This thesis is an exploration of American ideology of dieting, fat and the body using Medical Anthropology and Feminist theory. Using historical and contemporary theories of the body and society, I analyze the role of these ideologies and weight control behaviors -- which I call the dieting continuum. This paper focuses American's women's rejection of fat and the preoccupation with controlling body weight as a cultural phenomenon within the context of the body as a symbol and tool of social control. The explanation offered is that participation in the dieting continuum serves to mediate both individual and societal fears of women's bodies and women's power by redirecting women into a treadmill of preoccupation with weight.

This thesis is an exploration of American ideology of dieting, fat and the body using Medical Anthropology and Feminist theory. In researching this, I began with an interest in examining the mechanisms that control body weight and fat distribution in humans and cultural preferences around size. I was interested in finding out what the literature could tell me about the American view of the body, and women's bodies in particular. Looking at cross-cultural material gave me the added insight into the ethnocentricity of the current biomedical and popular views of weight in America.

At first, the question of the origins of the American views of fat and their function in society were difficult to conceptualize. This is partially due to the fact that I am an American woman, socialized to accept the ideology as fact. It wasn't until I began to explore historical and contemporary theories of the body and society that I began to understand the context in which the current American ideology of dieting is perpetuated.

The purpose of this paper is to analyze the role of these ideologies and weight control behaviors, which I call the dieting continuum. Reducing diets and other weight control methods are a form of social control in American culture that serves to label, constrain and punish deviance -- especially in women. This paper will focus on the rejection of fat and the preoccupation with controlling body weight for women in America as a cultural phenomenon within the theoretical context of the body as a symbol and tool of social control.

Despite much evidence that reducing diets and other forms of weight control are almost always unsuccessful and have potential health risks that are in often in excess of any potential health benefits, millions of American women spend much of their time, money and energy in the pursuit of an unrealistically thin ideal body type. The explanation offered is that participation in the dieting continuum serves to mediate both individual and societal fears of women's bodies and women's power by redirecting women into a treadmill of preoccupation with weight.

The first section of the paper establishes the participation in the dieting continuum, the mechanisms by which weight control works, or doesn't work, female physiology and weight, the creation of obesity as a disease category and it's underlying assumptions and the prevailing attitudes of prejudice towards fat people in America.

Section two focuses on Western ideology of the body: a look at the theories about the use of bodies as symbols and mechanisms for social control, the ways in which women's bodies and fat have been medicalized in the last century, and how the dieting continuum with its preoccupation of control is part of the world view of Cartesian dualism and individual autonomy.

The final section investigates weight control as a form of social control in which society's fear of women is mediated through a system of suppression and diversion into dieting. The conclusion looks at the way that resistance to this system has grown alongside the problem and increased in intensity in the past few years.

Although the theory presented here is by no means the answer, I believe it is helpful in explaining much of the seemingly contradictory information obtained about dieting and weight. Unfortunately, due to the constraints of this project, the focus is entirely on gender and focuses on research which primarily pertains to white, middle-class America. People of color, older women, disabled people and other marginalized groups are also subject to the same power dynamics and these factor into the questions of weight and body image in America. I have explored these areas in other projects and will continue to do so in future work.

"Women are more obsessed with their bodies than men, less satisfied with them, and permitted less latitude with them by themselves, by men, and by the culture" (Bordo 1988:100).

In America today, getting and staying thin has become a principal female pastime, consuming a significant portion of women's time, energy and money. In a study conducted with readers of Psychology Today in 1973, 50% of the women and 33% of the men who responded were unhappy about their weight (Hatfield 1986: 204-206). A decade later, a 1984 poll by Glamour magazine found that this number had grown substantially. Of the 33,000 women who responded, 75% said that they thought they were "too fat." Yet even according to the conservative 1959 Metropolitan Life Insurance ideal weight tables only 25% of these women were heavier than the specified standards, and a full 30% were below the recommended weight (Glamour 1984:1).

The dissatisfaction with their bodies is a feeling of weighing too much and a dislike of those areas where women have the most body fat. For example, the majority (61-72% of these women were dissatisfied with or ashamed of their stomach, hips, and thighs (Glamour 1984:1). These women reported that fear of fat becomes so strong that it takes precedence over other areas of their lives. "Symptomatic of the near-obsession with weight, when asked what would make them happiest" more women said "losing weight" (42%) than work success (21%), dating (21%) or hearing from an old friend (15%). Even "normal and underwight" women say they'd be happier losing weight than any of the other options given (1984:2). The preoccupation with being or wanting to be thin weighs heavily even on the minds of those who are not fat. The fear of fat in America is so powerful that when 500 women were asked in one poll what they feared most in the world, 190 replied "getting fat" (Bordo 1988:89).
This preoccupation with being thin leads most women to try to lose weight or control their weight in an attempt to conform to the culturally prescribed body shape. A 1991 telephone survey by the Calorie Control Council in Atlanta, Georgia, revealed that 48 million Americans are dieting. At least 62% of adults in the U.S. dieted to lose weight in 1988, while 18% are constantly dieting (Marketdata 1991:15-16). Most studies report that 90% of dieters are women. At any given time, it's been estimated that at least 50% of American women are on a diet (Hatfield 1986:205).

Marketdata Enterprises, an independent research company, reports that women who wish to lose weight go on a weigh-loss regimen an average of five times per year. (1991:16) The following range behavior makes up what I call the dieting continuum: counting calories; eating low calorie foods and drinks; joining weight loss programs; taking diet pills, laxatives and diuretics; self-induced vomiting; excessive exercise; going on liquid protein diets; and having weight loss surgeries as well as the behaviors that characterize eating disorders such as anorexia nervosa and bulimia. These behaviors are practiced by people of all body shapes and sizes, fat and thin, who are worried about weight.

The commitment in time, money and energy put into the dieting continuum is overwhelming. Market Data Enterprises estimates Americans spend $33 billion a year (and rising) on diet programs and products (Market Data 1991). The 1984 Glamour study goes on to chronicle the widespread use of weight control mechanisms: "Almost all who answered have tried moderate calorie restrictions and exercise" and a "surprising number...use such potentially dangerous substances as diet pills (50%), liquid formula diets (27%) and diuretics (18%)." In addition, 45% have tried fasting and 15% have used self-induced vomiting (1984:201).

Participation in the dieting continuum begins early for women. According to a 1986 study by researchers at the University of California at San Francisco, one in five girls in the fourth grade are dieting (Toufexis 1988:54). In Detroit a University of Michigan study of dieting habits found that 38% of girls in grades six through twelve and 49% of their mothers, considered themselves overweight. In reality, only 15% of both groups weighed more than recommended (King 1988:76). By the time they reach 18, 80% of American women will have been on diet (Elgin 1990:177).

When dieting fails, many women turn to weight loss surgeries. By 1985, an estimated 450,000 Americans had undergone either stomach stapling or intestinal bypass surgeries (Ernsberger 1984:9). In the late 80s, the gastric bubble and liposuction were also added to the list of weight loss surgeries. Despite shaky success rates, significantly dangerous side effects, and high death rates, thousands more fat people will go under the surgeon's knife each year, risking everything to be thin. Of these, 80-90% are women (Ernsberger 1984:3).

Experts say that eating disorders have reached epidemic proportions in America in the last few years and over 90% of those afflicted are women (Bordo 1988:100, Chernin 1981:62-63). The National Anorexic Aid Society reports that surveys find as many as 1% of girls age 12-18 suffer from anorexia nervosa; 20-30% of women 18-34, show bulimic symptoms (Freedman 1986:155).

