Life Lessons

Abstract

In this article, we argue that mass media representations of obesity operate biopedagogically and, in doing so, teach viewers how to think and feel about what it means to be fat. These teachings are what we call “life lessons”—that is, lessons aimed at instructing viewers in how to relate to both their own bodies and the bodies of others—and are readily discernible in a wide variety of magazines, radio segments, and television shows. We suggest that life lessons of this sort are neither separate nor entirely distinct from public health campaigns, but rather overlap with and, at times, intensify their messages. With this in view, we undertake a four-part analysis of how the North American mass media represent obesity. In the first part, we outline contemporary theories of biopower, biocitizenship, and biopedagogy and how they can be used to make sense of these representations. In the second part, we contextualize them by providing an overview of relevant public health policy such as the United State’s Let’s Move campaign and the World Health Organization’s Prioritizing Areas for Action in the Field of Population-Based Prevention of Childhood Obesity. In the third part, we present a systematic review of the critical literature on representations of obesity with an emphasis on the North American media landscape. And in the fourth part, we submit an episode of the popular television program Nip/Tuck to an in-depth critical examination as a case study of how mass media representations of obesity function biopedagogically. In the end, we show that the representations we discuss not only reflect public health priorities but also reproduce neoliberal ideas about how to manage the life of the human body.

Keywords

obesity health media representation biopower biocitizenship biopedagogy

Introduction

In recent years, critical research on obesity has taken what might be called a “biopedagogical turn” (McPhail, 2013; Rail, 2012; Wright & Harwood, 2009).¹ This research has tended to focus on public health and education campaigns and, in doing so, has sought to understand what they teach modern-day individuals about how to relate to both their own bodies and the bodies of others (Azzarito, 2009; Beausoleil, 2009; Burrows, 2009; Fullagar, 2009; Leahy, 2009; McPhail, 2013; Rail, 2009; Rich & Evans, 2009). While these teachings operate through a variety of tactics and strategies, they all aim to instruct individuals in how to “work on themselves qua living beings” (Rabinow & Rose, 2006, p. 215). Indeed, biopedagogies are life lessons; that is, lessons in “how to live, how to eat, how much to eat, how to move” (Harwood, 2009, p. 15). Ultimately, biopedagogies offer individuals “a number of ways to understand themselves, change themselves and take action to change others and their environments” (Wright, 2009, p. 2).

While researchers often refer to media representations of obesity as biopedagogies, these references tend to be anecdotal in nature (Halse, 2009; Harwood, 2009; Jutel, 2009; Wright, 2009). To go beyond the anecdotal, we present a comprehensive consideration of how the media represent obesity and, by extension, how these representations can be seen to have biopedagogical operations and effects. Our analysis is divided into four parts. First, we outline contemporary theories of biopower, biocitizenship, and biopedagogy and how they inform our research on the media. Second, we situate our research socially and culturally by providing an overview of relevant public health policy. Third, we present a systematic review of the critical literature on representations of obesity with an emphasis on the North American media landscape. And fourth, we present a case study of how these representations function as biopedagogies. Ultimately, we show that the representations we discuss not only reflect public health priorities but also reproduce neoliberal ideas about how to manage the life of the human body.

Thinking Critically About Mass Media Representations of Obesity

For Foucault (1978, 1979), the workings of power have changed as Western society has shifted from a pre-modern to a modern context. In a pre-modern context, power was what Foucault calls “repressive” or “sovereign”; it was premised on the sovereign figure’s right to repress and “take life” (Harwood, 2009, p. 16). In a modern context, however, power is what Foucault calls “disciplinary” or “regularizing.” Unlike repressive or sovereign power, disciplinary or regularizing power is “the power to ‘make live’ and ‘let die’” (p. 16). Given its tendency to “make” rather than “take” life, modern power can, according to Foucault, be understood as “biopower.”

Following Foucault (1978, 1979), Rose (1999a) explores how biopower shapes modern-day individualism. For Rose, experts are involved in every aspect of modern life. More specifically, experts allow individuals to manage their lives by helping them to make informed choices and, in doing so, to live effectively, efficiently, and productively. Rose sees this kind of individualism as both empowering and disempowering: It empowers individuals to change themselves, but it also disempowers them by filling them with doubt and insecurity about the everyday experience of living.

