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Book Excerpt: The War on Drugs and the War on Obesity

The following is an excerpt from a chapter of Da’Shaun Harrison’s forthcoming book, Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness

In March 2004, during a news conference with widespread coverage, the Centers for Disease Control and Prevention (CDC) published a report that claimed that obesity was “killing 400,000 Americans a year,” and that it was becoming America’s “number one preventable death”—surpassing tobacco. The CDC defines obesity as “weight that is higher than what is considered as a healthy weight for a given height.” Body mass index (BMI) is used as a “screening tool” to determine who is and is not obese. The report was published in the Journal of the American Medical Association (JAMA) which, at least at the time, was the most prestigious medical journal in the nation. Since Julie Gerberding, director of the CDC at the time, and other top CDC scientists co-authored this report, it had the credibility it needed for waves of reporters and news outlets to publish it. It would soon lead to egregious and violent headlines across the nation about fat people, fat bodies, and the alarming rate at which they were allegedly dying from obesity. It would also be cited repeatedly by officials including then Secretary of Health and Human Services Tommy Thompson, several members of Congress, and creators of weight loss drugs seeking to draw attention and funding to anti-obesity efforts. From that moment forward, throughout the rest of that year, public officials and other media platforms used that report as evidence that obesity was the greatest threat facing the American people, and as justification for what would eventually become a forceful and strapping diet industrial complex. This was the start of “The Obesity Epidemic.”

There were a few public indictments of the JAMA report, starting with Science magazine in May 2004. In a report of their own, they wrote: “Some researchers, including a few at the CDC, dismiss this prediction, saying the underlying data are weak. They argue that the paper’s compatibility with a new anti-obesity theme in government public health pronouncements—rather than sound analysis—propelled it into print.” This became, at least on record, the first acknowledgment of an emerging anti-fat theme within government, health, and science institutions. Soon after Science magazine’s report, the Wall Street Journal published a story of their own that covered the errors in the study published in JAMA. On November 23, 2004, they opened their story with “America’s obesity epidemic may not be as deadly as the government has claimed.” Continuing, they wrote that the study “inflated the impact of obesity on the annual death toll by tens of thousands due to statistical errors.” On April 30, just a month after the later-disputed report was published, Dr. Terry Pechacek, who was the associate director for science in the CDC’s Office on Smoking and Health, wrote in an email to his colleagues that he was “worried that the scientific credibility of the CDC likely could be damaged by the manner in which this paper and valid, credible, and repeated scientific questions about its methodology have been handled.” After stating that he had warned two of the report’s authors along with another senior scientist, Pechacek wrote, “I would never clear this paper if I had been given the opportunity to provide a formal review.”

According to J. Eric Oliver in his book Fat Politics: The Real Story behind America’s Obesity Epidemic:

“… the CDC researchers did not calculate the 400,000 deaths by checking to see if the weight of each person was a factor in his or her [or their] death. Rather, they estimated a figure by comparing the death rates of thin and heavy people using data that were nearly thirty years old. Although heavier people tend to die more frequently than people in mid-range weights, it is by no means clear that their weight is the cause of their higher death rates. It is far more likely that their weight is simply a proxy for other, more important factors such as their diet, exercise, or family medical history. The researchers, however, simply assumed that obesity was the primary cause of death, even though there was no clear scientific rationale for this supposition.”

In other words, the CDC contrived this number from an estimation after reviewing data that was thirty years old. It was never a calculated number concluded from their own intense research; it was a scientific guess made with the hope to punish fat people for their bodies. And it worked. The damage had already been done. The people and institutions who would stand to benefit from that report had already won, and it was the start of the modern genocide of fatness and fat people. As Oliver states, fat people do tend to die at higher rates than their thin counterparts, but it isn’t because of their weight. Fat people tend to die at higher rates than thin people because doctors misdiagnose them, or refuse to treat them, due to their fatness.