At all points on the dieting continuum, it is women who are the primary participants in this cultural ritual of starvation. It is women for whom the fear of fat takes on such overpowering significance that they invest, and risk, their lives for the sake of getting and staying thin.

Americans believe that unlike other characteristics such as height and eye color, that their weight is determined by conscious control. The tenet is that those who are fat have gotten that way because they eat too much and are lazy. It is usually an unquestioned belief that with a reasonable amount of will power and self-control, anybody can control how fat he or she is -- and should.

With the enormous effort going into participation in the dieting continuum, it would be reasonable to expect that Americans, especially the diet conscious women, would be getting slimmer. Yet, since the Civil War, when statistics on inductees were first gathered, the U.S. population has been growing not only taller, but fatter. According to the insurance company studies, between 1968 and 1983, the weight of the average American increased by five pounds. In 1983, it was estimated that 20-50% of Americans weighed more than the Metropolitan Life Insurance charts recommended (Hockman 1983:12). A recent survey by Prevention Magazine indicated that 64% of the American population was "overweight" (Harris & Assoc. 1990:12).

Studies indicate that weight loss is almost always temporary and usually results in eventual weight gain. At least 98% of all dieters are said to regain the weight within five years, and 90% to gain back more than they lost (Chernin 1981:29-30, Mayer 1983:8). Because most dieters repeat the cycle of weight loss and weight gain, chronic dieting is called "yo-yo" dieting. Obesity researcher Dr. Paul Ernsberger says that this pattern of dieting is the leading contribution to obesity in the United States (Ernsberger and Haskew 1987).

In addition, to the weight gain, the psychological and physical stress of yo-yo dieting may actually cause the high blood pressure and heart disease normally associated with weight gain. Some symptoms of chronic dieting include irritability, poor concentration, anxiety, apathy, depression, mood swings, fatigue, and social isolation. And the physical complications can be even more extreme: high blood pressure, hair loss, gall-bladder disease, heart disease, constipation, anemia, dry skin, skin rashes, dizziness, reduced sex drive, menstrual irregularities, gout, infertility, kidney stones, numbness in the legs, weakness, reduced resistance to infection, lowered exercise tolerance, electrolyte imbalances and even death. All or most of these symptoms were formerly thought to be associated with being fat (Bennet and Gurin 1982, Ernsberger and Haskew 1987, New York City 1991). So not only does participation in the dieting continuum not guarantee long-term weight loss, it can harm the person both physically and mentally. A recent study found that the risk of dying from heart disease is 70% higher in those with fluctuating weight than in those whose weight remains stable, regardless of their initial weight, blood pressure, smoking habits, cholesterol level and level of physical activity (Lissner, et al. 1991).
Most people in America assume that fat is a result of overeating and laziness. Yet all studies that have attempted to validate this premise have failed:

Garrow...reviewed thirteen separate studies of the relationship of body weight to food intake. Twelve of the thirteen found that obese subjects consumed the same amount of food or less than normal-weight controls. The thirteenth study produced no differences between the two groups by one method of measurement, and larger amounts eaten by obese by another method. Another seven studies have failed to find differences between the groups (Dyrenforth et al. 1980:45).

Although overeating does exist, researchers explain, there are thin and fat people who overeat and there are many fat people who eat less than thin people (Bennet and Gurin 1982, Ernsberger and Haskew 1987, Dyrenforth et al. 1980). Polivy and Herman in their able, researchers say the brain resorts to other survival mechanisms.

According to this theory, people who fail to diet or maintain weight loss are not weak-willed. Dieters, they say, are fighting their own bodies' survival mechanisms. Fat (adipose tissue) not only has a form (amount and placement) but is a normal constituent of the human body that serves the important function of storing energy for mobilization in response to metabolic needs as well as a layer of insulation to protect the rest of the body. In the Dieter's Dilemma, William Bennet and Joel Gurin explain that each time a person diets they are voluntarily starving their body. At first the body will use what resources are readily available while signaling hunger. The resources the body uses at first are not the fat reserves, which are saved for last. The body will begin to metabolize nerve and muscle tissue including the parts of the brain and heart (Bennet and Gurin 1982, Ernsberger and Haskew 1987). Once the body realizes that the food is not coming or not coming fast enough, it will begin by increasing symptoms of hunger -- dizziness, anxiety, headaches, depression. The chemical messages to the brain induce a preoccupation with food to stimulate the person into foraging for food. In the meantime, the metabolic rate will slow down to conserve energy. This period where weight loss levels off is often called the dieter's plateau. Only as a last resort will the body begin to burn the fat reserves -- but it never lets up on the hunger demands.

By turning the metabolism down and demanding food, the body is able to begin to rebuild the lost resources. In fact, the body will continue to gain weight, even on a smaller food supply than before, and will often gain additional weight to protect against future crisis situations. Each time a person diets the body becomes more and more adept at maintaining weight and will continue to build its resources. In this way, dieters find it increasingly difficult to lose weight and continue to gain more and more weight after each attempt (Bennet and Gurin 1982).

Exercise has been known to help a person maintain a healthier body and maintain a slightly lower weight. But Bennet and Gurin content that exercise is not entirely effective for weight loss, because when the body exercises, it demands more food. If that food is not provided, the results can be the same as dieting. The metabolism slows down and the person becomes less energetic.

The next step in the protection of the set point is to decrease energy expenditure:

Energy is expended in two ways. It drives the chemical (or 'metabolic') reactions needed to keep the organism in good repair, and it powers the contraction of muscles required for activity. Either of these energy drains may be limited in order to preserve the body's fat. During long periods of semi-starvation, people and animals spontaneously become less active. A more subtle form of energy conservation also comes into play: The metabolic rate -- the speed at which calories are burned to perform the body's maintenance functions -- slows down with underfeeding; overfeeding has the opposite effect... Instead of regarding activity, eating, and metabolic rate as three independent functions that may or not be at a 'normal' level, set point theory sees them as the means for maintaining a certain quantity of fat. (Bennet and Gurin 1982:64)

Applying set point theory to the question of why people are fat or thin allows one to understand that since the body is self-regulating, the amount of fat a person has may not be a matter of conscious control but instead is the response of a normal functioning system. Those people who are fatter than others have systems that are designed for more fat storage than others.

Set point is the result of a genetic background and are inherited much the same way a person's height and skin color are. Numerous studies have shown a correlation between heredity and fat. These studies conclude that where both parents were fat, 80% of the offspring were also fat. When only one parent was heavy, 40% of the children were heavy too. Only 9% were fat when both parents were lean. (Bennet and Gurin 1982, Roberts 1988, Stunkard et al. 1986).

Although a person's set point is believed to be determined largely by genetics, it also changes over time. Researchers point out that cross-culturally, as people grow older, they will usually gain weight as part of the aging process. Pregnancy causes additional weight changes for women, as the increased energy demands require a more efficient metabolism.

These researchers contend that dieting is therefore a destructive and futile attempt to override the body's own protective measures. Besides the stress involved in this process, they say most diets carry further health liabilities. For example, many diets carry further health liabilities. For example, many diets are nutritionally unbalanced and can cause problems with increased cholesterol levels, uric acid levels, and potassium depletion (20:41). Diet drugs and hormones, liquid protein diets, diuretics and laxatives all have numerous negative side effects, and in themselves, are an extreme health risk (Bennet and Gurin 1982, Ernsberger and Haskew 1987). Drugs such as amphetamines and nicotine can create an artificial but temporary reduction in the set point but these drugs have many hazards. And once their use is suspended, the body will react in much the same way it does to dieting by raising the set point to protect against future crisis (Bennet and Gurin 1982:63).

