Chasing Stigma Through the Ages, Part 7

While obesity is not exactly a curse, at least not compared to some other fates, like life inside an iron lung, it is still not a future anyone looks forward to — especially a parent in regard to a child. The purpose here is not to condemn bariatric surgery, GLP-1 meds, or any other weight loss trend, but to emphasize that, in every instance, the mind and heart need care too. Any sort of extreme change can mess up a person’s life, and in the case of massive weight loss, mental and emotional health must be considered and provided for.

Better yet, and most of all, an important goal is to convince parents to begin early with ensuring that such drastic measures are never needed. Chronic obesity is the sort of problem much better avoided in the first place than faced later under difficult circumstances.

To put it as plainly as possible, one of our goals is to encourage parents to steer clear of, rather than ever need to handle, such problems. We point out the many disadvantages of being an overweight adult in the modern world, for a reason: in hopes that parents will understand that preventing obesity now is infinitely more valuable than dealing with it later.

Good news and bad news

The science of prosthetics has come a long way, especially thanks to experiences gained in treating patients wounded in needless wars and preventable vehicle accidents, etc. A person can get an artificial leg so well-crafted that an onlooker might not be able to spot it. But no parent who learns about the existence of such marvelous devices would proceed from there to conclude, “Well, if my kid needs an amputation, it won’t be such a bad thing.”

Although that sentiment may be true, it has no place in our minds as long as the best alternative still exists: to do everything humanly possible to make sure that our child never needs a leg replaced. Likewise, as parents and other relatives; as teachers; as medical personnel of every sort: Our energy is better spent in guaranteeing that our children, the ones under our care, for whom we are responsible, don’t get fat!

Roughly one-half to two-thirds of children obese at age seven may still have obesity at 18, and roughly two-thirds may still have it at 25. The available evidence does not support a precise figure at 65 or at death, but the estimated numbers are large. These are population averages, not a child’s destiny.

Early, family-based treatment can change the trajectory, and improvement does not require reaching a “normal” BMI immediately. Health can be substantially improved by preventing further excess weight gain as height increases. Meanwhile, let’s not delude ourselves. To think, “In a couple of years he’ll get interested in sports and the problem will solve itself” is false comfort. This is not a chance worth taking.

Back to Goffman’s findings

Erving Goffman’s book, Stigma: Notes on the Management of Spoiled Identity,

[…] is specifically concerned with the issue of “mixed contacts” — the moments when stigmatized and normal are in the same “social situation,” that is, in one another’s immediate physical presence…

To the person who is unconcealably different, this becomes a problem when she or he perceives — rightly or wrongly — that others certainly do notice the difference and, no matter what they may claim or pretend, do not really accept it. The subconscious mind concludes some version of “I’m not what I should be; I don’t belong in company with this person or these people; they don’t and never will accept me as worthy or equal…”

And on and on into an infinite number of sad and dire possibilities. This is the fertile mental/emotional soil from which shame grows and then transmogrifies into any number of emotions and convictions ranging from simple unworthiness to suicidal intention.

Goffman quotes examples drawn from a large number of sources, like Katharine Butler Hathaway’s memoir detailing the effects of spinal tuberculosis on her childhood years and later life:

I didn’t scream with rage when I saw myself. I just felt numb… I saw a stranger, a little, pitiable, hideous figure, and a face that became, as I stared at it, painful and blushing with shame.

That person in the mirror couldn’t be me. It became impossible that I should speak of it to anyone, and the confusion and the panic of my discovery were locked inside me then and there, to be faced alone, for a very long time to come…

Not surprisingly, Hathaway specifically noted the emotion of shame, along with being “horror-struck” when she did not recognize herself in the reflecting glass. Perhaps even worse, that feeling did not remain in place but…

Slowly and stubbornly my robust persistent illusion of well-being and of personal beauty spread all through me again, and I forgot the irrelevant reality and was all unprepared and vulnerable again… My disguise had been put on me without my consent or knowledge, but it was on me for life.

Quite clearly, the trauma of being unacceptably different does not strike just once but can recur at any time, amongst any surroundings, over and over, many times a day, ad infinitum.

Your responses and feedback are welcome!

Source: “Stigma: Notes on the Management of Spoiled Identity,” WordPress.com, 1963
Source: “The Little Locksmith,” K. B. Hathaway, Coward-McCann, 1943
Image by geralt/Pixabay

Chasing Stigma Through the Ages, Part 6

Let’s keep going with Erving Goffman for a while, because that man was incredibly tuned in to issues that are exactly as vital (if not more so!) now as they were six decades ago when “Stigma: Notes on the Management of Spoiled Identity” was published. What an incredible find!

