A Moral Vision of Addiction - Parental-Child Fatness

Written by Stanton Peele

Garn (1985) also evaluated the question of inheritance of obesity and came to conclusions diametrically opposed to those announced by Stunkard et al. (1986), although Garn's work seems somehow to invite less media attention than the Stunkard group's. In general, Garn et al. (1984) also found continuities in parental-child fatness. However, this correlation peaked at age 18 and declined thereafter, as children left home. The correlation Garn found between adopted children and biological relatives decreased the earlier the age of adoption. Data like these have prompted Garn to propose the "cohabitation effect," based on the idea that "family-line resemblances in fatness, however striking, may be less the product of genes held in common than of the living-together effect" (Garn, 1985:20-21).

Resolving the Irresolvable - What Does Weight Have to Do with Values?

How do we account for the nearly opposite conclusions reached by Garn (1985) and Stunkard et al. (1986)? Perhaps these are due to different measurements - in Stunkard et al. the measure is body mass, which varies with height (and leg length) while in much of Garn's work (and Stunkard's Midtown Manhattan research) the measures were of actual fatness (such as triceps skin-fold thicknesses). Interestingly, in Stunkard et al.'s (1986) but not in Garn's (1985) data, childhood weight correlated far more with mother's than father's weight - a difference which would seem more the result of feeding habits than genetic inheritance. Nonetheless, despite their opposite points of departure, Garn and Stunkard have issued almost identical statements about the relevance of their findings: for Garn et al. (1984:33), "The largely learned family-line nature of fatness and obesity becomes important in the early diagnosis of obesity, the prevention of obesity, and in ... fatness reduction."

Stunkard "suggests that the children of overweight parents could be targeted for intensive weight-control measures, particularly vigorous exercise programs.... Such notions are the backbone of ... [Stunkard et al.'s] new weight loss program for black teenage girls" ("Why Kids Get Fat," 1986:61) - or, in other words, exactly the same group Stunkard et al. (1972) found to suffer obesity from a socioeconomic source. This popular news magazine story was accompanied by a photograph of a slender Stunkard and another thin researcher with an obese black woman, her husky husband, and their overweight daughter. Apparently, whatever the source of obesity, it infects underprivileged groups more readily and it becomes less likely when people are aware of the dangers of obesity and have the resources with which to combat it.

The most emphatic rejection of the idea that people successfully achieve desired weight levels through planned eating strategies was presented by Polivy and Herman (1983:52), who argued "for the forseeable future, we must resign ourselves to the fact that we have no reliable way to change the natural weight that an individual is blessed or cursed with." Instead, the effort to go below this preordained body weight by restraining eating is doomed to failure, a failure often marked by compulsive dieting, episodic binge eating and subsequent guilt and self-induced vomiting that characterize bulimia (Polivy and Herman, 1985). Polivy and Herman's model is a complex one that emphasizes the role of cognitive factors in binge eating and that it is not weight loss per se, but dieting as a method of weight loss that leads to eating disorders.

There are certainly strong grounds to say that the marketing of unrealistically thin images of beauty leads to bulimia, because people (usually young women) strive for a weight goal unobtainable through their ordinary eating habits. There is nothing that requires, however, that biological inheritance creates "natural" body weight or prevents people from being as thin as they like. Polivy and Herman's work has regularly found that all people restrain their eating - after all, most people don't eat banana splits for breakfast, no matter how delicious an idea this is in the abstract. Bulimia could as easily be described as the failure of some people's habitual eating habits to bring about desired weight and hence their need to rely on unsuccessful dieting techniques. On the other hand, people generally conform to cultural norms of weight and thinness, change their weight as they change social groups, and frequently (though not inevitably) bring their weight (and eating) in line with a desired self-image.

Harris and Snow (1984) found that people who maintained considerable weight loss (an average of 40 pounds) displayed little binge eating, in contrast to unsuccessful dieters who had lost less weight and regained it. Apparently, there are better and worse ways to go about losing weight. We all know such stable examples of weight loss because they frequently appear on our television and movie screens, in the forms of entertainers and actors like Cheryl Tiegs, James Coco, Judith Light, Lynn Redgrave, Dolly Parton, Joan Rivers, professional weight watchers like Jean Nidetch and Richard Simmons, and athletes like Joe Torre, Billie Jean King, John McEnroe, and Chris Evert Lloyd. Perhaps no group of people has greater motivation and opportunity to become biologically new people than those who go before the public, and they regularly take up this opportunity. Polivy and Herman's pessimism and recommendation that people accept whatever weight they find themselves at lest they do themselves more harm than good represents more a world view than a proven empirical position (Peele, 1983).

Addiction as Intentional, or Value-Driven, Activity

My argument is that in a real sense, people select their weight and obesity levels in line with who they are. In particular, the continuous excessive eating or periodic binge eating that most correspond to addiction cannot be understood biologically. Yet a crucial image of addictive behavior is that it is uncontrollable. Otherwise, people would simply cease doing whatever it was (overeating, overdrinking) that caused them problems or brought about undesired results. Levine (1978) argued that the idea of loss-of-control drinking inaugurated the modern conception of addiction and was first used at the turn of the eighteenth century to explain excessive drinking. In recent years, loss of control à la the addiction model has become increasingly popular as an explanation for all sorts of self-defeating and self-destructive behavior (Room, 1985). Still, the concept of loss of control is nowhere more insistently marketed today in the definition of alcoholism, most notably by Alcoholics Anonymous.

To challenge the notion of loss of control, as Marlatt and Gordon (1985) and others have done, is to reorient our thinking about addiction in a manner whose impact has not yet been fully explored. To begin with, that addicts often do things they regret and wish they could change does not distinguish their behavior from much ordinary behavior; nor does their desire to reorient the larger pattern of their life and their inability to do so. In the words of philosopher Herbert Fingarette (1985:63): the "difficulty in changing the large pattern [of alcoholism] is not an 'impairment' of self-control; it is a normal feature of anyone's way of life.... This is no mystery or puzzle, no rarity, no pathology or disease needing a special explanation." From this perspective, addiction is a medicalized version of an essential element in all areas of human conduct, an element that has been noted throughout history but which has for the most part been explained by concepts of habit and will or the lack of it.