Paul Ernsberger contends that weight loss surgeries carry an extremely high morality risk and all have severe debilitating side effects. He found in 1985 that "the total death toll from weight-loss surgery has exceeded or will soon exceed 50,000... More Americans have died from the surgeons' War on Fat than died in the Vietnam War" (1984:9).

Then what of the 2% who actually succeed in losing and maintaining the weight loss? Some researchers say they may have traded their fat for constant starvation and a shorter life span. Another study at Rockefeller University looked at dieters who had succeeded in and maintained a large weight loss. The dieters, members of Overeaters Anonymous, looked normal but when studied, they showed many of the same effects as people who have anorexia -- tiny cells, cessation of menses, slow pulse, and a slowed metabolism, burning 25% fewer calories than normal for their height and weight. They had to maintain a starvation level diet in order to maintain their size. These people not only resembled starvation victims biochemically, they acted like them too. They were intensely preoccupied, even obsessed, with food and exhibited all other symptoms of starvation (Dyrenforth et al. 1980:94).

Participating in the dieting continuum is then an effort to struggle to subdue metabolism in order to reduce body size. Yet, according to many researchers, because of the protective measures that the human system has developed to protect against starvation, such attempts are almost always doomed to fail and are in themselves a health risk.

The American Dieting Continuum is especially problematic when women's biology is taken into account. Women are more prone to fat deposit and normally have at least twice the fat level of men (Bennet and Gurin 1982). Men have an average of 15 to 24% fat per body weight while women range from 26 to 44%. Women are fatter in every site tested, especially in the breast and buttocks (though this varies considerably by population) (Bailey 1982). Newborn girls in all ethnic groups weight less at birth than newborn boys but are fatter. This fat is deposited in the fetus of either sex late in the last trimester of pregnancy which suggests genetic factors that make it important that female babies have more fat (Beller 1977:57).

The mother, too, gains weight. Women all over the world, regardless of how fat or thin they may have been to begin with, gain at least a modicum of extra weight during pregnancy. Metabolic rate increases by 25% during gestation and food intake should increase accordingly (Durnin 1987). Infants born to women underfed during pregnancy appear to have less than optimal brain development at birth, and their livers, spleens, and adrenal glands are measurably smaller than normal (Beller 1977:82, Bennet and Gurin 1982).

To insure that these energy resources are available, women must have a critical ratio of fat to lean body weight in order to achieve reproductive fertility as well as to successfully reproduce (Frisch 1987). Studies indicate that a minimum level of fat, about 17% of body weight, is necessary for ovulation and menstruation. Frisch (1987:88) writes that fat storage "would have given our female ancestors a selective advantage by ensuring that they conceived only when they could complete pregnancy successfully."

Girls over every ethic group and culture show a sudden weight gain at puberty and fully half of this gain consists of subcutaneous fat. Although boys have a growth spurt at about the same time, most of the added tissue in boys is muscle and bone. Before puberty, girls have 10-15% more fat than boys, but by the end of adolescence they will have twice as much as boys. (Beller 1977:86, Bennet and Gurin 1982:155) As mentioned earlier, this process does not end with adolescence. Women gain weight with each pregnancy as well as when they age. In fact, weight gain after middle age is as universal a feature of human development as weight gain during pregnancy. (Bennet and Gurin 1982:159)

Until very recently in human history, women were valued highly for their fertility. This fertility was symbolized by the fat female who not only looks more like a pregnant woman but has a greater chance of becoming pregnant. Fatness was associated with femininity, motherhood, nurturing, and food. (Beller 1977, Chernin 1981) In 1951, when Clellan S. Ford and Frank A. Beach studied different cultures' body build preferences they found the majority of cultures considered a "plump:" woman more attractive than a slim one (Ford and Beach 1951). Thirty years later, anthropologists Peter J. Brown and Melvin Konner confirmed this trend. In their analysis, 81% of the cultures in question preferred a fat body build over a thin. By far the most famous example of a society which clearly doesn't idealize thin bodies is Samoa. Studies done in Samoa found that women and men were expected to gain weight as they mature (MacKenzie 1980, Baker et al. 1986).

Preference for a particular body size or shape is a cultural variable, grounded in a specific historical moment and continually shifting. For example, statistics indicate that as these cultures become "Westernized" many adopt values closer to those expressed by Americans (Bennet & Gurin 1982).

The twentieth century brought the medicalization of body size and fatness as a form of sickness or disease -- called obesity. It is important to understand that although fatness has existed throughout human existence, "obesity" is a relatively new disease. The development of obesity theory has revolved around the redefining of the human condition of fatness as illness -- not a process of discovery but of redefining a currently existing state. Even though fat people are part of the natural range of human diversity and, historically, have been considered healthier than thin -- modern theorists reclassified the state as an ailment.

"The word `obesity' itself (Latin obesus, from obedere, 'to eat up') presents a view of fat people which rules the thinking of all obesity scientists, regardless of their specific field" (Mayer 1983:26). The origins of the word obesity clearly delineate it as a form of overeating. Yet, as pointed out earlier, fat has not been proven to be a direct result of overeating. Rather, it is a naturally occurring part of the body.

The notion that body fat is a toxic substance is now firmly a part of folk wisdom: Many people perversely consider eating to be a suicidal act (Bennet and Gurin 1982:107).

Cellulite, for example, is just another term for fat. The fat is exactly the same as any other, but it is referred to as if it were a foreign substance to be destroyed like a virus.

[Most] books or articles on the subject of obesity begin with the pious, but unfounded, assertion that "over-weight" has become a major threat to public health. The very expression 'overweight,' which is now used as a well-intentioned euphemism for 'fat,' carries as expectation of early death, for it means "over the weight associated with maximum life expectancy (Bennet and Gurin 1982: 107-108).

Since the beginning of this century, the life insurance industry had reported "ideal" weights for men and women and insisted that anyone who has weighed more than the ideal was likely to die at a relatively younger age. They had, so far, not roused enthusiastic support in the medical profession.

In the 1940s, Louis Dublin, a biologist who worked for Metropolitan Life Ins., became convinced that weight was a problem. Dublin was an influential and prolific writer of public health documents. He almost single-handedly "convinced a generation of physicians and Americans that overweight shortened life" (Seid 1988:116). He wrote more than 600 articles, papers, brochures, and speeches in an attempt to persuade, as he first said in 1951, that "Obesity Is America's No. 1 Health Problem" (Bennet and Gurin 1982, Schwartz 1986, Seid 1988).

Dublin's efforts culminated in the "Build and Blood Pressure Study," published by the Society of Actuaries in 1959. "Although the design (of the study) left much to be desired...its conclusions became, for a time, medical gospel. One of the most important assertions of the report was that the lightest people live longest, and that any increase in body weight is associated with an increase in mortality rate: (Bennet and Gurin 1982:108).
Dublin used the actuary tables of that time to create the recommended weight charts that are, with some modification, still in effect today. Several researches claim there were many problems with his study. The sample group was very small and not representative of the population as a whole. In fact, since few women were insured, they were barely represented at all (Bennet and Gurin 1982, Ernsberger and Haskew 1987, Schwartz 1986, Seid 1988). In addition, his use of different size frames has no scientific basis at all. Important factors such as racial heritage, body composition and age were not even included in his charts. Metropolitan Life still claims that a person should weigh the same for their entire adult life regardless of mounting evidence to the contrary (Bennet and Gurin 1982, Ernsberger and Haskew 1987, Schwartz 1986, Seid 1988).

It is from these highly controversial but widely used charts that the term "overweight" derives. The term specifically refers to the belief that a person who weighs more than these standards, is beyond acceptable levels and therefore "deviant." Metropolitan Life still clings to Dublin's assumption that weight above those charts is a health risk, even more so than below the charts. Although the "Desirable Weights for Men and Women" were modified in 1983 to reflect that fact that the American public is growing steadily heavier, they are still based on assumptions about the correlation between mortality and weight (Ernsberger and Haskew 1987).

In 1985, The National Institutes of Health Consensus Development Conference declared that obesity is a "killer disease." The panel declared any otherwise healthy adult is still at risk if they are 20% or more above the "desirable" weights. Again, this conference relied heavily on insurance date to the exclusion of more scientifically accurate studies available (Ernsberger and Haskew 1987:108). Ernsberger and other researchers presented convincing evidence that disputes these claims. Many mortality studies have shown that the longest life spans are 20-40% over the weights that Metropolitan Life and most medical care providers use. Though there is an increased risk with weight above 40%, there is an even greater risk for being too thin (Bennet and Gurin 1982, Ernsberger and Haskew 1987, Friedman 1974, Mayer 1983).

In addition, those populations in other countries and other places that do not hate fat such as Samoa, do not have the increased rates of the illnesses the NIH associates with being "obese." Even in Samoa where most people are well over the weight charts, they often have disease rates under the American national average. It is only when these populations move into areas where fat is hated, that they too are at risk for these diseases (Baker 1986, Bennet and Gurin 1982, MacKenzie 1980).

Researchers Paul Ernsberger and Paul Haskew also question the definition of obesity as a disease. They argue that being fat is simply a "condition," as there are too many health benefits also correlated with increased weight. They chronicle an exhausting list of illnesses fat is associated with lower incidence of: most cancers, respiratory disease, infectious disease, bone disease, cardiovascular disease, gynecological and obstetric illnesses, and more. They also point to a more favorable prognosis for fat people with some other diseases such as some forms of diabetes (Ernsberger and Haskew 1987).
The list of responsible scientific studies that challenge the more widely publicized findings of the insurance industry is impressive. When reviewing this data it becomes clear that a reasonable look at the evidence brings into question most of the information given to the general public by the medical, insurance, weight-loss and mass media industries. Given the uneven presentation of the available information on weight and health it becomes important to question what effect this has and what purpose this one-sided view of the issue has served in American culture.

Weight and health, for most Americans, isn't just a medical issue -- it seems to be a moral mandate. Each individual is seen as morally obligated to be healthy and physically fit. Of all the health issues in this country, fat and the fear of becoming fat have taken on overwhelming significance in people's lives, especially for women. The fear and hatred of fat is one of the most time and energy consuming obsessions in America. One study indicated women in America fear getting fat more than they fear nuclear wan (Bordo 1988).

To be fat is considered to be a moral weakness as well as a physical illness. Fat people are considered less intelligent, ugly, lazy, lacking in self control, asexual, and selfish. The extreme prejudice that most people feel toward fat is rationalized by their assumption that fat people are responsible for their own condition. It is believed that if they only had more self control, they could easily lose weight (Mayer 1983).

Discrimination against fat people is one of the last "safe" prejudices. People who are otherwise aware of human rights issues still feel and/or behave as if fat people don't deserve to be treated equally. Fat people face discrimination in almost every aspect of their lives -- education, employment, insurance, housing, adoption, health care, clothing, social settings, and access to public facilities.

Children learn early in America that fat is bad. One study found that children as young as six years old describe silhouettes of a fat child as "lazy," "dirty," "stupid," and "ugly." The findings have been replicated across age, race, sex, socioeconomic status, geographic area of residence in the United States, regardless of the perceiver's body size (Dyrenforth et al. 1980:32-33). In a survey of members of the National Association to Advance Fat Acceptance (NAAFA), half reported being the brunt of tricks and anti-fat jokes and even given nicknames or called negative names in junior and senior high school, and to a lesser extent in college. They reported being left out of parties and dances, being ridiculed in gym class, not being chosen for school sports, being left out of honor role, feeling isolated, having food thrown at them, being told to sit in the back of the class, and not fitting in the small school chairs (Rothblum, et al. 1988).

While this might be chalked up to children's ignorance, the studies of adults view of these fat children are just as appalling. Fat students receive abuse not only from their peers but from the system as well. Teachers give fat students less attention and lower grades even for comparable work (Dyrenforth et al. 1980:36). A New England study found that "a fat high school girl has one-third the chance of getting into college than a thin girl, even though of the same intelligence" (Hatfield 1986:211). Teachers evaluate children considered children as smarter, more likely to go to college, more likely to have parents who cared about their education and better able to get along with peers (Hatfield 1986). They found that teachers considered the misbehavior of an unattractive child as more serious than that of an attractive one and considered the unattractive child more dishonest (Hatfield 1986).

In the NAAFA survey, fat people mentioned teachers telling their parents to place them on a diet, teachers offering a prize if they would lose weight, and professors writing negative comments about their weight in letters of recommendation (Rothblum, et al 1989).

In the job market, many studies have found that fat people, especially women, are less likely to be hired, rarely promoted, and paid less than equally qualified people who weight less (Hatfield 1986:213). There are many examples of employees being fired for gaining weight or refusing to lose weight (Bennet and Gurin 1982:278). A survey of employers found that 16% said they would not hire a fat woman regardless of how qualified she was (Kolata 1986:93). Fat employees had lower paying and less prestigious jobs than their thin counterparts and they were more likely to be overqualified for the job and in a job that didn't involve the public (Rothblum et al. 1989).

In the NAAFA survey, of the 367 women and 78 men who responded, 60% of fat women and 40% of fat men (fat being 50% over average on the ideal weight charts) reported not being hired because of their weight, 30% were deprived of promotions and 25% were deprived of benefits such as health and/or life insurance. Nearly all those who responded said they were questioned about their weight on the job or urged to lose weight, even if they were only moderately fat or even at the recommended weights (Rothblum et al. 1989).

In Maryland, employers characterized fat workers as "lazy, lacking in self-discipline, sloppy, not well motivated, unclean, and in one instance, smelly" (Maryland 1977). In medical care: Many physicians are prejudiced against fat people in ways that affect their advice to patients and the quality of their care. "Most physicians responding to one questionnaire characterized obese patients as 'weak-willed,' 'ugly,' and 'awkward'" (Bennet and Gurin 1982:275).

Some NAAFA members said they stayed away from medical treatment because of these experiences or fear of injury and abuse because of the doctor's prejudice (Rothblum et al. 1989). A third of the fat men and women in the NAAFA survey were called negative names by health professionals because of their weight and one quarter were refused treatment because they were fat. Medical staff told them their illnesses were caused by being overweight regardless of their medical complaint and even before they were examined. They wrote about receiving rough treatment, verbal abuse and harassment. Several reported being misdiagnosed. In some cases a dangerous condition was ignored, or a fat woman told incorrectly that she was not pregnant, just fat. They were also refused birth control prescriptions or told to lose weight before coming back (Rothblum et al. 1989).

In the 1950s it was also a popular idea to consider fatness a psychological disorder. Even though the American Psychiatric Association has declared that obesity is not a psychological problem, the popular belief still remains that there is something defective in the character of fat people or an unresolved emotional disorder. Yet, as long ago as 1962, studies found no significant differences in the amounts of neurosis shown by fat people and those of normal weight (Bennet and Gurin 1982, Stunkard 1976).
Several researchers now believe that fat people often have poor self-esteem because they are constantly abused by a fat-hating society. They often find it difficult to maintain proper health care with a poor body image (Rothblum 1989).

"Feelings of sluggishness and of being 'weighed down' are at least partially a reaction to the culture's fat-hating, internalized and expressed in the "overweight" person as self-hatred. (Kelly 1983:10)

Women are more likely than men to be the recipients of this abuse. What this translates into in terms of socio-economic levels is a downward mobility for fat women. Fat women are more likely to be of lower status than thin women. Using the 1980 weight charts as a reference: 91% of lower-class women, 81% of all middle-class women, and 63% of all upper-class women are fat. (Kelly 1983:18) In addition, fatness for women results in downward mobility. One study showed that of the women who remained in the social class into which they were born 17% were fat. Among women who moved downward in social status, 22% were fat, and only 12% of those who rose in social status were fat. (Stunkard 1976:148)

Clearly obesity has become mythologized in our culture into something more than a physical condition or a potential health hazard. Being overweight is now imbued with powerful symbolic and psychological meanings that deeply affect a person's identity in the world. She is stereotypically viewed as unfeminine, in flight from sexuality, antisocial, out of control, hostile, aggressive (Millman 1980: xi).
Fat women are subject to pervasive and stringent discrimination that parallels that of members of minority groups. And fat women receive double punishment of fat prejudice and sexism.

In order to understand the problematic issue of women and weight in America, one must look at the symbolic study of the human body. This study has a long tradition in anthropology and sociology. Anthropologist Ted Polhemus in his article "Social Bodies," gives an analysis of what American and European anthropology contributes to our understanding of the body as a system of socially constructed meanings. Although his analysis begins with Charles Darwin and others who focused on expression and gestures, he credits Robert Hertz (1909), Marcel Mauss (1935), and Mary Douglas (1970) as having contributed the most to the focus on the human body "as it is transformed by its social environment and 'embodied' with social meaning" or the development of the "social body." (1975:28)

Mary Douglas in her book Natural Symbols begins with the assumption that "the social body constrains the way the physical body is perceived" (1970:65). She observed that the body is a natural symbol supplying some of our richest sources of metaphor. Polhemus explains:

[i]f Douglas is correct that "the human body is always treated as an image of society" then it follows that by examining a people's attitudes to the human body, and the definition of its boundaries, we should gain some understanding of the native informant's other body -- his social body, his society. (1975:28)

Drawing upon the work of Douglas and other earlier theorists, anthropologists Nancy Scheper-Hughes and Margaret M. Lock in their essay, "The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology" present three perspectives from which the human body may be viewed:

(1) as phenomenally experienced individual body-self; (2) as a social body, a natural symbol for thinking about relationships among nature, society, and culture; and (3) as a body politic, an artifact of social and political control. (1988:6)

They discuss the ways in which scientists and people from various cultures have "conceptualized the body" because "Western assumptions about the mind and body, the individual and society, affect both theoretical view-points and research paradigms" (Scheper-Hughes and Stein 1987:6). They begin with "an assumption of the body as simultaneously a physical and symbolic artifact, as both naturally and culturally produced, and as securely anchored in a particular historical moment." (Scheper-Hughes and Lock 1988:6) This premise is an important understanding for any analysis of the body within a culture. Without such an understanding of the cultural and historical context, such inquiries may fall prey to ethnocentric assumptions.

Although human bodies are part of the natural world, they do not come to us naturally. Robert Crawford explains:

As our most immediate natural symbol it [the body] provides us with a powerful medium through which we interpret and give expression to our individual and social experience...It is a vital foundation upon which behavior and values are predicated. Conversely, as a symbol of nature the body must be contained and transformed by culture. (1985:60)

Michel Foucault described the body as constantly "in the grip" of cultural practices. Susan Bordo, in her article "Anorexia Nervosa: Psychopathology as the Crystallization of Culture," clarifies:

Not that this is a matter of cultural repression of the instinctual or natural body. Rather, there is no "natural" body. Cultural practices, far from exerting their power against spontaneous needs, "basic" pleasures or instincts, or "fundamental" structures of body experience, are already and always inscribed, as Foucault has emphasized, "on our bodies and their materiality, their forces, energies, sensations, and pleasures." Our bodies, no less than anything else that is human, are constituted by culture. (1988:90)

This perspective is called the "lived body" or the body-as-experienced. An understanding that humans don't experience bodies outside of culture can release us from our misconceptions about what is "natural."

By understanding the subjective conditions in which the human body is experienced, one can pull back from the biomedical view of the body as objective reality and analyze the interactions between Western ideology, medicine, and the way American women experience their bodies.

Why are studies that promote dieting embraced while those that don't are shunned? Basic to the idea of Western medicine is the belief that medical science is an objective look at reality uninfluenced by social factors. In order to answer these questions one must reject the positivist notion of science and examine the way in which "Western scientific endeavor is a product of specific historical and cultural context" (Lock and Scheper-Hughes 1990:48). By focusing on the way all knowledge relating to the body, health and illness is culturally constructed we can see than biomedical researchers and other health care professionals share the same ideology as the rest of the populace. And wherever inequalities and hierarchy are institutionalized, biomedicine can become a way of imposing inequalities, "which is likely to inflict a negative self-image, distress, and often ill health on the underprivileged and disenfranchised" (Lock and Scheper-Hughes 1990:49).

And, unfortunately, the history of the biomedical system's treatment of women has often been enforced of the prevailing prejudices:

Medical science has been one of the most powerful sources of sexist ideology in our culture. Justification for sexual discrimination -- in education, in jobs, in public life -- must ultimately rest on the one thing that differentiates women from men: their bodies. Theories of male superiority ultimately rest on biology. Medicine stands between biology and social policy, everyday life... More generally, biology traces the origins of disease; doctors pass judgment on who is sick and who is well (Ehrenreich and English 1973:5).

The late nineteenth century was a time where the medical industry took more and more control of women's bodies. They defined all aspects of femininity as 'illness' and used this label of disease to command jurisdiction over women lives.

[This period] was obsessed with female sexuality and its medical control. Treatment for excessive "sexual excitement" and masturbation included placing leeches on the womb, clitorectomy, and removing of the ovaries (also recommended for "troublesomeness, eating like a ploughman, erotic tendencies, persecution mania, and simple 'cussedness'") (Bordo 1988:107).

This process, medicalization, involves the expansion of the medical "profession's power over wider spheres of life, especially deviant behaviors, replacing religious and legal actors and their modes of social control." (Crawford 1985:369). In this context, the medical system replaced the church as the primary enforcer of sex roles in America.

[The medical system] has unique authority to judge who is sick and who is well, who is fit and who is unfit. The presumed scientific basis of medicine lends credibility to these judgments, yet... the judgments themselves have no consistent basis in biology. (Ehrenreich and English 1973:83)

If Ehrenreich and English are right, then what is the underlying basis which structures the way Western medicine views women's bodies, and the way American's view fat and dieting?

Tied together in the way they shape American ideology about weight and weight loss is radical materialism, capitalism, Protestantism, and modern healthism.