Note these incontestable facts about what has happened since then:

  • Science has advanced to an unimaginable extent.
  • Academic papers containing millions of words have been published.
  • Entire institutions dedicated to this exact issue have been built and staffed, and have established formidable reputations for themselves.
  • Billions of dollars have been spent on research and theories and programs and methods and trials and the education of new generations of scientists and doctors.
  • Thousands of brilliant professionals have devoted their careers to figuring out how to stop obesity from being such a curse.

 

And yet, meanwhile, grownups who were not even born yet when Goffman articulated his ideas have spent their entire lives regretting how an extra-large body has impacted their lives. All over the world, countries that did not even use to know the meaning of the word “obesity” are now drowning in tons of it. Entire professions that did not yet exist when Goffman did his work are dedicated to making sure that people all over the planet consume tons of stuff whose intent and purpose is to destroy them. That stuff, incredibly, is unquestioningly accepted as food.

Further, we do not want our current babies and kindergarteners to be the next generation made miserable by obesity… Which they are in serious danger of becoming, because no matter how much science has progressed in the meantime, human nature has not improved by one iota. And we need Erving Goffman today, because the threat of obesity is hanging over our children worse than it has over any previous generation since people were invented.

A wide range of interests

Goffman’s sympathy did not extend only to the obese. He empathized with people stigmatized for other reasons, too. A woman unable to conceive a child, for instance, might be pushed aside and totally disregarded. A person of either sex who was born with a facial deformity might be shunned and avoided throughout life.

Depending on geography, education, religious faith, “political correctness,” and dozens of other variables, there are plenty of circumstances all around the globe right now that cause individuals to be “othered.” They might be shunned, or barely tolerated, or made to feel their difference in a number of ways.

What it all boils down to is that, just like in almost any society that has ever existed, certain individuals are deemed unacceptable. Goffman’s book concentrated on…

[…] the issue of “mixed contacts” — the moments when stigmatized and normal are in the same “social situation,” that is, in one another’s immediate physical presence, whether in a conversation-like encounter or in the mere co-presence of an unfocused gathering. The very anticipation of such contacts can of course lead normals and the stigmatized to arrange life so as to avoid them. Presumably this will have larger consequences for the stigmatized, since more arranging will usually be necessary on their part.

Looking back in history, Victor Hugo’s 1831 novel The Hunchback of Notre Dame is perhaps the prime fictitious example of a character who is “othered” by physical circumstances.

An interesting side note is that in the late 1950s, just before Goffman’s non-fiction work on stigma was published, Lawrence Durrell wrote a series of novels known as the Alexandria Quartet, which caused a sensation in the realm of literary fiction. Two of the characters suffer from facial deformities that strongly influence their personalities and activities.

One is landowner Narouz Hosnani, described as jealous, frustrated, and fanatically religious. Despite his cleft lip and palate (surgically uncorrectable at the time), he is an impressive orator who also enjoys killing wild animals with a whip, and murders a human by forcing a hatpin into his skull.

Another Durrell character is Leila, whose famously beautiful face is “melted” by smallpox. Despite also being a very intelligent woman who speaks several languages, she has no choice but to wear a heavy black veil and live reclusively in a country house with a tame snake as companion.

Even today, many people who have been taught that they are unacceptably different catch on quickly, and do society a favor by self-isolating, to whatever extent is possible. What are the results of such categorization? Goffman wrote,

Lacking the salutary feed-back of daily social intercourse with others, the self-isolate can become suspicious, depressed, hostile, anxious, and bewildered.

Of course, those are not the only negative results. A person who is “othered” may feel insecure, inferior, jealous, disrespected, shunned, deficient, unwanted, undesirable, hopeless, and unfixable.

Your responses and feedback are welcome!

Source: “Stigma: Notes on the Management of Spoiled Identity,” WordPress.com, 1963
Image by jovemVoodo/Pixabay

Chasing Stigma Through the Ages, Part 5

Is the title of this series intended to carry a double meaning? Absolutely! It’s about how, for centuries, bias has been inflicted on and felt by humans who bring out a negative reaction in others. When a person is automatically, perpetually criticized at first sight, it is unlikely to be because they prefer Canadian maple syrup to the sort harvested in the USA, or because they like a piano solo better than a drum solo. Those differences cannot be ascertained by a mere glance.

But obesity can easily be spotted, and anyone who is considered by others to be too physically large is a target waiting to happen. Too many people feel entitled to comment out loud, either to the obese person or to bystanders. Depending on their age, upbringing, and degree of basic humanity, random strangers may feel compelled to voice their disapproval. Even familiar folks, friends and relatives, might be perfectly comfortable dishing out criticism.

In another sense, the title is a reminder that obesity is not a problem that growing older will solve. The opposite, in fact. A 7-year-old child whose body size attracts ridicule and censure is statistically likely to still be in that situation at age 18 and 21 and 35… And possibly even at retirement age and beyond.

