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Date Posted: 01:05:52 01/07/03 Tue
Author: isabelle
Author Host/IP: 238.pool1.ftthtokyo.att.ne.jp / 165.76.217.238
Subject: too fat too thin

The politics of thin

We are bombarded with images of skinny people and yet the planet is groaning under our burgeoning weight. How can something as natural as eating and drinking be so complicated?

Nicci Gerrard
Sunday January 5, 2003
The Observer

The new year has begun and all over the world people are standing on their bathroom scales making resolutions to lose weight. Try this calculation: divide your weight in kilos by your height in metres squared: if you score over 25 you are overweight; if you score over 30 you are obese; over 40, morbidly so.

But what should be so simple - eating less, exercising more; refusing that piece of pie, spreading a little less butter on your bread, one glass of wine instead of two - is actually very complicated. The habits of a lifetime are hardwired into our brain. And our attitude to food is rarely straightforward, particularly for women. We don't eat just because we are hungry, or because we need food: we eat because we are bored, sad, anxious, angry; and we give others food to placate them, welcome them, control them. On the other side of the coin, we don't not eat because we are not hungry: we starve ourselves out of psychological disturbance, and because everywhere we look thin is beautiful and powerful.

Being overweight is no longer an emblem of happy self-indulgence: Father Christmas, Falstaff and Friar Tuck are cheery figures, but today's fat are regarded as gluttonous, slothful and sad. In prosperous countries, food is seen as dangerous. We can poison ourselves with the sweepings from the abattoir floor; sit on the sofa and in a blur of fatty snacks balloon into obesity; refuse to eat and shrink into a mimicry of a famine victim; binge on all the food that's 'bad' and then vomit. We can either eat or starve ourselves to death.

Although she is a stranger to me, I do not need to ask Janet how I will recognise her. I know she is fat; her agent has recommended her to me because of her 'massive' size. And there she is, leaning her soft bulk against a bin outside the Underground station. Her belly is pendulous and her features look tiny in the broad expanse of her face. Her hands are dimpled; her ankles swollen. She sways as she walks and is breathless when we reach a café. When she sits down the chair is spindly beneath her. She smiles sweetly and then I see the person beneath the mountain of flesh. It's as if she is hiding behind her fatness. 'Yes, she says, 'or maybe it's simply that you don't see fat people properly.' She says what most overweight people say: that the not-fat (what Natalie Kusz, writing in The Bitch in the House, published by Penguin in March, calls 'the Smalls') are contemptuous of obesity and cruel towards those suffering from it.

Janet, 43, makes her living from being fat: she is on the books of the Ugly Agency and you might have seen her illustrating articles about obesity. She weighs about 22 stone; she is a size 28. She has always been overweight - she was a plump child, a fat teenager; 18 stone when she met her husband (who's 'not skinny himself') in her late teens; putting on the pounds with the years. She has tried all the diets - the high-fibre diet, the starvation diet, the rotation diet; the fruit diet; but she talks about it as if it were a battle against her appetites that she never believed she would win.

I ask Janet what she eats in a day and at first it doesn't sound too bad - porridge made with water in the mornings, a bacon butty at eleven, baked beans on toast at lunch, a cooked meal with her husband in the evening. But she eats at other times as well - biscuits, cakes, chocolate, toast in the afternoon; a large baked potato oozing with butter at night... She does not eat because she is particularly hungry but because she's bored or dreary or full of rage. Janet eats even though her obesity has caused adult-onset diabetes. She eats even though her doctor has warned her of the dire consequences. She eats even though she hates to look at herself in the mirror and dreads going out and suffering the brutal comments of strangers. Janet knows that to be fat is to turn yourself into a stereotype: greedy, self-indulgent, lacking will-power, stupid. She fishes a photograph out of her bag, a graduation photo. 'I wanted you to know I'm not ignorant,' she says.

Janet is not stupid, not ignorant, not lazy - yet she remains morbidly obese, endangering her life with too much food. Millions are like her. The doctor and New Yorker writer Atul Gawande, writing in his book, Complications, of the Roux-en-Y gastric bypass (stapling a stomach down to the size of an ounce) that he performed on a 428lb patient, lists the complications of being morbidly obese. The patient had high blood pressure, high cholesterol, diabetes. His legs and back ached all the time. He could barely walk. He could not mount the stairs to the second floor of their house. He could doze only in snatches. Skin folds became chafed and red and would develop infections and boils. Sex was non-existent. Life was pretty hellish for this man - but he couldn't stop eating.

To think about appetite is to wonder how much say we have over our lives. Obesity is behaviour that is out of control and many would even call it a disease - implying, of course, that it cannot be cured by will alone. The history of weight-loss is one of implacable failure. People can lose weight, but they put it back on. A recent survey showed that between 90 to 95 per cent of people regained one- to two-thirds of any weight lost within a year, and all of it within five years. People endure the weirdest diets; they have their jaws wired, their fat surgically removed; they have plastic balloons inflated inside their stomachs, but still they are unable to resist. They may eat themselves to death, mirroring those who starve themselves to death. Never have we been so obsessed with being thin and never have we been so overweight. Food has lost its function. Hunger and appetite have become unlinked and nature dislocated.

Although I recognise Janet because she is overweight, she is not so different from many people on the street that afternoon. Obesity is massively on the increase. In her revelatory book about food and obesity, The Hunger Gene, published by Atlantic later this month, Ellen Ruppel writes that 1.1 billion adults in the West are clinically obese (this at a time when billions in developing countries are dying from lack of food). In the US, 34 per cent of the population are overweight and a further 27 per cent are obese. Half of the populations of the UK, Brazil, Chile, Colombia, Peru, Finland, Russia, Bulgaria, Morocco, Mexico, Saudi Arabia are obese or overweight. In the UK youth obesity rates have soared by 70 per cent in a decade and adult-onset diabetes now affects children who have high blood pressure, high cholesterol, high insulin levels, causing illnesses normally associated with old age such as renal failure and heart disease.

At my children's swimming class, I watch a very fat boy waddle towards the water and enter the pool with an ungainly splash. Later that evening I turn on the television. There are barely any fat people on TV. Most are slim, some are very thin, with jutting collarbones, a ladder of ribs, and gaunt faces. To be thin is to be desirable - a few years ago the World Health Organisation announced that the Miss Worlds of recent years could be officially declared malnourished. When celebrities put on weight, they are taunted and bullied: the gorgeous Kate Winslet was said to be too 'fleshy' in Titanic. In a recent interview with Patsy Kensit, the Daily Mail devoted a distasteful level of attention to the fact that she'd put on weight.

People - especially women - are regarded as objects, weighed up. In the US, as the average size rockets, the perfect size is zero. Food is served in giant portions; fizzy drinks consumed in vast quantities - and yet £33 billion is spent on diets every year, far more than the gross national product of most countries. Everywhere in the developed world there are health clubs, personal trainers. Roux-en-Y gastric by-passes are performed on tens of thousands of people deemed to be in mortal danger from the weight of their flesh. In a 1997 survey published in Psychology Today 15 per cent of women and 11 per cent of men said they would give up five years of life to be slim - and yet still people cannot lose weight.

At the same time, anorexic people dread every extra ounce that they put on - eating becomes a torment. It is as hard for the compulsively under-weight to put food in their mouths and chew it and swallow it and keep it down as it is for the overweight to stop. 'Recovered' anorexics talk about it in the same way as members of AA, who haven't touched a drop in years but know that they are still alcoholics. Their response to food will always be anxious and obsessive.

Ann Millen, 53, is one such a person. She was always a normal weight as a child - never thinking about what she ate. When she was 17 years old, she left her convent boarding school, and went to France as an au pair. There, she was unhappy - and she started eating 'little chocolate dessert pots. I became obsessed with them,' she said. 'When I came home, my mum thought I was pregnant, I'd put on so much weight. So then I stopped eating. Everything was about avoiding the next meal. I got married but my marriage broke up. I weighed five stone. My mother dragged me back north where I stayed for a year. I did see a psychiatrist, but he just told me to pull myself together.

'For years my anorexia came and went in spasms. Sometimes I would eat a lot. If my weight got to eight stone I'd panic and stop eating. I started to think everyone was watching me - and so I became bulimic. I'd eat normally and then throw up.' When Ann met her second husband and they decided to go to South America, backpacking, she was advised by her doctor not to go. At five stone, she was at great risk. She went nevertheless and remembers feeling great happiness in a mountain village, where people had nothing; where the Old and New Worlds met. It was experiences such as this - of still having a life; of enduring through illness - that pulled her through anorexia. She has a daughter of her own now, and is anxious not to pass on her anorexia. She admits that she has found it hard not to say: 'Don't eat that because it will make you fat'.

Ann has thought a great deal about why she became anorexic. She talks about low self-esteem (her parents were unhappily married; she boarded at a convent school from the age of five and was bullied by the nuns). And she talks about media influences - she grew up in the age of Twiggy. She is 'better' now but knows she will never think of food in a straightforward way. 'I am aware of it all the time.'

So is Karen Wood, who has also struggled with anorexia and bulimia since the age of 13, when she was hitting puberty and felt bigger and clumsier than her peers. One New Year she resolved to lose weight - and she took it to extremes. Dieting became starvation, until her parents put her into a psychiatric hospital, where she was abandoned in an adult ward, 60 miles from home, and terrified. Like Ann Millen, she received no psychiatric treatment - anorexia was still not regarded as a sickness, and it was thought that one could only recover through willpower.

She put on weight, was allowed home, and immediately starved herself again, then binge-ate, until she ballooned to 13 stone. She says she had 'no control whatsoever' over her eating. Her parents put locks on the cupboards, but that didn't stop her. Soon she was making herself sick - cramming herself with forbidden foods at night then vomiting, blocking the drains. She was taking a hundred laxatives a day, sleeping most of the day, and making herself seriously ill. But bulimia, she says, is both a hidden and an inadmissible illness. 'Before Diana, I'd never even heard the word - I thought I was the only person who did it.' The doctors didn't take it seriously: she was told to pull herself together.

She missed her education. She was friendless, isolated, ashamed. And this increased the vicious cycle of obsessive-compulsive behaviour she was trapped in. Making herself sick 'removed anxiety; it was my coping mechanism'.

Even when she met her husband - who has devoted himself to saving her, giving up work to supervise her health - she didn't immediately improve. She was drinking a great deal and at one point she took pills and vodka and went into a suicidal coma. She had a child, but found motherhood stressful. She was spending £60 or £70 a day on food and laxatives. Eventually, they went bankrupt and had to sell their house.

With the awareness of the consequences of her phobia, and with children and her loving husband, she was gradually 'motivated to make myself better', a process that took years. Now, she eats regular meals and is a healthy weight. 'It took me decades to understand what my natural size was and to listen to my body.' Both Karen Wood and Ann Millen point to environmental triggers for their food-phobias, and both look back to their childhood and understand that unhappiness and insecurity were central to their eating disorders. The same sense of environment bearing down on young people is demonstrated in a Channel 4 documentary, Skinny Kids, to be broadcast this month. Pre-pubescent children, some as young as six, tell the camera that they want to lose weight. A slim 11-year old points to her 'fat' legs and 'fat' tummy. A slim seven-year-old says that she is the only one in her class with fat legs. The mother says she cannot understand her daughter's obsession - she's never been on a diet herself; she just eats normally. But her daughter says that the cupboards are full of 'this drink to keep you thin'. A six-year-old says only her ankles are thin; she hates her thighs. The programme shows girls comparing weight, skipping to lose pounds, going to gyms with special equipment for children. It also shows them wearing high-heels, practising flirting in front of the mirror, putting on make-up (helped by their mothers), mimicking their peer group and their parents, picking up on their fears and anxieties.

The director, Zizi Durrance, agrees that we are seeing behaviour passed down by mothers, who may not be aware of the trouble they are storing up. She says that of course people have always been judged largely by their appearance, but that it is now happening earlier and earlier. When a normal six-year-old thinks she should go on a diet, then 'that's the death of childhood'. Children are growing up earlier and earlier - they are so aware of the world around them; the world in the magazines their mothers read. They might be emotionally young still, but they are savvy and know-it-all; a new generation that reflects the pressures that are on them. They assume all women diet. And they're right, because most women do.

Ellen Ruppel Shell, in The Hunger Gene, shows how scientists increasingly believe that we cannot blame it all on individual psychology. There is no evidence of an obese personality. Experts suggest that fat is set in the body mechanism - that a combination of genes and environmental changes have created a world in which obesity is the fastest growing kind of malnourishment. In the Eighties and Nineties, we believed in behaviour modification - counting calories, running miles - but in the twenty-first century we may be starting to believe in a kind of biological determinism that suggests we are not entirely to blame for our weight.

On the one hand, there is evidence that some people are physiologically bound to become fat. There are those who suffer from an inherited dysfunction (the Prader-Willi syndrome) and are incapable of experiencing satiety. They never feel full, whatever they eat. They may raid the rubbish bin or eat pet food in their desperation to obey their body's command to eat. But, at the same time, there is the 'toxic environment' in which we live, which explains why obesity has risen so rapidly in the past decade. Take the common potato: it is now bought more in processed form than it is unprocessed - in other words, we don't peel, boil, bake, mash; we gobble crisps, pop pre-prepared chips into the oven. In America, fizzy drinks are drunk more than coffee and tap water combined. We have a relentless fast-food culture. Every high street contains fast-food restaurants, where it has been calculated that the average length of a meal is 11 minutes. Food is gobbled. We live in a blur of snacks - but the snacks are getting bigger. We are ordering the 'value-meals', which means that you can buy a meal twice as large as you want, because it costs less than twice as much. We eat in the car (the dashboard break), in the office (the deskfast), in front of the TV. We eat without noticing what we are eating or even that we are eating. We graze. We pacify ourselves with food.

Just as tobacco companies have been sued by cancer patients who wanted compensation, the same is now happening to the fast-food companies that lure customers to eat cheap, fatty junk. For the argument goes that we are not to blame for our obesity - it's the fault of the businesses that used all the temptations that billions could buy to put their food into our mouths. The implication is that we don't really have control over our lives, and certainly not over our appetites. We need help.

In the subject of weight and food, all our most pressing concerns converge: genetics versus environment, free will versus determinism, celebrity and the cult of the image. There's a whole world on your plate.

· Skinny Kids will be broadcast on Monday 13 January at 9pm on Channel 4

A to Z of the diet industry

ATKINS DIET Bestselling diet by Dr Atkins. Strictly no carbs; weight loss guaranteed

BULIMIA Life-threatening eating disorder involving binge eating followed by purging

CALORIES Ideal intake: 2,000 per day for women, 2,500 per day for men

DETOX Jane Scrivner style. No fat, caffeine, sugar or alcohol. Usually lasts a week

EXPERTS From Carol Vorderman to Geri Halliwell, they've all got something to say

FAT FLUSH PLAN New US diet, eradicates bloating and jumpstarts metabolism

GRAPEFRUIT DIET Theory: grapefruit has enzymes that speed up fat-burning process

HIGH PROTEIN DIET Recommends 30 to 40 per cent of calories come from protein

IRRITABLE BOWEL SYNDROME Can be linked to poor nutrition

JUICE FASTS One to five days of pure juices only

KEEP FIT Gym memberships soar in January

LOW-FAT FOODS From crisps to chocolate

METABOLISM Controls how quickly food is turned into energy

NUTRITIONIST Everybody's got one these days, darling

OBESITY 50 per cent of women and 60 per cent of men in England are clinically overweight

PRITIKIN DIET Based on whole grains, fruit and vegetables

QUANTITY Controlling the amount of food is an essential element of any diet

ROSEMARY CONLEY Original UK diet queen

SEX Burns more than 150 calories per hour

TUMMY TUCK When all else fails_ surgery

UNIVERSAL CONTOUR WRAP Cheat with compacting beauty treatments

VITAMINS Needed to supplement an unbalanced diet. Do not induce weight loss

WEIGHT WATCHERS Established diet plan based on points system

XENADRINE Popular slimming pill

YOGA Still all the rage. Helps tone body and increase fat metabolism

ZONE DIET à la Jennifer Aniston. High-protein, low-carb. Decreases hunger, then weight
Vikki Miller

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