If health is a metaphor for self-control, body weight is the metaphor within a metaphor. When people talk about health as a goal they are often describing their desire to lose weight. To be healthy is to be thin, literally to be 'in shape.'... At the same time, thinness is believed to be an unmistakable sign of self-control, discipline, and will power. The thin person is an exemplar of mastery of mind over body and virtuous self-denial. (Crawford 1985:70)

The unifying paradigm is Cartesian dualism which separates mind from body, spirit from matter, and real from unreal. Western epistemology beginning with Aristotle and Hippocates, is founded on a type of radical materialist thinking that separates the mind and body as separate, and opposing, elements of human existence. (Scheper-Hughes and Lock, 1988)

The natural/supernatural, real/unreal dichotomy has taken many forms over the course of Western history and civilization, but it was the philosopher-mathematician Rene Descartes (1956-1650) who most clearly formulated the ideas that are the immediate precursors of contemporary biomedical conceptions of the human organism... Descartes proceeded to argue the existence of two classes of substance that together constituted the human organism: palpable 'body' and intangible 'mind.' (Scheper-Hughes and Lock, 1988:9)

Thus Cartesian dualism became the "singular premise guiding Western science and clinical medicine." (Scheper-Hughes and Lock, 1988:8) Later "social thinkers as different as Durkheim, Mauss, Marx, and Freud" would build upon these concepts while holding that these oppositions were "inevitable and often unresolvable contradictions and as natural and universal categories." (Scheper-Hughes and Lock, 1988:10)

Yet, these categories are by no means cross-culturally accepted. There are those "non-Western civilizations that have developed alternative epistemologies that tend to conceive of relations among similar entities in monistic rather than dualistic terms." (Scheper-Hughes and Lock, 1988:11) Chinese, Islamic and Buddhist cosmologies differ greatly from Western thought in that they are holistic. The elements in these traditions are complementary rather than opposing forces.

Western thought is bound up in dual opposing forces, with one dominant over the other. Examples include the "symbolic and cultural dominance of reason over passion, mind over body, culture over nature, and male over female." (Scheper-Hughes and Lock, 1988:11) These beliefs are common themes through-out the development of both Capitalism and Protestantism, and later, healthism.
Western perceptions of the relationship of the individual to society are also bound up in these polar concepts:

Geertz has argued that the western conception of the person "as a bounded, unique...integrated motivational and cognitive universe, a dynamic center of awareness, emotion, judgment, and action...is a rather peculiar idea within the context of the world's cultures. (Scheper-Hughes and Lock, 1988:14)

Each person is seen as independent of, and often in opposition to, the greater society. Within the individual, the mind is also seen as separate from and superior to the body.

In cultures and societies lacking a highly individualized or articulated conception of the body-self it should not be surprising that sickness is often explained or attributed to malevolent social relations (i.e., sorcery), or to the breaking of social and moral codes, or to the disharmony within the family or the village community. (Scheper-Hughes and Lock, 1988:15)

Thus, it also follows, that within the highly individualized American culture, illness is perceived to be located in either the body or the mind. And that it is the responsibility of the individual mind to control the body. This "healthism" is a system where the individual is held morally accountable for the health of the body and the perceived amount of "self-control" is seen as a measure of the person's self-worth.

Health is discussed in terms of self-control and a set of related concepts that include self-discipline, self-denial, and will power... Whether in the name of health, fitness, or weight loss -- themes that become entangled -- some disciplined activity is usually mandated... Health is not a given; nor is it a result of good luck or heredity... Neither is it believed to be an outcome of normal life activities... Health must be achieved. (Crawford 1985:66-67)

It is assumed that a person is fat because they eat too much and do not exercise. People are especially disgusted with fat people because it is assumed that being fat is self-inflicted. Americans believe that if fat people would just diet and exercise, they would lose weight. They are considered deviant and weak because the person is seen as refusing to abide by the rules. "Failure...becomes a sign of a social, not just individual, irresponsibility." (Crawford 1980:379)

One possible explanation for this is an identification of the fat person as a failure of the system. The United States is a complex, stratified society where the class system is, theoretically, based on achieved status. Social mobility within this system is exemplified by the political ideology of the American Dream. The American Dream says that anyone can, and everyone should, be beautiful, rich, healthy, and happy -- if they just work hard enough. Fat people may be seen as refusing to conform to these American values (MacKenzie 1980). The old saying that one can "never be too rich or too thin" is part of the values of Capitalism and the Protestant work ethic.

Another important factor in examining how Western thought effects modern perceptions of fat in America is the tradition that identifies women as more "embodied" than men. Women then are seen to represent the body -- needs, desires, passion, weakness and lack of control. Conversely, men are seen as identified with the mind -- logical, intellectual, and in command. Women are seen as emotional and out of control -- bodies that must be controlled by men.

Even as American women in this century have moved to banish the idea of male superiority, they have at the same time embraced the idea of the mind over body. The conceptual framework of dual oppositions is still firmly in place and is in direct conflict with the ideas of equality and female power. This internal conflict within American culture is at the root of the obsession with weight and the behaviors of the dieting continuum.

Within a year of women's suffrage and of the first widely acceptable birth control, society adapted the popular notion of attractiveness as a "flapper" body, as "thin." Dieting books and articles increased -- and so did the number of cases of anorexia nervosa. As women entered the work place and other public sectors, the model woman of the 1920s was outgoing, assertive and "boyish."
The depression came and the ideal female figure, once again, returned to the more voluptuous image most cultures prize. In an era of food lines and shanty towns, self-induced starvation was no longer glamorous. There were not enough jobs for the men, let alone women. So if she had one to go to, women returned to the home. The curvy, big-breasted body remained the ideal through the World War II and into the 1950s when motherhood was a woman's career.

In the 1960s, women once again began to demand equal rights. As educational and occupational opportunities for women increased -- the size of the ideal woman once again decreased. Over the last thirty years, women have continued to strive for equal rights and the popular images of women have become increasingly out of reach. (Bennet and Gurin 1982, Chernin 1981, Schwartz 1986, Seid 1988)

The hipless and flat-chested midtwentieth-century version of the familiar feminine cult figure is one who comes closer in actuality to the real-life model of an adolescent boy still deep in his growing period than to that of a historically "normal" adult female: the lanky Seventh Avenue epigone with her narrow pelvis and unremarkable behind conforms in many ways much more closely to a male skeletal -- and adipose -- model than to a typically female one. (Beller 1977:58)

The larger, rounder image of a woman is associated with femininity as typified by motherhood. Femininity is still associated with nurturence, dependence, passivity, domesticity, and professional incompetence. Because of the assumptions involved in Western thought, female bodies are symbolic of a loss of control.

The cultural conflict between femininity and intelligence is particularly troubling for women who are insecure about their competence and how other people see them. Women who value achievement, higher education and professional careers, particularly male dominated careers, are especially likely to practice weight control to achieve a thin body type and the associated success that comes with it.

We live in a culture that values leanness in both sexes; if there is any lesson for feminists in this preference it may be that the ideal of feminine beauty has thus come increasingly, within the span of the past half century, to reflect a male ideal model in preference to a typically female one. The status assumptions implicit in this choice are interesting. People tend to ape their betters, and women's aspirations to the unmodulated physiques of men express unvoiced, and until recently probably largely unconscious, judgments about the nature of male status and privilege as compared to their own. (Beller 1977:57-58)

Hatred of fat is a fear of women. As American women strive for equality and start gaining independence, they are caught up in a paradox of female power and individuality in opposition to the ideas of femininity in Western thought. This dissonance is brought to harmony by a symbolic representation of female success as the achievement of maleness.

The dualistic mandate of mind over body is played out through women as they struggle to control and contain their own desires, feelings and, ultimately, bodies. The young anorexic or bulimic is her attempt to escape becoming female , is only taking the culture's own conflicts upon herself.

Far from being the result of superficial fashion phenomenon, these disorders reflect and call our attention to some of the central ills of our culture -- from our historical heritage of disdain for the body, to our modern fear of loss of control over our futures, to the disquieting meaning of contemporary beauty ideas in an era of female presence and power. (Bordo 1988:88)

In their shared expression of these cultural ideals, there is little difference between the woman who drinks a diet soda and the bulimic who vomits to remain thin. At every point on the dieting continuum, these women are using their bodies to mediate and express the American fear of women's bodies and female power.

Researchers have even found a direct link between the "sensible diet" and the development of eating disorders. Polivy and Herman found dieting almost a prerequisite for bingeing (bulimia) which promoted them to recommend that: "A dispassionate view suggest that perhaps dieting is the disorder that we should be attempting to cure" (1985:200).

In this social climate of repression and anxiety about women's bodies, the fat person becomes a focus for the Western fear of unrestricted femininity and unfettered nature:

For every historical image of the dangerous, aggressive woman, there is a corresponding fantasy -- an ideal femininity, from which all threatening elements have been purged -- that women have mutilated themselves internally to attain. (Bordo 1988:107)

All elements of America come together to uphold the ideal -- the mass media, medical community, diet and food industries, clothing manufactures, and other institutions reflect and perpetuate the ideal. Individuals are socialized into and enforce the fear of fat and the mandate of weight control as a form of social control that serves to mediate the ambivalence felt towards women's equality.
The emphasis on thinness in American culture not only oppresses fat women, it serves as a form of social control for all women:

Fat oppression doesn't just affect fat people or fat women. It really works to keep everyone in line. It's a whole system of social control that keeps thin women absolutely terrified of being fat or thinking they are fat, and a whole lot of energy goes into dealing with fat. It keeps women who are medium-sized absolutely panic stricken because they are right on the border. Those of us who are fat are over that border into some state of evil, basically, very much outside of what is permissible within white American culture. If you are fat, then what you are supposed to do is strive desperately to get non-fat. (Sanford 1984:372)

Social control goes beyond simply repressing deviants. Fundamental means of social control affect every person in the society. In addition, people at all levels participate in the regulation of society's demands. The oppressive attitudes towards women's bodies is not simply a matter of male suppression of women, but a matter of the entire social structure unified around an ideological framework.

The same is true for more moderate expressions of the contemporary female obsession with slenderness. Women may feel themselves deeply attracted by the aura of freedom and independence suggested by the boyish body ideal of today. Yet, each hour, each minute that is spent in anxious pursuit of that ideal (for it does not come "naturally" to most mature women) is in fact time and energy diverted from inner development and social achievement. (Bordo 1988:105)

Thus, the dieting continuum fed by rejection and fear of femininity, is in opposition to the very movement than spawned it. As long as American women strive to achieve a culturally mandated body type that is at odds with female physiology, they will be contained by the very ideology they are fighting.

[O]ur society can simply not afford to waste the energy that is being consumed in the frantic pursuit of unrealistic expectations for body size. Women must acknowledge to themselves and to each other that there is no freedom and no true liberation in a society that prohibits participation of a group defined by characteristics not amenable to individual control. (Dyrenforth et al. 1980:53)

The fear of fat and women's bodies are the symbolic expression of the conflict between the feminist movement and Western concepts of superiority of the mind over the body, and male over female. This struggle is played out in the symbolic interaction between the ideals of femininity and fat as associated with the body and maleness/thinness as representative of the mind and power. The dieting continuum is the means of social control that minimizes the impact of the women's movement by redirecting women's energies into the pursuit of a male body rather than male power.

From outside and within the very institutions that promote the ideal of thinness there has always been conflict. The medical community is a good example. Since the introduction of the weight charts from the insurance industry, there has been a strong undercurrent of dissent over their use for medical purposes. The dissenters in the field have obviously not won out, but thread of disagreement is strong enough that it has gained momentum and credibility over the years (Ernsberger and Haskew 1987). For example, in California a popular television and radio personality, Dr. Dean Edell has been very outspoken in contradicting popular notions of fat. He cautions people against weight loss programs and promotes good nutrition, exercise and self-acceptance for fat people. (Personal observation.)
Although resistance to the thin ideal has always been present in America, especially in the minority groups, it has also come out of the civil and women's rights movements in the last fifteen years. Beginning in the mid-seventies, at a time when many feminists were questioning all ideals of femininity, a small number began what is called the "Fat Liberation Movement." These so-called "fat activists" have gained in numbers over the years. There is even a national civil rights organization to protect the rights of fat people -- The National Association to Advance Fat Acceptance (NAAFA). This group, as well as many other smaller organizations, works to dispute popular notions about fat people and to promote legislation to protect fat people's rights. In the mainstream feminist front, The National Organization for Women (NOW) officially joined the resistance last year when it passed a resolution against size discrimination.

In the past ten years, there have been dozens of books and hundreds of articles challenging the thin body image and fat discrimination. Articles have appeared in such popular publications as Ms., Vogue, Glamour, Woman's Day, Time, Mademoiselle, New Woman, and Savvy. (Personal collection of articles.)

Medical and mental health care professionals are beginning to look at the social conditions surrounding the personal problems they treat. Conferences on eating disorders have begun to include speakers on the politics of body image. (Personal experience as speaker.)

Even the way people talk about the thin ideal seems to be changing. Deadly eating disorders such as anorexia-nervosa and bulimia have shown that there can be such a thing as too thin. People may now describe the very thin model as looking "anorexic." This doesn't have the same positive connotations as words like "slim" or "thin." (Seid 1989)

These changes may signal an attempt to solve the cultural conflicts around fat, femininity and power. Cultural definitions of the ideal body type are not static, but respond to forces in the society. The model female body has changed in the past and will likely continue to shift in response to attitudes toward women's bodies and what those bodies represent to the culture. As long as the conflict between feminism and Western thought remains unresolved, the hatred of fat and women's bodies is likely to continue. The health hazards and the failure of the dieting continuum, combined with the enormous pressure of discrimination and alienation perpetuated by the obsession with thinness in America, is a powerful form of social control over women. This endless battle with their own physiology channels much of their energies into an unproductive and dangerous pursuit of thin/male bodies rather than into the pursuit of real power within the society.

Atkins, Dawn
1988 Untitled investigative article on the diet industry. Unpublished, Santa Cruz, California

Bailey, Stephen M.
1982 Absolute and Relative Sex Differences in Body Composition. In Sexual Dimorphism in Homo Sapiens: A Question of Size. R. Hall, ed. Pp. 363-390. New York: Praeger.

Baker, Paul T., Joel M. Hanna and Thelma S. Baker
1986 The Changing Samoans: Behavior and Health in Transition. New York: Oxford Univ. Press.

Beller, Anne Scott
1977 Fat and Thin: A Natural History of Obesity. New York: Farrar, Straus, & Giroux.

Bennet, William and Joel Gurin
1982 The Dieter's Dilemma: Eating Less and Weighing More. New York: Basic Books.