Random circumstances and determining factors

Naturally, all these numbers are dependent on variables, like the person’s genetics and gender; their position in society, and particularly in the economic spectrum; the degree of obesity they start out with in childhood; and of course any treatment that might have been attempted or successfully completed.

It goes without saying that statistics will differ according to year and location, but it is probably fair to say that there is a 50% to 70% likelihood that the obese child will still be obese at 18… And a slightly higher chance that they will still be obese at age 25.

And what about the remainder of adulthood? Will an obese child still be that way on her or his deathbed? There are too many variables to really say anything solid about that likelihood. Just to complicate matters, someone might lose weight in later years for causes unconnected to their earlier excess of it; and some of the reasons are not good: aging, starvation, illness, a wasting disease, or treatment for a medical condition.

This needs to be kept in mind

Still, in general, the longer the state of childhood obesity endures, the more likely the individual is to continue into adulthood as an obese person. The longer the condition is allowed to persist, the more difficult it is to shake off, and the less likely a return to non-obesity will become.

Overall, the general prognosis does not look good. Of course, we are now raising a whole generation of young people whose fate will be determined by the absence or presence of the radical weight-loss drugs that even many children now have access to, and it will take many years, and a whole lot of science, to discover how that turns out.

The same doubts can be expressed about the adults who are currently involved with the revolutionary drugs. As of yet, there is no way to know what sort of shape a 30-year-old will be in 20 years from now, although a number of possibilities are of course on the table. Can the meds, like the training wheels of a bicycle, be left behind? Or is the patient, determined not to return to obesity, destined to a lifetime of these medications as surely as someone with diabetes is tied to insulin forever?

Call to action

The general point here is, any grownup responsible for a child or children really needs to be aware that childhood obesity is unlikely to “just go away.” The particular point is, don’t doom your kids to a lifetime of being the butt of other people’s jokes. We can’t all bequeath to our children a trust fund or a townhouse, or even a secondhand car. In the wake of certain tragedies, some caregivers can’t even hand down the simpler things like an album of family photos or grandma’s engagement ring.

But we can all take an active interest in figuring out the very best way, in our own unique case, to help our own particular children avoid lifelong obesity. If your circle happens to include a child who could benefit from such an advantage, here is one starting point: Check out BrainWeighve.

Your responses and feedback are welcome!

Source: “Predicting obesity in young adulthood from childhood and parental obesity,” NIH.gov, 09/25/97
Image by Brainweighve

Chasing Stigma Through the Ages, Part 4

Author Erving Goffman has more to tell us about the inner lives of people who carry around too many pounds. Since one of these people could be a beloved child of yours or mine, it just might be useful to check out Goffman’s insights about this matter, especially the parts that involve interactions with strangers.

In recent years, out there in the world, a lot of attention has been focused on one particular way in which a child can be damaged. Sadly, that is not the only possible way. Although less immediately traumatic (and less punishable by law) than inappropriate contact, the focusing of negative attention on a child’s weight can cause significant harm.

A random stranger can do damage in a minute that will reverberate for years, causing emotional pain and influencing behavior. For instance,

The stigmatized individual can also attempt to correct his condition indirectly by devoting much private effort to the mastery of areas of activity ordinarily felt to be closed on incidental and physical grounds to one with his shortcoming.

A person who is unable to shed fat might adapt to it in a way that seems good-natured and healthy.  As parallel examples, Goffman mentions a wheelchair basketball team, or “the blind person who becomes expert at skiing and mountain climbing.” There is nothing wrong with such an adaptation, except that in the case of a dangerously overweight person, it might only signify avoidance which, if it could be overcome, would illustrate that the same amount of energy, differently applied, could actually have solved the obesity problem instead.

Multiple possibilities

Whether the physical fact is a facial scar, hilariously prominent ears, or obesity, some very odd psychological effects may ensue:

The stigmatized individual is likely to use his stigma for “secondary gains,” as an excuse for ill success that has come his way for other reasons… It is the “hook” on which the patient has hung all inadequacies, all dissatisfactions, all procrastinations and all unpleasant duties of social life…

Just as effectively as a facial scar, morbid obesity can be used as an excuse to avoid competitive situations and other types of challenges. It can be manipulated into a reason to ignore normal social responsibilities, or provide a plausible excuse for the person’s refusal to become emotionally involved. If a miracle comes along, like a way to pay for bariatric surgery, a whole new landscape of problems might open up.

In ways either recognized or unacknowledged, the severe medical handicap might have functioned as a screen that always served to hide some other problems:

He is unprepared to cope with this situation without the support of a “handicap,” and he may turn to the less simple, but similar, protection of the behavior patterns of neurasthenia, hysterical conversion, hypochondriasis or the acute anxiety states.