For Rose (1999b), individuals are bound up in a kind of governance without government and are, therefore, plagued by self-created problems. Self-evaluation, self-scrutiny, and self-questioning are all defining features of self-governing individuals. Individuals are made responsible for taking charge of their health through ongoing monitoring and management. But for this monitoring and management to be successful, the individual must choose from—and act in accordance with—free market health options. The self-governing individual who makes choices informed by health-related expertise is, according to Rose and Novas (2005), a “biocitizen.”

As Halse (2009) explains, biocitizens are responsible not only for their own well-being but also for that of their family members, their communities, and their countries. Here the “individual-as-life becomes thoroughly allied with the population-as-life” (Wright, 2009, p. 18). Indeed, the biocitizen operates in and through what Crawford (1980) calls a “healthist” context; that is, a context in which individual health is treated as an individual matter to be managed through individual rights and responsibilities. Crawford explains,

The aetiology of disease may be seen as complex, but healthism treats individual behaviour, attitudes, and emotions as the relevant symptoms needing attention. . . . Health problems may originate outside the individual, e.g. in the American diet, but since these problems are also behavioural, solutions are seen to lie within the realm of individual choice. (p. 368)

But how do individuals, who are expected to manage both their own well-being and that of others by making well-informed, expertise-driven choices, know which choices to make? Who teaches them how to make them? Critical obesity researchers have turned their attention to biopedagogies for answers.

Biopedagogy scholars have noted the importance of examining how the mass media serve as a significant site of knowledge production and dissemination where obesity is concerned (Halse, 2009; Harwood, 2009; Jutel, 2009; Rich, 2011a, 2011b; Wright, 2009). As Wright explains, the meanings attached to the obese body are “constituted in multiple pedagogical sites” that include not only clinics and classrooms but also “the web, [television], radio and film, billboards and posters” (pp. 7-8). Building on Wright, Harwood notes that clinics and classrooms “represent only a fraction of the spaces where this pedagogy occurs” (p. 21). For Harwood, “the interrogation of sites of communication and knowledge exchange” (p. 21) such as the mass media is crucial to fully understanding present-day biopedagogical practices. Like Wright and Harwood (2009), Leahy points to interdisciplinarity as a way of engaging “with the complexities of biopedagogies and their work” (p. 172). There is, therefore, a consensus around the need to expand this emerging area of inquiry so that it can account for not only the most explicit biopedagogical sites such as public health and education campaigns but also the more implicit ones such as the mass media.

Situating Mass Media Representations of Obesity

A review of recent influential policy documents sheds light on how public health priorities affect, and are affected by, media representations of obesity. As part of the Let’s Move! initiative, the U.S. government established its first task force on childhood obesity. In 2010, this task force released a report titled Solving the Problem of Childhood Obesity Within a Generation. Framed as a “national health crisis” (Executive Office of the United States, 2010, p. 3), the report finds that one out of every three children in the United States is either overweight or obese, placing them at risk of developing diabetes, heart disease, and cancer. The report also finds that obesity-related costs can reach up to US$150 billion per year. The report targets parents and, especially, mothers. In doing so, it suggests that parents who fail to be good managers of both their own bodies and the bodies of their children are dooming their families to the negative health outcomes associated with obesity. Ultimately, it holds individuals responsible for their health while creating moral panic around the risks posed by obesity in general and childhood obesity in particular.

In keeping with its emphasis on individual responsibility, the report situates the state as both unable and unwilling to regulate corporations that contribute to obesity. The report acknowledges that, as with tobacco prevention and control, “comprehensive, multi-sectoral approaches are needed to address the many behavioral risk factors associated with obesity” (pp. 7-8). Despite this acknowledgment, however, the report fails to recommend any taxation tools that could curb the consumption of unhealthy food products.

Like Let’s Move, the World Health Organization’s (WHO, 2012) Prioritizing Areas for Action in the Field of Population-Based Prevention of Childhood Obesity aims to determine “priority areas . . . [in the] population-based prevention of childhood obesity” (p. 10) and instructs member nations in how to improve the lives of their citizens through changing their environments. Pointing to a dramatic increase in overweight and obesity worldwide, the report goes on to list the health risks associated with this increase such as disease, a reduced quality of life, and more incidences of teasing, bullying, and social stigmatization. After describing childhood obesity as “one of the most serious health challenges of the 21st century” (p. 11), the report presents a variety of approaches to addressing it that are “systematic and locally relevant” and can be adapted to “local, regional or country-specific factors” (p. 15). The “[localized] relevance” of the report is, however, restricted by its “systematic, evidence-based and stakeholder informed” (p. 15) perspective, which positions expert knowledge as neutral, objective, and authoritative in relation to determining a community’s health priorities. Here, the “problem” (e.g., overweight or obesity), its “causes” (e.g., unhealthy diets and inactive lifestyles), and the “solutions” (e.g., removal of social, cultural, and economic barriers) are all determined before a “localized” environmental analysis has taken place.

