Curious Reads: What does "skinny" cost?

ICYMI: Being Fat Isn't A Moral Failure, According to God

Hello friend, Liz here.

#1 Today’s “top of the fold” story is Ozempic—that is, the cultural phenomenon of a diabetes drug that, taken off-label, causes dramatic weight loss.

“It is hard to recall the last time a drug so excited the general public. Fen-phen in the 1990s, maybe? Viagra or Botox in the 2000s?”

Read “Ozempic Can’t Fix What Our Culture Has Broken” by Tressie McMillan Cottom for the New York Times.

By Alice Rosati at Trunk Archive

Here are the highlights:

Now there are pills to make you skinny.

Pharmaceutical companies have discovered the magic compounds that help us lose weight with no hard work required. (Theoretically—more on that to come.)

And the gold rush toward owning the market on the obesity fix has begun because consumers cannot snatch up the products fast enough. The popularity is hardly on the same scale as past trendy meds (Was Viagra like this? wonders the author of the article.)

The reason for the popularity is easy enough to explain:

These drugs are blockbusters because they promise to solve a medical problem that is also a cultural problem — how to cure the moral crisis of fat bodies that refuse to get and stay thin.

Because obesity is not only a medical/physiological reality. Underneath the language of diets, weight and body size is a mountain of connotation, a “coded language of shame, stigma, status and bias around fatness.”

The reason these drugs are so popular is because being fat is so unpopular.

Three in four Americans are overweight. And as public health experts have admitted, “Encouraging weight loss through lifestyle changes was an ‘abject failure.’” Why? Obesity is a social condition as much as an individual one.

Studies show that the crops the U.S. government subsidizes are linked to the high-sugar, high-calorie diets that put Americans at risk for abdominal fat, weight gain and high cholesterol. Sprawling communities, car-centered lives and desk jobs make it hard for many Americans to move as much as medical guidance thinks that we should. Under these conditions, telling people to change their lifestyle to lose weight or prevent diabetes is cruel.

“Skinny” is presumed normal and healthy. We see skinny as morally superior.

Thinness is a way to perform moral discipline, even if one pursues it through morally ambiguous means. Subconsciously, consciously, politically, economically and culturally, obesity signals moral laxity.

In case you doubt this, consider the last time you laid out on the beach or lounged at the neighborhood pool. How did you view your own body in a swimsuit? And which other bodies drew your eye among your fellow swimmers, and why?

I’m a fat lady myself.

Because of my own size, I’m particularly attuned to these dynamics within the wider culture and also in the Christian church, where bodies are especially suspect. To be fair, bodies of all kinds are suspect within at least the evangelical expression of Christianity, but non-normative bodies are especially so.

The sexualized language that many male pastors and leaders use toward their “hot and holy” wives only goes to emphasize those of us who have not “achieved” such a body. I have often heard teachings about marriage and sex in which male pastors urge a wife to “not let herself go” and to “take care of herself,” so as to remain sexy for her partner…which in turn, secures his fidelity.

What do these pastors mean when they talk of a woman “letting herself go”? Do they mean wearing sweatpants in the evenings? Forgoing a make-up ritual? Not likely, friends. The underlying assumption is that when a woman “lets herself go,” she’s gained weight. The judgment inherent in these teachings is that the woman who gains weight does not care about her partner, has no self-discipline, and must be disordered spiritually and mentally as well as physically (physical disorders and weight gain are often lumped together, an assumption in itself).

But what about the differently-abled or those who did not start off with the standard beauty norms? Are they wrong from the outset? By this way of thinking, the answer is yes.

According to a culture obsessed with one singular form of beauty—Barbie beauty—any change away from that norm and any perpetually non-normative bodies are wrong, with a moral bent implied.

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Pssst Rachel Held Evans covered this beat before—read her take, “Thy Shall Not Let Thyself Go?”

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And so the unstated goal of drugs like Ozempic is not just to solve the medical problem of obesity (as in, the side effects that may or may not arise due to living in a larger body). The goal of these drugs is, in effect, to eliminate fat people from our society.