Strange as it may seem, to undergo successful weight-loss surgery, and follow it up with all the right moves, may not be the end of the story. The transformation might not even last very long. Some folks feel anxiety and/or depression. Objectively, the body might be lookin’ good, but the sad truth is that’s a stranger in the mirror. And the world might be just as full of strangers as it ever was.

It works both ways

Friends who enjoyed the company of one of those jolly fat people with the legendary sense of humor might now be confronted with an unfamiliar human who is anxious, depressed, confused, and bummed out because now, s/he no longer even has the coping mechanism of eating food for comfort. The formerly overweight person might not have realized there would be so much loose skin. The miraculous weight-loser might feel like s/he went to a whole lot of trouble and expense just to wind up feeling more alienated than before.

If alcohol use was not a problem previously, it might be now, because the body absorbs substances differently.  If the patient already had a lover or spouse, that partner might undergo unexpected emotional impact, and the whole relationship may have to be renegotiated. Children might feel uncomfortable with their greatly changed mom or dad. If the patient had been unattached, s/he might have expected to find someone quickly, and feel unjustly rejected. If suicide had never been “on the table” before, it might now look like a viable alternative.

What is going on here?

Why are we even bringing up such depressing scenarios?

As a way of reminding ourselves that going through life vulnerable to any sort of stigma can be a miserable existence. To remind ourselves that we certainly do not want to inflict any of this misery on our children, and that there are ways to avoid having obese children.

Not to be too obvious, but this is a good place for a reminder. If it seems that this sort of trouble might be brewing at home, it might be helpful to have a look at Brainweighve.

You’re welcome!

Source: “Stigma: Notes on the Management of Spoiled Identity,” WordPress.com, 1963
Images by Tumisu, trtasfiq/Pixabay

Chasing Stigma Through the Ages, Part 3

Here is the sort of fact that AI proves its singular brand of genius by identifying: In modern written English, the verb “stigmatize” occurs only once in every million words.

In real life, the act of stigmatizing occurs a million times every second. Yes, that is only a figure of speech, not officially verified. But an aware parent is all too likely to discover that when their kid is stigmatized, one incident per year is too many.

We don’t want a child to cry because another six-year-old decided that it’s lame to bring an apple in your home-packed lunchbox, and made an issue out of it. Nor do we want a 14-year-old to contemplate suicide because some teenage idiot mocked his haircut. Humiliating one’s peers is a favorite sport of kids, and learning how to avoid being targeted is an important life skill.

To stigmatize a fellow human being is to brand, label, mark, stamp, defame, denounce, and disgrace… All things that a decent parent does not want done to a daughter or son, no more than they would want that child to be shot, drowned, or set on fire. Acknowledging his expertise on the subject, we stick for a while longer with author Erving Goffman:

By definition, of course, we believe the person with a stigma is not quite human. On this assumption we exercise varieties of discrimination, through which we effectively, if often unthinkingly, reduce his life chances.

Tragically, even some parents exist who practice types of discrimination against their own overweight offspring, and effectively reduce those children’s odds of ever achieving various life benefits, including mental health. Those parents are of course welcome on this page, with the understanding that they need more help than can be found here, and with the hope that they recognize the sad fact and seek that help.

Sticks and stones may break my bones…

“[b]ut words will never hurt me.” For centuries, parents have repeated that old saying to their children, with little effect. Goffman, of course, mentions the obvious: the cruel propensity for inventing rude nouns and adjectives to characterize the stigmatized people. In our particular area of interest, we have seen how even the professionals who are trained and paid to care most about their clients have been capable of using, and even coining, terminology that can easily be read as offensive.

But of course, it goes further than verbal insults. Humans have always had a wonderful talent for explaining the world by constructing mythologies, origin stories, legends, doctrines, lore, and folk tales to explain the various universal phenomena of everyday life. Goffman wrote,

We construct a stigma-theory, an ideology to explain his inferiority and account for the danger he represents… We tend to impute a wide range of imperfections on the basis of the original one, and at the same time to impute some desirable but undesired attributes, often of a supernatural cast, such as “sixth sense,” or “understanding…”

That last remark is striking because, of course, it is true of fat people, who are rumored to be gifted with an extraordinary sense of humor. On the downside, however, this is countered by the large number of associated negative stereotypes that are so familiar, there is no need to list them here. Goffman wrote,

Shame becomes a central possibility, arising from the individual’s perception of one of his own attributes as being a defiling thing to possess, and one he can readily see himself as not possessing… In some cases it will be possible for him to make a direct attempt to correct what he sees as the objective basis of his failing.

Obesity is famous for being — unlike blindness, for instance — a handicap that a person can get rid of just by taking control and doing what’s necessary to shed 50 or 250 pounds. Many people have done exactly that, and still come out on the other side with problems.

