Free What's Wrong With Fat? by Abigail C. Saguy Page B

simultaneous association with poor Irish immigrants. 40 This would suggest that, in the United States, the stigmatization of fatness and adulation of thinness were interrelated and profoundly raced, classed, and gendered processes. This further points to how the framing of fatness as immoral was closely linked to the framing of it as ugly or unfashionable, which remains a powerful framing of fat today that has been examined elsewhere. 41
    In any case, it is clear that by the twentieth century, a slender body provided an important way for Americans to demonstrate not only their wealth and status but also their moral virtue. Beginning in the late nineteenth and early twentieth centuries, “an appropriately slender figure could denote the kind of firm character, capable of self-control, that one would seek in a good worker in an age of growing indulgence; ready employability and weight management could be conflated.” 42 In the United States, where there is a deep-seated cultural belief in self-reliance, body size was especially likely to be regarded as under personal control and reflecting moral fiber. In contrast, in France, fat remained more of an aesthetic than a moral issue, although slenderness rather than corpulence was now the valued aesthetic. 43
    The original supporters for this frame have been (male-dominated) religious authorities. Sociologist Lynne Gerber has shown how contemporary Christian weight-loss programs continue to “frame the moral problem that body size represents in more traditional Christian terms, namely gluttony.” Gluttony, in turn, raises “concerns about control and lack of control, surrender to and rebellion against God’s will.” 44 While religious in origin, this frame has broad resonance in the United States. 45 Thus, in the contemporary United States, slenderness, or toned muscularity for men, is widely praised as the embodiment of willpower, restraint, moderation, and self-control, while the fat body is seen as the incarnation of moral failure, poor impulse control, greed, and self-indulgence. 46 For instance, Fumento describes anti-fat prejudice as “a helpful and healthful prejudice for society to have” because it is a “prejudice against overeating and what used to be called laziness.” 47 He condemns the fat acceptance movement for turning “what had been two of the Seven Deadly Sins—sloth and gluttony—into both a right and a badge of honor.” 48 As this idea has become secularized, its roots in Protestantism are obscured, and it appears to be universal. 49
    MEDICAL FRAME
    By the middle of the twentieth century, fatness was increasingly framed as a health condition requiring medical intervention. 50 This required that physicians persuade the public that corpulence was a medical (as opposed to predominantly aesthetic or moral) problem and that they were best qualified to deal with it. Calling fatness by the medical term obesity was crucial in convincing public opinion that fatness represented a medical problem. According to sociologist Jeffery Sobal, mostly male physicians began to portray fatness as both a disease in itself and, beginning in the 1970s, as a risk factor for other diseases, including cardiovascular disease. This helped the medicalization of fatness to stick; it was a medical problem on two different fronts, both as a disease and as a risk factor. 51 Appealing to this double status, in an interview with me, obesity researcher James Hill calls obesity “a huge disease that’s driving all of our other chronic diseases.” The medical frame draws on a master frame of health. As we will see, the public health crisis frame and the health at every size frame also draw on a master frame of health. Indeed, part of what is at stake in the fat field is what “health” actually means.
    The medical frame has been promoted by doctors and by medical associations. Indeed, the American Society of Bariatric Physicians in 1949 and the Association for the Study of Obesity