“O say, does that star-spangled banner yet wave
O’r the land of . . .”
The average American adult has a Body Mass Index (BMI) of 28.2. BMI is a person’s weight in kilograms, or pounds, divided by the square of height in meters (or feet). A high BMI can indicate high body fatness.
18.5 to 24.9 Normal or healthy weight
25 to 29.9 Overweight
40+ Severe obesity
Hmmm . . .
Some years ago, a no-name press published my lengthy screed, Desolation’s March: The Rise of Personalism and the Reign of Amusement in 21st Century America . Its fate was, as Hume said of his Treatise of Human Nature, to fall “dead born from the press.” (Absolutely no comparable merit of the two books is suggested here.)
One of Desolation’s motifs is what I termed “the medicalization of morality” — hardly original, but at the time the medicalizers seemed to be going “where no man [sic] has dared to go before,” so some comment seemed to be in order.
One of the aggressive moves of the elites bent on “modernizing” the serfs under their watch is the top-down “reform” of language that properly reflects what the demos should be thinking. Wrong words = bad thoughts = bad person. That’s “bad” as in “deplorable,” “unredeemable,” “thankfully not part of America.” “Colored people” — no! “People of color” — the right words. “Colored people” was a verbal felony committed by a bad person followed by a pink slip. The hierophants at CNN  were there to help navigate the hermeneutics of “racism” and the enforcement of right-think.
The Bolsheviks were the pioneers in the creation of “progressive-speak” — primitive by today’s standards. Primitive or advanced, progressive-speak is a game of “gotcha” and outing bad people to make them pay a heavy price. Apologies won’t help you evade the penalties.
The medicalizing of morality was heavily ramped up at the end of the Second World War. The budget for the National Institute of Mental Health in its inaugural year of 1950 was $8.7 billion. 17 years later, it would be $315 billion.  The medicalizing involved, among other things, the top-down managed change of a vocabulary that points toward moral excess. The Aristotelean notion of “the mean,” finding the proper balance of pleasure and pain in day-to-day life — avoiding excess and deficiency — was the embodiment of practical moral wisdom that was reflected in the way people spoke about human action. A bad person possessed human agency, which made him different from a sick person. You talk about and treat bad people differently than sick people. Medicalizing morality in part means talking about badness as if it is sickness. It muddles and confuses the important question of what to think about and do with bad people, which seems to be the goal.
Behind the move of medicalizing morality was a massive transfer of power. Immoral people are accountable and responsible for their behavior; sick people much less so. Sick people are helpless. They rely upon doctors, experts, and specialists to help them “manage” their behavior. Thus, we observe over the years an insidious surrender of human agency to a regime of experts whose exert their unchallenged power in the form of therapy.
The success of traditional morality’s medicalizing Conquistadors is reflected in the way we now talk about behavior. The use of words, at least in polite company, that suggested outright moral disapproval and personal agency — “glutton,” “pervert,” “fatso,” “degenerate” — was heavily discouraged. Drunkards became “alcoholics.” Gluttony became an “eating disorder.” Blowing the monthly rent at a casino became a “gambling disorder.” Words that suggest displays of objectionable and louche conduct — “vulgar,” “crude,” “nasty” — have been dialed down to the anodyne, generic “inappropriate.”
From the bowels of psychiatric wisdom, what used to be called “juvenile delinquency” is now “conduct disorder”:
Conduct Disorder  DSM-5 is a diagnosis that is usually given to children and adolescents under the age of 18.They repeatedly violate the rights of other people, and they refuse to conform their behavior according to the law, as well as to what is considered normal for their age in society.
Good luck with trying to assert “what is considered normal” for children these days.
“Debauchery”? No, it’s “sexual addiction,” mental illness. Worth noting about this is how the top-down folks during the antinomian reign of the Clintons wanted regular folks to think about the President of the United States getting fellated in the Oval Office by a twentysomething, chubby White House intern. Monica did, by the way, have the good sense to hold on to her soiled blue dress . Might such an adventure have suggested that the judgement and character of Arkansas Elvis was not a match for his current job description? That would have been old-school Aristotelean.
To help us make the transition to the kingdom of virtuous compassion came clinical psychologist Jerome D. Levine, who most likely never heard of Aristotle. His job was to scold anyone inclined to be “judgmental” of the priapic POTUS, who in the post-Jeffrey Epstein era appears to also be a pedophile.
The good doctor Levine never had any personal interaction with the President, but took it upon himself to deliver The Clinton Syndrome: The President and the Self-Destructive Nature of Sexual Addiction.
“Syndrome”? “Sexual addiction”? Already you sense that this guy is trying to slip you a rusty musket. Then it’s confirmed: Sexual addiction is not about sex. It’s
about insecurity, low self-esteem, and the need for affirmation and reassurance. At bottom, the sexual addict feels unloved and unlovable, and so looks obsessively for proof that it is not so. 
Think of this psychobabble as a kind of modern-day alchemy. With the medieval version, base metals were mysteriously converted into gold. With this modern version, doctors like Jerome conjure up a risible emotional causality that turns people we should object to into people we should feel sorry for, as in “they are crying for help.”
However, let’s move on to medicalization and a rapidly expanding demographic: fat people.
From Aristotle to Oscar Wilde: “Moderation is a fatal thing. Nothing succeeds like excess.” This is successful excess as in inches, pounds, type 2 diabetes, and lots of fat kids .
From ABC News , “Doctor Reprimanded for Calling Patient Fat”:
Dr. Terry Bennett believes in being honest with his patients, but one woman was so offended about the way he spoke to her about her weight, she filed a complaint with the state Board of Medicine. The New Hampshire state attorney general launched an investigation, asked Bennett to take a medical education course and admit he has made a mistake. Bennett refused to take the course and says he is outraged by the investigation. “Part of my job is to tell you the truth,” Bennett said.
Poor Dr. Bennett didn’t realize he’s living in “alternative universe America” where make-believe is compulsory and where “truth,” like moderation, is a fatal thing. Where else would a state Attorney General have “launched an investigation” because a doctor has told a fat lady, “You are fat; you need to lose weight”? She didn’t deny being fat. What was there to investigate?
This story is worth a harder look. It turns out to be a mise en abyme, a kind of frame story in which the core narrative turns out to reveal some hidden aspects of the framing story, aspects of which the reporter was likely oblivious, revealing aspects of a culture in deep decline.
First, why did an event like this rise to the level of an ABC News/Good Morning America national news story? The subtext of the story’s title is that “fat” in any context is now outside the boundaries of progressive-speak. Not even a doctor can get away with it, even when his patient is medically certifiable fat: “Doctor reprimanded.” The reprimand part, however, is not exactly true. Dr. Bennett, “asked” by the state AG “to take a medical education course,” told him to pound sand.
What would a “medical education course” entail for a doctor who tells his patient that being fat is not healthy? What should he have told her? “Fat is beautiful”? That’s the current position of today’s right-thinkers. See how it looks at the Target  stores.
Second, within the story is another hidden aspect: the push toward the demoralization of language that eschews reference to human agency. Dr. Bennett used harsh, shaming language in an effort to motivate his patient to take personal responsibility and change her behavior. “The mean” and “excess” come to mind: Eat less and you will be a better, healthier person. In the article, one can sense Bennett’s frustration in dealing with his obese patients and the need to be blunt:
You come in here, you pay $75 to sit on the couch. I’m not going to sit here and talk about the weather with you. If you’re noticeably obese, I know that you are going to have future health problems.
Sometimes you have to be blunt to break through the anti-reality shields thrown up by the “new moralists.”
Third is another insidious and ironic feature of the medicalization of morality and the demolition of human agency: self-esteem. The self-esteem movement that began with psychologists like Carl Rogers in the 1960s went hand-in-hand with the medicalizing of morality. In 1986, California State Assembly member John Vasconcellos — friend and disciple of Carl Rogers — sponsored a bill for a taxpayer funded program to promote self-esteem. Think of public policy promoting self-esteem as the “new morality” under the guise of public health:
In light of the emerging evidence, it seemed both morally and fiscally responsible to create a formalized effort to explore whether in fact self-esteem might be a social vaccine, a quality capable of strengthening people, making them less vulnerable to problem behaviors. 