Or, they were unable to succeed in the first place, often because of insufficient knowledge and preparation. The author cites “[…] the stigmatized person’s exposure to fraudulent servers selling speech correction, skin lighteners, body stretchers, youth restorers, cures through faith….” or, in this case, shady peddlers of methods and medicines that somehow just never seem to work out.

Here is Goffman’s take on one way in which “happily ever after” can be an elusive outcome:

Where such repair is possible, what often results is not the acquisition of fully normal status, but a transformation of self from someone with a particular blemish into someone with a record of having corrected a particular blemish.

Who wants to spend the rest of their life being introduced with the footnote, “You’re not gonna believe this, but Howard used to weigh more than 400 pounds!”

Of course, it’s still preferable to the alternative.

Your responses and feedback are welcome!

Source: “Stigmatize,” OED.com, undated
Source: “Stigmatize,” Thesaurus.com, undated
Source: “Stigma: Notes on the Management of Spoiled Identity,” WordPress.com, 1963
Image by diegartenprofis/Pixabay

Chasing Stigma Through the Ages, Part 2

“Stigma: Notes on the Management of Spoiled Identity” is a golden oldie, a work published years ago (more than 60 of them) that makes so many excellent points, the question arises: “What else about that subject could possibly have been thought or said since then?”

The author Erving Goffman seems to have pretty much said it all, with an enviable expertise in the art of seeing and articulating multiple aspects and angles of a topic — and the concept of stigmatization gave him plenty of raw material to work with.

The author noted that certain individuals and groups seem to possess an immunity to stigma. Whatever is thought or said about them, they simply don’t care. The Roma are an obvious example of people who have done their own thing for centuries, oblivious to the opinions of the world. Whether critics have admitted it or not, they have been unable to avoid feeling respect, right alongside the hate.

Inescapable truth

The ugly fact is that stigmatization carries many associations and can manifest in innumerable ways. One is the identifier, the outward sign. If nature neglected to provide the identifier (for instance, a different color of skin), humans have obligingly figured out how to supply the lack. In ancient society, law dictated that the good people should restrain a transgressor, and brand his or her face with an ineradicable mark, as a warning to the normies who deem themselves acceptable.

In practical terms, belonging to a certain race is something that cannot, in any case, be changed. This factor provides society with a group of people who can be looked down on, and treated differently. To separate and “other” those problematic folks, the righteous majority does not even need to take the trouble to heat up a branding iron. The stigma of shame does not need to be added. It arrives as part of the package.

Cruel nature

What happened when a child was born with a birthmark? Did the leader gasp and warn the rest of the people that such a mutant should immediately be smothered? The reactions of different societies to such challenges are the story of civilization, which in many places and over the course of millennia, seems not to have progressed much.

What happens now when a person shows up with purple hair? The range of tolerance can vary. When an individual goes so far out of their way to be so confoundingly different, some would want that rebel thrown in jail, for reasons they may not have examined. Others, astonished that anyone could feel so strongly about the issue, shrug and say “It’s no skin off my nose.”

When a person is different due to an accident of nature, Goffman reminds us,

Shame becomes a central possibility, arising from the individual’s perception of one of his own attributes as being a defiling thing to possess, and one he can readily see himself as not possessing.

Someone born with a facial birthmark, or a gigantic nose, or an allergy to sunlight, or a preference for same-sex partners, isn’t trying to make trouble. They didn’t do that on purpose. They didn’t ask to be different, and certainly never intended to make others uncomfortable or upset in their presence. And yet, a certain proportion of fellow humans will make it their business — nay, their mission — to be sure the divergent person feels uncomfortable and unacceptable.

A tricky exam

If asked to name the most powerful destructive force on earth, most people would probably answer, “a nuclear bomb,” while a certain proportion would say “shame.” Millions of people feel the pain of shame, mostly generated by factors they can’t control, like having been born with a facial birthmark. This is the secret door to understanding the phenomenon of fat-phobia, the condition that causes a human (who might be a perfect darling in every other way) to fear and/or hate humans who are overweight.

Even someone who might feel compassion for the person with a facial birthmark, or stretch their mind and heart far enough to understand that another person could not help being gay — even someone who is that far advanced will let themselves freely hate a morbidly obese person on the grounds that they didn’t have to be that way.

That person let themselves get fat, made themselves get fat, and does not care one single bit how uncomfortable the sight of their corpulent body makes others feel. Therefore, that person deserves to experience every bit of shame that can possibly be piled on them, from every direction, day and night, for the rest of their disgusting life.

This, Moms and Dads, is one of the very excellent reasons why we would rather not have our kids become overweight.

Your responses and feedback are welcome!

