In the first of an occasional series, Debbie Cameron re-reads what T&S had to say about the politics of body size in the 1980s and 1990s, and asks what has happened to feminist thinking in an era of moral panic about obesity.
Throughout its life as a print magazine, T&S regularly published pieces about the sexual politics of size, weight and appearance. The very first issue included Margot Farnham’s reflections on Kim Chernin’s book Womansize; a year or so later, Cath Jackson offered a critical re-assessment of Susie Orbach’s 1978 classic, Fat is a Feminist Issue. Other contributions dealt with the political activism that was going on at the time, interviewing women who were involved in groups and campaigns, and reporting on a national fat women’s conference that was held in 1989. The last piece on this topic which I can find in the archive is my own 1998 review of Fat and Proud, whose author, Charlotte Cooper, had been active in the fat women’s movement. Re-reading this, and all the other pieces T&S published in the 1980s and 1990s, made me wonder what’s happened since the end of the 20th century. Is fat still a feminist issue, and if it is, what are feminists doing about it?
After the second wave: body image and the ‘beauty myth’
What Kim Chernin dubbed ‘the tyranny of slenderness’—the cultural pressure put on women to be thin, and the way women internalize that pressure, with all kinds of negative effects—is clearly still an issue for feminists. It was one of the themes of Naomi Wolf’s 1991 book The Beauty Myth, and it also features prominently in two more recent books (reviewed in T&S by Delilah Campbell), Kat Banyard’s The Equality Illusion and Catherine Redfern and Kristin Aune’s Reclaiming the F-Word. These writers point out that the pressure on girls and women has got progressively more extreme. Young women today grow up in a world where images are routinely photoshopped to make their subjects look thinner than they really are, a world of size zero models and weekly magazines making catty comments about any female celebrity who appears to have gained a few pounds. Girls are starting to worry about their weight at younger and younger ages, and there has been a sharp rise in recorded cases of ‘adult onset’ anorexia.
These developments haven’t gone unchallenged. In addition to the critical analyses offered by writers like Banyard, Redfern and Aune, there have been protests against the use of excessively thin catwalk models at London Fashion Week, and a campaign (backed by the TV presenter Gok Wan) for lessons about ‘body image’ to be part of the school curriculum. One company—Dove cosmetics—has found it commercially advantageous to pick up on these criticisms of the fashion and beauty industry. The advertisements produced for Dove’s ‘campaign for real beauty’ show what are presented as ‘normal’ female bodies rather than the atypical bodies of fashion models. They do span a range: they aren’t all young, skinny or perfectly proportioned. But nor are any of them particularly fat.
Of course, there is nothing unexpected about the absence of overtly fat women in ads for beauty products. But I can’t help feeling there’s a certain similarity between Dove’s approach to ‘real beauty’ and the approach taken in many feminist discussions of body image. These tend to focus on feeling bad about the size of your body as an experience all women share; the seriousness of the damage this can do is most frequently evoked in the figure of the anorexic girl or woman. Kat Banyard’s chapter on body image, for example, is structured around the experiences of ‘Ellen’, a woman with a severe eating disorder. I don’t want to deny that this is an important issue, nor dispute the more general point that consumerist ‘beauty myths’ make most women feel dissatisfied with their bodies. Yet it seems strange that feminists have so little to say about another issue to do with size and weight—one which affects far more women than anorexia and bulimia. How is it possible, in the 21st century, to talk about oppression based on body size without broaching the subject of obesity?
Obesity: naming, blaming and shaming
It isn’t very long since the terms obese and obesity were medical jargon : today, more than a decade of moral panic about the so-called ‘obesity crisis’ or ‘obesity epidemic’ has made them part of our everyday vocabulary. And the effect of the ‘crisis’ rhetoric has been to demonize fat people (or as we now say, ‘the obese’) to a degree that was scarcely imaginable 20 years ago.
The obesity crisis is represented not only as a public health emergency, but also as an economic disaster: this has led not only to the intensification of old forms of blaming and shaming, but also to some new ones. In addition to being lectured even more insistently on their gluttony, sloth and lack of self-control, fat people are now continually told that they are a burden on the welfare state, taking scarce resources away from more deserving cases. There is talk of rationing their access to healthcare: in some cases fat people have already been told that they cannot have treatment (e.g. hip replacement surgery) unless they lose a certain amount of weight. By contrast, there are some kinds of treatment—most notably bariatric surgery—which obese people are now encouraged to sign up for, though they are not without risk, they are permanently life-changing, and their long-term health consequences remain unclear.
