I have really been appalled by some of the recent controversy that Regina Benjamin's weight in any way compromises her ability to serve as a good example in the capacity of Surgeon General. Such comments pop up on message boards across the web, many from morons and twits, but others from genuine aficiniados of exercise and/or nutrition who think they are speaking on behalf of women's health, but in reality have no idea what the fuck they are talking about; I am very glad will we have a Surgeon General who by her very presence will begin to disabuse us of these misconceptions.
The fact is, concerns about obesity are not a partisan issue; many of the most strident critics of being overweight are progressives at the forefront of medicine and nutrition, noting it as a causal factor that increases risks for a myriad of diseases, based on their extended expertise in their specific fields.
However, for those of us who view the issue of women's health through a more holistic lens that acknowledges the intertwining and interacting factors of physical health, psychological self-image, and sociological pressures, the greatest causal threat to women's health is actually not obesity at at all - in fact it is entirely the opposite; the greatest causal threat to women's health is negative body image.
Specifically, this negative body image manifests itself as perpetually seeing one's self as too fat regardless of the reality, a compulsive self-loathing fervor to lose weight that usually only backfires.
While there are many alarming statistics about obesity, the amount of women who have suffered at one time or another from an eating disorder like bulemia or anorexia is just as staggering - but it only begins to tell the story; I can only speak for my own generation and not those that came before (I just turned thirty), but most women I have have had the fortune of getting to know in my life still have an endless loop of "I'm too fat" going in their minds every time they look at the mirror, regardless of their weight. In fact, I would say at least three out of four women I have met in my life have some unhealthy level of this fixation, and even thought in most cases it may not rise to the level of a diagnosable eating disorder, the psychological, emotional, and spiritual toll of struggling daily against these kinds of expectations is still immeasurable, and only serves to bolster detrimental health factors like stress, depression - and yes - weight gain as well. What's worse, these body image problems that many women face appear to be, if anything, getting even more acute with today's teenage girls and young adults.
In many ways, it is no surprise that this phenomenon targets women in particular and only seems to be getting worse; we have a multibillion dollar weight loss and cosmetics industry which has created immense social and psychological pressure on women to get to a size nonexistant, an Orwellian Two Minutes of Hate that women regularly are conditioned to inflict on themselves. As this industry has expanded, along with its compatriots in the fashion, tabloid, and modeling industries, spreading their mantra of female self-loathing through new technologies and digital airbrushing breakthroughs, the problem has become more acute. How many weight loss commercials, between TV and Internet ads, does a young woman see by the age of 15 nowadays? How about compared to thirty years ago, or even ten years ago?
My point is that if we are looking at causal factors when we talk about obesity causing poor health, we must equally concede that the biggest causal factor for obesity and weight gain among women is negative self-image, and almost always before diet and exercise even come into play; a highly negative self-image inevitably tends to provoke inconsistent attempts at diet and exercise, as opposed to the kind of steady long term regiment that truly leads to improved health. This serves the cosmetics/weight loss industry just fine, though, as they don't make nearly as much money if people just lose weight and keep it off; their entire financial model relies on women who will keep trying to lose weight in an endless cycle and buy their products over and over again, as they richochet between modes of fierce determination and bitter resentment towards weight loss that inherently lead to an inconsistent regiment. One can expect little more from those industries, granted, but it certainly is the duty of people in and around the health care, nutrition, and fitness industries to look past their short term bottom lines and NOT reinforce those same stigmas, as they often have in the past; to do so directly undermines their stated main objective of good health for their female clients perhaps in the most destructive way possible.
Throughout the course of my relative short life, I have personally heard more stories than I can count about women who were incessantly bugged about being fat when they were growing up, often just for being a little chubby, and then ended up losing control of their weights when they got older as a result. I will share just one such story in the interest of brevity:
My fiancee was a chubby as a child; however, her mother always berated her for being fat, and constantly made it the focus, to the point where a resentment towards restraint and exercise was engendered. My fiancee continued to gain weight as she got older, despite attempts to diet, with each of her boyfriends having a very negative attitude towards her size and constantly harassing her to lose weight. It was only until she and I were together for a couple years and she felt no such pressure about her size that she all of a sudden found herself losing weight this year - without even trying - and essentially by accident.
This is really just a basic rule of humanity; after a certain point of pushing someone to do anything too hard, it will inevitably backfire, because it is interpreted as a disparagement of the very will power needed to overcome the problem. Although motivation can be very helpful in many situations throughout life, there gets to be a point where people just need a little breathing room to feel something other than bad about themselves if they are ever to feel any better.
This highlights a rule of weight loss, and really, of most any substantive changes we attempt to make to our lives: it is vital to feel at least somewhat IN CONTROL to be successful. Once a person feels like things are completely out of their control, things do not go well, and the primary message that women get from society when it comes to weight loss is that - no matter their size - they ARE out of control, that they MUST always be somewhere else than where they are now, and that they've therefore ALWAYS fallen short and have ALWAYS been out of control (and always will be).
I will pose one last example from my personal experience, as it relates specifically to that issue of feeling in control. A number of years ago, one of my friends had put on some weight during a depressing period in her life following the death of a parent; when I saw her in 2001 for the first time in over a year, she was caught up in a negative view of her body that went beyond anything I had remembered. As the time went on and we began to hang out again, though, a funny thing started to happen; she started to joke about her weight in a positive, almost cathartic sense, not in a self-depreciating tone as much as one defiant towards conventional expectations. It became so common that it was a running joke she had going among our group of friends; she would make cracks about how her weight shook the floor or how she could squish people she didn't like with her weight, interpeting it as something empowering instead of a liability. It may sound silly, but she was able to look at the idea of being fat through a positive lens; what she had once perceived as a woman's ultimate weakness, through endless social conditioning, she now perceived as a manifestation of "goddess power", as she liked to put it - the weapon that so long had been used against her was in reality only hers to wield as she pleased. In the months following her regaining a sense of control over her size, she lost all the extra weight with minimal effort and is now in the best physical shape of her life - not by beating herself up or trying too hard, but by simply cutting herself a break. It's amazing what a positive self-image of one's body can do.
Now, some may read this diary and think that I am trying to argue against or minimize the health consequences of obesity. Let me be clear, I am doing no such thing - the health risks of obesity are well-established and foolish to dispute. However, anyone that thinks that an increase in overweight and obese women stems from women not worrying about their weight enough is OUT OF THEIR FUCKING MINDS.