Dr. Bennett somehow missed the “social vaccine” unit in his continuing education program. His malpractice consisted in injuring his patient’s self-esteem. Remarkable is that the patient perceived hurt feelings as a legally actionable offense. Even more remarkable is that the New Hampshire state Attorney General attempted to punish the doctor by coercing an apology and forcing him into some kind of struggle session. Bennett did write the patient a letter of apology, but not a groveling one; rather the kind a gentleman would offer a lady he did not mean to offend:
Bennett said he regrets offending a patient and wrote her a personal letter of apology when he learned of the complaint. “My job is not to offend you,’ Bennett said. ‘It’s to educate you and that’s all I’m trying to do.”
But back to anti-Aristotelean, Oscar Wilde, and the success of excess. In this particular case –excess eating — folks just keep getting bigger.
From the CDC :
From 1999–2000 through 2017–March 2020, US obesity prevalence increased from 30.5% to 41.9%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%. [Full disclosure: I once had a BMI of 31. That was a long time ago.]
To get a better understanding of fatness in America, try the following experiment. Go to your local supermarket and set aside an hour or so in the soft-drink and snack food aisles. There you will see many of those whom a Japanese exchange student I once heard call “the bubble people.” Observe the customers making purchases, and use the following rubric for estimating their BMIs: 25 for skinny to normal; 29 overweight, 20 to 30 pounds extra; 35 for obese, 50 pounds to 90; 40 for severe obesity, 91 and up. Record your observations: be conservative, be discrete.
This is a depressing and perhaps mean-spirited exercise, but the average BMI will likely be 35 or higher, depending on what part of the country you are in. Black women have substantially higher BMIs than white women, and Hispanics generally quite high, so a demographic slanted in those directions will move your averages higher.
No one will be coercing the purchasers; they are expanding at their own volition.
What you are seeing makes perfect sense and introduces a new element that explains BMI inflation: amusement. Rampant obesity is the physical consequence of a relatively new phenomenon: eating not to satisfy hunger, but to amuse oneself; amusement eating. The “snack food” aka “junk food” aisle at the supermarket segregates amusement foods — chips, candy, soft drinks, etc. They are high in calories and devoid of nutritional value, made to be eaten as amusement and to deflect boredom and accompany passive amusement: Sunday afternoon NFL football, for example.
From amusement eating, like amusement in general, arises a curious symbiosis. Amusement is pleasurable and naturally pushes us toward excess; hence, Aristotle’s “mean” to push back toward moderation. But pleasure is good. Who is to make a “value judgement” about what limits should be imposed? But the excess puts us into the debilitated straits from which we need to be rescued. Amusement begets therapy. The amused need the therapists; the therapists attend to the amused. “People, people who need people .”
To be genuinely “healthy,” to survive in our world of medicalized morality, one needs to recognize how the panem et circenses (bread and circuses) mindset works to induce passivity and entrench a class of overseers who want to control what you say, what you think, what you do, how you educate your children, and how you live. Your excesses make you passive, duller, dependent, and easier to manipulate. They make them more powerful, more condescending, more ruthless.
What you eat and how much are under your control, and is an important part of resisting the professional moralizers, their conceits and deceits. Good habits are the best prophylactic in this age of decadence.
The virtues therefore are engendered in us neither by nature nor yet in violation of nature. Nature gives us the capacity to receive them, and this capacity is brought to maturity by habit. — Aristotle, Nicomachean Ethics, Book II
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  Ellen Herman, The Romance of American Psychology: Political Culture in the Age of Experts (Berkeley, Calif.: University of California Press, 1995), p. 119.
  Jerome D. Levine, The Clinton Syndrome: The President and the Self-Destructive Nature of Sexual Addiction (Rochlin, Calif.: Prima Publishing, 1998), pp. 1-2.
  John Vasconcellos, “Preface,” in The Social Importance of Self-Esteem (Berkeley, Calif: University of California Press, 1989), p. xvi.