Another effect of the panic has been the proliferation of media formats which turn the bodies and lives of obese people into popular entertainment. Television schedules are awash with this stuff: in the last three days, if I’d wanted to, I could have watched the first episode of Weight Loss Ward, a new TV documentary series following the staff and patients of a Sunderland hospital’s specialist obesity unit, Big Body Squad, the continuing saga of a team of professionals who care for obese people, Embarrassing Fat Bodies, an obesity-themed spin-off of the long-running medical show in which TV doctors advise people on various ‘embarrassing’ conditions, and Fat for Cash, an ‘investigative’ documentary about obese women selling sex to male fat fetishists. And that’s just the prime-time programmes: daytime and late-night schedules are filled with endless repeats of old shows in the same vein, from ‘makeover’ formats like Supersize vs Superskinny to ‘human interest’ programmes with titles like Half Ton Mum (where the narrative can always be summarized in the question, ‘will this extremely obese person get a grip, or will s/he die’?)
Voyeuristic, moralistic and utterly demeaning, these programmes are 21st century freak shows. They are made in, and contribute to, a cultural climate in which fat people can be mocked, degraded and dehumanized with impunity. As I write, controversy is raging around a new Channel 4 TV docudrama series entitled Benefits Street, which has been criticized for reinforcing stereotypes and popular misconceptions about benefit claimants by depicting its subjects, working-class residents of a street in Birmingham, as wasters, scroungers and criminals. Many viewers have complained about the programme, and a petition demanding that Channel 4 stop showing it is circulating online. But there is no such outrage about the many programmes that parade obese people as freaks, or present them as a burden on society.
This culture of contempt for fat people as a group has made the bullying of individuals more acceptable than ever. The use of language and images in a deliberate effort to humiliate the obese is common enough to have acquired its own name, ‘fat-shaming’. And it isn’t just the media that encourage or condone this. One policy think tank has seriously suggested that fat-shaming should be used in public health campaigns: they’d like the government to plaster the streets with billboards reading ‘If you’re obese or overweight, are you happy with the way you look?’
Sexism and the crisis
The argument is sometimes made that the advent of the obesity crisis has made discussions of size and weight less gender-specific, and less sexist, than they used to be. Fat may have been a feminist issue, but obesity is not. On that point I would beg to differ. The oppressive practices associated with the moral panic around obesity affect women in specific ways, and in many cases more adversely.
Take fat-shaming, for instance. While it can be and has been used against both sexes (a recent high-profile case involved the actor James Gandolfini, whose sudden death from a heart attack in 2013 prompted a flurry of tweets blaming him for his own demise), the use of shaming as a form of social control is not a gender-neutral phenomenon. Women are socialized to see their bodies and their behaviour as an endless source of shame, and their sensitivity to being shamed is exploited both commercially (you couldn’t, for instance, sell vaginal deodorant without it) and politically.
I will return to the matter of shame, since I think it is at the heart of what makes obesity both an important and a difficult issue for feminists to address, but the complicated gender politics of shame are not the only thing that makes fat women’s experience distinctive. Women are still more likely than men to face discrimination on grounds of size, because of the greater tendency to judge them by appearance. They are more likely to be subjected to street harassment and verbal abuse. They are the prime targets for the diet and weight-loss industry—look at any sample of adverts for weight-loss products and you will see not only that women predominate in all of them, but that their predominance increases as the products get more extreme. Men make an occasional appearance in ads for, say, Weightwatchers, but when we get to the ads for very low calorie meal replacements, or drugs that interfere with the absorption of fat, the men have disappeared. And being fat only exacerbates the problems women have with the sexist assumptions and patronizing attitudes which we still encounter all too frequently in our dealings with healthcare professionals.
The obesity crisis has also produced one new kind of demonization which is explicitly gendered: the blaming of mothers for childhood obesity. Women—particularly working class women—are charged with destroying their children’s health and shortening their lives through ignorance, incompetence and laziness: they feed their kids on junk food instead of healthy home cooked meals, and let them spend all day playing video games. These ‘bad mothers’ are now being targeted for re-education by an army of middle class do-gooders, whose attitude towards them is at best condescending; at worst it is a toxic brew of snobbery and misogyny.
Feminists in the fat-o-sphere
What have feminists had to say about the obesity crisis and its effects on women? So far as I can tell, surprisingly little. If you look at what has been written about the issue of size and weight by feminists since around 2000, what you find is a mixture of abstruse postmodernist theory (in which the idea of fat female bodies as ‘unruly’ and ‘transgressive’ seems to feature prominently) and the same sort of literature—a blend of identity politics and self-help—which was discussed by Charlotte Cooper in her account of fat women’s politics in the late 1990s. In those days feminists were producing zines with titles like i’m just so fucking beautiful; today they’ve migrated to the blogosphere, or as this part of it is apparently known, the ‘fat-o-sphere’. But the general approach seems not to have changed much, as we can infer from the title of a book based on one of the most popular of the new fat feminist blogs: Lessons from the fat-o-sphere: quit dieting and make a truce with your body.
Such political analysis as these texts contain is based on arguments developed in the ‘fat acceptance’ movement that has existed since the late 1960s. In addition to pointing out that dieting doesn’t work, the fat acceptance movement has consistently challenged the orthodox view that being fat is incompatible with being healthy. On that basis it argues that persecuting fat people does not serve the public interest, but is simply a form of unjust discrimination against a socially stigmatized minority. As minority rights campaigns go, this seems pretty mild-mannered; but in the present climate of hysteria about obesity, it is regarded in some quarters as dangerous extremism. Its contemporary critics often seem to associate the idea of fat acceptance specifically with feminism: recently, one contributor to a health blog called it ‘one of feminism’s most glaring moral failures’, going on to explain that
…in promoting obesity as ‘acceptable’ [feminists] are hampering efforts to address the problem while we still have a little time. The day of reckoning is approaching fast, and every day Americans get fatter is another day closer to a public health catastrophe. It’s time to stand up to the fat acceptance feminists and confront them over this critical issue.
The rise of this kind of apocalyptic rhetoric is an indication of how much the climate has changed since the 1990s, and I’m not sure that shift can be addressed by a movement whose goal is ‘fat acceptance’. Granted, something depends on what is actually meant by that phrase: does it mean demanding that society should accept fat people instead of persecuting them, or is it more about fat people learning to accept themselves? Originally it was probably intended to have both meanings, but over time the emphasis has shifted more and more to the self-acceptance side of the equation. And the trouble with that is, individual selves do not exist in a vacuum. The way you see yourself is inevitably affected by the way other people treat you. How can you ‘make a truce with your body’ when the rest of society has declared war on it?
In the present climate of fat-shaming and freak shows, threats to restrict fat people’s access to medical treatment and take obese children into care, it seems pretty clear that the fat acceptance project has failed. What we’ve got now is institutionalized fat intolerance, and what we need is grass-roots fat resistance. I’d like to see campaigns against all kinds of size-based discrimination; I’d like to see media companies bombarded with complaints about their depiction of fat people in obesity-themed reality shows. I’d like to see activists follow the example of the Fat Underground (a radical, feminist-led group that split off from the US fat acceptance movement in the 1970s) and turn a critical eye on the obesity research which supposedly underpins current policy and practice. That would help to expose the many vested interests (both commercial and professional) which distort the picture we’re presented with by ‘experts’; it would also feed into another form of resistance, demanding the regulation or outright prohibition of ineffective and dangerous weight-loss products.
But there is a problem with this vision of organized fat politics (and more specifically, fat feminism). Explaining what I mean brings me back to the question of why feminists aren’t really talking about obesity, except in the quasi-therapeutic language of ‘fat acceptance’, and it also takes me back to some of the points made by earlier contributors to T&S. At the heart of it is the issue I began with, shame; and in the spirit of that old feminist adage ‘the personal is political’, I’ll start by talking about my own.
Don’t know what you’ve got till it’s gone
My review of Fat and Proud made clear that for me the issue was personal: when referring to fat women, I wrote ‘we’ rather than ‘they’. I had been fat since around the age of 10, and I was bullied at school for it; as an adult I suffered all the usual petty humiliations, and some that were not so petty. I thought I knew fat oppression pretty well from first-hand experience. But actually I hadn’t realized quite how deep the prejudice goes—or how far I had internalized it myself.
I always thought that I had achieved ‘fat acceptance’—or as much of it as was possible for an individual fat woman in the culture I belonged to. Though I resented other people’s negative judgments of my body, I didn’t hate it myself; I didn’t feel guilty about eating and I had never in my life attempted to lose weight. Until, in my late 40s, I was scared into dieting by a medical test result. A couple of months later, a repeat test showed that the first one had been inaccurate. Yet I didn’t abandon my diet: I carried on with it until I was no longer (in clinical terms) obese, or (in everyday life terms) noticeably fat. That isn’t to say I became thin: I just became someone whose size passes without any particular comment. And that answers the question of why I didn’t stop dieting when the original, medical reason for it became irrelevant. I had already discovered how much difference it makes to the quality of your life when your size is no longer the first thing anyone notices. Losing weight meant not being routinely stared at or insulted in the street; it also significantly reduced the time it took me to get served in a cafe or a shop. As I lost more weight, I found many kinds of encounters became less stressful—though before I lost weight I would not have described them as particularly stressful. I only realized they had been causing me stress when the source of the stress was removed.
A random, minor incident made me think about this seriously. A drunk man in the street called me a stupid cunt. It was the first time for a long time that I’d experienced any street harassment, and my first reaction, literally the first thought that came into my mind, was ‘wow, he called me a stupid cunt and not a fat cunt’. At that moment I realized that virtually every sexist insult ever hurled at me for 40 years had been prefaced by the epithet ‘fat’. Fat cunt, fat bitch, fat cow, hey fat girl—the two forms of contempt, for femaleness and fatness, were always yoked together, as if being female compounded the offence of being fat, and vice versa. But even as I recalled this, I felt bound to ask the question: ‘what does it say about me that I’m relieved, maybe even pleased, that this drunken misogynist called me stupid rather than fat?’ And the only answer that made sense was that I’d internalized the same shame as everyone else. My so-called self-acceptance had been, if not a complete lie, then at least a partial one. The truth was that I preferred not being fat. I do not assume that I will never be fat again, and if it comes to pass I won’t regard it as a tragedy. But if I’m honest, I can’t imagine that I’ll be happy about it either.
Of course what applies to me will not necessarily apply to every woman, but I don’t think my feelings are unique: in fact, I’d guess that they are shared to some degree by most fat women whose cultural experience is similar to mine. If women were told they could wave a magic wand and become instantly slim—or just slim enough not to be seen and treated as fat—I don’t think many would say, ‘no thanks, this is who I am and I’d rather stay that way’. But if that’s true, it creates a particular problem for organized fat politics, perhaps especially of the feminist variety. And while the problem itself is not new, the ‘obesity crisis’ has given it a new dimension.
Politics and pride
It is part of the condition of subordinated groups to be made to feel inferior and ashamed: overcoming that shame has been an important goal for every major liberation movement of the past century. In addition to fighting structural oppression (unjust laws, endemic violence, discrimination and exploitation), movements for civil rights, the end of imperialism, women’s liberation, gay liberation and the rights of people with disabilities have all made use of a rhetoric of pride, exhorting people to embrace and celebrate identities which had been deemed inferior and shameful. This is one of the characteristics of identity politics, where the demand for recognition—acknowledgement of and respect for a group’s own definition of itself, its experiences and its values—is as important as the demand for redistribution of power and resources.
Fat and Proud located the feminist fat politics of the 1990s squarely within this tradition. The title itself makes the point loud and clear, and it is also unmistakable in declarations like this one, which appears on the second page:
I feel lucky to be fat. The difference my fat connotes has been and continues to be one of the most challenging and enriching areas of my life. I am very proud of my difference. I feel like a survivor, and I think my perspective as a fat person is a benefaction that has made me special.
When I reviewed the book in 1998, I was critical of this kind of language: for me there’s a difference between not being ashamed of being fat (a goal I am absolutely committed to) and treating fatness—or body size in general—as a source of identity and pride. I also had problems with the idea of fatness as a self-defined identity. As Charlotte Cooper noted herself, the number of women who define themselves as fat is significantly greater than the number who are, in fact, sufficiently fat to be targets for sizeist oppression. Inside the fat women’s movement, this has often been a contentious issue; outside, it’s one reason why so many discussions end up revolving around women’s shared experience of feeling bad about their bodies, while not addressing the more specific ways in which fat women are oppressed.
Another reason why this happens is the idea that ‘size prejudice cuts both ways’—i.e., women who are judged to be too thin face the same hostility as those who are judged to be too fat. On this view, the problem isn’t specifically fat oppression, it’s a definition of acceptable body-size which is so narrow as to exclude almost everyone. But as the feminist blogger Glosswitch observed, after a high-profile version of this argument was made by Emma Woolf, the formerly anorexic co-presenter of Supersize vs. Superskinny:
Failure to acknowledge the difference between sniping at thin people and the constant discrimination faced by those who are fat is a real slap in the face to anyone who’s been on the receiving end of the latter.
The analysis that produces complaints about ‘thin-shaming’ is at best politically naive: at worst it is takes us into the reactionary realm of ‘backlash’ movements advocating ‘straight pride’, or calling on men to celebrate their masculinity. But that criticism is starting to look increasingly beside the point. The identity/pride-based fat politics that Charlotte Cooper’s book represented is now coming under pressure from a new direction.
As the proportion of fat people in the population increases, while oppressive policies and attitudes are also on the rise, the conditions in theory exist for a new wave of fat activism taking its cue from earlier campaigns by other identity-based movements. We could, hypothetically, see the rise of a movement whose goal would be for fat people to follow minority ethnic groups, LGBT people and people with disabilities down the road that leads to legally protected equality and greater social acceptance. (‘We’re here, we’re fat, get used to it’.) But that doesn’t seem to be how things are going. Rather, we are seeing the emergence of a ‘progressive’ political position which does acknowledge that obese people are being unfairly treated, but which also assumes that the ultimate goal should be to eliminate that injustice by eliminating obesity itself.
The position I am describing here is espoused in particular by socialist commentators, who have interested themselves in the issue because of its connection to material, class-based deprivation. Obesity in developed societies is now associated with poverty rather than affluence, and there is, as I pointed out earlier, a tendency for politicians and the medical establishment to blame it on the unhealthy lifestyles chosen by working class people out of ignorance, incompetence and laziness. The socialist counter-argument is that poor people are forced into unhealthy lifestyles by the workings of contemporary capitalism. On one hand, the overworked and underpaid can’t afford to eat a healthy diet, spend time cooking from scratch or go to the gym; on the other, they are relentlessly targeted by the profiteering purveyors of cheap but unhealthy food. The result is to increase the existing health inequalities between the rich and the poor. And the political solution is to attack the problem at its capitalist root. Force the food industry to reduce levels of sugar, salt and fat in its products, stop the sale of sugary soft drinks in containers the size of a bucket, ban the advertising of unhealthy foods to children, tax the profits made by making people ill and put them into the health service which is obliged to pick up the pieces.
Clearly, this is not a politics of fat pride, identity or recognition; it’s a form of old-style economic redistribution politics. In the current British political climate it is explicitly a criticism of the conservative-led coalition government’s pusillanimous and hypocritical stance on the problem of obesity: they bleat endlessly about the cost of it to the economy and the NHS, while refusing to take on the powerful industries who are really responsible for the problem. However, the left shares the government’s assumption that obesity is indeed a serious problem, and that our long-term aim should be to eliminate it. Standing up for obese people’s rights is only an interim measure: in the longer term, what socialists defend is the right of all human beings to an affordable and healthy diet which will not make them obese in the first place. If fat is indeed a feminist issue, then feminists are going to have to engage with this argument and decide where we stand in relation to it.
My own feelings about it are mixed. On one hand, there is much that I agree with in the socialist analysis—it would be hard to dissent from its criticisms of the food industry, for instance, and even harder to disagree with the point that poor people are being unjustly scapegoated by politicians and mainstream obesity ‘experts’. On the other hand, I find the new ‘progressive’ line problematic insofar as it completely bypasses the questions feminists have raised about the politics of body size.
One of those questions is about the psychological dimension of the issue and how that relates to the social experience of oppression. What and how people eat is not all about what they can or can’t afford. Susie Orbach may have had her limitations from a radical feminist perspective, but she wasn’t wrong to point out that for some people, and especially some women, overeating (or indeed not eating) can be a way of dealing with the misery and rage produced by powerlessness and abuse. Orbach evidently thinks this line of argument can be used to explain the current ‘obesity crisis’: when speaking recently on a ‘body image’-themed edition of BBC Radio 4’s Woman’s Hour, she was critical of the term ‘epidemic’, suggesting it was coined to suit the interests of the pharmaceutical industry (the link in note  offers some evidence to support that), but she did link increasing rates of obesity to the growing prevalence of what she called ‘troubled eating’. Her analysis in other words placed more emphasis on the emotional element in obesity than on the socioeconomic factors that are central to the leftist account.
Once again, I’m ambivalent about this: while I find it hard to ignore the connections between obesity, poverty and the aggressive marketing of cheap processed food, I think it is also unhelpful to gloss over the presence of other recurring themes in the stories obese people tell about their lives. For example, on what I would consider the least dehumanizing of the current crop of obesity TV shows, Weight Loss Ward, a surgeon mentioned in passing that the majority of the patients he treats are taking medication for depression and anxiety. Initially I assumed that this was because being a target for the sort of persecution discussed earlier tends to make people anxious and depressed. But later, a nurse clarified that many patients had been depressed before they became obese: in her experience, the root cause of the kind of severe obesity the unit deals with (where people have become virtually immobile, or are at imminent risk of life-threatening illness) was psychological distress stemming from earlier traumatic experiences. ‘The general public’, she concluded, ‘has no understanding of what makes these people the weight they are’.
While I don’t think that observation applies equally to everyone who is obese by the standard medical definition, it does suggest that a purely economic analysis of obesity—what causes it and what will eliminate it—oversimplifies a more complicated set of issues. (It also, of course, begs some questions about why obesity clinics like the one in the programme are treating what they themselves recognize as a symptom, without addressing the deeper causes.)
The other issue the economic analysis bypasses is the politically fraught relationship between the medical definition of a ‘healthy’ body and the cultural evaluation of some bodies as more acceptable or desirable than others. For feminists this is an important question: sizeism and fat-hatred, both external and internalized, are inextricably bound up with the wider issue of women’s objectification, and the tendency to judge women first and foremost by how they look.
Although the socialist analysis of obesity does criticize the victim-blaming indulged in by politicians and policy-makers, it does not actively challenge the prejudices which are common in the culture at large—the belief, for instance, that fat is physically repulsive and axiomatically unhealthy. What it is saying to the obese boils down to, ‘you are a problematic symptom of capitalist exploitation; we don’t think that’s your fault, but in a better, more socially just world you would not exist’. Susie Orbach, similarly, was sometimes criticized for implying that after the feminist revolution we would all find it easy to achieve an ‘acceptable’ weight, and consequently there would be no more fat women. If you were yourself a fat woman, it was hard to hear this message as liberating rather than oppressive. I doubt the new obesity-era version will sound any more positive to those at the sharp end of the current moral panic.
I don’t know how, or if, these tensions–both within feminism and between feminist and other forms of ‘progressive’ politics–can be resolved; but I would like to see them more openly discussed. And in the meantime, I think it would be helpful if we could make more of a distinction between the issue of body image, which in some form or other affects the great majority of women, and the more specific issue of fat oppression, which does not affect all women equally. It’s time to stop glossing over that difference, and to recognize how oppressive the treatment of obese people (and the mothers of obese children) has become. It’s also time to become more vocal in opposing size-based discrimination, persecution and shaming. To me that is not about pride, or identity, or making a truce with your body. It’s about the justice, equality, dignity and respect that feminists demand for all women.
 The standard medical definition of obesity is based on Body Mass Index (BMI), calculated from an individual’s height and weight and expressed as a numerical value. You are considered ‘obese’ if your BMI is 30 or more (‘very’ or ‘morbidly’ obese if it is 40+), and ‘overweight’ if it is between 25 and 30. There is considerable debate among scientists about the validity of these definitions. Some consider BMI itself to be a crude and inaccurate measure; even where its validity is accepted, there are disputes about the basis on which specific BMI values are taken to indicate whether someone’s weight is ‘healthy’ or ‘unhealthy’. In particular, there seems to be very little evidence for treating BMI values of 25-30 (‘overweight’) as medically problematic. These definitional details matter, because public health policy is based on them; and the minute you start to look into where the definitions come from, you also start to realize how much of what we are told about obesity by politicians, public health spokespeople and healthcare professionals is based on questionable assumptions, disputed statistics and inadequate or unreliable evidence. (For an accessible discussion of some of these problems—and the vested interests associated with them—see here. And here.) ↩