Source: “Stigma: Notes on the Management of Spoiled Identity,” WordPress.com, 1963
Images by Conmongt and Tumisu/Pixabay

Chasing Stigma Through the Ages

Because some truths are eternal, today’s post refers to a work published six decades ago, whose roots go back centuries. Written by Erving Goffman, its title is “Stigma: Notes on the Management of Spoiled Identity,” and its subject is one that concerns us because if our children grow up to be unacceptably obese according to the standards of the time and place, stigma is what they will face daily throughout their lives.

The word itself has a complicated origin, intertwined with not only punitive laws but with the Christian religion. Stigmata are wounds or scars that spontaneously appear on the body of a saint or other particularly holy individual, in locations (hands, feet, torso) commemorating the violence inflicted on Jesus during the crucifixion.

But no…

What we are talking about here is the other meaning, the intentionally inflicted wounds that served as warning labels, signaling to others that they should avoid a stranger because of potential trouble. The presence of those scars meant, “To help this escaped slave could get you imprisoned,” or “While this sinner did not do something bad enough for a sentence of execution, he was convicted of a serious crime, so steer clear.” It’s where the expression “He’s a marked man” came from — there would be a literal mark, usually on the face, the meaning of which was clear to the general public.

One of the points made by Goffman’s work is that “shifts have occurred in the kinds of disgrace that arouse concern.” To be stigmatized, a person no longer needs to be a fugitive or a convict — or to be held down and branded with a hot iron. A body that is too big, according to the standards of the time and place, is enough to signify that a person’s “social identity” is one that decent, upstanding, right-minded citizens might (and probably should) be repelled by. Because of this expectation, it is easy to “read” the stranger as worthy of blame for being dangerous, evil, or at the very least, weak.

The author’s extensive study of the subject causes him to occasionally throw in a phrase like,

A stigma, then, is really a special kind of relationship between attribute and stereotype.

How does this relationship manifest itself, out in the world?

The term stigma and its synonyms conceal a double perspective: does the stigmatized individual assume his differentness is known about already or is evident on the spot, or does he assume it is neither known about by those present nor immediately perceivable by them?

Then, in many instances, another if/then factor becomes apparent. Even in the case of obvious differentness, like skin color or obesity — does anybody really care? If they don’t, then the interaction or the relationship can move on to more relevant points.

But just in case

In reaction to a stigmatized individual, the author points out, we let our prejudiced mental stereotypes take over — “transforming them into normative expectations, into righteously presented demands.” Those demands can show up in many guises. For instance, if the morbidly obese stranger is gracious enough to make a little joke like, “Gee, I hope I don’t break your chair,” we might feel inclined to give that person a pass (at least temporarily) because they have bowed to our automatic revulsion by acknowledging how disgusting they are.

Our mental filing cabinet registers that gesture of surrender and makes a note: “At least she knows her place in the hierarchy of worthiness.” The overweight individual can mollify and (temporarily, anyway) neutralize our disgust by confessing to their inadequacy. A fat teenager can become acceptable and even popular within a friend group by frequently insulting himself and saving everybody else the effort.

Acceptance, even grace

A stigmatized person who bows to, and often acknowledges, the group’s stereotypes can earn forgiveness. In their subconscious minds, the others are doing the person a favor by granting a temporary pass into the human race. Of course, the trouble with a temporary pass is that it can be revoked at any time.

We are only on Page 5, and Goffman is just getting started. Here are a few more points:

By definition, of course, we believe the person with a stigma is not quite human. On this assumption we exercise varieties of discrimination…

We construct a stigma-theory, an ideology to explain his inferiority and account for the danger he represents…

We use specific stigma terms…

We tend to impute a wide range of imperfections on the basis of the original one…

Obviously, even the most limited and un-intellectually inclined “normal” individuals can generate sufficient insults, pranks, slurs, putdowns, slights, taunts, and sneers to make anyone’s life miserable. But wait, there is more:

Further, we may perceive his defensive response to his situation as a direct expression of his defect, and then see both defect and response as just retribution for something he or his parents or his tribe did, and hence a justification of the way we treat him.

When persecutors with a few more brain cells, material resources, and additional free time become involved, they have the means to concoct entire theoretical constructs and mythologies and old wives’ tales to justify the mistreatment of some particular type of person. Not only that, but they can accrue enough power and influence to affect the scientific fundamentals, and even the religious institutions and the legal underpinnings of a society, to the detriment of a chosen group.

(To be continued…)

Your responses and feedback are welcome!

Source: “Stigma: Notes on the Management of Spoiled Identity,” WordPress.com, 1963
Image by Tumisu/Pixabay

Words, Feelings, and Healthcare Professionals

A few years ago, someone noticed that while research had been done to determine how overweight people felt about the names that friends, relatives, and strangers chose to call them, nobody had really looked at patients’ emotional response to the terminology used by healthcare professionals. To make this inquiry involved surveying almost 3,000 adults (2,911 actually), of whom well over half (1,963) were actually overweight or obese. Others were the parents of children with weight problems, and all were asked to express their opinions about the relevant vocabulary.