Enter the weight loss miracle pills. Or, in the case of Ozempic, a once-a-week shot. Attaining the ideal of “skinny” is attractive enough on its own. (The American diet industry netted $76 billion this year, based on idealism alone.) But achieving “skinny” with the minimum effort? That’s as seductive as Scrooge McDuck’s mountain of gold coins.

However, just for the sake of argument, let’s assume the pills do everything they seem to do.

“For the sake of argument,” the author writes, “[Let’s say] obesity is a public health crisis and it can be solved with one imperfect injectable… should[n’t] it be possible to make it so that everyone can afford the solution. Right?”

Nope. If you want to take one of these drugs, it’ll likely cost Scrooge’s entire mountain of coins.

Health insurance refuses to cover these diet drugs, and Pharma refuses to subsidize them. (Currently, the two are in a stand-off to see who can make the most money from consumers.) So, without any assistance, an Ozempic prescription would cost one person between $10K and $16K out-of-pocket per year. And those who take diet drugs tend to become dependent upon them because, once they stop filling the prescription, they gain back the lost weight, their appetites returning at full force, so these power users will likely continue to use these meds FOR THE REST OF THEIR LIVES. So, multiply the yearly cost by the number of years you have left on this earth and that’s what it would cost you to be skinny. Meaning that, yet again, we have a bespoke weight-loss solution designed for rich people.

Of course, that doesn’t mean taking these drugs is unreasonable. On the contrary, for some people, “the price of being fat is so high that there will always be a rational reason to pay an exorbitant amount to be thin.”

The price of being fat is not only measured in health outcomes, by the way. Social scientists have observed an “obesity penalty” in the workforce, with larger women and men making significantly less than their colleagues. (Women suffer this penalty more dramatically than men do.)

So, while the high price tag might be the most obvious problem with a drug like Ozempic, the conversation about diet drugs really reveals our stunted imaginations. We have no idea what it means to accept and welcome the strange diversity of bodies that exist in our real world. And we have no idea how to give each body ethical health care without building exclusion into the system.

Fatphobia—the fear of being fat—is structural, built into the systems of government and employment and health care. So if you’ve grown up in the USA, the assumption is that once you reach a certain level of success as a fat person, your further success will be impeded by your larger size.

A body’s size and shape becomes a glass ceiling. A larger body means less opportunity, lower paychecks and limited influence. Which is to say, to reach a certain socio-economic station, skinny is the price of entry. Because to reach the top of the ladder, to keep acquiring platform and promotions, the most successful people will always be willing to pay to be skinny because being successful includes a certain body type. So the ideal of success is reinforces our own personal and cultural prejudices so that we also keep out those who don’t fit that picture. And so the cycle continues.

In the end, being skinny was never about weight, but about power and privilege. Because everything seems to come back to that.

…No wonder people are pounding down the doors of their doctors for Ozempic.

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What messages have you received in church about female beauty, especially in terms of the size and shape of a woman’s body?

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But is this the society we want to live in?

I can tell you for certain that a society that functions by power and privilege is not the society of the kingdom of God. Consistently, God’s preference is for the weakest and lowest:

“It is not the healthy who need a doctor, but the sick,” says Jesus.

“God chose what is low and despised to shame the strong,” says Paul.

“God opposes the proud but gives grace to the humble,” says Peter.

I wonder, do our churches embrace the hierarchy of God? Are we more likely to embrace the weak, despised, humble, sick…and fat as God does? Or do we preference the powerful, rich, successful…and skinny? If we do preference the top of the food chain, as so often happens, I believe that reveals much about our belief in God—after all, if God cannot uplift the lowest and weakest among us, then what is our faith for? Or, as Paul put it, if Jesus was not raised from the dead on Easter morning, then why bother?

But if God really does tip power and authority structures on their heads, well then, we might need to start reevaluating more than just our beauty standards.

Only when we embrace the “upside down” reality of God’s way can we lean into the paradox of a faith that asserts, whenever I am weakest, then I am strongest. Why? Because God’s strength is made perfect in weakness. Meaning, those at the bottom are the closest to the way of God.

From one bottom-dweller to another,

Liz Charlotte Grant

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