. Fat, Sick & Nearly Dead. Brooklyn, NY: RebootYourLife, 2011.
Fruh et al. “Weight Bias and Stigma: Impact on Health.” The Nursing Clinics of North America, 56(4), pp. 479-493, doi: 10.1016/j.cnur.2021.07.001.
Spurlock, Morgan, director. Super Size Me. Roadside Attractions, 2004.
Image credit: Rennett Stowe, Food Addiction, 2009. (https://upload.wikimedia.org/wikipedia/commons/thumb/3/34/Food_Addiction_%283316432769%29.jpg/640px-Food_Addiction_%283316432769%29.jpg)