The researchers chose 22 common English words and phrases, and here they all are:
Overweight, obese, higher weight, weight problem, unhealthy weight, weight, heavy, chubby, fat, extremely obese, large, plus size, curvy, big, BMI, high BMI, morbidly obese, very overweight, extra large, obesity, super obese, excess weight.

As it turned out, the great majority of respondents found “weight” and “unhealthy weight” to be the least offensive terms. Many people preferred references to the BMI number, despite the fact that it has become much less respected as a meaningful standard.

The reported reactions are complicated:

The term “BMI” may be perceived positively and thus preferred by people within the healthy weight range, while people living with overweight or obesity may consider the term BMI to represent a perceived threat, and do not prefer its use. Further research is required to explore these differences in the preference based on the word “BMI”.

Grownups do not want themselves or their children to be described as super-obese, extremely obese, extra-large, or even fat. And chubby? Forget it. Nobody thinks that word is softer or less offensive than any of the others.

Hurt feelings

Respondents reported their emotional states when offensive terminology is used. Not surprisingly, the feelings inspired by various rejected terms included sadness, anger, disgust, contempt, and several other negative states. The researchers discovered that parents react differently to certain words used by healthcare professionals in relation to the grownups themselves, versus when describing their children. The report duly observed that “HCPs working with adults and children should note these subtle nuances.”

They also suggested that clothing manufacturers might get a clue and stop using some of their accustomed descriptors. Young customers particularly do not want to hear “extra-large,” nor do they care for “super obese” or even the seemingly inoffensive “chubby.”

Fine distinctions

The findings included some noteworthy details. For instance, the word “obese” by itself inspires sadness, while more descriptive adjectives added to it, like “extremely” and “morbidly,” stir up feelings of disgust.

The researchers found this interesting because in other studies, when normal-weight participants are asked what, exactly, it is about heavy people that they find so objectionable, they tend to use the word “disgust” a lot. They often report how that emotion is responsible for their negative emotions, including weight bias, negativity, and extreme prejudice. One captivating detail is described here:

Interestingly, evidence suggests that although some parents might be upset by HCPs using the words “overweight” or “obese”, these terms would be concerning enough to motivate them to make changes.

Many of the results suggested that there are still more layers of meaning to sort through before coming to any definitive conclusions. For instance, advice has been offered to use “person-first language,” for example “person living with obesity” — but that construction apparently does not reduce patients’ hostility toward the term “obesity” itself. The consensus is that professionals need to show more compassion, and the best available advice so far seems to be this:

HCPs should use “weight” when discussing body weight with both adults and children. Given that “weight” was the uniformly preferred term across all BMI categories, and elicited the least negative emotional response… HCPs are advised to use weight neutral terms and ask people for their preferred weight-related terms, as not all terms are uniformly accepted.

(Note to any reader who looks up the document discussed here: The authors consistently use the word “adverb” when they mean “adjective.” But they are not English majors. The scientific aspects of their material are presumed to have passed inspection by many knowledgeable eyes.)

Your responses and feedback are welcome!

Source: “Preferences and emotional response to weight-related terminology used by healthcare professionals to describe body weight in people living with overweight and obesity,” Wiley.com, 06/09/21
Image by rhuf/Pixabay

Stigma and Association

Not long ago, an academic paper with several authors examined the existence and relationship of two concepts: weight stigma and weight stigma by association. The subjects were members of “a large, community-based sample.”

One objective was to rate parents on how caring and helpful they were willing to be, along with a rating to indicate how well they succeeded in that effort. When the results were tallied, it appeared that both obese parents and non-obese ones care equally for their children, be they daughters or sons. Furthermore, obese and non-obese parents are equally caring.

But: Obese parents are less effective, and parents of obese children are less effective.

One conclusion drawn by the researchers is that “Parents of children with obesity may experience weight stigma by association, which could have direct consequences for the parents, the children, and the parent-child relationship.” And, no matter how much they themselves weigh, parents of obese kids are rated as less effective. According to the authors of the paper,

There was also an effect of weight stigma wherein parents with obesity were also rated as less effective and helpful than parents without obesity.

Who is doing all this evaluating, and based on what standards?

It comes as no surprise to learn that a lot depends on who performs the evaluations. People who believe that parents are strictly and solely to blame for a child’s obesity do not care if those parents are themselves bulky or slender. The amount of censure is the same. And apparently, when either the young folks or their parents are obese, critics really don’t care how brilliant or talented the obese children in question may be. There is plenty of disapproval to go around.

