Skip to content

Big Bother —

August 19, 2013

Weight LossFat HealthExerciseWeight Loss SurgeryDiet Talk

Shriver

Author Lionel Shriver

One month ago today, my wife and I were listening to Here and Now on NPR when we heard this interview with author Lionel Shriver, author of the novel Big Brother. The first thing I noticed was graphic descriptions of the 400-pound main character, Edison, as read by Shriver:

It took some doing to get the front passenger seat of our Camry to go back to the last notch. Climbing inside, Edison braced one hand on the door. I worried whether the hinges could take the stress… He lowered himself into the bucket seat with the delicacy of a giant crane maneuvering haulage from a container ship. When he dropped the last few inches, the chassis tilted to the right. His knees jammed the glove compartment, and I had to give his door an extra oomph to get it shut.

My wife is nearly the same size as this character, and we both found the description both laughable and sad. At no point would this describe Veronica’s experience of getting into a car, and yet as host Robin Kelly said, “that’s one of the prettier descriptions of Edison.”

I haven’t read the book, but I read a ton of professional and Goodreads reviews. I also read the first chapter in Shriver’s interview with Diane Rehm and the next three chapters in this NPR exclusive excerpt. The main character of the book is Edison’s sister, Pandora, who has talked her husband, Fletcher, into letting Edison, a down-on-his-luck jazz pianist, stay with them for a while. And when Pandora picks up Edison at the airport, this is how we meet him.

We hear a woman and a man complaining about the enormous passenger they sat beside on the plane. Finally, the woman says, “By the way, on the plane with that guy, what I really couldn’t stand? Was the smell.” And then, unbeknownst to Pandora, her brother enters:

I was relieved the woman’s suitcase had arrived, since the pariah whom she and her seatmate had so cruelly disparaged must have been the very large gentleman whom two flight attendants were rolling into baggage claim in an extra-wide wheelchair. A curious glance in the heavy passenger’s direction pierced me with a sympathy so searing I might have been shot. Looking at that man was like falling into a hole, and I had to look away because it was rude to stare, and even ruder to cry.

Greg

Lionel Shriver’s brother, Greg.

Edison is based on Shriver’s real-life brother, Greg, who gained nearly 200 pounds after two accidents left him physically disabled. Shriver wrote an infamous article back in 2009, originally for Standpoint and republished in The Guardian. The article was critical of Fat Acceptance (FA) and Health at Every Size® (HAES), and included a detailed account of her brother’s rapid decline in health. Ten days after being rushed to the hospital for dangerously low oxygen levels, and hours after filing her story, Greg died of a cardiac arrest.

To a certain extent, I understood Shriver’s hostility toward FA and HAES, even though Greg was not explicitly a believer in either movement. I understand why people think FA and HAES are promoting unhealthy lifestyles, since the societal assumption is FAT = UNHEALTHY, and therefore Fat Acceptance makes no more sense than Smoking Acceptance. But the reality is that FA and HAES are two separate movements: FA defends the dignity and respect of people regardless of their size and/or health and HAES teaches people of all sizes how to become healthy without resorting to draconian diets and unrealistic expectations. So what bothered me about Shriver’s takeaway was when she says at the end, “My brother is eating himself to death. I love him dearly, and I can’t support any political movement that would have him believe he can be ‘healthy at any size’.”

Likewise, in the Here and Now interview, she said, “I don’t know where the AMA saying that obesity is a disease is that helpful, but I do think that at least that says no, you can’t be healthy at any size. This is a disorder, and your body doesn’t work as well when you’re carrying a huge amount of fat.”

So on top of the morbid, stereotype-driven descriptions of Edison, I bristled at the fact that Shriver denounced HAES based on a deeply-flawed interpretation. Were that the end of the story, I would have just written an open letter excoriating Shriver for her uninformed opinion. But then, I noticed some other things Shriver wrote and said about fat people that gave me pause.

For example, on the Here and Now interview, immediately after her comments on the AMA and HAES, she said this:

On the other hand, I would like us to start distinguishing between the aesthetic and the medical, and I think that in this culture we get them confused. It’s one thing to say, you know, if your BMI is over 30, then you’re going to be in better health if you’ve dropped some weight. But it’s quite another to say, you know, if your BMI is over 30, you’re unsightly, and I don’t want to look at you.

In effect, and possibly without knowing it, Shriver was teasing out the differences between FA and HAES, and saying she could support FA, but not HAES. Fair enough. And then I read her recent column in The Telegraph, and I found quite a bit to like about her opinions. Like this:

So perhaps one solution to our present-day dietary woes is to restore a measure of casualness about daily sustenance that’s gone missing. For this is not one more essay urging you to cut down on processed foods and hit the treadmill. Such ubiquitous, hectoring articles may be making the so-called ‘obesity epidemic’ worse. Our obsession with diet is backfiring. We think about food too much. We impute far too much significance, sociologically, psychologically and morally, to how much people weigh. Worst of all, we impute too much significance to how much we weigh ourselves. Unrelenting self-torture over poundage is ruining countless people’s lives, and I don’t mean only those with eating disorders.

And this:

It’s heartbreaking how many people hate themselves sometimes over gaining just a few extra pounds, allowing nagging weight issues to destroy not only the pleasures of the table but their ability to enjoy anything.

And this:

Righteous calls for caloric moderation still encourage us literally to navel-gaze, still urge us to consider what we eat and weigh as a verdict on our worth and decency, thereby reinforcing a grotesque sense of disproportion that may not be merely part of the problem, but the problem.