Although it appears to offer a multilayered analysis, the WHO report fails to account for the more intricate and intersecting power relationships that shape health (e.g., gender, class, and race). Instead, the WHO proposes community-based solutions (e.g., improving active transport systems, taxing unhealthy foods, subsidizing healthy foods) to globally driven problems (e.g., neoliberal economics, consumer capitalism, corporate rule). While these problem-solving strategies seem to encourage collective action, critics like Kirkland (2011) argue that they leave the structural conditions that perpetuate health-related inequalities unchallenged.

The reports produced by public policy makers in both the United States and the WHO correspond with what critical researchers call the “dominant obesity discourse” (Boero, 2007; Evans, Rich, & Davies, 2004; Gard & Wright, 2005; MacNeill & Rail, 2010; Monaghan, Colls, & Evans, 2013; Oliver & Lee, 2005; Orbach, 2006; Rail, 2009; Rail, Holmes, & Murray, 2010), which is characterized by an emphasis on individual rights and responsibilities, a lack of systemic analysis, a focus on risk and risk management, an assumed relationship between personal failings and weight problems, a mechanistic view of the body and how to assess its health, a reliance on expert knowledge, an appearance of social neutrality and scientific objectivity, and the creation of fear and panic. Working within a biopedagogical framework, we argue that the reports teach this discourse through three mutually constitutive and reinforcing teaching techniques: moralism, sensationalism, and scientism. Through moralism, the reports teach us that good people live in accordance with neoliberal principles that emphasize staying active, eating nourishing food, managing their bodies and the bodies of their family members appropriately, and not making demands on the state’s resources. Similarly, through sensationalism, the reports teach us that obesity-related risks are omnipresent, ubiquitous, and life-threatening. And finally, through scientism, the reports teach us that the fears and panics generated around obesity are legitimate because they are based on “truths” established by experts. To show the extent to which public health policy both propels and is propelled by the mass media, we now consider how these same teaching techniques are at work in representations of obesity.

Reviewing the Literature on Mass Media Representations of Obesity

Media representations of obesity teach us at least one overarching life lesson: that obesity is a problem for which the individual and the individual alone is responsible. This lesson is at the very heart of how body size, shape, and weight are represented in a variety of media forms, including television (Fisanick, 2005; Giles, 2003; Grostern, 2011; Kendrick, 2008; Kyrola, 2005; Rich, 2011b; Ringrose & Walkerdine, 2008; Silk & Francombe, 2009; Sender & Sullivan, 2008), newsprint (Boero, 2007; Brooke, 2010; Caulfield, Alfonso, & Shelley, 2009; Gingras, 2005; Holmes, 2009; Kim & Willis, 2007; Saguy & Almeling, 2008; Warin, 2011), and video games (Rich & Miah, 2009). Through moralism, sensationalism, and scientism, these media instruct individuals in how to work on themselves in the name of both personal and public health.

Moralism, Sensationalism, and Scientism

The mass media constitute a privileged site in and through which North Americans gain knowledge about body weight (Boero, 2007; Boyce, 2007; Rich, 2011b; Rich & Miah, 2009; Roy, Faulkner, & Finlay, 2007; Saperstein, Atkinson, & Gold, 2007; Ye & Ward, 2010). Yet this knowledge is neither produced nor disseminated in a vacuum. Researchers report that the media tend to represent weight issues in moralistic terms (Boero, 2007; Brooke, 2010; Inthorn, S., & Boyce, T. (2010); Oliver, 2006; Saguy & Almeling, 2008; Saguy & Riley, 2005), linking a low body weight with moral success and a high body weight with moral failure. A moral individual, within the context of media representations of obesity, “takes charge of [his or her] health” (Roy, 2008, p. 363). Not all forms of “taking charge” are valued and rewarded, however. To be valued and rewarded, the individual must engage in active, agential, and ongoing work. Wilson (2005), for example, found that the “thin-loving” media did not approve of weight-loss surgeries; they were “too easy” and came without “sacrifice and willpower” (p. 252). For Wilson, the media tended to represent the “take charge” subject as morally superior to the “thin-at-any-cost” surgically improved subject.

