Fashion Week is not the only time of year when size zeros are put in the limelight. On and off college campuses, eating disorders and mental health issues have increased as being thin has been established as the ideal and being fat as the ultimate taboo.
With obesity on the rise in the United States, numerous health and nutrition campaigns nationwide, like First Lady Michelle Obama's "Let's Move!" anti-obesity campaign, employ a variety of methods with the hope of lowering obesity rates. Yet these efforts come with a harsh consequence: the stigmatization of being overweight.
Public health campaigns against obesity struggle with the challenge of making sure they don't unintentionally reinforce negative perceptions of overweight people.
Edith Balbach, senior lecturer and director of the community health program at Tufts, said it is easy to discriminate against heavy people when promoting well-being and healthy weight.
"It is very easy to slip into language that makes it sound as if it's their fault or that they are lazy or they don't have willpower if their weight is higher than average," Balbach said.
To avoid stigmatization, Balbach said, health programs should strive to improve overarching factors that inspire healthy eating habits, such as making sure that individuals have access to healthy food and that they can afford to pay for it.
"If you are doing good community health interventions, you really focus on the environmental and social factors that are leading to obesity, and you try to avoid blaming the person for being obese," Balbach said. "You try to look at the larger factors that are leading to obesity."
Similarly, Miriam Nelson, director of the Friedman School of Nutrition Science and Policy's John Hancock Research Center on Physical Activity, Nutrition and Obesity Prevention, stressed that designing nutrition-related policies and campaigns unique to the communities in question, rather than focusing on the scale, was key to avoiding stigmatization.
"You want to focus on becoming healthier, eating better, becoming fitter and managing any health concerns that the person might have," Nelson said. "You focus on the behaviors around fitness and good nutrition rather than on the weight itself."
Balbach cited Shape Up Somerville as one such program that focuses on positive language and messages. The citywide campaign, started by the Friedman School, aims to increase daily physical activity and healthy eating in the community — not weight loss.
"When we intervene from a public health standpoint, that is the kind of stuff that we are looking at as opposed to doing a lot of shaking our finger at people because they are eating too much," Balbach said.
While eating disorders are prevalent on college campuses, obesity might be less present in college environments because it is correlated with lower social classes, Balbach said.
"Inasmuch as the college-aged population would tend to be more affluent, coming from middle class, there is just less obesity," she said.
Environmental factors built into the campus experience, such as healthy food options and walking as the dominant method of transportation, also contribute to low obesity rates.
Nonetheless, Balbach worried that while obesity rates on campus are too low to determine whether people suffering from the condition are stigmatized, overweight people may very well be.
"I do worry that, in the Tufts population as a whole, there are people who take on disordered eating patterns to conform to a thin norm, even if that is not their normal body weight," she said. "Stigmatizing anyone for their health behavior is a terrible strategy to try to improve the situation."
Nelson, who is also an associate professor at the Friedman School, explained that, in general, there has always been a negative stigma against overweight and obese people. Yet the problem today is not so much the growing stigmatization but the growing national obesity rate itself, which brings the stigmatization into view.
Still, Nelson said that the degree of stigmatization depends on geographic location and the values accepted by certain communities. For communities with strong stigmas against obesity, the consequences can be far-reaching.
"It makes it even more difficult for someone to change their behaviors, it contributes to poor mental health and possibly some other risky behaviors like excess drinking, eating disorders or smoking," she said.
While thinness has been established as the model of attractiveness in society, it was not always the goal, according to Stephen Bailey, associate professor of anthropology. Historically, he said, individuals who were moderately obese were seen as desirable in many cultures.
"It was a signal that [people] had enough food, that they were successful and probably had enough wealth to be able to consume extra food," he said. "That was a good thing in some cultures. It was even a mark of beauty. Young brides were deliberately fattened prior to their weddings."
Meanwhile, thinness is often associated with the upper-middle classes.
"Part of the equation is that wealthy people have time and disposable income to work out, have access to healthy food and access to better health care that leads to lower levels of obesity," Bailey said.
In certain areas in Latin America and much of sub-Saharan Africa, Bailey said, it is still considered desirable to be obese or at least overweight, the primary reason being those areas' relatively little exposure to the Western world and its standards. The popular opinion of obesity as a distinctly bad thing is fairly new, he said, and seems to have been born in the Occident.
"What we find in America and in Western culture in general is that there has been a stigmatization of obesity and an identification of obese individuals as being out of control, lacking self-discipline," Bailey said. "A lot of moral judgment has been fixed to individuals on the base of their physical appearance."
Largely, this equation is the result of modernization, Bailey explained. In the Western world, factors such as Hollywood and the mass media have contributed to a shift in the perception of obesity and thinness, he said.
"In the modeling industry, a plus-size is actually what the average American woman is," Bailey said. "Nowadays, it's not enough to be average."
