Susie Orbach is a psychotherapist, writer and co-founder of The Women’s Therapy Centre in London and New York. In this extract from her pioneering work Fat Is A Feminist Issue, the author explores our obsession with body image.

In classrooms around the world girls swap tips on how to eat less, how to ratchet up their exercise and how to mimic those perfect bodies they see staring out at them from music videos, TV soaps, the catwalk, magazines and billboards. Somewhere they know that these bodies aren’t quite real – that they have been physically enhanced by surgery, lighting, camera angles and digital manipulation to make them appear to have longer legs, smaller waists, larger breasts and rounder bums. But no matter. The deluge of visual images that wallpapers our world has seeped into all of our consciousnesses. It has changed the way we view our bodies and what we can and should do to our bodies, including those of our children.

Bodies today have almost come to define the way our lives can be lived.Without a body that girls feel all right about, nothing much in their lives feels OK. Their bodies cause them trouble and worry. All the normal difficulties of growing up, dealing with the conflicts, choices and angsts of adolescence, get subsumed under a preoccupation to get one’s body right. Concerns about whether their still developing body will be like the current fashionable figure, whether they will be found acceptable, pretty, sexy and desirable, and whether the size, shape and way they look are good enough, consumes their thoughts and hopes. Cosmetic surgery is now something too many girls anticipate; the much-wished-for sixteenth birthday present.They hope that the surgeon will resculpt their bodies and if they are deeply unhappy with their own looks, they can request the bottom, teeth, breasts, even the face, of their favourite celebrity.

From as early as 5 years old, when little girls copy their favourite pop heroines, through adolescence, early adulthood, mothering, middle age and even old age, preoccupation with how the body appears has became a crucial aspect of female experience. Increasingly women are not realising how quickly their lives have become dominated by these concerns. But while we are aware of the many efforts we make to look good, exercise, and eat well, the underlying
questions about why and how we have come to be so concerned about our bodies is just taken as a given we all accede to.We don’t, however, just become passive victims; we actively make it our own cause.We embrace the challenge and in doing so we often make decisions which are
not only damaging to our well being but inadvertently create and then reinforce an anguished relationship to food and the body.

Whatever point we choose in the lifecycle, we can see the evidence of our cultural preoccupation with food and body image. The latest celebrity craze for having elective caesarean deliveries at 36 weeks is designed to avoid the increase in weight associated with the last month of pregnancy and lose that tummy more quickly, although most women don’t significantly gain weight in the last two weeks anyway. Shockingly, the example is all too often followed by pregnant women who can afford this option. The impact of this kind of decision on the mother and baby extends beyond the actual pregnancy and birth; quite unintentionally, the woman’s ability to breastfeed and nurture her newborn is clouded by her concerns about her own appearance and appetite.

Most new mothers naturally feel some nervousness about whether they can respond well to their baby’s needs. Of course, every new Mum wants to give her baby a good start in life and if she had weight or eating problems she will be eager to make sure that she doesn’t pass these on. But, sadly, the push to return to a pre-pregnancy figure and the premium on doing so speedily, brings eating anxieties right into the early feeding relationship. Many children are now growing up confused about their appetites.They have little idea that eating is something you only need do when you are hungry. The basic appetite mechanism is undeveloped and gives way to the influence of emotional states on eating. Ideas about body size predominate and influence the choice of foods so that some become designated good while those considered bad gain a special attraction. As children become more independent and have pocket money to spend they become interested in making food choices that veer towards everything a parent wishes they weren’t interested in, partly because it is pitched to them as special and partly because they have an undeveloped sense of what and when and how they should eat.

Befuddling our appetites has been part of the food industry’s aim for several decades now. Their profits increase when they sell us more and when they can reduce the cost of producing, transporting and storing the food. Over the last few decades we have been accustomed to a wider availability of relatively cheap food, lots of which have stabilisers and artificial flavours added to them to increase their shelf life. If we don’t like those foodstuffs then we can choose the fresher and more organic options. If we don’t like mass produced food we can purchase the unprocessed or gourmet lines. The food industry apparently caters to all of our appetites, whims and budgets and the latest in nutritional theory. Reduce fat? Sure, they say, we’ll take it out or add water and just add some sugars and cellulose fillers to give it more texture and taste while we find ways of selling you back the fat we’ve skimmed off by promoting naughty, indulgent food: luxury cookies, extra rich ice cream, limited edition crisps and so on.

