Obesity: The Post-Mortem and “gratuitous fat-shaming”

The Doctor and I recently watched “Obesity: The Post-Mortem”, a BBC3 recording of the autopsy of a 17 stone (108kg) woman. Unless you have access to BBC’s iPlayer, you’ll not be able to watch it (legally), and I imagine many of you wouldn’t want to in any event.

But even if you can’t watch it, you can nevertheless engage with the point made in her post on the show, where the Doctor says that there’s a difference between something being uncomfortable or unpleasant, and it being offensive. I agree, and want to expand on that point here.

The primary argument for the show being considered offensive is that it is said to be an example of “fat-shaming”. In the Guardian, Helen Archer argues for this view, in a piece that describes the deceased body as a “vast landscape of pale, mottled flesh” (which seems slightly incongruous in a piece arguing against fat-shaming), and that also makes comparisons to shows like “The Biggest Loser” and “Secret Eaters”.

Shows like those latter two, however, do two things very differently: first, they identify their subjects; and second, they make explicit reference to what those people do (eat too much, or eat the wrong things) as well as to what they don’t do (exercise). In other words, these shows by and large blame their subjects for the state they find themselves in.

For “fat-shaming” to be obviously present, someone has to be shamed. BBC’s “Post-Mortem” never identifies its subject, so the only kind of shaming that seems possible here is a “shaming by proxy”, where obesity is treated as a weakness or flaw, perhaps as the result of shameless gluttony and/or lethargy.

Again, the show doesn’t do that. You can argue that it’s perhaps ghoulish, (I’ll return to that a bit later), but the explicit focus is on how obesity affects the body – not what causes obesity, or what sorts of people might or might not become obese.

The intended value of this is clear – just as photographs of diseased lungs are an attempt to make the physical costs of smoking more real, showing organs encased in fat or deformed ventricles (the deceased died of a heart attack) are meant to shock people into awareness of the full extent of the damage done on the inside, partly because we focus so much on external appearance.

You are not necessarily engaging in fat-shaming when you make the factual assertion that our lives can be compromised by obesity, or the broader point that a public health epidemic like diabetes costs us all, in that the medical system we all use has to bear the burden.

For some people who are obese, and who wish to not be obese, a show like this can be a spur to action. For people who are not obese, and care about remaining so, a show like this can add motivation to persist or improve with whatever they are currently doing in terms of managing their mass.

In short, “shaming by proxy” isn’t necessarily entailed here. Some viewers might well feel shamed, yes – but why are we compelled to define a show’s merit (or a book, etc.) through the worst interpretations of how it might function, or through ways in which it could be abused, rather than through its intended purpose?

Everything and anything can be interpreted in ways that result in outrage. But encouraging this leads to defining offense far too broadly, and limits our ability to be critical of ourselves and each other.

To return to the personal aspect of fat-shaming, this 7 minute “behind the scenes” video of the autopsy (caution: it does contain a few images some might find upsetting), will also tell you that the BBC engaged with (and got permission from) the Human Tissue Authority (HTA) to make this show.

The HTA serves to ensure “that the bodies of the deceased and tissue taken from them are treated with respect and the dignity of the person is maintained”, and I think that they succeeded in this case. Perhaps they were assisted by some bioethicists in making their decision and, as David Edmunds recently reminded us, moral experts are useful for exactly this purpose: to ask us to think more carefully about our instinctive outrage.

My impression here is that much of the outrage is either unfounded (as is the case with the fat-shaming argument) or a simple expression of revulsion at the ghoulish aspect, where our conception of ourselves and our bodies as sacred is being challenged. We simply don’t expect or appreciate being dealt with in this matter-of-fact or mechanical way.

On this conception of things, we might almost be said to have interests even after death. On one level this is of course absurd, in that the dead cannot have interests. But what those who make this argument are instead appealing to is human interests more generally, where being this callous or clinical may be an index of a more general dehumanisation.

Much of what I wrote in 2012 about Gunther von Hagens and his “Body Worlds” exhibition is relevant to this aspect of the argument, so I’d encourage you to read that rather than repeat it here. In short, though, I wouldn’t want to dismiss entirely the problem presented in these collisions between materialism and conceptions of human dignity – but I would want to reject the claim that this autopsy was entirely indefensible.

There is some merit in not rushing to trivialise all of our taboos, and not rejecting our sensitivities out of hand. But there is also merit in not becoming hypersensitive to offence, and in not allowing words like “fat-shaming” to become so broad in their interpretation that they cover instances which seem to do no shaming at all.

Also published on Medium.