In January 2005, the CDC admitted that their 400,000 deaths number was a result of a “mathematical error,” and in February of that same year—just after the CDC published a summation of the internal investigation that was launched following the initial report’s release—the Los Angeles Times published a response to the investigation. Their report opened with this firm statement: “A controversial government study that may have sharply overstated America’s death toll from obesity was inappropriately released as a result of miscommunication, bureaucratic snafus and acquiescence from dissenting scientists.” This would become the second public acknowledgement of governmental disarray that was leading the nation in one of the most violent pseudoepidemics in the nation’s history.

In April 2005, just a year after the initial report was published, the CDC released another report—also through JAMA—wherein they not only offered a much smaller number of deaths per year due to obesity, but also claimed that “moderately overweight people” live longer than people at a “normal weight.” The new report in JAMA cut the death toll to 112,000, which was well under half of what was initially reported, but the damage had already been done. Around the world, people were using the CDC’s original numbers as fuel for the war waged on fat people. The diet industry, at the time, was already well over a century old. Americans had been dieting and trying to lose weight for decades. But with this war waged on obesity, the early-to-mid 2000s is a pivotal moment in history for the creation of this modern diet industrial complex. The CDC’s report cemented a growing belief: fat people were dying rapidly and the only solution was to kill them quicker—either through forcing them to transform their bodies or to die trying. Despite how theatrical that reads, that is what was being demanded of fat people. The goal was, and continues to be, to eradicate fatness. To do that, one was to either overinvest in dieting—which has proven to be ineffective—or die trying to reach an ideal weight defined by organizations like the CDC and WHO, either on an operating table or in a gym.

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But this was not the first time in America’s history that a genocide would be declared on an entire community at the behest of this country’s leadership. Just three decades before the start of the War on Obesity there was the genesis of the War on Drugs.

In the 1960s, drugs were a prominent part of the sociopolitical climate of the times. They became associated with juvenile uprisings, and in many ways, they became emblematic of the political and ideological contestation over harmful policies and practices by the United States government—arguments led mostly by Black and other marginalized people. As such, the government ceased all research on the safety of these drugs and, in 1971, former president Richard Nixon declared a war on drugs. Nixon substantially increased the amount and power of federal drug control agencies in the country and bulldozed mandatory sentencing and no-knock warrants into the forefront of the legislation being passed at that time. Though it passed during his tenure as president, the legislation picked up momentum under Reagan’s presidency in the 1980s. By the early 1980s, local police had used over 1,500 no-knock warrants, according to Peter Kraska, a professor with the School of Justice Studies at Eastern Kentucky University. By the year 2000, that number had increased to 40,000 per year. In 2010, it increased to 70,000 per year. Of these searches, over 40 percent impacted, and continue to impact, Black homes—including the home of Breonna Taylor who was killed in Louisville, Kentucky in 2020.

Soon after that legislation was passed, Nixon placed marijuana in the most restrictive category of drugs, schedule one, where it would stay until it was reviewed by a commission led by then Governor Raymond Shafer—a commission appointed by Nixon. Despite the concordant recommendation from the commission in 1972 to decriminalize the possession and distribution of marijuana—for personal use—Nixon ignored the report and did not adhere to the proposed recommendation. Irrespective of this, eleven states around the country decriminalized marijuana possession between the years 1973 and 1977—a year in which former president Jimmy Carter ran and was elected on a platform inclusive of the decriminalization of marijuana. And in that same year, the Senate Judiciary Committee motioned to decriminalize the possession of up to an ounce of marijuana for personal use. But soon after, these efforts were left behind as former president Ronald Reagan ushered in what would become known as “mass incarceration” through his expansion of Nixon’s war on drugs. The incarceration of people charged with nonviolent drug offenses grew from 50,000 in Reagan’s first year in office to 400,000 by the end of 1997. Stress levels and concerns induced by the fearmongering of the Reagan administration were high, forcing upon mostly Black communities a proliferation of arrests. By the end of 1999, over half a million Black people were held in state or federal prisons. In 1980, the overall federal prison population was 24,000. By 1996, the number had grown to 106,000—the majority of which were arrested for drug offenses. According to Kenneth B. Nunn in “Race, Crime and the Pool of Surplus Criminality: Or Why the ‘War on Drugs’ Was a ‘War on Blacks,’” from 1979 to 1989, the percentage of Black people arrested on drug charges doubled from 22 percent to 42 percent of the overall number of drug-related arrests. Also during that time, the amount of Black arrests for drug use violations grew exponentially from 112,748 to 452,574—an increase of over 300 percent.

Ronald Reagan introduced zero tolerance policies in the mid-80s and Los Angeles Police Chief Daryl Gates—who, according to the Drug Policy Alliance, once stated that “casual drug users should be taken out and shot”—founded the Drug Abuse Resistance Education (D.A.R.E) program that would soon be implemented in schools across the country despite there being no evidence stating that it was useful. This also meant, however, that there was no widespread evidence that it was ineffective—an unsurprising failing of the United States’ medical industry. The Drug Policy Alliance also states that “the increasingly harsh drug policies also blocked the expansion of syringe access programs and other harm reduction policies to reduce the rapid spread of HIV/AIDS,” making the War on Drugs not only a war on recreational use of drugs but also on medicinal use. They continue:

In the late 1980s, a political hysteria about drugs led to the passage of draconian penalties in Congress and state legislatures that rapidly increased the prison population. In 1985, the proportion of Americans polled who saw drug abuse as the nation’s “number one problem” was just 2–6 percent. The figure grew through the remainder of the 1980s until, in September 1989, it reached a remarkable 64 percent—one of the most intense fixations by the American public on any issue in polling history. Within less than a year, however, the figure plummeted to less than 10 percent, as the media lost interest. The draconian policies enacted during the hysteria remained, however, and continued to result in escalating levels of arrests and incarceration.

In 1994, John Ehrlichman—domestic affairs advisor and top aide to Nixon, as well as a Watergate co-conspirator—told investigative reporter Dan Baum a truth that had long been understood but never really confirmed: the War on Drugs was a legal way to criminalize and abuse Black people. In his report, published in Harper’s Magazine, Baum records Ehrlichman saying:

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”

In a recording of a conversation between Nixon and Reagan, released by the National Archives in 2019, Reagan—who was the governor of California at the time—was quoted saying, “Last night, I tell you, to watch that thing on television as I did … To see those—those monkeys from those African countries—damn them, they’re still uncomfortable wearing shoes.” At best, this was a conversation between two anti-Black white men ranting about their hatred of Black people. At worst, this was a collusion of two anti-Black white men—both of whom held social, economic, and political power—who met with the intent to forge a plan that would help them leverage that power over the people and communities for whom they held a lot of hate. It was a success. The war—that was and has been more accurately called a genocide, waged first by Nixon—has been continued by every president that followed him, across party lines.

At the core of the War on Drugs is the Black, and at the core of the War on Obesity—even if not as explicitly so—is the Black fat. Black people make up roughly 13 percent of the American population, but about 51 percent of America’s fat population. Obesity is determined by body mass index (BMI), something people have been taught is a direct measure of one’s health. Over two hundred years ago, a Belgian man named Adolphe Quetelet created what we now know as the BMI. Quetelet was not a physician, nor did he study medicine in any capacity; Quetelet was a mathematician and a sociologist, and it was that on which the BMI was created. Quetelet is known for his envisioning of l’homme moyen—an image of what he understood to be “the average man”—which he developed through “the measurement of human features with the deviation plotted around the mean.” He began the development with the use of physical features of the human, who—at least as his work suggests—he understood to be cisgender white men. Those features included the chests of Scottish Highland regiment soldiers. After, he moved on to moral and intellectual qualities like suicide, crime, and madness. On Quetelet, Erna Kubergovic writes in the Eugenics Archive:

“For Quetelet, the average body presented an ideal beauty; the normal, conceived of average, emerged as an ideal type to be desired. It was Quetelet that formulated the BMI, initially through the measurement of typical weights among French and Scottish conscripts. Instead of labelling the peak of the bell-curve as merely normal, he labelled it ‘ideal’, with those deviating either ‘overweight’ or ‘underweight’ instead of heavier than average or lighter than average. Thus, while informed by statistics, Quetelet was still working within the medical context of the normal; that is, he envisioned the normal (i.e., typical) as the ideal or something desirable.”

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What he had created was the standard for male beauty and health, built only with white Europeans in mind and determined by something that measured whole populations and not individuals. By the twentieth century, Quetelet’s work was being used as the basis of, and justification for, eugenics. And though all of his work in that time period was based in anti-Black race science, he was clear that the intent of the BMI was to measure populations to develop statistics. Aubrey Gordon, creator of “Your Fat Friend” and author of What We Don’t Talk about When We Talk about Fat, wrote more on this in an online essay:

“By 1985, the National Institutes of Health had revised their definition of “obesity” to be tied to individual patients’ BMIs. And with that, this perennially imperfect measurement was enshrined in U.S. public policy. In 1998, the National Institutes of Health once again changed their definitions of “overweight” and “obese,” substantially lowering the threshold to be medically considered fat. CNN wrote that “Millions of Americans became ‘fat’ Wednesday—even if they didn’t gain a pound”—as the federal government adopted a controversial method for determining who is considered overweight.”

It was that second change, Gordon notes, that gave way to “a new public health panic: the ‘Obesity Epidemic.’” Gordon continues:

“By the turn of the millennium, the BMI’s simple arithmetic had become a de rigueur part of doctor visits. Charts depicting startling spikes in Americans’ overall fatness took us by storm, all the while failing to acknowledge the changes in definition that, in large part, contributed to those spikes. At best, this failure in reporting is misleading. At worst, it stokes resentment against bodies that have already borne the blame for so much, and fuels medical mistreatment of fat patients.”

As covered in chapters 3 and 4, “health” was created as the antithesis of Blackness; the Black fat was always already removed from the possibility of “good” health—meaning always situated inside / under the label of “bad” health—and was to always and already be the criminal. From the moment white Europeans saw fat Africans, the science that followed was intended to always separate them from the rest. In this way, the BMI—created to maintain whiteness as superior —was always going to harm the Black fat and it is for this reason that Black people make up over half of the fat population and why Black people also have more “health risks” than their white counterparts.

Crack, too, is a “health” failing. The government convinced the public that Black people were the only ones doing hard drugs; that the “crackheads” were rummaging the streets looking to harm anyone who may stand in between them and their “fix”; that addiction was a moral failing rather than a direct result of one’s immediate environment, overrun by poverty, anti-Blackness, and the inability to acquire proper (mental) health care. And it was this that led to punitive, carceral responses to drug addiction rather than methods rooted in harm reduction. Because the Black always already fails in, or is removed from, morality, and as such never has access to care.

The world’s obsession with obesity and being overweight is less about health and is more about the cultural and systemic anti-Blackness as anti-fatness that diet, medical, and media industries profit from. Just like with the War on drugs and the crack epidemic, major institutions falsified evidence about the effects of fatness or obesity as a way to criminalize and profit off fat people—especially the Black fat. That damage is still being done. The Black fat is not dying from being obese, nor is the Black dying from drug addiction. The Black—the Black fat—is dying because of a medical industrial complex committed to seeing fatness, Blackness, and Black fatness as death; they are dying because of a lack of proper resources—like housing and employment—that would provide them with money, health care, and a place to rest their heads; the Black fat, in particular, is dying because of an inherently anti-Black system of policing that sees them as the deadly Beast that needs to be put down. This is the Belly of the Beast: removed from care and placed always in the way of harm.

Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness is available for pre-order now.

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Da’Shaun Harrison is a nonbinary abolitionist and organizer in Atlanta, GA. They write and speak publicly on race, sexuality, gender, class, religion, disabilities, fatness, and the intersection at which they all meet. Harrison is the author of the forthcoming book, “Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness,” which is expected to be published in July 2021. Their portfolio and other work can be found on their site: dashaunharrison.com.

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