That’s not to say the article is without problematic, like how her own personal eating habits involve eating once a day so that she feels “deserving” enough. But what I did see was the seedling of HAES embedded in her seemingly-evolved beliefs. She appeared to be calling for an end to the War on Fat and the tyranny of weight loss as moral quest. She appeared to be calling for a normalization of eating habits, one of the central tenets of HAES.

I sensed an ambivalence in Shriver’s opinion between contempt for Fat Acceptance and her tempered call for a truce in the War on Fat. And it was this ambivalence (and Veronica’s recommendation) that prompted me to send an email to Shriver’s literary agent requesting an interview. I explained our blog and the intent of the interview, not expecting a serious author to take a request from Fierce, Freethinking Fatties seriously. But she responded to me directly and agreed to an email interview.

So, after explaining that I had only read the excerpts, interviews and reviews, I sent her a list of detailed questions about her book and her opinions, attempting to get to the heart of the issues I saw. Shriver responded almost immediately, citing her concern that I hadn’t read the book and that my aggressive questioning would make her appear defensive. My intent was to be direct, but not a dick, though I’m not sure how successful I was. I have put Shriver’s answers in bold green to distinguish from my questions.

The Interview

In 2009, you wrote for Standpoint magazine about your 330-pound brother, Greg, who died of a cardiac arrest just an hour after you filed your article. You wrote about how he was eating himself to death. You describe the catalyst for Greg’s weight gain as follows:

Having been beaten up with a metal baseball bat in 1998 and broadsided by a careless driver while on his moped two years later, he boasts that his body clinks with “24 pieces of titanium” that set off alarms at airport security. The resultant chronic pain has made it impossible for him to exercise. The fact that my brother is fat is not, altogether, his fault.

However. He also eats too much.

Big BrotherFrom what I’ve gleaned, your brother developed many of his obesity-related health problems after this point, when he was no longer able to exercise. You mention in that article that Greg’s blood sugar was high and that he developed type 2 diabetes. I’m curious what his lifestyle was like prior to the accident. Was he physically active? Did he have a healthy diet? Aside from losing his ability to exercise, were there other marked changes in behavior, including his diet, that contributed to the development of those diseases, as far as you know?

I have to say up front that I’m not sure about combing over the details of my real brother’s medical files (to which I have never been privy) and his lifestyle.  For what it’s worth, no, he wasn’t ever big on exercise, though he was once vigorous.  I can’t testify to what he ate exactly, though he wasn’t into fast food, and he was a pretty good cook.  The food he ate didn’t change; he just ate more of it.

You also mention that Greg was a heavy smoker, and smoking exacerbates a diabetic person’s blood sugar (Time has an excellent article on this). Several of the book reviews pointed out that Edison, the eponymous big brother of your book, is also a smoker, but that his sister, Pandora, does not address this habit. Given that smoking is the most potent risk factor for cardiovascular disease, why ignore Greg/Edison’s smoking habit in your writing while zeroing in on his weight? Along these same lines, you repeatedly say that Greg died from obesity when there were obviously multiple contributors to his poor health, including smoking, uncontrolled diabetes and being sedentary due to disability. Why continue to emphasize that it was his weight that killed him, rather than a confluence of factors?

Let’s not confuse the character in the novel, Edison, and my real brother Greg.  Note that I have always said that my brother died “from the complications of morbid obesity,” and not from obesity itself.  Clearly smoking didn’t help.  But you don’t order your older brother to quit smoking.  It doesn’t work.

In the novel, Pandora reluctantly decides to take on only one of Edison’s dependencies at once.  Expecting him to go on an all-liquid diet and quit smoking at the same time would be a bridge too far.  (She knows he would simply refuse.)  But it’s not a pro-smoking book!

It appears to be important to you to dissect my brother’s medical history in such a way that he seems to have died from complications completely unrelated to his weight.  That just isn’t the case.  He wouldn’t have been in the hospital to begin with had he not had sleep apnea, which was definitely related to his size.  But I’d be the first to concede that smoking contributed considerably to his poor health.

In the Standpoint article, you also say the following regarding Health at Every Size (HAES):

Authors such as Marilyn Wann (Fat? So!) and Linda Bacon (Health at Every Size) challenge the assumption that fat is a problem. For the two-thirds of Americans now overweight or obese, their message is beguiling: being heavy does not equate with being unhealthy. What’s really required, they argue, is a cultural attitude shift, whereby we stop sneering at the obese as over-indulgent slobs, accept the high-calorie habit as a defensible lifestyle choice and expand our aesthetic to embrace fat as beautiful.

I have never seen either woman teach people to “accept the high-calorie habit as a defensible lifestyle choice,” except to say that we all have the right to make our own health choices. In their books, both women make a vigorous case for exercise and a healthy, balanced diet as the path to long-term health. So I have to ask: have you ever read the work of Wann or Bacon, whether books or articles? Because it seems like you’re making an argument against HAES based solely on the name, rather than the principles as taught.

Afraid I find the distinction between “accepting the high-calorie habit as a defensible lifestyle choice” and arguing that “we all have the right to make our own health choices” rather slight.  Have I read those books?  No.  But have you read my book?  By your own admission, no.  So if I make assumptions about the content of books that I have merely read about, perhaps you also make assumptions about mine.

On a side note, you seem conflate HAES with Fat Pride or Body Acceptance. HAES is not concerned with aesthetics. HAES is about encouraging healthy behaviors regardless of whether they makes you thin or not. The two movements overlap, but HAES is strictly about health, not beauty.

The column you quoted from also cited the Fat Pride movement, so any assertion about aesthetics pertained to the larger umbrella of fat activism.  I’m not–and wasn’t in that article–especially concerned with what each faction specifically advocates.  What I am concerned with?  That much of the hectoring about how being overweight is “unhealthy” is a disguise for aesthetic prejudice.  I just published a long essay on this point in the 30 July 2013 Washington Post.  The whole conversation about body size mixes up health and beauty in a way that is dishonest, and I can certainly see why that makes heavy people mad.

Ironically, some of the recent things you’ve written have a ring of HAES to them, at which point I find myself nodding my head vigorously. For instance, in the Telegraph you wrote:

So perhaps one solution to our present-day dietary woes is to restore a measure of casualness about daily sustenance that’s gone missing. For this is not one more essay urging you to cut down on processed foods and hit the treadmill. Such ubiquitous, hectoring articles may be making the so-called ‘obesity epidemic’ worse. Our obsession with diet is backfiring.

We think about food too much. We impute far too much significance, sociologically, psychologically and morally, to how much people weigh. Worst of all, we impute too much significance to how much we weigh ourselves. Unrelenting self-torture over poundage is ruining countless people’s lives, and I don’t mean only those with eating disorders.

This sounds like the HAES that I promote. HAES is about normalizing our relationship with food, rather than treating it as a crisis or a crutch. This is why the National Eating Disorder Association promotes HAES as a treatment for those with eating disorders. In fact, one of our bloggers, Dr. Deah, wrote an article explaining the advantages of HAES in treating EDs.

If you had read the book, you wouldn’t find those passages surprising.  Moreover, the nonfiction essays I have published in concert with this novel’s publication have universally called for the restoration of sanity in relation to food and body size.  As I indicated in our correspondence, we are not on opposite sides!  Check out the essay I wrote for the Guardian, in which I despair: “We have bought into a new materialism even more demeaning and superficial than the old kind, whereby the good life meant ownership of a slick make of car.  Now we are the material.  The mere body in which we shamble defines who we are, and fat-to-muscle ratio scores our very worth as human beings. … The new materialism is philosophically crude, morally deficient, evolutionarily regressive, existentially stunted, and plain dumb.”

But from the reviews I’ve read of Big Brother, Pandora becomes the polar opposite of this approach with Edison, who weighs nearly 400 pounds. Pandora moves into an apartment with Edison, where she helps him with a liquid diet for six months, followed six months of a “sensible diet” with exercise. He successfully loses over 200 pounds this way, but begins to regain weight toward the end of your novel.

The diet in “Big Brother” is a clone of the Cambridge Diet, and it is safe so long as it is not carried on too long.  Six months is the limit.  Meantime, the supplements include enough protein, enzymes, vitamins, etc. to make sure you get enough nutrition.  I know someone who’s done it, to impressive effect.  I needed a regimen that was dramatic–remember, a novel is entertainment–and the all-liquid one is about as dramatic as diets get (er–meaning, not very).  But you’re totally right (this is in the novel): this kind of drastic program ill-prepares one to resume a normal, healthy, moderate, unself-conscious relationship to food.  Even when Edison returns to solids, he has to weigh everything he eats fanatically, because he can’t trust himself.  Which is a hideous way to eat.  I sure don’t eat that way.

The epigraph of the book says, “The dieting industry is the only profitable business in the world with a 98 percent failure rate,” so you seem appropriately fatalistic about Edison’s chances. But on Diane Rehm you said that “if you’re going to successfully lose weight, you have to do it for your own reasons.” Given the desperate urgency with which people are being told to lose weight for their health, how much of that 98% failure rate could possibly be due to a lack of “self-motivation, self-concern”? Do you believe the reason for the failure rate is due to lack of motivation rather than biological impedement (as explained in the NYT piece “The Fat Trap”)? On Diane Rehm, you said this book was your way of “exploring” what would have happened if you intervened on your brother’s behalf.  How does Edison’s failure to keep the weight off relate to your expectation of “what might have been” if Greg had gotten gastric bypass? What have you learned about your regrets regarding your brother’s health by exploring this subject through your writing?

I imagine there are as many reasons that diets fail as there are dieters.  Making some blanket statement in that regard would be impertinent.  In some instances, there must be biological explanations, in others psychological.   The novel explores one problem of goal-oriented projects like I-must-get-back-to-163-pounds: ok, you’re 163 pounds.  Now what?  Reaching some target weight doesn’t solve whatever host of other problems you may be contending with in your life, some of which might explain why you gained the weight in the first place.  Moreover, when my narrator Pandora also becomes, in fact, underweight, being slim is a huge let-down.  An anti-climax.  She finds out it just doesn’t matter very much.  WHICH IT DOESN’T.

What I mostly regret is that my brother is dead.  Unfortunately, no novel can change that. 

However, the Daily Mail contrived to frame one of my essays with not only melodrama but a gross distortion of the truth, “My Brother Ate Himself to Death, and I Will Never Get Over the Guilt.”  Guilt?  What guilt?  I wasn’t responsible for what he ate, what he weighed, whether he smoked, or whether he touched his toes twenty times every morning.  That headline made no sense, and it also sounded arrogant.  Who am I, to take on the sins of the world?  That role, I recall, is taken.

Finally, in recent interviews you go to great lengths to separate the health issues surrounding obesity from the basic dignity and respect that you said your brother lost once he was fat:

Moreover, my brother was an accomplished sound engineer who’d tested as having a genius-level IQ. He was politically astute, technologically brilliant and often very funny. But once he got big all strangers saw was some fat guy.

What traits do we instinctively ascribe to the obese? Laziness, sloth and gluttony. Indulgence, indiscipline and lack of self-respect. If not outright stupidity, at least irrational self-destruction.

I do hope you realize that the latter quote is a lament.  These unthinking attributions are clearly outrageous.

While you certainly give dignity to Edison as a person, you also embodied him with pretty much every grotesque stereotype about fat people. When readers first meet Edison, his fellow passengers describe him as smelling terrible. When he’s exiting a plane he’s pushed in an extra-wide wheelchair by two flight attendants because it’s airline policy (although plenty of 400 pound airline passengers can tell you this isn’t the case). Later, according to one Good Reads review, Edison “spoons huge mouthfuls of confectioners sugar straight out of the box in such large amounts that he can’t swallow them and it falls all over the front of him.” One of the pivotal scenes in the book involves Edison breaks a chair that was the favorite of Pandora’s husband, who makes furniture. At one point, Pandora describes her brother as “the creature that had swallowed Edison.”

OK, slow down.  One of the passengers sitting next to Edison makes a mean remark about how he smells.  The remark is meant to make the passenger look bad.  Nowhere else in the text is there any reference to Edison having a body odor problem.  Because he doesn’t have one.  I put that line in expressly because one of the stereotypes of big people is that they smell bad.  Which is ridiculous.  But these prejudices are so deeply ingrained that the airline passenger imagines a smell that isn’t there. 

As for the wheelchair, that’s the airline being ridiculous.  Since Edison can walk.   Airlines vary.  They have different policies.  And this is a work of fiction.  My fictional airline attendants chose to put Edison in a wheelchair to speed up deplaning, since he walks slowly.

The confectioner’s sugar scene is simply a binge-eating scene, and it’s a pity that you have to go to Good Reads for a rather poor, inaccurate summation when you could have read the scene, and quoted from the scene, in the book.  Do you even have a copy?  Simple: if you do eat confectioner’s sugar straight from the box, it dusts everywhere.  I get flour all over the kitchen every time I dredge fish.

The husband’s handcrafted furniture is quite delicate, and it’s hardly a stretch to imagine that a man Edison’s size might break one of his chairs.  That’s not to feed some “stereotype” that fat people break all the furniture; the furniture isn’t some dining set from Target, but very finely crafted, spindly, handmade furniture that I designed that way on purpose–that is, the chair’s real creator (me) designed it to break.  This is fiction.  I was trying to exacerbate the antagonism between the husband and his brother-in-law.  The husband gets mad.  There are words said.  Savage words.  Drama!  Story!  Secretly not real!  Shriver doing her job!

“The creature that had swallowed Edison” is taken out of context.  Pandora is in shock.  Her brother looks nothing like the last time she saw him.

And on Diane Rehm, you said the following:

It’s hard for him even to get in and out of a car. When he gets in the car he has to spool out the seatbelt to its maximum extent and, you know, there’s a really unfortunate scene when he really hits bottom before going on the diet when he’s been severely constipated and clogs up the toilet. And that’s, you know, that’s really humiliating for him.

Even if you’re publicly advocating for the dignity of Edison and Greg, aren’t you still simultaneously appealing to the morbid voyeurism that reduces fat people to caricatures of sweaty, gluttonous slobs and clods? Why give Edison so many unpleasant physical traits? Even though stereotypes are used to describe Pandora’s “nutrition Nazi” husband, Fletcher, there isn’t an existing stigma for thin people, so it doesn’t quite “hit” the same way. What would you say to readers who were upset by the use of stereotypes?

Edison is not sweaty.  Edison is certainly gluttonous; he is a fictional character, and in this particular case he did not become large from a glandular problem but because he overeats.  True, he’s rather untidy, but again that is in order to make him all the more disagreeable to the husband, who’s a neat freak.  We all know that house guests who don’t pick up or pitch in with the cleaning can be trying.  Edison is certainly not a “clod”–he’s a quite sophisticated jazz pianist.  The bunging up of the toilet scene of course could have happened to anyone, of any size, but at that exact juncture in the story it marks Edison’s hitting bottom, if you will–which is necessary for the plot to progress and to make his going on an all-liquid diet credible.  I don’t find Edison a stereotype, and the reasons for his food issues are meant to be particular to him and to exhibit a certain psychological complexity.  But I’m damned if I understand why I am defending a character to you whom you have never met.  And who is not meant to be some iconic representative of All Fat People, either.

Also, I take issue with your assertion that there’s no stigma that attaches to the very thin.  They are assumed to be neurotic and joyless.  The presumption with skinny people is that they’re just as obsessed with food as heavy folks supposedly are; they’re just obsessed with not eating it.  They are subject to an envy that inverts into resentment and a fierce, aggressive dislike that can be quite unpleasant on the pointy end.  During the release of Big Brother, I was raked over the coals in the UK press all over my diet and exercise habits–oh, and never mind the book, that got lost in the shuffle, as did the fact that I’m writer for fuck’s sake, and whatever I eat and whether or not I do sit-ups ought to be my business.  It was humiliating.  A la Edison, it was my own little toilet scene.  As I wrote in the Guardian, “If you’re thin, you’re a kook; if you’re fat, you’re a failure.  You can’t win.  In fact, nobody in this game is winning.”

Not a bad sentiment to end on, then.

I hope these questions are acceptable and I look forward to hearing from you. If you’d like any clarification or have any concerns, please let me know. Thank you again for taking the time to respond.

Peace,
Shannon

We really don’t disagree with each other very much.  Which I fear must be disappointing for you.  Mind, it is truly incredible that I agreed to do this interview with your not having even read the book.  My publicist would shoot me.

The Followup

Recognizing that I stymied the discussion with my confrontational line of questioning, I did my best to tie my questions and her response together in a way that explained where I was coming from:

Hi Lionel,
When I heard your interview on Here and Now, there were a few things you said that caught my ear. I wanted to have a discussion on the health issues you’ve been speaking and writing about. As I said in my previous email, I agreed with some of your opinions, but found your comments on HAES troubling. For example:

That was a column I wrote on the Fat Pride Movement, of which I was a little skeptical, and I was using my brother as an example of someone that I wasn’t sure could be called healthy at any size. That’s one of their little aphorisms.

That last part sounded snarky to me, and when I read the column from 2009, you were definitely dismissive and snarky toward HAES. And in both cases, you didn’t seem to be aware of the basic tenets of Health at Every Size. I apologize if my questions seemed antagonistic. My intention was to get to the heart of the concerns I’ve been ruminating on, as I read more interviews and reviews.

One of the reasons I wanted to speak with you was that you were misrepresenting what HAES actually teaches. Just because your brother is “every size” doesn’t mean he’s healthy. If you’re going to publicly bad-mouth HAES, I hope you’ll at least do it based on what we actually believe. I also found some of the descriptions of Edison troubling. As I said, I’m not opposed to reading the book, but as a consumer, when I read about scenes humiliating fat people, then I’m honestly not that interested in reading it. In preparation for this interview, I read reviews to get an idea of what Big Brother was about, and it sounded like an attempt to humanize a fat person that included some stereotypes critical to the plot.

I completely understand that this is fiction and that you invented an airline that deplanes the obese in wheelchairs, but there is literally no airline with such a policy. The reason it seems egregious to me is precisely because you chose to invent an airline with this policy so that Pandora first sees Edison in an enfeebled state: pushed by two flight attendants. You said the policy was in place to “to speed up deplaning” because the airline was being ridiculous. But again, the airline is still you and how you chose to portray Edison.

The same goes with the chair you “designed to break.” Of course you did, since you made Fletcher a struggling furniture craftsman so that the chair itself meant much more than just a piece of furniture. But again, what bothered me is the fact that you chose the cliche of chair-breaking, no matter how carefully you set it up to be more than just a chair. I read how it was used to drive the wedge deeper between Edison and Fletcher (and therefore Edison and Pandora), but as an author, you have countless options for how to achieve this goal. It seems like there would be ways to do this without invoking a stereotypical fatty humiliation.

I get the chair was intentionally delicate, but the whole idea around fat people breaking furniture is typically used in one of two ways: to mock fatties and to serve as a warning. My wife has been Edison’s size since she was in college. I’ve known her for 11 years now. I’ve never seen her once break a single piece of furniture. And yet she lives in fear of it because it’s something she knows could happen. When you write that scene, for you it’s a clever way to move the story that gets to the heart of both Edison and Fletcher. But for fat people reading it, there’s a context already there that doesn’t go away by citing the craftsmanship of the chair. The same goes for every problematic scene I mentioned, including the binge on confectioner’s sugar.

Don’t get me wrong, I’m not suggesting you had malicious intent. You were writing about what you experienced with your brother, who was very, very sick, and you were writing about this one specific instance where obesity was truly morbid. But you also have to understand that fat people who live the experiences you’re fictionalizing are bound to notice these things in a novel that is, in its individual way, representative of us.

For the first time in a long time, fat people are starting to push back against the work of people who do have malicious intent and do rely on stereotypes to reinforce the stigmatization of fat people. If you write a book that draws some of its themes from the same well as trolls and assholes, it should come as no surprise that it’s going to raise some hackles. I hoped to raise some of these concerns in a respectful, but direct manner because I don’t believe you are intentionally trying to stigmatize anyone. Nevertheless, the book does.

As far as social stigma goes, there are varying degrees of stigma at pretty much all weights for American women (not as much for men), just as there is for a woman’s sexual status. But the stigma attached to being thin is not nearly as intense and widespread as the stigma of being fat. Thin women aren’t at a disadvantage in finding a job or being treated with respect by society. Nine times out of ten, being thin works to a woman’s advantage in pretty much every corner of our country. You said this:

[The very thin] are assumed to be neurotic and joyless.  The presumption with skinny people is that they’re just as obsessed with food as heavy folks supposedly are; they’re just obsessed with not eating it.  They are subject to an envy that inverts into resentment and a fierce, aggressive dislike that can be quite unpleasant on the pointy end.

Envy and assumptions aren’t the same as stigma. Stereotypes based on body size are always unjust and can lead to poor treatment, but thin people aren’t subject to the kind of systemic stigma documented by Dr. Rebecca Puhl of the Yale Rudd Center for Food Policy & Obesity (who I interviewed). Yes, people can be absolute assholes toward thin women, including those interviewers who asked about your diet. Personally, I think that’s grossly inappropriate, and something that reporters would only ask a woman.