One unfortunate result is that parents who are blamed and shamed “may internalize the negative parenting evaluations and subject themselves to further self-blame…,” which of course is exactly what their critics hope they will do. Even when parents exert themselves to make sure their methods “align with professional pediatric recommendations,” if their kids are overweight, those parents are still disrespected. The authors write,

One study found that parents who were stigmatized for their own weight reported greater use of restrictive feeding practices…

And yet, other research shows that when moms get strict about feeding, their kids are likely to eat more, not less. In effect, when an obese mama is picked on by someone who likes to stigmatize others, her kids will be even less carefully fed, and probably gain weight.

Another study dug deep and learned that when a girl is called “too fat” by a relative, her odds of being obese 10 years later increase by 62%. So maybe everyone should just pause and consider the many virtues of silence.

Several strengths

Characterized by its authors as possessing several strengths, this study is described as “the first randomized experiment to test weight stigma by association in a parent-child dyad using a large community sample.” Elaborate randomization standards are said to balance all potential variables and confounds across groups. It also involved large numbers of participants.

The authors note that their experimental stimuli “represented positive parenting practices” and
“used the same vignette of the parent-child dyad in all experimental conditions, which was crafted using the AAP parenting recommendations.” Summing up, they say,

Overall, the present randomized experimental study provides causal (rather than merely associative) evidence that weight stigma by association indeed occurs… Though a nascent area of research, weight stigma by association may have potential implications for parenting and effective pediatric obesity care.

Your responses and feedback are welcome!

Source: “Weight Stigma by Association Among Parents of Children with Obesity: A Randomized Trial,” ScienceDirect.com, 2022
Image by Tama66/Pixabay

Prepare for the Worst, Part 3

The posts in this sequence explore some of the dark corners of obesity-related attitudes, because parents of children who seem to be headed in that direction might benefit from awareness about the future possibilities. The intention here is not to frighten anyone into locking the potentially obese child into a closet where a few hundred calories per day can be passed through a slit in the door.

However, evidence exists in every corner and on every level of society that the life of a morbidly obese individual is not ideal. Of course, no parent is advised to make a child’s existence miserable in order to avoid obesity. On the other hand, no parent is advised to ignore a potential situation in the hope that it will just go away.

It has long been accepted that to attach “phobia” to a word does not exactly connote fear of the thing. “Homophobia,” for instance, is understood to signify an emotion closer to hatred, but it sounds more acceptable in polite society.

In a nightclub

This sentence in a Psychology Today article was written by Seth Meyers, Psy.D., about a live standup comedy performance where an obese comedian told a stupid joke that would not have been funny, or even interesting, no matter who might have said it. About the audience, Dr. Meyers observed,

They laughed because they hate fat people, and worse, because they believe fat people deserve such spite.

But then, the mental health professional pulled a switcheroo and went on to explain how that was not true at all, and actually, a totally different dynamic was in play. Here is what really happens when haters display their obnoxious behavior:

They’re taking a mental break — almost like releasing a valve with too much pressure — from judging themselves.

In this situation, the performer on stage has volunteered for a role that should have become obsolete centuries ago, and it’s not a court jester. In the olden days, anyone who mattered was forced to live in or near the royal palace, where the monarch could keep an eye on them, and also to make sure that the ruler could be seen to administer justice. But if the crown prince misbehaved, his sacred person could not be violated, so there was a staff member called the whipping boy, who would be punished instead, in the hope that the prince would feel bad and learn how to behave properly.

In modern times

So, what a professionally obese person does is fill the role of whipping boy, absorbing the scorn that members of the general public (in this case, audience members) secretly feel they themselves actually deserve. And at least the stage professional volunteered for the job. But the lady next to you in the airplane didn’t ask to be your whipping boy. She gets the job anyway, as you spend on her that disgust you actually feel for your own 30 extra pounds.

Meyers observes that “there appears to be limitless self-judgment out there in the universe,” which is reflected in the amount of judgment that the ordinary citizen is prepared to dish out, especially on obese people, who are pathetically easy targets. The random observer in the grocery store aisle will not be equipped with enough knowledge to judge you for eating your own hair, but will certainly be able to guess that you eat too many doughnuts.

And, parents: The world is full of sad, mad, self-hating people who can’t wait to judge, dislike, and embarrass your child, in the unconscious and very mistaken belief that pouring out scorn on somebody else will make them feel better, and heal their pain-filled lives.

Here is another thing: While helping our own child to grow up undamaged, we probably don’t particularly want to damage anybody else along the way, or contribute to the unhappiness of somebody we don’t even know. Also, Dr. Meyers suggests a way to help make the world a kinder, more understanding place by taking the Empathy Test.

Your responses and feedback are welcome!

Source: “The Psychology of Why People Dislike or Hate Fat People,” PsychologyToday.com, 05/06/11
Image by FreeFunArt/Pixabay

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources