Blame and responsibility: the chicken or the egg?

At the beginning of this week, I took part in a Twitter chat about weight stigma. I mentioned in my previous blog post about it that I spent a lot of time expounding the view that it matters not a whit whether people are fat through their own ‘fault’ or ‘weakness’ or ‘poor character’ or if they are ‘blameless’. Stigma is bad. Full stop.

Naturally, I stand by this because I believe it to be unequivocally true. But there is at least one reason that ‘blame’ may come into a discussion about weight stigma. And that is because a lot of people claim that the reason they dislike fat people is not because of the fatness per se, but rather that it represents a distasteful lack of personal responsibility, and such selfish behaviour is not considered acceptable in modern society.

I’ll start with the science.

Without a doubt, high rates of anti-fat stigma do seem to go hand in hand with a belief in the controllability of body weight and endorsement of what is known as the the ‘Protestant work ethic’ – the idea that hard work will be rewarded and that it is the individual’s responsibility in life to pull himself up by his bootstraps; failure to succeed is therefore due to lack of effort and moral fibre. 

However, I do sometimes wonder whether the ‘personal responsibility’ argument is merely a sop to the prejudiced. A socially acceptable excuse for their bigotry. And the science has something to say about that also.

Interventions aimed at reducing anti-fat bias in medical students have sometimes used an educational approach, intended to reinforce the complex causality of obesity. These interventions appear to be quite effective in changing students’ minds about how controllable weight is. They don’t, however, have much of an impact on their anti-fat attitudes.

Another example – and I will happily admit to not providing a broad overview of the literature here; I just happened to be reading this paper recently – was a study that looked at how both emotional dislike of fat people and beliefs in their responsibility for their fatness predicted support for a potentially discriminatory health policy (non-weight related surgery refused to heavier people), and found significant effects for emotional dislike only.

So I’m not sure how REAL the link between perceived personal responsibility and anti-fat bias truly is. I believe that people truly think that’s what their problem with fat people is. But I’d argue that that is pretty much just self-serving rationalisation of bigotry.

Let me draw a historical parallel for you. In her fantastic 2009 paper ‘A Historical Analysis of Public Health, the Law, and Stigmatized Social Groups: The Need for Both Obesity and Weight Bias Legislation‘, Jennifer Pomeranz draws parallels between current public health approaches to ‘obesity’ and the treatment of other historically stigmatised groups – where personal responsibility was propounded whilst ignoring structural inequalities.  You can read the full text for free by following the link above, but I’m just going to quote a couple of paragraphs here:

“During this period and largely as a result of their separate and unequal living conditions, African Americans disproportionately experienced illnesses associated with their extreme poverty, lack of access to health care, and the outright discrimination they faced. For example, in Richmond, Virginia, African Americans only comprised 38% of the city’s population but they accounted for 57% of the city’s deaths from tuberculosis (15). Rather than investing any of the city’s resources in research, prevention, or treatment of tuberculosis among African Americans, the Mayor issued “a warning against the indiscriminate employ- ment of negroes in our households” (15). Because those afflicted were stigmatized, society and the government did not address the African Americans’ health concerns appropriately.

In the absence of genuine science explaining the health disparities between the races, experts in the fields of statistics (16) and public health (17) added to the institutionalized racism at the time by touting the theory that African Americans were an inherently weak race. In 1914, Allen presented at the General Sessions of the American Public Health Association on the topic of “The Negro Health Problem;” (17) his position became the dominant theory of that time. He explained that it “is the lack of physical and moral cleanliness that causes the death- rate to be so much more among the negroes than it is among the whites” (17). The doctor attributed the African American’s illnesses to their “lack of self-control,” failing in cleanliness and chastity, and on the fact that their homes were too small and their schoolhouses too dirty (17). Allen’s proposed solution to these disparities was to give the African Americans “an education that will take the place of the discipline which he received in slavery times” in order to teach “good character, good habits, and skill” (17). Allen’s solution was to teach the oppressed group personal responsibility. There was no mention of a need to better the African American’s living conditions or rectify economic disparities. Instead he wanted to discipline them into being healthy. Focusing on education alone has been considered a form of victim-blaming (13) and is unlikely to effectively change health disparities without also focusing on changing the social and economic environment.” 

We must not allow ourselves to be oblivious to the endemic anti-fat hatred that is running through all these discussions about health and responsibility. We must recognise these rationalisations for what they are: an attempt to ignore our own privilege and legitimise our biases.

So those are my thoughts on WHY people link personal responsibility and weight stigma. But I’d like to reiterate what I said at the start.

It matters not a whit whether people are fat through their own ‘fault’ or ‘weakness’ or ‘poor character’ or if they are ‘blameless’. Stigma is bad. Full stop.


One Response

  1. …”A socially acceptable excuse for their bigotry”

    I’d agree with this, but add that most people do not analyze their own actions, let alone question themselves. Attitudes in bigotry and prejudice are slowly changed over time. Positive reflections of ‘fat people’ in media, intelligent but broad reaching debate and most importantly promotion of the real facts behind obesity, will help.

    I worry for this and the next generation as it’s only in the last 20 years specifically, (though more generally last 60 years, but last 20 has been bad) that ‘fat hate’ really kicked in, in such an insidious way.

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