Discourse analyses of the reality television shows The Biggest Loser (Silk & Francombe, 2009; Winter, 2004) and Honey, We’re Killing the Kids (Kendrick, 2008) found that they function through a moral framework that divides the “good” biocitizens from the “bad.” More specifically, Kendrick suggests that Honey, We’re Killing the Kids pathologizes those who fail to self-manage and self-regulate. Using Kristeva’s (1982) work on abjection, Kendrick argues that the central function of these shows is the transformation of “abject” bodies (i.e., fat and unhealthy) into “clean” bodies (i.e., slim and healthy). Grostern (2011) makes a similar case in her analysis of the reality television show Ruby, which features an obese woman who attempts to lose 100 pounds. This weight-loss journey is, as Grostern makes clear, portrayed as a moral obligation to both the woman herself and those around her.

Like moralism, sensationalism is a key feature of the literature on media representations of obesity. Saguy and Almeling (2008) maintain that the media throw “fat on the fire” in their coverage of weight issues, emphasizing dramatic scientific findings and extraordinary life stories while downplaying structural and systemic factors. Saguy and Almeling (2008) use Schudson’s (2003) notion of “para-journalism” to argue that authors of press releases try to anticipate what is likely to appeal to the media and, in doing so, focus on extreme research results and shocking individual testimonies (Saguy & Almeling, 2008). Like Saguy and Almeling (2008), Roy and her colleagues (2007) note that representations of healthy eating and active living in the Canadian news media are framed in dramatic terms that justify the nature of the research being reported on. Similarly, Brooke (2010) claims that American print media representations of obesity tend to be characterized by “conservative values” (p. 40) that correspond with commonsense understandings of why people get fat. Here, lifestyle causes, which are often exaggerated and simplified, gain particular purchase.

Scientism is also at work in media representations of obesity. Indeed, according to scientistic accounts, body weight is little more than a function of calories consumed and expended. For Gingras (2005) and Holmes (2009), however, these accounts fail to consider the social, cultural, environmental, and biological factors that influence body weight. Other researchers (Roy et al., 2007) have found that science is positioned as the authoritative voice on the prevalence, causes, consequences, and solutions to obesity. The prevalence of science in media reports on obesity gives the impression that it is complex, clinical, and requires cutting-edge scientific innovation and intervention.

In short, the media use techniques such as moralism, sensationalism, and scientism to teach us that obesity is an individual responsibility. These teaching techniques are, however, bound up with normative constructions of gender (Himes & Thompson, 2007; Inthorn, S., & Boyce, T. (2010); Kyrola, 2005; Young, 2005), class (Boero, 2007; Kendrick, 2008; Ringrose & Walkerdine, 2008), and race (Anijar, 2005; Campos & Mastin, 2007; Childress, 2005; Sender & Sullivan, 2008; Scholler, 2005; Shaw, 2005) that must be considered if we wish to fully understand how media representations of obesity do their biopedagogical work.

Gender, Class, and Race

In her discourse analysis of an Oprah episode featuring women trying to lose weight, Fisanick (2005) identifies two responsibilizing discourses: First, that women can and do have the ability to take control of their bodies; and second, that doing so is a necessary condition of being attractive and happy. In their content analysis of paid television weight-loss programming, Blaine and McElroy (2002) also found that fat people were portrayed as unattractive and unhappy. With twice as many images of women as there were of men, the programming in question was clearly and consistently gendered. Similarly, Inthorn and Boyce (2010) found that television news coverage tended to suggest that achieving a socially acceptable body weight was not only a matter of health for girls and women, but also a matter of self-actualization and self-improvement. Finally, Bishop (2005) noted how media representations of two weight-loss surgeries were gendered: When a well-known male media personality underwent weight-loss surgery, the media represented him as a responsible family man; when an equally well-known female media personality did the same, her surgery was represented as an attention-seeking act aimed at beautifying her body. Bishop’s findings complicate Wilson’s (2005) insofar as they suggest that the media both approve and disapprove of weight-loss surgery; that is, they applaud men’s choices to undergo it but not women’s choices to do the same.

The critical research suggests that the media responsibilize some individuals more than others. As Bell, McNaughton, and Salman (2009), Boero (2007), Kendrick (2008), and Saguy and Almeling (2008) show, women—and especially mothers—tended to be represented as both the cause of and solution to the obesity epidemic. Interestingly, Boero claims that the contradiction between mothers as both the causes of and solutions to the obesity epidemic points to a broader contradiction in the media coverage. That is, although representations of obesity appear to operate through a logic of universal health messaging, they nevertheless target some populations—especially single and poor women of color—more than others, representing them as in need of greater surveillance and intervention (Anijar, 2005; Bell et al., 2009; Kendrick, 2008; Ringrose & Walkerdine, 2008).

The changing meaning of gender, class, and race in North America is, according to Sender and Sullivan (2008), reflected in the reality television shows What Not to Wear and The Biggest Loser. While class and race were rarely mentioned directly, viewers nonetheless interpreted these shows in class- and race-based terms. Indeed, viewers deemed practices of self-transformation, including weight loss and the reduction or refashioning of the traditional markers of race (e.g., hair, skin complexion), to be necessary for upward social mobility. In addition, viewers assumed that fat Black contestants on The Biggest Loser were impeded by individual weaknesses as well as by what they saw as the Black community’s acceptance of fatness and resistance to weight loss.

Our review of the literature shows that the mass media instruct modern-day individuals in the truths of the dominant obesity discourse. Having demonstrated how these truths are taught by means of moralism, sensationalism, and scientism and cross-cut by normative constructions of gender, class, and race, we now consider how an episode of the television show Nip/Tuck can be seen as a compelling case study of how the media teach life lessons.

A Case Study of Mass Media Representations of Obesity

Nip/Tuck was the first medical drama on North American television to focus explicitly on issues of body image and body modification. When the first season aired in 2003, the show was the most highly rated basic cable series of all time for the 18 to 49 and 25 to 54 age demographics. When its third season aired in 2005, its premiere episode, “Momma Boone,” drew more viewers than any of the premiere episodes that came either before or after it (Nip/Tuck: US Television References, Online).² In addition to being among its most highly rated, the episode was—somewhat surprisingly—one of the show’s only sustained considerations of obesity.³ Indeed, with its record ratings and considerable critical acclaim, the show serves as an important point of entry into how the media in general, and Nip/Tuck in particular, function as a site through which millions of viewers gain knowledge about their bodies (Boero, 2007; Rich, 2011a, 2011b; Rich & Miah, 2009; Saperstein et al., 2007; Ye & Ward, 2010).⁴

“Momma Boone” (Season 3, Episode 1) tells the story of a 600-pound woman who must be surgically separated from a couch. The episode is framed in and through the show’s serial killer storyline. The serial killer is “The Carver,” a man known for carving up the faces of those who perpetuate the modern-day obsession with the “perfect body.” The show’s star surgeons, Sean McNamara and Christian Troy, have both been his victims.

Momma Boone’s story begins when a detective assigned to The Carver case summons Sean to her home. When Sean arrives on the scene, it is clear that Momma’s house smells disgusting and this is communicated through the use of aural cues (e.g., the detective declares that “no one enters without masks and menthol”) and visual cues (e.g., a paramedic vomits as he reaches for a mask while the windows of the house are broken by firefighters to ease the flow of air). Momma’s house is, moreover, coded as working class and this is conveyed through its appearance (i.e., it is small, run-down, and surrounded by plastic statues), its location (i.e., it is situated in a densely populated low-income area), its décor (i.e., it is strewn with stuffed animals, mail-order porcelain dolls, and garbage), and its possessions (i.e., it features a large television blaring the phrase: “like animals in a cage”). Through these aural and visual codes, Momma is represented as living in filth (i.e., “like [an animal] in a cage”) and is linked to a slovenly and sedentary “white trash” working-class culture. Here, then, the show teaches us that to be inactive is to be abject, and that inactive and abject individuals are often found among those who make up the working classes.

A stressed and nervous detective greets Sean outside the house. When Sean asks if another victim has been found, the detective answers: “Worse.” Given that what is “worse” is an obese woman, the detective’s choice of words is significant. It suggests that the circumstances surrounding Momma Boone’s situation are more horrifying than the work of a serial killer and that her obesity is an even greater insult to the human body than The Carver’s mutilations. In short, obesity is represented as a fate worse than death.

Sean and the detective enter Momma’s home with masks in hand. “They could smell her three doors down,” states the detective. “We responded to a 9-1-1 call about a possible heart attack and found this.” The detective’s use of the impersonal pronoun “this” when describing Momma is, again, significant. Like the earlier reference to “animals in a cage,” the detective’s choice of words functions as a powerful linguistic coding that suggests that obese individuals are something other than human.

Now inside the house, Sean peers at Momma Boone. As he grips his mask, he appears to be both afraid and appalled. As in Hollywood horror movies, the camera angles create suspense as Sean approaches something that we now expect to be monstrous. He introduces himself to Momma. She exclaims: “Has anyone ever told you that you look like Damon on Guiding Light?” Here Momma’s compliment positions Sean as someone who comes from a world of “high culture” that is full of light—somewhere clean and well-maintained. Momma, however, is positioned as someone who comes from a world of “low culture”—somewhere dark, dank, and chaotic. Indeed, the distinction between Momma’s world and Sean’s world is depicted through contrasting portrayals of the light, sunny outdoors and the murky, mysterious indoors. These visual markings act as what Foucault (1979) would call “dividing practices.” Through these practices, new species—that is, normal species and pathological species—are created. By means of both its aural and visual cues, then, the show teaches us that healthy people and ill people, or slim people and obese people, are different not only in degree but also in kind.

As their conversation continues, Momma asks Sean to refer to her as “Momma” rather than “Mrs. Boone” because “everyone does.” Presented as a common woman who dispenses with formalities, Momma’s nickname links her to both femininity and working-class maternity. When Sean moves in to start physically examining Momma, she insists she does not require medical attention. Referring to the paramedics, Momma says, “Can you make them stop looking at me please?” Sean obliges her and asks the paramedics to vacate the room, which they do. Momma tells Sean that she has been on the couch since 2002. She blames this state of affairs on the pain her “sciatica” causes her. In doing so, she maintains that her Health Maintenance Organization (HMO) told her to “just lie down” to “make the pain go away.” Sean explains that “there are anti-inflammatory medications [she] could have taken for her back,” to which Momma replies: “I know there are things I could have taken . . . But I’d gotten pretty big. And you know how people get out there when you’re big.” Two points can be drawn from this exchange: First, there is a shift away from a systemic explanation of Momma’s state—one that attributes her problems to a failing private medical system—to an individualistic explanation that attributes these problems to her failure to successfully self-manage her health; and second, Momma’s claim that she did not want to leave her home once she had “gotten pretty big” indicates that social stigma played a role in her now life-threatening condition. In other words, obesity is shown to result in social alienation and exclusion. HereNip/Tuck teaches us that Sean and Momma are prime examples of the different choices individuals can make. Like Sean, they can choose to be a self-managing and self-governing individual who continues to work hard even after he has been attacked by The Carver, or, like Momma, they can choose to “give up” and, by extension, endure humiliation, devastation, and degradation.

As the episode continues, Momma’s obese body is shown to be idle and expensive. For instance, when Sean asks Momma about how and what she eats, she explains that her husband Denny—who has the same name as a major American fast food chain—“cashes [her] disability cheques and brings [her] whatever she wants.” Through these references, the episode represents Momma’s body as a “soft body” that is overly reliant on the welfare state (Jeffords, 1994) while linking the welfare state to inactive lives and ill health. In addition to idleness and expense, Momma’s body is associated with foulness and repugnance. When Sean asks Momma about “going to the bathroom,” Momma replies, “I’d rather not talk about that.” Momma has not used a bathroom for some time and has, instead, soiled herself and her couch. Here her abject body, with its overgrown toenails and its scabrous skin, is represented as one that lives in urine and feces. In other words, Momma’s body is shown to lack the boundaries required to separate itself from its waste products. This scene is, therefore, driven by anxiety relating to blurred bodily boundaries and, as Kristeva (1982) would put it, threats to the “clean and proper” body.

As Sean proceeds with the examination, he is represented as compassionate, kind, and, above all, necessary. It is worth noting, however, that by featuring such an extreme example of obesity, the episode effectively preempts debate around the need for Sean’s expertise. What is more, the cosmetic surgeon’s vested interest in promoting and perpetuating the dominant obesity discourse is concealed by the fact that Momma is in an undeniably urgent situation. The surgeon is, therefore, represented as the only solution to Momma’s problems whereas surgery is represented as that which turns “out-of-control” unhealthy bodies into “in-control” healthy bodies.

The examination scene is characterized by the same aural and visual codes as a science fiction movie: The room is dark, space-age music plays in the background, and Sean, wielding a flashlight, is wearing what appear to be night-vision goggles. These codes suggest once again that Momma is a member of another species—an abject other who must be approached carefully and cautiously. As Sean completes the examination, Momma’s abject otherness is further reinforced by the fact that her “exposed skin has grafted itself to the couch,” a fact that causes the detective to show signs of nausea. His nausea is, in our view, indicative of the extent to which the body disrupts and disturbs when its skin fails to serve as a rigid boundary between inside and outside, self and other, subject and object. Again, then, anxiety is produced by and through the blurring of the obese body’s boundaries. The exchange between Sean and the detective continues:

Detective:

But how is that even possible?

Sean:

She’s been lying in her own waste in this humid air for 3 years. Bacteria can live for years on synthetic fibers. That coupled with the moisture from her bodily fluids and her extreme weight caused her to literally fuse with the fibers on that couch. . . . We have to move her fast. . . . This woman has sepsis and severe deep vein thrombosis. One of a dozen clots in her legs could travel toward her lungs and kill her. I need to get her legs moving. The only way to do that is to get her off that couch.

Detective:

How? There isn’t a door big enough to get her and that couch through.

Sean:

Take this wall out.

In what looks like a military operation, paramedics, police officers, and firefighters begin to chain-saw the wall in question. Momma begins to show signs of concern over being seen in her couch-bound state, so Sean ensures that she is concealed by a tarp as she is carried out. Scores of people are watching. The exercise is a circus and Momma is its freakish main act.

As she is taken away on a flat-bed truck, the woman everyone knows as “Momma” is represented as a child. With a stuffed animal in hand and tears running down her face, she asks Sean to comfort her. Both an abject mother and an unruly child, Momma is portrayed as a colossal drain on the state’s tax base. Indeed, through its detailed depiction of the staff and services required to move her, the scene emphasizes the enormous public cost involved in trying to rescue, rehabilitate, and save someone with a body like hers. As Momma is going into surgery, Denny arrives, demanding to see her. The surgeons, however, prohibit it. Denny is visibly upset, so Sean decides to speak with him:

Denny:

I’ve got conjugal rights.

Sean:

Do those rights extend to keeping her chained to that couch and feeding her like a veal calf? You might as well have been pouring gasoline down her throat.

Denny:

I gave her what she asked me for.

Sean:

Oh bullshit. Keeping her in that house let you control her. If you had loved her at all you’d have gotten her help.

Denny:

Don’t you dare challenge my love for that woman. . . .

Sean:

They should bring you up on charges of criminal negligence.

Denny:

The only thing they can charge me with is loving Momma too much.

Sean:

Then why do you show it by enabling her sickness?

Denny:

You think I didn’t want her to lose weight? You try getting someone to do something they don’t want to do. It’s like serving them a sandwich made of shit. They may eat it, but they ain’t gonna like you or it afterwards.

A number of important things happen in this scene: Momma is made responsible for her obesity; Momma’s obesity is represented as a “sickness” for which both she and Denny ought to “have gotten her help”; Momma’s abject otherness is likened to that of a “veal calf” who was “chained to the couch”; and Momma’s life choices are linked to “shit.” So what does the episode teach us about obese people in this scene? First, they choose to be as they are; second, they are ill and in need of medical intervention; third, they are members of a species that is neither fully animal nor fully human; and, fourth, they are, like shit itself, a waste.

Shortly after Sean and Christian have begun Momma’s surgery, Christian discovers that Momma has “necrotising fasciitis”—a flesh-eating disease—and may require an amputation. Christian takes Momma’s hand during the surgery, and they talk about her daughter who no longer visits her:

Momma:

(Tears). She stopped coming because she got so damn mad at me. . . . She said she couldn’t take it. Offering help and support and me not taking it.

Christian:

Why didn’t you try getting off the couch, Momma?

Momma:

. . . I’m a neat freak. I’ve always run a clean house. . . . I’d look around my place and see that there was just so much to do. I’d get to thinking about all the dust and scrubbing the walls down . . . and I’d just feel exhausted. I got so tired planning all the work that had to be done. So I’d say to myself: “tomorrow, Momma, tomorrow when you get your strength back, it will be scrub day. . . .”

Christian:

And tomorrow would come and you would still feel exhausted.

Momma:

Right. That’s right.

Over the course of this conversation, the episode connects obesity to both inactivity and filth. In doing so, it suggests that when Momma ceased to run a clean and proper home, she ceased to maintain a clean and proper body. Here, then, her abject home becomes a metaphor for her abject body.

The nurse confirms that Momma has gangrene and that the surgeons will have to amputate at least one leg. As they excuse themselves to discuss their options, Momma looks around at all the bloodied gauze and needles and falls into a coma. When the surgeons return and try to revive her, the anesthesiologist shows them that Momma—in an uncharacteristic act of agency—indicated “do not resuscitate” on her form. These events, in combination with the abundance of surgical equipment and medical protocols, suggest that modern medicine is the solution to obesity and that any effort to treat Momma is a complex clinical problem requiring cutting-edge scientific technology.

The final scene is Momma’s funeral. A crane has to lower the coffin into the ground due to its size. Momma’s daughter, June, gives a short speech:

I’m sure you are wonderin’ what kinda daughter would let her momma end up like she done. But it was Momma who made me promise to leave. I think about you every day, Momma. You were trapped under the weight of your own fear. Nothing was going to save you. All you could do was find it in your heart to free me. And that’s done. And I thank you for it.

June’s parting words underscore the episode’s recurring themes: It was all Momma’s fault; nothing could have saved her; and the most useful thing she did in her life was to save others from herself. Ultimately, this final scene crystallizes the key insights of critical obesity researchers such as Hodgetts, Bolam, and Stephens (2005) who argue that, in the neoliberal age, individuals are blamed for their own illnesses; intolerance is generated on the basis that these individuals are perceived to lack self-discipline; and their perceived lack of self-discipline contributes to a rising level of health-related anxiety which, in turn, affects public health policies and priorities.

Conclusion

In this article, we have shown that the life lessons that characterize public health promotion campaigns, such as Let’s Move and Priority Areas, are neither distinct nor separate from those that characterize health-related entertainment programs such as Nip/Tuck. Instead, public health promotion campaigns and health-related entertainment programs teach life lessons using similar techniques. Through our review of the critical literature on media representations of obesity and our case study of one of these representations, we show that moralism, sensationalism, and scientism are mobilized and deployed to instruct viewers in the truths of the dominant obesity discourse. Viewers are taught that obesity is a problem of individual responsibility; that it is a threat to population health; that science and medicine are required to control it; and that obese individuals are bad biocitizens who drain the state’s resources. Through our case study of Nip/Tuck’s “Momma Boone,” we show how the lessons of this dominant discourse are also constituted by and reinforced through other discourses, such as sexism, classism, and racism. In and through them, viewers learn that obese individuals are unhealthy, abject, excessive, irresponsible, and monstrous others. Indeed, in the case of media representations like these, the combination of text, image, and sound makes the biopedagogical operations and effects all the more powerful. In this way, normative constructions of obese bodies, whether in public health promotion campaigns or the mass media, are not merely represented as health problems to be solved, but are complex repositories in and through which entangled social anxieties and embodied oppressions play out. Given our analysis in this article, we contend that representations of obese bodies warrant a biopedagogical analysis so as to identify the “hard lessons” for “soft bodies” that so often characterize them.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors acknowledge the support of the Social Sciences and Humanities Research Council of Canada.

Notes

Author Biographies

Marc Lafrance (PhD, University of Oxford) is an associate professor of sociology at Concordia University. Informed by contemporary poststructuralist and psychoanalytic approaches, he explores media representations of gender, sexuality, race, and class and how they are bound up with broader issues of self, body, and society. He is especially interested in North American television and how a number of its most popular shows portray surgically assisted body modification. More specifically, he focuses on how the televisual media represents new frontiers of surgical practice—ranging from obesity-related procedures to facial transplantation and sex-reassignment surgeries—and how these representations can be seen to express a variety of collective fears and fantasies pertaining to present-day body modification practices. His work has been published in leading refereed journals and book collections as well as in the popular press.

Stirling Lafrance earned his master’s degree in social and political thought from York University. His research interests include conceptions of health and illness, the pharmaceutical industry, understandings of the self, and the role of the free market in embodied experience and modern life.

Moss E. Norman (PhD, University of Toronto) is an assistant professor in the Faculty of Kinesiology and Recreation Management at the University of Manitoba, Canada. His primary area of research is on the body, masculinity, health, and fatness. He is currently working on an SSHRC-funded project that uses community-based research design to examine the indigenous physical cultural masculinities of boys and men in Fisher River Cree Nation.

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