Bordo, Susan
1988 Anorexia Nervosa: Psychopathology as the Crystallization of Culture. In Feminism and Foucault: Reflections on Resistance. Irene Diamond and Lee Quinby, eds. Pp. 87-109. Northeastern Univ. Press.

Brown, Peter J. and Melvin Konner
1987 An Anthropological Perspective on Obesity. Annals of the New York Academy of Sciences. 499: 29-46.

Chernin, Kim
1981 The Obsession: Reflection on the Tyranny of Slenderness. New York: Harper and Row.
1985 The Hungry Self: Women, Eating and Identity. New York: Harper and Row.

Crawford, Robert
1980 Healthism and the Medicalization of Everyday Life. International Journal of Health Services 10:365-388.
1985 A Cultural Account of Health: Self Control, Release, and the Social Body. In Issues in the Political Economy of Health Care. J. McKinlay, ed. Pp. 60-103. Londor: Tavistock.

Durnin, J.V.G.A.
1987 Energy Requirements of Pregnancy. The Lancet, October 17, 1987. Pp. 895-900.

Dyrenforth, Sue R., Orland W. Wooley and Susan C. Wooley
1980 A Woman's Body in a Man's World: A Review of Findings on Body Image and Weight Control. In A Woman's Conflict: The Special Relationship Between Women and Food. Jane Rachel Kapland, ed. Pp. 29-57. Englewood, New Jersey: Prentice-Hall.

Ehrenreich, Barbara and Dierdre English
1973 Complaints and Disorders: The Sexual Politics of Sickness. Old Westbury, New York: The Feminist Press.

Elgin, Suzette Haden Elgin
1990 Staying Well with the Gentle Art of Verbal Self-Defense. Englewood Cliffs, New Jersey: Prentice Hall.

Ernsberger, Paul
1984 Report on Weight-Loss Surgery. Bellerose, New York: NAAFA.

Ernsberger, Paul and Paul Haskew
1987 Rethinking Obesity: An Alternative View of its Health Implications. The Journal of Obesity and Weight Regulation 6(2):1-81.

Ford, Clellan S. and Frank A. Beach
1951 Patterns of Sexual Behavior. New York: Harper & Row.

Freedman, Rita
1986 Beauty Bound. Lexington, Mass.: Lexington Books.

Friedman, Abraham I.
1974 Fat Can Be Beautiful: Stop Dieting, Start Living. New York: Berkley Publishing Co.

Frisch, Rose E.
1988 Fatness and Fertility. Scientific American 258(3): 88-95.

Glamour
1984 Feeling Fat in a Thin Society. Glamour 2-82:198-201.

Hatfield, Elaine and Susan Sprecher
1986 Mirror, Mirror: The Importance of Looks in Everyday Life. Albany, New York: State Univ. of New York Press.

Hochman, Gloria
1983 Bad News for the Fat of the Land. Inquirer 10-16-83: 12-17.

Kelly
1983 The Goddess Is Fat. In Shadow on a Tightrope: Writings by Women On Fat Oppression. Lisa Schoenfielder and Barb Wieser, eds. Pp. 15-20. Iowa City, Iowa: Aunt Lute Book Co.

Keys, Ancel
1980 Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease.

King, Mary
1988 In the Eye of the Beholder. Savvy 8-88:76-77.

Kolatoa, Gina
1986 Weight Regulation May Start in Our Cells, Not Psyches. Smithsonian Magazine 16(10):91-97.

Lissner, Lauren, Patricia M. Odell, Ralph B. D'Agostino, Joseph Stokes III, Bernard E. Kreger, Albert J. Belanger and Kelly D. Brownell.
1991 Variability of Body Weight and Health Outcomes in the Framingham Population. New England Journal of Medicine 324(26): 1839-1844.

Lock, Margaret and Nancy Scheper-Hughes
1990 A Critical-Interpretive Approach in Medical Anthropology: Rituals and Routines of Discipline and Dissent. In Medical Anthropology: A Handbook of Theory and Method. Wesport, Connecticut: Greenwood Press.

` 1990 The Prevention Index '91: A Report Card on the Nation's Health. Emmaus, PA: Prevention Magazine.

MacKenzie, Margaret
` 1980 Fear of Fat: The Politics of Body Size. Unpublished manuscript. Berkeley, California.

Marketdata Enterprises
1991 The U.S. Weight Loss and Diet Control Market. Lynbrook, NY: Marketdata Enterprises.

Maryland Commission on Human Relations
1977 Report on the Study of Weight and Size Discrimination: As Directed by the Legislature of the State of Maryland in House Joint Resolution 75. Baltimore, Maryland: State of Maryland.

Mayer, Vivian F.
1983 The Fat Illusion In Shadow on a Tightrope: Writings by Women on Fat Oppression. Lisa Schoenfielder and Barb Wieser, eds. Pp. 3-14. Iowa City, Iowa: Aunt Lute Book Co.
1983 The Questions People Ask. In Shadow on a Tightrope: Writings by Women on Fat Oppression. Lisa Schoenfielder and Barb Wieser, eds. Pp. 23-35. Iowa City, Iowa: Aunt Lute Book Co.

Millman, Marica
1980 Such a Pretty Face: Being Fat in America. New York: Berkley Books.

New York City Department of Consumer Affairs
1991 A Weighty Issue: Dangers and Deceptions of the Weight Loss Industry. City of New York.

Polivy, Janet and C. Peter Herman
` 1985 Dieting and Bingeing: A Causal Analysis. American Psychologist 40(2):193-201.

Polhemus, Ted
1975 Social Bodies. In The Body as a Medium of Expression. Jonathan Benthall and Ted Polhemus, eds. Pp. 13-35. New York: E. P. Dutton & Co. Inc.

Roberts, Susan B., Judith Savage, W. A. Coward, B. Chew and Alan Lucas.
1988 Energy Expenditure and Intake in Infants Born to Lean and Overweight Mothers. The New England Journal of Medicine 318(8):461-466.

Rothblum, Esther, Pamela Brand, Carol Miller and Helen Oetjen 1989 Results of the NAAFA Survey on Employment Discrimination. Unpublished manuscript. Univ. of Minnesota.

Sanford, Linda Tschirhart and Mary Ellen Donovan.
1984 Women and Self-Esteem: Understanding and Improving the Way We Think and Feel About Ourselves. Garden City, New York: Anchor Press/Doubleday.

Scheper-Hughes, Nancy and Margaret M. Lock
1988 The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology. Medical Anthropology Quarterly 6-31.

Scheper-Hughes, Nancy and Howard F. Stein
1987 Child-Abuse and the Unconscious. In Child Survival: Anthropological Approaches to the Treatment and Maltreatment of Children. Nancy Scheper-Hughes, ed. Pp. 339-358. Dordrecht: Reidel.

Schwartz, Hillel
1986 Never Satisfied: A Cultural History of Diets, Fantasies and Fat. New York: Free Press.

Seid, Roberta Pollack
1988 Never Too Thin: A History of American Women's Obsession with Weight Loss. New York: Prentice Hall Press.

Stunkard, Albert J.
1976 The Pain of Obesity. Palo Alto, California: Bull Publishing Co.

Stunkard, Albert J., Thorkild I.A. Sorensen, Graig Hanis, Thomas W. Teasdale, Ranajit Chakraborty, William J. Schull and Fini Schulsinger.
1986 An Adoption Study of Human Obesity. The New England Journal of Medicine 314(4):193-198.

Toufexis, Anastasia
1988 Dieting: The Losing Game. Time 1-20-88:54-60.