The choice between avarice and civic responsibility becomes intensified in relation to fat. Given what we know about human metabolism and its response to repeated dieting, it is immoral to promote types of diets that can not be lived with or which guarantee weight gain. To ignore or misuse research to enhance cash profit parallels the tobacco industry’s decision to obscure, and sometimes secretly enhance, its product’s addictive characteristics. But making money from fat related goods and services need not be predatory or self-serving. There are responsible ways to make money from fat.

Fat and Education

Economics and education must be coupled. Health providers have special roles as educators. These educators must acknowledge that solutions to chronic obesity are complex and not simple, multifaceted and not monolithic, and individual not general. Providing strategies for individual patients could be considered as “a coaching service in a health partnership” rather than specialized top-down consultation. Making the mental shift from BMI’s (Body Mass Indexes), calorie counting and scale obsession to mutually agreed upon health goals could go a long way in making fat’s educational aspects legitimate sources of revenue for health professionals. This could revolutionize the way we educate the community when our science has not as yet solved health problems. A participatory approach including patients, para-professionals and professionals in health care is long overdue. Addressing this larger question of medical education and service in the context of fat could be an admirable starting place.

Fat and Politics

Politics has to do with internally conflicting interrelationships among people in society. While fat can lead to disease and has health ramifications for our society, obese people can be made the victims of social prejudice. Wilber suggests that a differentiation exists between a disease that can be cured and a sickness in need of healing. Cure involves the upper right quadrant of objective science. What is the most effective way to minimize the harmful effects of fat in the human body? Research is needed to find the link between the causation factors of obesity. Socially, sickness involves the meaning we attribute to a disease. In Grit and Grace, Wilber says that we are doomed to search for a meaning to our sickness. This search naturally takes place in the left-hand quadrants, both subjectively and collectively. At what point do we consider having a certain amount of body fat as being sick and what social meaning do we bring to that sickness?

If obesity is something that we do to ourselves, if it is completely a question of will-power, then requiring society to pay health care expenses or employers to swallow the expense of absenteeism is unfair. Conversely, if obesity is not a matter of willful gluttony but truly an eating disorder or genetic condition then it is only right that sufferers of this disease be treated with dignity and compassion. It seems that the less that is known about the condition the more prejudices surround the sufferers.

As obesity becomes understood objectively we will be able to respond to it subjectively and culturally. The first political step would be attempting to find out the causes of obesity through research and distinguishing between simply being overweight and suffering from a chronic disorder. The second step would be to educate the public and then protect those with obesity from prejudice and misinformation. A cure may be found but, more importantly, healing of the chronically obese can only come when the original meaning of the term therapy is restored. Therapy means “an aid from one who attends.” Ironically it can be paraphrased as “bear each other's burden,” until we are able to carry our own. This is the least and the most that should be asked and received from society.