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14. Bon Bon Fatty Girl: A Qualitative Exploration of Weight Bias in Singapore
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127 14 Bon Bon Fatty Girl A Qualitative Exploration of Weight Bias in Singapore Maho Isono, Patti Lou Watkins, and Lee Ee Lian “You’ve put on weight, haven’t you?” is a common entrée to conversation in Singapore , where casual remarks about body shape and size are widely accepted. This chapter explores how such remarks affect individuals, particularly young women in this culture. Results from a qualitative study are discussed in the context of the existing literature on weight bias in personal spheres. The discussion also speaks to Singapore ’s efforts to address eating disorders and forge a more adaptive approach to weight and health. Since gaining independence in 1965, Singapore has seen dramatic economic development . This increase in wealth has coincided with an increase in weight among its people. Between the 1970s and 1990s, Singaporean males and females became 34.5% and 19.3% heavier, respectively (Jin-Jong, 1999). Meanwhile, “obesity in students from primary, secondary, and pre-university schools showed an almost three-fold increase from 5.4% in 1980 to 15.1% in 1991” (Toh, Chew, & Tan, 2002, p. 335). In 1992, the government conducted a national health survey of cardiovascular risk factors, using the widely accepted yet problematic criterion of body mass index (BMI) > 30 to define “obesity” (Prentice & Jebb, 2001). This survey revealed that 5.1% of Singaporean adults exceeded a BMI of 30. A 1998 follow-up survey showed that this rate had increased to 5.9% (Toh et al., 2002). Interestingly, eating disorders have also increased considerably in recent decades, with a sixfold rise in documented cases between 1994 and 2002 (Ung, 2005). In contrast to “obesity,” no national statistics have been gathered. Once unheard of, two case reports appeared in the early 1980s (Kua, Lee, & Chee, 1982; Ong, Tsoi, & Cheah, 1982). Over a decade passed before publication of a third study (Ung, Lee, & Kua, 1997). As presentations increased, health-care professionals garnered resources to treat these problems, establishing an eating disorders clinic at the Institute of Mental Health (IMH) in 1995. Lee, Lee, Pathy, and Chan (2005) recently published findings derived from 126 patients with anorexia nervosa who came there or to the Child Guidance Clinic. They appeared quite similar to anorexia nervosa sufferers in Western societies; most were females (91.3%), single (92.9%), and teenagers at the time of symptom onset. Subsequently, Ho, Tai, Lee, Cheng, and Liow (2006) analyzed 128 Maho Isono, Patti Lou Watkins, and Lee Ee Lian questionnaire responses from 4,461 girls and women aged twelve to twenty-six years, recruited via random and convenience sampling. Results revealed a 7.4% prevalence rate of risk for developing eating disorders, again comparable to results from Western studies. How did Singapore come to emulate Western cultures regarding rising rates of both “obesity” and eating disorders? Brown and Konner (1996) offer an anthropological explanation, noting that citizens’ weights commonly increase in countries following industrialization. Further, as weight increases, fat bodies become stigmatized and thinness becomes the cultural ideal. According to Scheper-Hughes and Lock (1996), the body regulated by society is considered “correct” among the populace, and the “correct” body becomes associated with cultural meanings such as beauty, strength, and health. Over the past forty years, Singapore has transitioned from a relatively poor nation, in which body fat was desirable and plumpness was celebrated, to an economic power, in which body fat is abhorred and thinness is celebrated. Fung (2004, p. 34) states, “Not more than a few decades ago, the concept of beauty was a lady who would be, by today’s anorexic standards, an overweight woman averaging more than 70 kilograms. These days, women larger than 40 kilograms may be considered too big.” Support for these changing beauty standards comes from Wang, Ho, Anderson, and Sabry (1999), who found a strong preference for thinness among Singaporeans between the ages of seventeen and twenty-two. Nearly one-third of female respondents whose weights were deemed “borderline” to below “normal” expressed a desire to be even thinner. In that study, preference for thinness was significantly related to speaking English (vs. Chinese) at home. Wang and colleagues equated this language preference with rejection of traditional customs and subsequent adoption of Western mores. One reflection of modern Singapore’s disdain for fat is the burgeoning business of slimming centers and products (Ung & Lee, 1999). Lee and colleagues (2005) report that popular Singaporean magazines marketed to women contain approximately eight slimming ads per issue. The slimming industry explicitly links thinness with beauty and health. Paradoxically, the...