Regarding my defense of Linda Bacon, you wrote, “Afraid I find the distinction between ‘accepting the high-calorie habit as a defensible lifestyle choice’ and arguing that ‘we all have the right to make our own health choices’ rather slight.” I don’t think the difference is slight in the least. The approach is, if you want to improve your metabolic health, then these are the things you should be doing. As you said regarding your brother Greg, “Clearly smoking didn’t help.  But you don’t order your older brother to quit smoking.  It doesn’t work.” The same goes for any healthy behavior. You can’t force people to eat more fruits and vegetables or go for a walk. You have to explain the natural benefits of eating more wholesome foods and getting more exercise. What I meant when I wrote the above was that HAES proponents don’t believe in shaming those who make unhealthy choices because shame sure as hell doesn’t motivate people to make healthy decisions. HAES is about education and self-care, not intimidation.

In your interviews, you’ve said you wanted to have a conversation about obesity, but it seems like your novel frames the conversation around your brother’s health, which was severely compromised for a multitude of reasons. You also said that “It appears to be important to you to dissect my brother’s medical history in such a way that he seems to have died from complications completely unrelated to his weight.” I wouldn’t say unrelated, I’d say that your brother was a perfect storm of poor health choices and unfortunate circumstances that produced a sharp and steady decline in his health. I realize that you want to have a conversation about obesity, but obesity is not the reason your brother died at the age of 51. Your brother had emphysema caused by smoking, which, combined with sleep apnea, causes a life-threatening depletion of oxygen. If your brother hadn’t been a smoker, his sleep apnea would have been as manageable as it is for the majority of people of comparable size. Your brother’s sleep apnea may have gotten worse because of his size, but his persistent smoking habit made it deadly.

Likewise, his diet and forced sedentary lifestyle may have contributed to his poor health, but even saying he died of obesity-related diseases is not entirely accurate. Even if we set aside smoking, your brother died from complications of insulin resistance (IR), which obesity exacerbates. But IR begins before weight gain. The recently discovered hunger hormone, ghrelin, correlates directly with insulin levels and IR, so the more insulin circulating, the more ghrelin in your body and the hungrier you are. The excess of insulin in the blood also causes high blood pressure, blood sugar and cholesterol. Metabolic syndrome is basically uncontrolled IR, and it leads to heart disease, stroke and type 2 diabetes (with genetic influences pushing you toward one end or another). Saying that your brother died of obesity-related diseases is like saying a smoker dies of yellow teeth.

The whole goal of making healthy lifestyle changes according to HAES is to improve your insulin function, which reduces your blood pressure, sugar and cholesterol, neutralizing the effects of metabolic syndrome. And although diet certainly contributes to improved insulin function, exercise absolutely must be part of a healthy life as well. Muscle burns glucose, reducing insulin production and stress on the liver.

Whether you’re being vigorous through your job, or by playing sports, swimming, walking, cycling, stair-climbing (which I’m training for) or whatever gets your heart rate up and you enjoy, then you’re on your way to sustainable, joyful movement. For those seeking a fitness goal to shoot for, I personally recommend the American College of Sports Medicine minimum of 150 minutes moderate/75 minutes vigorous exercise per week, plus strength training. Adding a modest amount of exercise has profoundly positive effects on insulin resistance, regardless of whether it makes you thin (according to The New York Times). That’s HAES.

When your brother could no longer be vigorous, he began losing the muscle that was burning off excess glucose and keeping his insulin in check. Type 2 diabetes is largely genetic, so he was already highly susceptible to IR. Insulin triggers fat storage, so as your appetite increase you also get fatter. And the fatter you get, the worse your IR gets. I interviewed Linda Bacon (I was skeptical of her at the time and had not yet read her book either, so I’m 2 for 2), who explained the cyclical nature of IR and obesity.

Combine your brother’s uncontrolled diabetes with the fact that smoking makes both heart disease, diabetes and sleep apnea worse, and you can see why I think it’s not exactly accurate to say that your brother died of obesity-related diseases. Your brother was clearly insulin resistant, but not every fat person is insulin resistant. And not all insulin resistant people are fat. If your brother wanted to improve his health, he could have quit smoking, followed a diabetic diet and found a simple, low-impact exercise like water aerobics, that could have helped improved his metabolic abnormalities. But the fact that Greg was shutting off his oxygen tank to smoke another cigarette suggests something more than “Fat Man Eats Himself to Death.”

If your brother really wanted to get healthy without resorting to the Cambridge Diet (which, by the way, was considered unhealthy back in 1983, according to The New York Times), he had better options. HAES is one of the most sensible options available to fat people who have spent a lifetime yo-yo dieting their weight higher and higher, as well as people of all sizes. If you want to see me explain HAES in under three minutes, our local news did a brief segment on me. And this is what HAES advocates are promoting across the board, starting with Linda Bacon and Marilyn Wann.

If you’re still interested, I’d like to make you a deal… I will read Big Brother if you will read Bacon’s Health at Every Size. I’m not so foolish as to think that reviews are an adequate substitute for reading your work, but I wanted to discuss the things you’ve been saying in interviews and don’t currently have the means to read the entire book. I’m always happy to be proven wrong and I will gladly apologize if I’ve misrepresented the sections I found offensive.

I did realize that the one quote (and the following unquoted paragraphs) was a lament. I was acknowledging that you seem vehemently opposed to the stigma fat people face, and I greatly appreciate that. But it seemed like even while you are speaking out against body shame and stigma, the book seems to include scenes of shame and stigma. Again, I’m willing to be proven wrong to that effect.

Also, I was aware of the surprise ending (though I really had to dig to finally find it) and I included a question in my first email that was preceded by a lengthy apology/disclaimer about how we didn’t have to discuss it. But when I finished the entire email, I deleted it because I didn’t think it was necessary. I also assumed you wouldn’t want the spoiler to be out there anyway. I do think the twist ending puts the book into a completely different context, including my questions about the airline’s wheelchair policy. But even so, it seems like that makes Pandora, and ultimately you, seem like the source of all the problematic cliched themes.

I wanted to ask something that’s confused me since I began reading articles about your brother. In the November 2009 article that was filed the same day your brother died, you said he weighed 24 stone, or 330 pounds. But in the article you wrote this past April, you said “Towards the end, he must have been closing on 30st” or 420 pounds. Why the discrepancy?

Thank you for your time, Lionel. I appreciate you taking the time to answer my questions, despite not being as prepared as I should.

Peace,
Shannon

And Lionel’s final response:

Hi, Shannon.  Thanks for your thorough reply.

I’ll make this one clarification, just because it explains what otherwise seems like sloppy journalism on my part: when I wrote that original column back in 2009, I quoted my brother’s weight as 330 pounds, because that was the only number he’d ever self-reported.  I had not seen him in a year and a half.  When I saw recent photos following his death, it was clear that he had put on much more weight in the time since we’d seen one another.  400 pounds or so was simply a guess.  It could have been considerably higher.  That should explain the discrepancy.

Otherwise, I’m going to wrap this up.  But not without saying: I want to thank you for assuming such a civil, respectful tone in this conversation.  More, you’re an incredibly articulate writer, and you express your views convincingly.  I have no doubt you make a fine advocate for HAES.  If I have seemed to misrepresent the aims of your movement by lumping it in with others, I’m regretful.  You’re clearly a smart and passionate person.  I really don’t think we disagree on v much.  I’d probably allow that there is a limit to this HAES business–I’m thinking of those documentaries about people who weigh close to 1,000 pounds and can’t get out of bed–but I’d readily agree that many people would do better getting exercise and eating a decent diet than constantly trying (and usually failing) to lose weight.  I’m as sick as you are of the grotesque amount of time and energy that’s squandered on dithering about our physical size.  So: truce.

I have myself now squandered so much time on the same stuff during the release of BB that I hope you understand that I have hung up my fat hat for now.  So here’s an alternative deal: I’ll agree that I don’t have to read HAES, and you’ll agree that you don’t have to read “Big Brother.”

Wishing you and your wife the very best for the future,
Lionel

In the end, I think this was a productive conversation. I’m glad I wrote to her and I’m glad that Lionel took the time to respond thoroughly and directly to my questions. It’s not easy to respond to such skepticism and incredulity, so I greatly respect Lionel’s willingness to do so. I do agree with her that we aren’t very far apart on our views and I hope that this conversation has helped to bring our views even closer.

UPDATE

I forgot that I responded Lionel’s comment about the 1,000-pound fatty:

Lionel,
Thank you for taking the time to read and reply. I wish you the best in your health and your career. Not every author on a promotional tour would agree to answer questions from a blog, let alone answer the questions I asked. You’ve been consistently straightforward and open about your thoughts and feelings, which I respect immensely. As I said, I found myself nodding vigorously with much of what you’ve written recently and said in interviews.

As far as people who weigh, let’s say, 500 pounds or more, they’re very rare. I’m 5’7″, 265 pounds with a BMI of about 41.5. The percentage of the population with a BMI over 40 is about 3%, while the percentage with a BMI of over 50 (me if I weighed 320 pounds) is 0.42%. Setting aside that statistical point, people who are genetically susceptible to gaining that much weight are also more susceptible to metabolic issues. But the “prescription” is the same for the health of a 500 pound person, as it is for a 120 pound person: eat a healthy, balanced diet without being sadistically restrictive and exercise. If a 500-pound person has a healthy lifestyle and they lose 300 pounds, great. If they only lose 50, great. But it’s the sustainability of the behavior that ultimately matters for long-term health, and that’s achieved through self-love, not self-loathing. And I appreciate that you get that.

Peace,
Shannon

18 Comments leave one →
  1. Kala permalink
    August 19, 2013 12:47 pm

    Lionel comes across as hostile and frustrated, and perhaps incredulous that you’re asking the questions that you asked.

    I guess I’d advise reading the book next time? She seemed really caught up on your not reading the book and I think it colored the tone of the interview a lot.

    • August 19, 2013 1:07 pm

      I explained to her that it was a financial issue for me. Where we live, we have to pay for a library membership, and we just couldn’t afford to re-up a few months back. So we haven’t had a library membership. But I did the best I could to be up to speed on the book. I’m still not satisfied with her response about the stereotypes (my problem was portraying a fatty binging on powdered sugar, not how it looked), but, yeah, that definitely got in the way.

      Peace,
      Shannon

      • Kala permalink
        August 19, 2013 1:44 pm

        I don’t know, maybe next time you could do an amazon wishlist and see if someone in the community could buy it for someone on this site to review?

  2. Ninabeenaribeena permalink
    August 19, 2013 2:00 pm

    What a fascinating read. I have long been an admirer of Lionel Shriver’s writing, and political commentary (she lives in the UK and is often on the news here). ‘We Need To Talk About Kevin’ is a truly great work. When I heard about the subject of her latest book, and that it was (to quote one review) “a criticism of the fat-acceptance movement and HAES”, I was alarmed to say the least. How could someone so intelligent and well-informed disagree with HAES??! Reading this interview has clarified a lot of things for me, and reassured me that Shriver is not an unthinking fat-hater. She should so totally read HAES though! Thanks for a great post.