One way and another, our shopping baskets increase, the fast food outlets proliferate and that other great segment of the food industry, the diet industry, ratchets up its profits, safe in the knowledge that for every 100 people that go on a diet, 97% of them will be return customers whose diets have failed and who have already regained whatever weight they lost and then some.

A $40 billion diet industry makes itself fat on the pain and misery of those who have eating problems or imagine they are fat.This industry capitalises on the post-Christmas and pre-summer holiday market with unrealistic promises of instant weight loss. But our body has quite natural mechanisms for coping with the extra food we eat at different times of the year. It simply speeds up our metabolism until our weight restabilises itself. Equally when we eat less food than our body requires, our metabolism slows as though it were protecting us from the effects of famine. Each of us has a set point which regulates our body size to within a few pounds or kilos. When we consistently interfere with it by continually eating more than our body can handle or when we choose to diet many times a year, if not almost permanently, the thermostat that resets our metabolic rate as our eating varies, gives up or gets stuck at the lower rate and dieting then produces its opposite result, weight gain rather than weight loss. In fact repeated dieting is one of the most effective ways to put on weight.

FATfeministissue Dieting, as I argue in this book, is a recipe for increasing eating problems. It doesn’t deal with the underlying reasons why people eat when they aren’t hungry, and the solution it offers creates a bigger problem in its wake. Dieting is even more popular than it was when Fat Is A Feminist Issue was first published 28 years ago. Eating has become a psychological, moral, medical, aesthetic and cultural statement. Eating certain foods has become equated with moral value. To eat them is to wrong; to refrain is to accord oneself a sense of goodness. Thin is wise; fat is bad. Dieting, the interfering with one’s appetite to ensure that one is not eating too much, functions as a sort of guarantee that one is on the correct path. In an age of obesity, it is offered as the righteous alternative.

Undoubtedly, the explosion of obesity is a major cause for concern. We know that there are many more obese people in the west than 30 years ago.We know that certain fats and sugars, particularly of the long shelf life variety, coupled with a sedentary life make our bodies work less efficiently. We also know that the extreme pressure on people to be thin in part creates a mindset that they are fat when they are not fat.This mindset, this sense that one is too large or too fat, has penetrated into our awareness so that girls and women, boys and men, become increasingly self conscious of their body size.What is less clear though is why our governments are trumpeting an obesity epidemic rather than focusing on the rather more widespread and often more hidden problems of troubled eating which beset so many.

It is this hidden problem of troubled eating which is the true public health emergency and epidemic that needs confronting. The haunting belief that undermines the eating and well-being of those whose appetites and eating might otherwise be perfectly harmonious, is, as I have said, infecting the next generation too. Before they even know about categories of fat and thin, their early life experiences are imbued with anxiety around food and eating, thus making them
easy prey for the merchants of body insecurity.

Fat is no longer an objective word meaning adipose tissue. It is a word heavily laden with negative value and discomforting emotions. Even to have a book title Fat Is A Feminist Issue is to risk turning off potential readers. Culturally we find fat such an affront; negativity screams so intensely from the word that we are unable to sort out the facts from the fantasies.

We’ve become accustomed to training our eyes on the tobacco industry’s nefarious doings, and the escapades of the food industry show that their methods for increasing revenue are equally appalling. But let’s not let the other players out of our sight who are also responsible for driving the Obesity Agenda and categorising it as the number one health problem in the western world. Obesity isn’t. The new rise in obesity is not simple growth, it is largely also due to the Body Mass Index (the BMI) being revised downwards over the past 6 years. If you are Brad Pitt or George Bush, you are now considered overweight. If you are as substantial as Russell Crowe, you are obese. As Paul Campos writes in The Obesity Myth, overnight 36 million Americans woke up to find that they were obese. In her book Dispensing with the Truth, Alice Mundy details the million dollar funding that commercial weight loss groups contributed to Shape up America, a group which was part of a strategy to turn obesity into a disease which can be treated by the pharmaceutical, diet and medical industries (medicine is an industry in the States).‘Think of it’ Mundy writes, ‘as Obesity Inc.’

Evidence from the professional journals, however, shows that fitness, not fat, determines our mortality. You can be fat, fit and healthy. Body fascism and the tyranny of thin and the sense that we should all be one size is not only unrealistic, it is unhealthy and unattainable. But despite the fact that one size does not fit all, the desire to conform and to see reflected back in our mirrors an approximation of what we see on billboards, magazines and screens is compelling. The uniformity of the visual imagery that we are exposed to reconstructs our relationship to our bodies. We may think it doesn’t, we may think that ads are just a bit of fun, but now we have evidence that tells us that we have been seriously underestimating the impact that visual culture has on us. In 1995 TV was first introduced to Fiji showing many imported US shows. In 1998, only 3 years later, 11.9% of the teenage girls were hanging over the toilet bowl with bulimia, a previously unknown behaviour.1 This shocking fact reverberates in my mind when I try to understand the growth of eating and body image problems today and the factors that have accelerated them globally. It is not only key for the young women of Fiji, it is key for young women in England, Ireland, Scotland, Wales, Europe, North and South America, and increasingly those countries brought into globalism.

When one considers the facts from Fiji alongside the phenomenon of 35,000 cases of women’s noses being reshaped in Iran under the Hijab, and Chinese women’s legs being broken and prostheses inserted in order to create a few extra centimetres of height, and Japanese women thinking they are too fat, a picture emerges of body insecurity, even body hatred, becoming a major export of the western world.What binds people together in a superficial way in the enormous global village is an ability to identify with and recognise one another speedily through consumerism and specifically through the brands, clothes, food and music we wear, eat or listen to. In this global marketplace a woman’s body shape has in itself become a brand, her brand, her membership and entitlement to occupy space. Her body has to fit for the individual to feel she belongs and is recognised as belonging.

As women have fought to expand the ways in which they can act in and on the world, they have been given back a picture of femininity that is ever more homogeneous and diminutive.Yes, diversity appears to rule because models of all colours and ethnic groups now promote today’s look, but the ethnic variations are all circumscribed within a small body variation whose main architecture is skinny and long. In the last few years we have seen the idea of beauty democratised to include all people, not just the glamorous, or perhaps it is better to say that glamour has become more readily available and felt to be essential to more and more people. However, sadly and perplexingly, this idea of democracy has simultaneously arisen with a narrowing of the ideals of beauty, so that while people wish to include themselves, they are likely to feel inadequate if they fail to meet that narrow ideal.

If we read the zeitgeist and the research, we can see how unsatisfactory women find this state of affairs. They yearn for a wider representation of beauty, one which shows that beauty comes in many different sizes.There have been some promising advertising initiatives2 which have been trying to expand and extend the pictures of beauty we see around us and these are being met by women with enormous pleasure. It is refreshing and heartening to women all over the world. As these wider images of beauty become more commonplace, girl’s and women’s feelings about themselves and their bodies will change, and we can look forward to a reduction in those who try to manipulate their food to affect a lower than average weight.

It is not my argument that thin is bad and fat is good. That would be an absurd position. I am writing about the emotional meanings that we have bequeathed to fat and thin. More often than not, for the individual, fat isn’t about the physical: it is in their own mind and in their articulation of what they believe fat to be. For them fat is demonic and thin is wonderful and in accepting these notions we are missing more complex and contradictory meanings and ideas we ascribe to fatness and thinness which, if understood, can help the individual find ways to live in their bodies without constantly criticising them. Fat Is A Feminist Issue helps us to encounter these richer meanings and, ultimately, aims to provide a model for a different kind of eating – a sustainable way to eat what one’s body wants and needs and to be a healthy size. To all of you approaching this book, I hope it has meaning for you.

Fat Is A Feminist Issue, published by Cornerstone, is out now.

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