The Horror of “Obesity Autopsy”

Bad DoctorYes, the BBC is airing the autopsy of a fat person. No, it’s not ok. I can see the meeting now, someone stands up and says “how can we create programming that plays on and sensationalizes the social stigma against fat people, makes no medical sense, helps no one, and does tremendous harm?”  And thus “Obesity Autopsy” was born, eclipsing “Sharknado” as possibly the most ridiculous idea to get produced and aired but, of course, far more harmful.

Let’s start with the basics. They have flown the body of a “nearly” 238 pound woman, who died in her sixties of heart disease and donated her body to science, from Long Beach, California 5,000 miles to London so that Mike Osborn, a consultant for the Royal College of Pathologists, and Carla Valentine, an assistant pathology technician can perform an autopsy which will first be aired as part of a one hour program on BBC Three, an online service focused on the youth demographic, and then on a late-night slot on either BBC One or Two. The program will also include a panel of “obese young contributors,” who will explore the causes of obesity, and how it affects their day-to-day lives.

Before I get into this, let’s remember that fat people have the right to live and thrive in fat bodies without shame, stigma, bullying, or oppression and it doesn’t matter why we’re fat, what the consequences of being fat may or may not be, and if we could – or even want to- become less fat or not fat. Any suggestion otherwise will be some combination of sizeist, ableist, and/or healthist. The rights to life, liberty, and the pursuit of happiness are not size (or health) dependent.

Now that we’ve got that crystal clear, let’s start with the many ways that this is medically unsound:

I can’t imagine why they would fly a body 5,000 miles unless the UK has laws that require greater respect for the dead than this debacle, or that they want to make a spectacle of the transport as well as the autopsy.

The idea that one can extrapolate information about all fat people from the autopsy of one fat person is patently ridiculous.  This is taking what I’ll call the “Dr. Oz Fallacy” (wherein he tried to claim that all fat people have bad hearts based on the fact that the fat people who had come to him for heart surgery had bad hearts – as if the thin people who came to him for heart surgery were actually fine…) to whole new lows.

The autopsy can’t even tell us everything about this woman’s body (let alone everything about all fat people’s bodies, let alone how they do or don’t relate to thin people’s bodies.) For example:

It can’t tell us about her genetics in terms of body size or cardiac issues. It cannot tell us if her autopsy results are due to her body size, or something else entirely.  The  entire premise is completely bereft logic and I absolutely question the ethics of the pathologist and the assistant pathology technician participating.

It can’t tell us how she was affected by the culture of fat hate (Peter Muennig’s studies have found that the diseases that are correlated with “obesity” are also correlated with the stress of constant stigma, and that women who feel they are too heavy have more physical and mental illnesses than women who are fine with their size, regardless of their size.)

It can’t tell us if she was affected by the chronic dieting (and subsequent weight cycling) that is almost never successful and yet is prescribed throughout our lives to fat people by our healthcare providers.

It can’t tell us if she was affected by taking extremely dangerous drugs that doctors suggest fat people should take for a very tiny chance to get thin, despite the risk of death (often from heart problems,) or if she was affected by the tendency to prescribe to fat people what we diagnose in thin people.

It can’t tell us if her actual health problems were ignored by doctors who prescribed manipulation of body size instead of the evidence-based interventions that a thin person with the same symptoms would have received. It also can’t tell us if she avoided the doctor  or delayed seeking treatment because of their tendency to substitute shame and diets for actual evidence-based care.

It can’t tell us if her healthcare was compromised by the epidemic of fat bias among doctors.  It can’t tell us if doctors would have worked harder to save her if she was a thin person on the table.

What it can tell us is that instead of using this woman’s donation of her body to science to advance the care that fat people receive (for example giving future surgeons a chance to work on a fat cadaver rather than seeing their first fat body when they are working on it) they are exploiting her life and death. I can’t imagine how I, or my loved ones, would feel if I donated my body to science and instead it was used in a mockery of science for television ratings.  It is inexcusable, it is unjustifiable, it is disrespectful, it is wrong.

And for everything this autopsy won’t tell us about this woman, it tells us exponentially less about every other fat person. And the people behind this are so utterly ignorant about that, that it’s embarrassing.  According to the Telegraph (not linking because of headless fatty picture) “Damian Kavanagh, the controller of BBC Three, said young people needed to be shown the impact of unhealthy eating.”

Body size is not the same thing as “unhealthy eating.” Fat people have behaviors around eating (and everything else) as varied as any other group of people. Speaking of questionably drawn conclusions,  I’m concerned about a panel of “obese young contributors  exploring the causes of obesity, and how it affects their day-to-day lives.”

