AN ETHNOGRAPHIC STUDY OF THE AMERICAN FAT-ADMIRING COMMUNITY By ASHLEY N. VALDES UNIVERSITY OF FLORIDA 2010 TABLE OF CONTENTS ABSTRACT……………………………………………………………….……………..……….3 INTRODUCTION………………………………………………………………………………...4 LITERATURE REVIEW…………………………………………………………………………6 METHODOLOGY……………………………...……………………………………………….13 FINDINGS……………………………………………………………………………………….15 CONCLUSIONS………………………………..……………………………………………….20 BIBLIOGRAPHY………………………………………………………………………………..21 APPENDIX A – INFORMED CONSENT FORM……………………………………..……….24 2 ABSTRACT This paper is an ethnography of the American fat-admiring community. Fat admirers (FAs) are individuals who prefer overweight and/or obese sexual partners. Big Beautiful Women (BBWs) are the object of FA’s affection; they range in size from overweight to obese. This study explores two main ideas: terminology and classification within the group, and the group’s interactions with the medical community. Based on 13 semi-structured interviews, 7 key terms used in the community were identified and described. Anecdotal evidence of mistreatment of FA/BBWs on the part of the medical community was also collected. This study was conducted using semi-structured interviews with 13 interviewees (11 interviewed separately, and 2 interviewed as a couple), who were present at a convention for Fat Admirers and Big Beautiful Women. Although there are homosexuals in the FA community, as well as reverse-role couples (Female Fat Admirers and Big Handsome Men), all the interviewees were heterosexual and belonged to the FA/BBW pairing. This exploratory study revealed key terms and the impact of labels in the FA/BBW community. Also mentioned were concerns about size discrimination, the Fat Acceptance Movement, and the mistaken labeling of fat-admiring as a fetish or paraphilia. Interviews also provided the basis for further work in dealings with the medical community. Many interviewees mentioned the Health at Every Size Movement, and derided the notion that obesity alone, in the absence of nutrition and exercise factors, is solely responsible for many diseases and medical conditions. Further exploratory work should be conducted to understand interactions of FA/BBWs with the medical community in order to bridge the communication breakdowns that interviewees often mention when conversations with doctors turn to weight. 3 INTRODUCTION In the past half-century, we have seen a shift in American culture towards “thin” as the ideal body type. Multiple studies (Brumberg 1985; Killian 1994; Gremillion 2002) exist that examine the relationship between American cultural ideals of beauty and the psychosomatic response from the female public in the form of eating disorders. The focus on “thin” has both a cultural and medical component. “Thinness” has been reified medically; there are adverse health consequences to obesity with concomitant increased costs to health care delivery. The government has issued measurements of Body Mass Index (BMI) to calculate approximately healthy weights for people of different heights, ranging on a scale from below 18.5 (underweight) to 30 or higher (obese). According to this scale, 31% of the American population was categorized as obese as of 2000. The Center for Disease Control and Prevention (CDC) estimates that $78.5 billion was spent on healthcare for obese adults, half of this expense being covered by Medicare and Medicaid. Obesity is also tied in causality to cardiovascular disease, diabetes, and other illnesses (Centers for Disease Control 2009). If all the compiled research points to obesity as a detriment to good health, why is the percentage of obese Americans so high? There are social, economic, and biological factors to consider. For impoverished families, fast food restaurants offer cheap, calorie-dense food with little nutritional value (Hill & Peters 1998). There is also the tendency of neighborhood racial composition to play a role in prevalence of obesity (Boardman et. al 2005). Individuals may also inherit genes that cause them to become or remain overweight (O’Rahilly & Farooqi 2006). But, we have failed to consider the segment of the population that wants to be fat: an American subculture known as Fat Admirers (FAs). FAs are a group that embraces obesity as both a sexual preference and a way of life. They are largely unstudied; no formal research on their subculture 4 is available. The only research related to the topic are studies of fat preference in nations where this is the norm. The country of Mauritania is one such example, where nubile girls are forced to gain weight to be marriageable (LaFraniere 2007). The particular interest of American FAs is their presence in a culture that views being overweight in a decidedly negative light. The main goal of this research is to gain a basic understanding of FA/BBW culture. Using language as a barometer of cultural understanding, this work identifies key terms used in the community. Given the medical attention on obesity and the potential clashes that the medical community may have with the FA/BBW community, another stated goal of this research is to gather qualitative data involving FA/BBW’s experiences with medical practitioners regarding weight. Interviews within the community will also inform questions for further study. This project is significant because while we know of economic, social, and biological reasons for obesity, we do not fully understand cultural reasons for obesity in America. This ethnography is a necessary step in beginning to identify this unstudied phenomenon. To gain perspective on interrelated problems, such as the prevalence of obesity in America and discrimination against obese individuals, we must first better understand the perspective of those individuals who value their excess weight as an intrinsic part of their sexual life. Also, this study can impact treatment plans for obesity. In appreciating the cultural value of obesity for members of this group, we can offer them better health care intervention and delivery regarding obesity. After identifying patients as FAs, doctors can pursue other areas of overall fitness for these patients that do not necessarily include weight loss. This paper examines relevant literature regarding risk factors for obesity, followed by a description of the research methodology. Findings are presented in two categories: definitions of terms, and quotes and anecdotes from interviewees that describe issues that arise in the 5 community. Conclusions will include overall impressions of the community and future research based on these findings. LITERATURE REVIEW There is little to no formal, methodological evaluation of the fat-admiring community in the Western world; hence, the exploratory nature of this research. The literature review for this research draws instead on three main ideas: the social and economic costs of obesity, the risk factors for obesity, and the Health at Every Size movement. Understanding the socioeconomic costs of obesity is a necessary precursor to relating to the types and sources of discrimination that those in the fat-admiring community are subject to. Risk factors for obesity give us a rough profile of the types of individuals that may be part of the fat-admiring community. The Health at Every Size Movement (HAES) is an important concept in the fat-admiring community because it states that individuals can be healthy despite being obese, therefore dismissing the healthcare costs of obesity; which, in turn, is intended to diminish (often unsuccessfully) the social costs of obesity by dispelling the stereotype that obese individuals are a burden or drain on society. Obesity is defined as having a Body Mass Index (BMI) of greater than or equal to 30. Often lumped in under the catch-all term of obesity are categories of “overweight” and “extreme” (or morbid) obesity. Overweight describes an individual with a BMI of 25 to 29.9, and extreme obesity is characterized by a BMI of 40 or greater. BMI is calculated as (weight in kilograms)/[(height in meters)2]. Different names for these categories are used by the World Health Organization (WHO), which subdivides obesity into Class I and Class II based on BMI, and labels extreme obesity as Class III. The 2005-2006 National Health and Nutrition Survey, administered by the Center for Disease Control (CDC), showed that for Americans age 20 to 74, overweight rates had held steady at 6 near 35% of the population, but obesity and extreme obesity rose by 11.4 and 3 percentage points, respectively, since 1988. Another study estimates that approximately 130 million American adults, or 64% of the population of adults in the US, are overweight. (Morrill and Chinn 2004) Being overweight or obese is more than a cosmetic issue in the US; it is associated with a plethora of physical health risks. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), cardiovascular disease, type II diabetes, high blood pressure, stroke, gout, sleep apnea, gallbladder disease, osteoarthritis, and many types of cancer are all associated with obesity. Beyond the associations with physical ills, there are also detrimental psychological effects to contend with for those individuals living in societies where excess body fat is seen as unattractive, gluttonous, and/or lazy. In Richardson’s study of children’s reactions to handicap, a group of elementary school children were asked to rank pictures of children in order of who they liked best. The child with no physical handicap was always preferred, and the other drawings, which