University of California, Los Angeles, USA.
J Health Polit Policy Law. 2005 Oct;30(5):869-921. doi: 10.1215/03616878-30-5-869.
Despite recent and growing media attention surrounding obesity in the United States, the so-called obesity epidemic remains a highly contested scientific and social fact. This article examines the contemporary obesity debate through systematic examination of the claims and claimants involved in the controversy. We argue that four primary groups-antiobesity researchers, antiobesity activists, fat acceptance researchers, and fat acceptance activists-are at the forefront of this controversy and that these groups are fundamentally engaged in framing contests over the nature and consequences of excess body weight. While members of the fat acceptance groups embrace a body diversity frame, presenting fatness as a natural and largely inevitable form of diversity, members of the antiobesity camp frame higher weights as risky behavior akin to smoking, implying that body weight is under personal control and that people have a moral and medical responsibility to manage their weight. Both groups sometimes frame obesity as an illness, which limits blame by suggesting that weight is biologically or genetically determined but simultaneously stigmatizes fat bodies as diseased. While the antiobesity camp frames obesity as an epidemic to increase public attention, fat acceptance activists argue that concern over obesity is distracting attention from a host of more important health issues for fat Americans. We examine the strategies claimants use to establish their own credibility or discredit their opponents, and explain how the fat acceptance movement has exploited structural opportunities and cultural resources created by AIDS activism and feminism to wield some influence over U.S. public health approaches. We conclude that notions of morality play a central role in the controversy over obesity, as in many medical disputes, and illustrate how medical arguments about body weight can be used to stymie rights claims and justify morality-based fears.
尽管最近美国媒体对肥胖问题的关注度不断增加，但所谓的肥胖症仍然是一个极具争议的科学和社会事实。本文通过系统考察争议中的主张和主张者，考察了当代肥胖症辩论。我们认为，反肥胖研究人员、反肥胖活动家、肥胖接受研究人员和肥胖接受活动家这四个主要群体处于这场争议的前沿，这些群体从根本上参与了对超重的性质和后果的框架之争。虽然肥胖接受群体的成员接受身体多样性框架，将肥胖视为一种自然且在很大程度上不可避免的多样性形式，但反肥胖阵营的成员将更高的体重视为类似于吸烟的危险行为，暗示体重是个人可控的，人们有道德和医学责任来管理自己的体重。这两个群体有时将肥胖定义为一种疾病，这通过暗示体重是由生物或基因决定的来限制责任，但同时又将肥胖的身体污名化为病态。虽然反肥胖阵营将肥胖定义为一种流行病来提高公众的关注度，但肥胖接受活动家认为，对肥胖的关注分散了对肥胖美国人更为重要的健康问题的注意力。我们考察了主张者用来确立自己可信度或诋毁对手的策略，并解释了肥胖接受运动如何利用艾滋病活动家和女权主义创造的结构机会和文化资源，对美国公共卫生方法施加一些影响。我们的结论是，正如在许多医学争议中一样，道德观念在肥胖争议中起着核心作用，并说明了关于体重的医学论点如何被用来阻止权利主张和证明基于道德的恐惧是合理的。