  3. nof permalink
    August 19, 2013 2:06 pm

    Good on you for being so civil with her; I got to the point of not even being able to read her responses. IDK perhaps it’s because I’m in a bad mood today, but she seems to me kind of like a Hugo Schwyzer type. On the one hand–we totally shouldn’t stigmatize fat people! On the other–here’s a book propagating every single stereotype of fat people! There’s a very, very thin line between trope subversion and playing it straight; perhaps she was attempting to be subversive and failed. I don’t know and won’t know because I have no desire to read her novel, but the excerpts and reviews aren’t giving me hope that she was attempting subversion.

    And I feel bad that her brother died, but that she explicitly blames his fat for that when he smoked and suffered from two disabling injuries…maybe just me, but perhaps there’s more going on here? If he was eating “more”, I have to wonder if he was in pain and/or sleeping poorly, both of which can increase appetite because they screw with hormones. In either case, the solution is not a diet but to treat the underlying condition. Telling someone who is in pain that they must add to their suffering is all sorts of awful.

    Also LOL “you don’t tell your brother to stop smoking.” Smoking cessation has a higher success rate than dieting.

    • August 19, 2013 8:25 pm

      I’m further mystified by her saying that her brother had sleep apnea, but putting any blame for his death on the apnea. Was his apnea treated, how long had it been treated?

      I have fairly severe sleep apnea and I feel like I’d be dead already if I didn’t have a CPAP. I know you can’t really diagnose someone with only some information through the internet, but I think to focus solely on weight is a mistake.

      • August 19, 2013 10:09 pm

        From what I read, he did have a CPAP and when he had his severe health problem 10 days before he died, he had fallen asleep without it. But it was the smoking that made his apnea deadly, even if his weight made his apnea worse.

        Peace,
        Shannon

  4. August 19, 2013 4:47 pm

    Shannon, you are one WORDY writer! I tend to be quite wordy myself, but I believe you have me beat! Anyway, having taken the time to read all of your words in this particular post, I wanted to say that I share your feelings about Shriver kind of contradicting herself. I noticed it in reading her article in the NY Times magazine that was critiqued by Mary Stein in her More of Me to Love blog. So, I’m glad you succeeded in getting her to respond to your questions, and I enjoyed reading the exchange. I also found myself vigorously nodding “yes” to many of the things she says, but the way she perpetuates the stereotypes is very disagreeable. I hope she will take your words to heart and see the error of her ways. I myself am unsure whether or not I want to buy the book, and lend financial support to her stereotype perpetuation. Obviously, her brother’s weight gain has given her some insight into the fact that fatties are people, too, and should be seen and treated accordingly. Perhaps given the magnitude of her brother’s gain, she sees how foolish it is to be obsessed with weight even though one is within the “desirabe” BMI range.

    Just so you know a little more about my own perspective, I am in that 0.42% category with a BMI over 50, so it often feels like I am still a “minority” even in the fat acceptance community. And one more thing, while I’m talking – I don’t think I myself would ever call stair climbing “enjoyable!” I tried it once when I was in my twenties and much much thinner, and even then I didn’t enjoy it!

    • August 19, 2013 6:15 pm

      Hey, I’m part of the fewer than 1% too. Super-fatties unite!

      • August 19, 2013 10:33 pm

        Hi Larrylegend. It’s true that we “super fatties” need to support each other, for sure!

        • vesta44 permalink
          August 20, 2013 11:38 am

          Another DEATHFATZ “super-fatty” here (where’s my cape?). And I’m part of the over-50 crowd BMI-wise and age-wise (I’ll be 60 in November. . . .lol). So for those who say the very fat are death-waiting-for-a-place-to-happen, yeah, not so much. I’m still fairly healthy, thank you very much.

    • August 19, 2013 10:13 pm

      I know, it’s terrible. I really try hard on here to stay at 2,000 words or under. I can’t just fucking go for days on end. I can’t help myself. I would not personally buy the book. As I told her, if I read a review or a sample chapter and it’s all about how shitty being a fatty is, I’m not all that interested. And I would bet there is a heavy representation within FA (pun intended) of the over 50 crowd. After all, they suffer the most intense social indignation and discrimination.

      Peace,
      Shannon

    • August 20, 2013 7:42 pm

      I’m a deathfat too and we are a minority in the community but then again, we are a minority when it comes to obesity, despite what the news and medical community say every single day. I think they would be surprised to see the majority of “the obesity epidemic” do not have BMI’s of 50 and up, or even in the 40 range.

  5. Dizzyd permalink
    August 19, 2013 7:25 pm

    I looked at the NY Times link and was blown away by the article where it says that obese and overweight people with more than 40 percent weight to lose should go with very low-calorie diets (yes, I know, supposedly under the care of a physician), but still! That they think ANYBODY should be partaking of “voluntary starvation” as a means to procure health! That doesn’t say very much about their assessment of our worth as human beings! “Go ahead, fatty. We know that the Cambridge diet and others of its worthless ilk are dangerous but YOU should do it to get socially accep- er, I mean – HEALTHY, and if you die in the process, oh well.”

    • Jen permalink
      August 19, 2013 8:44 pm

      Not to mention the numerous quality of life issues. In my utopia it would be a license losing crime for physicians to promote such diets.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: