Unhealthy appetite: Is 'Fatsploitation' fuelling the obesity crisis?

In another life, Barry Austin would be up to his neck in blood and guts fighting for his country in the Afghan badlands or some other far-flung theatre of war. But instead of following his boyhood dream of becoming a professional soldier, Austin selected a different career path. He chose food; lots and lots of food.

Instead of becoming the man he aspired to be, he grew into one he hates; he became Britain's fattest man. Austin now spends his days bedridden, fighting infections instead of the Taliban, struggling to breathe, immobile and waiting to die. Weighing in at 55st, he's the undisputed heavyweight champion of a nation obsessed with obesity. The star of documentaries like Inside Britain's Fattest Man and Back Inside Britain's Fattest Man, Austin had his own magazine column and became a media personality.

Barry Austin was morbidly obese long before the first stories about him were written and broadcast, but the media attention did little to discourage his kamikaze lifestyle and inadvertently fuelled the enormous appetite that enslaved him. He'd consume up to 30,000 calories a day, and drink up to 15 litres of Coke and 40 pints of lager. The camera loved him. "I achieved a level of fame because of my size and I enjoyed that fame when it was there," Austin, 40, admits. "I liked being known. When I could go out, people would recognise me and I'd be lying if I said that didn't make me feel good. But ultimately, if I could change it all I would give it up in an instant just to be normal. The TV shows didn't help me. They put me in a hotel and said eat and drink whatever you like. It was like giving a heroin addict drugs."

The camera still loves Barry. Earlier this year he starred as a record shop assistant in the new British comedy film Just For The Record alongside Rik Mayall, Danny Dyer and Sean Pertwee. It was the first time he had reason to leave his house for months. He still maintains that there are positives to his unique brand of celebrity. "If it highlights the problems and the health issues associated with obesity then that is a good thing," he says. "Attitudes are changing. People see anorexics and feel sorry for them; they used to see fat people and were disgusted by us – we were fat and lazy. Now those perceptions are changing and obesity is becoming an acceptable illness. The danger, though, is when it gets turned into a freak show."

There's no better barometer of a society's interests and obsessions than the pages of its television guides. What we watch defines us as a nation; the homely family drama of Heartbeat, the ironic humour of Little Britain, the carnival of narcissism that is Katie and Peter: Stateside.

Open a TV guide or flick through a magazine, and you will find a measure of our culture and an indication of where we are as a society. With shows like Half Ton Mom, Fix My Fat Head, Supersize Teens: Can't Stop Eating and Fat Teens in Love, it's evident we may have a few hang-ups about the morbidly obese, who are wheeled out on reinforced gurneys for our entertainment. "Feeders", "squashers" and "BBWs" (men with a sexual predisposition for obese women, obese women who squash men for sexual gratification and big beautiful women respectively) vie for space in the womens' weekly magazine market.

It's only right that the obesity crisis should receive attention. As Chief Medical Officer Sir Liam Donaldson maintains: "Obesity is our number one health challenge." Almost half of men in the UK and a third of women are overweight. Estimates predict that by 2050, up to 90 per cent of children could be overweight too, costing the taxpayer £50bn a year in increased health provision. Ignoring the problem would be irresponsible. But how helpful is the increasingly sensational way obesity is portrayed and perceived?

In the US, where two-thirds of the population are overweight or obese, the forthcoming book The Fat Studies Reader argues the problem is not obesity per se but the way it is presented in culture. Sociologists point to a "societal fat phobia" which engenders prejudice against the obese – and argue that this prejudice is tolerated by those who would never dream of making racist or sexist remarks.

Kathleen LeBesco, a communications professor at Marymount Manhattan College, writes: "Fat people are widely represented in popular culture as revolting – they are agents of abhorrence and disgust." Fat phobia is fuelled by the way the overweight are characterised on screen. Think Chunk from The Goonies or the grotesque Fat Bastard in Goldmember, gluttonous comedy fall guys.

The appetite for "fatsploitation" entertainment isn't yet sated. Earlier this month in the US, a new sitcom, Drop Dead Diva took the controversial step of casting a US size 16 (UK size 18) actress in the lead role. The series, in which skinny model Deb dies in a car crash and is reincarnated as plus-sized Jane, drew record audiences and has been applauded for showing a larger woman in the main role. Rosie O'Donnell, Liza Minnelli and Paula Abdul have signed up for guest appearances and the Los Angeles Times and The New York Times gave it rave reviews.

Earlier in the summer, reality shows More to Love (a plumper version of The Bachelor) and Dance Your Ass Off (a super-size Dancing With the Stars) were also hits. Although Drop Dead Diva goes some way to redressing the fat phobia balance, it still employs stereotypes to explain Jane's obesity. The character drools over doughnuts and in a moment of despair, finds solace in a mouthful of squirty cream cheese straight from the can.

The obese are subject to prejudice, even cruelty. A 2008 report by the Rudd Center for Food Policy and Obesity at Yale University noted that teachers held lower expectations of overweight children. But judging by the media interest, that abhorrence is mixed with fascination.

***

Connor McCreaddie was an unlikely poster boy. In 2007, aged eight and weighing 14st, North Tyneside Council threatened to take him into care, arguing that allowing him to become so obese constituted a form of neglect. The story made headlines and McCreaddie was the subject of an ITV1 Tonight With Trevor McDonald special. Connor's mother won the battle to keep custody of her son – as long as she ensured he observed a strict diet. While Connor McCreaddie faded back into obscurity, the debate he unwittingly sparked still rages on.

Tam Fry of the National Obesity Forum, a body set up by health practitioners which aims to improve the prevention and management of obesity, explains: "Connor had the misfortune of being the first in a long line of obese children under media scrutiny and his name is known in obesity history. What his story did was to start the debate on whether obesity is a safeguarding issue. The legacy of Connor's story is that just as we worry greatly about very thin children and place them in care and residential clinics to build them up, people are now debating whether there is a difference between the dangerously thin and the other side of the coin, where a child is overtly neglected by his or her family in being allowed to eat whatever comes to hand. To that degree, the publicity surrounding him was of value."

The McCreaddie case, and its impact on the public, sent editors and commissioners hunting for bigger and better obesity stories. As a desk executive on a Sunday red top at the time recalls: "It was a feeding frenzy, everyone was hunting for a fatter kid."

Last year they found her. Georgia Davis weighed 33st at 15 and was dubbed "Britain's Fattest Teen". After seven months on a residential US boot camp style weight loss programme, Georgia lost half her body weight, a story featured on the front page of The Sun last month.

Fry continues: "After the Connor story I hoped we would have got rid of the initial voyeurism. Unfortunately things seem to have evolved to now concentrate on individuals and extremes and that must make a lot of people feel very uncomfortable. It also has the effect of turning many people off the issue. People will always be interested in the exceptional and many viewers like the Schadenfreude of looking at other people's problems and feeling better about their own, which is part of human nature.

"In Georgia's case what wasn't reported is how she'll maintain that level of weight loss when she comes off the programme, as critics say boot camps produce short-term success but long-term failure. However policy makers should look at the story and ensure that not only are there more weight loss camps in the UK, but that there is a tracking system implemented that ensures people on them get adequate aftercare. The Sun quite rightly put the story on its front page but one of the crimes is that she had to go to America to lose the weight."

***

Obesity as entertainment is nothing new. In the early 19th century, long before Barry Austin tucked into his first balti (he ate nine a night at the peak of his fame), Daniel Lambert weighed 52 stone and travelled the country in a reinforced carriage, charging people one shilling to gawk at him.

Today, owing to the increase in digital channels, the internet and print media, exploiting obesity has never been easier. And although editors maintain that there is a public interest in stories about the obese, they acknowledge the appetite for the sensational that drew crowds to stare at Lambert's tragic girth is just as acute today.

One red top executive, who asks to remain anonymous, explains: "It's important to highlight areas of public health concern, but there is also a demand from readers for the bizarre and the extreme. People like to read about really big people because the stories make them feel better about their own lives. The more extreme and unusual the angle, the more valuable a story is. No one wants to read stories about weight loss any more, they want weight gain, the bigger the better. There's an innate morbid fascination. It's the modern day equivalent of a freak show. If you put a web cam in the world's fattest man's bedroom, people would watch."

Channel 4 Commissioning Editor Andrew Jackson, who commissions the series Supersize vs Superskinny, a show in which overweight people swap diets and lifestyles with their underweight counterparts, believes documentaries concentrating on exceptional cases do have a social purpose.

"As a viewer sometimes you need to see the extreme cases," he argues. "The programmes put a mirror up to society and say 'there are these people out there and they haven't got a voice'. These programmes give them a voice. Clearly there is an appetite for them because people watch them. The market decides: if no one watched them, they would not get made."

He insists that the show's subjects are not exploited. "They are monitored carefully by healthcare professionals and there are lots of protocols and procedures in place. We don't just stop filming and leave them. Many of them continue losing weight after we stop filming and we aim to be informative." But he adds: "Entertainment is fundamental, the show cannot be self indulgent. It doesn't have to be laugh out loud but there needs to be light and shade."

But healthcare professionals argue that the balance has tipped too far into the light, illuminating the grotesque and the extreme at the expense of the measured and the informed. If the forecasted rise in obesity levels becomes reality, it will be a disaster for the NHS, which will struggle to cope without massive investment. Even now the service cannot provide the procedures for the 3.2 million individuals who are eligible for bariatric surgery on the NHS. Education and prevention are the keys. In 2004 the Government White Paper Choosing Health outlined a public service commitment "to halt, by 2010, the year-on-year increase in obesity among children under 11 in the context of a broader strategy to tackle obesity in the population as a whole".

Currently, as a result, millions of pounds are being spent on the Change4Life campaign, a society-wide movement that aims to prevent people from becoming overweight by encouraging them to eat better and move more. The imperative to change the unhealthy habits of a nation are pressing. Carnegie International Camp is arguably the UK's most successful young persons' weight loss programme. Developed 10 years ago by academics from Leeds Metropolitan University, it helps obese children and teenagers change their lifestyles and has gained a reputation for sound science-based practice. Eighty per cent of those it helps are referred by Primary Healthcare Trusts and to help gain that level of success, it actively represents itself in the media. Its technical director, Professor Paul Gately, acknowledges: "Media interest helped us initially; although we were subject to a lot of inaccurate reporting it let us connect with more children and families and raised awareness."

Carnegie was the subject for the daytime BBC show Weighing In and was also featured in a show about overweight pre-schoolers, Too Fat To Toddle, a title Gately admits he "hated". The secret of Carnegie's success in effectively controlling how it is represented lies in its insistence on maintaining some degree of editorial control.

Gately explains: "We only engage in programmes that feature children who fit in the normal obesity range. Programmes that concentrate on the extreme are pure entertainment and not relevant to 90 per cent of the public who see the very obese and say, 'I'm not like that, I can have another cream cake.'"

There is evidence to suggest that this propensity to portray only the most extreme cases is warping public perception of the condition. This month a widely-publicised study of obese families carried out by Plymouth's Peninsula Medical School suggested that the eating habits of severely-overweight parents had more bearing on the health of their children than genetics.

Little wonder, then, that 75 per cent of parents with overweight children define them as "just right", and half of parents with obese children classify them as being in the normal weight range. Gately says: "We have a national perception that what constitutes being overweight and obese is further down the line than the reality. Society as a whole is desensitised and subsequently the call to action is dropped because people think 'I am not that bad, I can carry on along the same path'. When they finally realise it is time to act, it is far too late."

***

While a desire to exaggerate the sensational appears to create a form of fat fatigue, it also marginalises the obese themselves. Dr Peter Rowan, a consultant psychiatrist who specialises in eating disorders at Cygnet Healthcare Trust explains: "Obese people live with a feeling that they are seen as being highly undesirable and as being abnormal. The media isn't responsible for that but it does support it, prolong it and accentuate it."

Across the Atlantic body size has become a civil rights issue. Activists have reclaimed the word "fat", size-positive dance groups take the message to the masses and fat studies are being introduced in classrooms alongside gender studies and race studies.

Marilyn Wann, a fat activist from San Francisco, explains: "Fat is a really powerful F-word. The power in the word 'fat' lies in taking it back from the people who gave it mean, unhappy and negative meaning, when I say I am fat I am saying it with pride. I became a rad fatty the day a guy I was seeing told me he was embarrassed by me being fat and I was denied health insurance based on weight alone. Because of that day I started a 'zine called Fat! So? and ever since, I've been asking that question: so?"

To push the message, Wann takes to the streets and encourages people to stand on her "Yay Scales"; a set of bathroom weighing scales that gives compliments instead of numbers. The message is clear: weight is irrelevant.

Kira Nerusskaya, a New York fat acceptance activist and filmmaker says that as the UK fat population grows, the movement is taking root here too. "There are activists and movements in the UK, they don't shout as loud as we do in America – but they are there. It is time to overturn the stereotypes. In sitcoms, the larger actors are never the heroes, they are the sidekicks or the butt of the jokes, always eating. It is vaudevillian and wrong," she says.

With current estimates suggesting that, without intervention, we will become a predominantly obese population within the next 40 years, the irony is that the minority currently castigated for their waistlines may become the majority.

Perhaps, with the help of fat activism – fuelled by the bloggers of the "fatosphere", whose anti-diet crusades were reported by The New York Times last week – the pendulum will swing the other way. Some time in the near future, size 20 magazine editors will put underweight actresses on weight gain programmes while TV executives networking in Soho cake shops will be debating whether Superskinny Teens: Can't Start Eating really is worth running in the 8pm slot.

That obesity is a health disaster in the making is not an issue. The human body is hard-wired to seek the highest calorific intake with the smallest physical effort and historically there has never been a more opportune time to store fat.

What is evident, however, is that, from the TV companies to magazine publishers and, ultimately, the consumers queuing up to take a guilty peek at the latest sideshow curiosity, we are all culpable to some extent for the way obesity is represented.