PCA, fat studies

Real Fat: The Disease Rhetoric of TLC’s Fat “Reality” Show

Please note that the medical language, disease language, and language of normalcy that is used throughout the paper is not mine, but the predominant language used by the medical community and the media to describe the relationship between fatness and thinness.

American culture views obesity as a curable disease, which is pathologized in both the physiological and psychological branches of medicine. Frequently, the medical community uses a rhetoric of disease to give credence to their stance that fatness equals ill health. The fear instilled by the psychological and medical communities has, in its most recent form, found its way into every American home through the programs shown on the Discovery network’s television channels, specifically on TLC: The Learning Channel. Because many Americans believe Discovery channels have expert authority and present information using an unbiased stance, it is especially troubling when they present information that is untrue and exploitive of large groups of people, as is the case with their many medical programs that deal with subject of obesity or fat.
Although the many Discovery networks have several different programs that highlight the “problem” of obesity, for me, the two most denigrating and propagandistic programs are Big Medicine and Inside Brookhaven Obesity Clinic. TLC has recently taken down the information for Inside Brookhaven, but I was able to find a description provided by TLC to another website called Associated Content. We learn: “This clinic is not for the average morbidly obese American but for what the television has dubbed the “super-sized obese.” The average weight, for those in this program, ranges from 400 to more than 800 pounds. Addicted to food, their struggle is an uphill battle. It is not the same as being addicted to drugs, alcohol, or cigarettes where some can stop entirely. With a food addiction you cannot stay away from eating.” In this paper, I will focus entirely on Inside Brookhaven Obesity Clinic, but the ideas and concepts can be used to analyze Big Medicine, as well as a variety of other shows on the Discovery channels in which fat people are exploited. By exploiting fat people through filmic manipulation and through the continual use of disease rhetoric, TLC’s Inside Brookhaven Obesity Clinic creates the fat equivalent of the horror film monster by fetishizing the body and instilling the fear that one day you, too, could be a fat kid. And that’s very bad. In fact, that may be the worst thing that could happen to you.
I started watching Inside Brookehaven because I read about the founder, Robert Kolman in an article in The New York Times, and I wanted to see if the program was, indeed, a venue that explored the real lives of fat people as the interview suggested. Kolman was motivated to found Brookhaven because he had a friend who died of “fat related complications,” and he wanted to prevent other “senseless deaths” of fat people. In the article, Dr. Butch Rosser said: ”Size discrimination is the last bastion of bigotry in this country, and the medical profession isn’t any more sensitive than anyone else. The people whose job it is to care for people, a lot of them have the attitude, ‘You deserve it.’ Right now, people with substance abuse issues get more respect and better health care treatment. Morbidly obese people get substandard medicine.” While Rosser borders on intelligently defining the nearsightedness of the medical community, he still compares fat people with addicts and uses the terminology “morbidly obese.” Though he attempts to deride his colleagues for their poor treatment of fat people, he simply rearranges the stigma and treats fatness in the same category as drug addicts.
Similarly, the doctors at Brookehaven convince their patients that their eating habits are addictions, which must stem from some mental instability or psychological need, and they are encouraged to visit the clinic’s psychological counseling facility. In his work “The Size Acceptance Movement and the Social Construction of Body Weight,” Jeffery Sobal writes: “The rise in emphasis on thinness was accompanied by a parallel rejection of fatness. Obesity became a stigmatized condition, a discredited characteristic that was perceived as a moral failure of fat people.” He continues later in the essay to write: “the medical community accelerated the medicalization of obesity and increased its attention and efforts to encouraging weight loss to enhance health and prevent illness…Other professions such as psychology began to intrude into medical turf, bringing different concerns and therapeutic perspectives about eating disorders and body image that conflicted with the physiological focus of the biomedical model.” As Sobal suggests: in the medical community, if being fat is not a physical problem, then surely it must be a mental one. Kolman thinks he is doing a service for fat people; however, the idea that fat people need a cure is problematic to begin with, but even more offensive is the way that Inside Brookhaven is filmed.
In his book New Developments in Film Theory, Patrick Fuery describes the gaze: “No longer is the gaze just a term for perception, but now includes issues such as subjectivity, culture, ideology, gender, race, and interpretation.” I add body size into the mix, as I follow Fuery’s argument that “the gaze is fundamentally about the formation of certain relationships between the spectator and the film.” If the gaze is fundamentally about forming relationships, what relationship is TLC suggesting between the viewer and the fat object of the viewers gaze? As Fuery continues to tease out his understanding of gaze, he quotes Freud: “the scopophilia instinct is auto-erotic; it has indeed an object, but that object is part of the subject’s own body.” To answer the above question: TLC is suggesting a relationship of fear of fat while constantly reminding the viewer that she, too, is one step away from obesity, immobility, or hospitalization; that fatness lurks forebodingly under the surface of the viewer’s otherwise “normal” façade. While the idea of Inside Brookhaven seems to be to treat the “whole patient,” the camera angles used frequently dissect the people into pieces of fat body parts and fatty tumors. Fat people are literally reduced to their fattest body parts and those parts are repeatedly filmed in isolation as they seek medical attention for their psychological and physiological “disease.”
Imagine the best horror films: Dracula, The Mummy, Silence of the Lambs, or any other well-known horror film. How are they filmed? Fetishistically. By separating the facet of the monster that scares the viewer or the facet that denotes that the monster is, in fact, a monster from the rest of the monster’s body, the cinematographer both highlights the monster’s freakishness and forces the audience to fear those abnormal parts of the monster’s existence. So, then, how does the cinematographer make the audience believe that the monster is real? By quickly focusing first on the fetishized body part and closing in on the abnormality, then panning back and forth between a far shot of the entire person and close-ups of the monstrous portion of the person, the desired effect of realism is achieved. The viewer learns that the monstrous portion of the body is but a small facet, so his empathy is increased. How does the film instill fear in its viewers? If the cinematographer can convince the viewer that the monster is scary and real, then the viewer begins to notice the parts of his own body (or persona) that resemble the monster. Once the viewer is convinced that her own body contains the abnormal facets of the monster’s body, the viewer becomes afraid that she, too, may become a monster, or may be absorbed in monstrousness.
For example, in virtually any version of Dracula, the monster’s canine teeth, usually dripping with blood, are filmed at close range. By seeing the teeth closely, the viewer recognizes that the teeth are the abnormal facet of the monster—the one which she should fear. The cinematographer then toggles between close-ups of the teeth to longer shots in which the viewer can sympathize with the humanity of the monster. Once that common bond is established, the viewer is implicated in Dracula’s crimes, but she also begins to question the presence and size of her own canines. She may even wonder if she is more like Dracula than she would like to admit.
Similarly, Inside Brookhaven captures the patients at the Rehabilitation Center in a horror-film-like presentation. In each episode, the portrayal of the main person is presented in such a way that the person becomes a monster at whom the viewer is invited to gaze and cautioned not to become. For example, in the first episode of the program, a man who the narrator repeatedly calls “Six hundred pound Bill Surrat” is first filmed from above as if being examined under a microscope. As he is being shown from every angle, we learn his story: he was a firefighter, wanted to be a police officer, was unable to control his weight, and was put in a desk job because he couldn’t pass the physical to be a field officer. Once we learn his story and are able to sympathize with him, the way he is filmed changes. He is no longer figured as a whole person, but he is broken into pieces: his oxygen tube, the fat on his arms, the computer resting on his belly which is exposed because the sheet is too small to cover him, and the skin on his sides hanging over the “specially made, extra-large bed.” Slowly, the way Surrat is filmed transforms him from more of a human to more of a monster, as we are encouraged to see him, see his fat, recognize our own bodies, and be afraid that our own bodies harbor the potential to become fat, too.
As if allowing his patients to be filmed and portrayed as monsters is not enough to make viewers question the intent of Dr. Robert Kolman, perhaps his insistence on the diseased status of fat people should be able to convince them. Throughout the second episode, along with being filmed and portrayed as I have described, a second man, George Cuadrado, is described as having a “deadly dependency” on food. As his medical diagnosis is being narrated, the viewer sees only small snippets of varying parts of George’s body: large fat deposits on the insides of his legs as he walks down a narrow hallway (a camera shot that in the time conscious world of television last over thrity seconds), the large amounts of food he ravenously shoves into his mouth, which subsequently spills back out and lands on his shirt, and a nurse lifting layers of his excess as she bathes him. Interestingly, Cuadrado is feminized in this manner, as well, and although it is not the focus of this paper, it is worth mentioning that the viewer is privy to a full frontal nude shot of a male, whose genitals are masked by his excess. Would TLC show a full frontal nude shot of a thinner man?
All of this happens as we listen to Kolman instructing us about the dangers of obesity, and if it we aren’t convinced by now that being fat is bad, the camera man focus in so close to Cuadrado that we can see his pores and we hear him say: “If I don’t stay, I’m not going to die; I’m going to kill myself.” He implies that he will literally eat himself to death: “Food is my crutch.” Food is presented as the solution to a psychological problem. Kolman and his patients consistently employ a language of death, morbidity, and disease when they talk about food, bodies, and consumption.
Similarly, Kolman extends the fear of fat beyond the parameters of the specific fat person’s body by delving into the eating habits of the patients’ families. By extrapolating the implications of the disease of obesity outside the patients’ body, Inside Brookhaven completes the cycle of the gaze and indicts the viewer in the monstrosity of fat. We come to believe that the patient is diseased, his family is diseased, and we could be, too. This again works like a vampire movie: first there is one vampire, then there is a group, and then they are knocking on the doors of every person trying to change them into vampires as well. If not only the patient is fat, but her children are also fat, then maybe hiding inside each of us watching, there is a fat person and one false move will cause us, too, to become TLC’s next monster.
But, perhaps I am taking it too far. Perhaps Inside Brookhaven is not received in the way I suggest. However unfortunate, it seems that the program is having the effect desired by Kolman and others. In an online forum called TWoP Forums, user lilith 1930 writes: “Shows like these are such a good incentive for my diet. I never want to eat again when I’m watching them. What happened to taking personal responsibility for your health? Of course, there are glandular and genetic factors you have no control over sometimes. But most of these people have eaten themselves into this state through buckets of fried chicken and entire pizzas. Who has been paying for Dennis to sit on his ass eating take-out food for 3 years? If it’s insurance, wouldn’t they want to see progress, and not reversal? I was glad that one doctor refused to do the gastric bypass on that woman. She clearly hasn’t addressed her food issues and learned to eat properly yet, she was going to rely on the surgery to do it for her. I’ll have to remember to catch this next week, too.” Lilith buys right into the idea that over-consumption is the reason for the patient’s obesity, and that if she eats too much, she will become undesirously fat.
Similarly, another user on the same forum, lambie, writes: “Oh Christ, I can’t believe this show exists. Does TLC do any shows besides ones on gastric bypass and the morbidly obese? I can’t decide if their philosophy is “let’s all watch the freak show” or if they think they’re really helping people. I haven’t seen it yet so I’ll try to remain optimistic that it’s a little more objective than other shows they’ve had on this subject. It’s encouraging to hear that someone was refused gastric bypass on the show. The surgery has become way too common and it’s being abused from the “tool” it was developed to be. I know 2 people who gained weight in order to qualify for it because they thought it was the easy way out. I know another who died a week after from complications, and several more who have all regained significant amounts of weight 1-2 years post-surgery. TLC never seems to show that side of the story though. If anything, knowing this show exists will hopefully incentivize me, like Lilith to stay on my diet and keep exercising. Ultimately I’m in charge of me and I refuse to hand the blame or the credit off to someone else for my weight.” On the first read, I was almost encouraged because it seemed like Lambie was resisting the urge to join in supporting the too frequent prescription of the gastric bypass, but as I reflected on the post, I recognized that Lambie, like Lilith was scared into dieting to attain a culturally constructed level of beauty. Seeminlgy, TLC and Kolman have succeeded in horrorizing the fat body and thereby instilling fear in the patrons of the television show.
While it is already problematic to equate fatness with ill health, as Jeanine C. Cogan suggests in her article “Re-Evaluating the Weight-Centered Approach toward Health,” “Obesity and eating disorders are not objective and value-free categories; their definitions and meanings are culturally produced…our shared understanding of obesity is that it is a public health threat in need of treatment and prevention.” She later writes that, “a central belief about obesity is that it is self-induced through overindulgence, gluttony, and laziness, which allows us to blame the obese individual.” Basically, throughout her essay she argues that obesity, and specifically the language of disease surrounding obesity, is culturally constructed without a substantial basis for the construction. Couple the fear instilled by Inside Brookhaven with a vague, culturally constructed belief that thin is beautiful and fat is not, and we end up with a general public that worries that fat, which equals ill-health and non-beauty, may one day happen to them.
By combining the filming techniques of horror films, and a language that the American public concedes to as medical, TLC has produced in Inside Brookhaven a program that instills a fear of fat and fat people in the American public. Again, what is worse in American culture than being fat? We know of course, that it is being forced to fear fat and fat people because of false assumptions made by the medical community, and being exposed to programs like those on TLC and the other discovery channels that pathologize fat; thereby, further instilling a horror-film-like fear of fat bodies into the psyche of America. I think it is time to drive a wooden stake through the heart of Inside Brookhaven Obesity Clinic and shows like it.

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