First I’m concerned with the effect on these panelists. Even if one believes that “determining the causes of obesity” is a noble pursuit, it should follow that the pursuit should be undertaken with scientific rigor, not by asking fat people (who live in a fatphobic society and get messages like the one from Damian Kavanagh that suggest that “obesity” is the same as “unhealthy eating”) to speculate wildly – even if they weren’t handpicked to agree with the stigmatizing premise of this show.

I’m also concerned that they are asking about the effects of obesity on these kids’ lives, when it’s so common to try to convince us to blame on body size what is actually the effect of fat stigma.

Not to mention that even if this autopsy could draw medically sound conclusions about fat people (and let’s be super clear that it cannot) that wouldn’t change the fact that fat people should be able to live without sizeist, healthist, ableist stigma, nor would it change the fact that there is not a single study where more than a tiny fraction of people have maintained significant long term weight loss, so if the suggestion is that being smaller would make us healthier than it’s as useful as telling us that being taller would make us healthier.

This show is an abomination that can only serve to disrespect the dead and stereotype and stigmatize fat people, and it has no place on the air.

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Edit:  I wanted to share with you this response from Daniel Goldberg, a bioethicist at the Center for Bioethics & Humanities at the University of Colorado Anschutz Medical Campus:

Having just taught several sessions on the “Cadaver as First Patient” to medical students, I can suggest that there are enormous power issues that are involved in dissection. The learners generally feel this, and it can be overwhelming — to their infinite credit, most students I’ve encountered intuitively get this and apply a huge amount of respect and even reverence for the cadaver that marks the beginning of their entry into medicine.

Moreover, many learners, albeit not all, humanize their cadaver by giving them a name and even a narrative backstory — to symbolize their belief that the cadaver on the table is more than just a thing. This was a person, with hands that held and eyes that cried. The abomination described here countermands all of these ideals — it encourages seeing the body as an object, and as one that exists purely to explore pathology, disease, and dysfunction. A more offensive, stigmatizing, and structurally harmful display would be difficult to divine. FWIW, this bioethicist finds it utterly transgressive and reprehensible.

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27 thoughts on “The Horror of “Obesity Autopsy”

  1. What the actual fuck?! Because clearly once someone weighs more than a certain amount they become exactly the same as everyone else that weighs the same as them, and therefore doing an autopsy on one fat person will tell you all you need to know about every other fat person everywhere, forever. Because, science. Oh, and let’s exploit some young people while we’re at it by playing fortune teller by “reading” another fat person’s body. Disgusting.

  2. So now they’re carving up fat people like chickens on TV whilst fat-shaming their dead corpses for the viewing audience’s salacious entertainment, and fat hate has become so normalized, fat people so dehumanized, the mainstream actually needs Ragen and others to *explain why this is wrong.* How does something like this happen?

    1. People are ignorant.

      If this is so educational, then why not carve up an example of a “healthy” person? I would think a “positive” example would be of greater instructional value.

  3. Not only is this a new low in fat-shaming, it’s a new low in “entertainment.” I can’t add anything new on the fat shaming aspects of this abominable idea, so here’s my take on the idea of a televised autopsy in general.

    “Hey, you know what would probably get great ratings? Let’s air a show where two pathologists are cutting up a dead body! What could be more entertaining than watching doctors remove body parts from a corpse?”

    Really, BBC?

    Television series like “Bones” or “CSI” can be a bit macabre as well, but we the audience know in the back of our minds that the cadavers and body parts are all just special effects. It’s all fiction, and we’re not watching the dissection and analysis of a real person. No one is going to tune in and see their mother or brother or someone else they loved and cared about being carved apart on National Television.

    This isn’t about education. It’s about sensationalism and promoting cultural stigma.

    This is a real-world analog to Idiocracy’s “ASS: The Movie.”

    I sincerely hope audiences utter a collective, “Eww!” and tune into something else instead, so that this bombs so bad that the people behind it lose their shirts. Maybe someone will perform an autopsy on them someday to see what made them do something so monumentally stupid.

    1. They’ve stooped pretty low with some of their online “news” articles as well. Shamelessly trying to get more clicks!

    1. After my mother died from a heart attack at only 58, a clueless coworker asked me if she had been “morbidly obese.” I maintained my composure and answered honestly, “She weighed 115 pounds soaking wet.”

  4. Just in case people don’t know the BBC is funded by the tv licence scheme, anyone who owns a tv or device capable of watching live tv (and some of the online catch up services – from September) needs to pay a fixed amount each year or risk getting a £1000 fine.

    This includes anyone on low income, although there are discounts of 50% for those who are blind and it’s free for those over 75 (on application).

    The current cost of the tv licence is £145.50 per year even if you never watch BBC or put the tv on (only use it for console games) – if it can receive the signal you need to pay.

  5. This brings to mind the treatment of Saartjie “Sara” Baartman at the turn of the nineteenth century, though that case was steeped in misogynoir in addition to sizeism.

  6. I’m finding this particularly obnoxious in light of the fact that fat corpses are often refused by medical schools as cadavers. I think it’s important that medical students understand the differences between thin and fat bodies, and I think some of the additional risks fat people face from surgery (increased risk of infection, etc) need study to find ways of reducing the danger…instead they’re making a side show TV offering?!?! Color me Seriously Offended!

    1. “Side show” – THAT was the phrase I was searching for.

      They are making fat people into circus acts, simply by virtue of their “unacceptable” size.

      Anyone who wants to join the circus and chooses that life, more power to them, but no one should be forced into the life. In the old days, parents of children born with various issues used to actually sell their babies to the circus, to be raised as “freaks.” This just strikes far too close to that old way of thinking, and it sickens me.

    2. Yes, my local med school at University of Washington refuses donations to science if the deceased is over a certain size or weight. I asked why and was told 1. the drawers are a set size and 2. staff and students could be injured moving bodies that are too heavy (and that they get heavier when embalmed). I didn’t find either argument terribly convincing for a learning institution–shouldn’t doctors be training on bodies like those they will be working with/on? Think of how much better, say, maternity or orthopedic care patients would be if docs knew their way around a fat body?

      1. Not only is it not convincing, it’s insulting. It’s a lot like saying that a hospital can’t accomodate a fat person because their beds aren’t large enough or nurses might get hurt turning the patient. There are enough fat and supersize people that we deserve scientific study and understanding–and maybe a drawer or two big enough to handle a larger cadaver. This attitude pretty clearly says to me, “you’re not worth our effort.”

  7. How is this even legal? Donating your body to science is not the same as donating your body to television, with all the exposure of the dead person and presumably the family that that would entail. I can’t believe no one is fighting this on legal grounds, because this can’t be what she had in mind when she made that choice, and that matters. If she didn’t know what she was consenting to at the time of choosing donation, then it’s not legal.

  8. That is horrifying. The person who donated their body to science, I’m imagining, did not give consent prior to death for a LIVE TV AUTOPSY USED TO SCARE “OBESE YOUNG ADULTS.” That seems like an extremely questionable definition of “science.” This makes me sick, and seems so, so counter to any sort of medical ethics that it is mind-boggling.

  9. I am completely horrified by this decision by the BBC. It is awful for all of the reasons already mentioned. However, I am heartened-up by the response from Daniel Goldberg. I am glad that some in medical ethics is speaking up on behalf of those that will be negatively impacted by this shit-show created by the BBC.

  10. Quite apart from the horrendousness of this TV “programme”, why on earth could the pathologists not have flown to the States? Wouldn’t that have been both logical and more cost effective? I can only concur with what you say, Ragen, that they were also determined to raise eyebrows during transit in respect of the size of the container used and methods required to get the body to wherever it was to be examined, and thus hold up this woman as an example not to be followed by the “obese young contributors”. Outrageous indeed. I wonder if her family was made aware of how her gift was to be used?

  11. I just did a quick search about donating a body after death to science and came across this site: https://medschool.duke.edu/about-us/anatomical-gifts-program/commonly-asked-questions

    Notice the weight limits.

    Someone was blasting Ragen for supposedly “failing to do her research” when she claimed that they don’t allow fat bodies to be donated, but then the BBC did for a show, which “proved” that she is full of crap.

    A quick search shows that, in at least some places, they don’t allow large bodies to be donated.

  12. Hi Ragen. Tech question. How do I attach a link for this entry in a share on our professional fb page? Can I cut and paste or just do a link? If so, what is the link? Thank you.

    On Tue, Aug 30, 2016 at 1:32 AM, Dances With Fat wrote:

    > danceswithfat posted: “Yes, the BBC is airing the autopsy of a fat person. > No, it’s not ok. I can see the meeting now, someone stands up and says “how > can we create programming that plays on and sensationalizes the social > stigma against fat people, makes no medical sense, helps” >

  13. What made it worse was that the pathologist was on the morning show discussing how it was all done with dignity, and making it seem as if the whole thing was ok, that the family wanted everyone to ” see how awful being fat is for the body” I felt hurt for that poor woman, and I am so so tired of hearing the phrase here in the uk ” war on obesity” everyday there will be some new story, supposedly ” proving” how terrible being fat it, lately it’s been all about how fat people are draining the resources of the nhs, no matter how hard I try to explain these storys don’t prove anything I will get back the old line … oh everyone knows……. so how ” does everybody know”.? I really wish I had a good answer for that when its thrown at me, I’m tired of justifying my exsistance,
    shows like this autopsy are appalling and I can’t imagine what will come next,

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