Scared thin: The obesity autopsy

At some point in the recent past, a roughly 60-year-old woman died in Southern California, and generously donated her body to science. 5,000 miles away, her body is about to be cut open for the titillation of British viewers on BBC3 in a horrific spectacle being performed in the name of science, but really it’s about sensationalism. Jane Doe, as I’ll call her, weighed 238 pounds at the time of her death, and she’s the posthumous star of the ‘obesity autopsy,’ to be performed by Mike Osborn and Carla Valentine. Viewers have been informed that the hour-long special will be an educational journey about the effects of clinical obesity on the body, but it sounds a lot more like something else: The cartoonish ‘scared straight’ lectures used to terrorise youth into staying on the straight and narrow.

This act of infotainment is a travesty, and on multiple levels.

The body

We don’t know very much about Jane Doe, as is common with people who donate their bodies to science. Typically, people don’t have a lot of choice when it comes to how their bodies are going to be used, because death is unpredictable, and though people can make dedicated anatomical gifts to medical schools (or the body farm), they don’t have much control over how their bodies will be used. While medical schools do use cadavers in anatomy classes and training, bodies are also used for anthropological research, safety research, and a number of other things. Your body might be slowly taken apart by medical students over the course of a semester, or it might be blown up by the Army.

It’s possible that Doe found out about the programme and specifically willed her body for this purpose. That seems unlikely.

Because people are sensitive about human remains, a lot of regulations as well as contracts and agreements surround body donation and the use of cadavers. For example, the faces, or at least the eyes, of cadavers are often covered in scientific publications to obscure their identities. There is educational value in performing full or partial dissections, or displaying prosections, for the public, but someone has to arbitrate that value. In this case, those responsible thought that literally flaying the body of a dead fat woman to terrify people into thinking that obesity is a monster was educational.

It’s very odd that a body from California was chosen for this programme, given that there are presumably plenty of dead fat people in the UK as well. Was it done to further sensationalise the event, by dramatising the journey? Are there restrictions and caveats on body donation in the UK that made it difficult or impossible to use someone from London or the surrounding area for this purpose?

The medicine

We’ve been repeatedly told that fat is unhealthy, and that fat bodies are inherently damaged. That’s the angle being used here, as Jane Doe died of heart disease, and the promotion for the feature repeatedly stresses ‘the effects of obesity on the body’ and provides images designed to evoke horror, like deposits of adipose tissue and changes in Doe’s skeletal structure. Yet, we know nothing about Doe’s background, and legally, many of the details of her life must be obscured. Does she have a family history of heart disease? A genetic condition? An underlying illness? Can anything be definitively attributed to her weight? Ragen Chastain wrote at length about her concerns with the autopsy, with a specific focus on the bad medicine and bad science involved.

The context

Researchers who work with bodies, especially in educational settings, treat them with profound respect in many cases. They develop connections and relationships with them, whether it’s a deceased patient being autopsied to look for cause of death, a body being dissected in a medical school lab, or a body being allowed to decay under natural conditions to advance the causes of forensic science. People often name their bodies, and come to develop a kind of appreciative affection for them.

At medical schools in particular, it’s common to hold a ceremony at the end of the year. The families of donors may be thanked, particularly in regions where body donation is stigmatised. The thought of exposing a dead body this way is chilling, with no respect for the former person who dwelt within it. Doe’s very body is becoming an object lesson — is that something she consented to? Even if it was, does that make it appropriate? What kinds of thoughts are going through the minds of the organisers of this event?

A panel of fat people will apparently be accompanying the autopsy, but it’s unclear what context, if any, they will provide. It seems unlikely that the panel will include fat activists who push back on bad science and bad medicine, who challenge people to rethink fat. It seems unlikely that the show will discuss fat stigma and medical discrimination experienced by fat people, let alone larger social stigma leveled at fat people. It seems probable instead that the panel will affirm the opinions presented as fact, the perpetuation of the myth that being fat is unhealthy, but a miserable and terrible fate.

The audience

This programme is being aimed at young adults and youth — BBC3 is an online network. While it may be picked up for broadcast on late night, because evidently the content is explicit enough to upset primetime, it’s quite clear that this is intended to scare young people. To bring things back, for a moment, to ‘scared straight,’ it’s notable that the Department of Justice actually came down against the use of fear tactics to cultivate healthy habits in youth. If the organisers genuinely believe that fat is unhealthy and that they need to trigger youth to be ‘healthier’ (i.e. less fat), it seems strange indeed to use a tactic that doesn’t work, and has in fact been shown to have the opposite effect.

Is this science in the public interest? Or is it a freak show, trafficking upon a group of already marginalised people to spin a grotesque, yet fascinating, narrative? This isn’t research: Examining a single cadaver without context provides no real contribution to science. And it’s not education: The goal isn’t to teach people about anatomy and physiology, but specifically to terrify people with a ‘gross’ body.

What it does is guarantee ratings and riveted viewers. And it perpetuates the stigma that surrounds fat people, who are likely to have an even worse go of it than usual in the UK as this airs. Children will taunt each other on the playground. Adults will feel emboldened to make hateful remarks. Physicians will find new reasons to discriminate against fat patients. Employers, thinking of the flayed innards of Jane Doe, will shudder when reviewing fat job applicants. This isn’t just a fiendish mockery of dissection and anatomical research, but something that will do very direct social harm.

Recently, I’d been thinking about anatomical gifts and whether I might like to donate by body for the betterment of society and my fellow humans. This has made up my mind against it, and I’m not the only one.

Photo: Rex Roof/Creative Commons