"I could relate to many, many, many of the experiences and emotions that Charlie, which is Brendan Fraser's character, was portraying," Patricia Nece recalls after watching the soon-to-be-released movie The Whale.
Much of the movie "rang true and hit home for me as things that I, too, had experienced," Nece, the board of directors' chair of the Obesity Action Coalition (OAC) and a person living with obesity, shares with Medscape Medical News.
Slated to hit theaters December 9, The Whale chronicles the experience of a 600-lb, middle-aged man named Charlie. Throughout the film, Charlie seeks to rebuild his relationship with his estranged teenage daughter. Charlie had left his daughter and family to pursue a relationship with a man, who eventually died. As he navigates the pain surrounding his partner's death and his lack of community, Charlie turns to food for comfort.
Premiering at the Venice Film Festival, Fraser received a 6-minute standing ovation. However, activists criticized the movie for casting Fraser over an actor with obesity as well as its depiction of people with obesity.
Representatives from the National Association to Advance Fat Acceptance (NAAFA) contend that casting an actor without obesity only contributes to ongoing bias against people of size. "Medical weight stigma and other socio-political determinants of health for people of all sizes cause far more harm to fat people than body fat does. Bias endangers fat people's health. Anti-obesity organizations, such as those consulted with for this movie, contribute to stigma rather than reducing it as they claim," NAAFA wrote in a statement to Medscape Medical News.
And, they added, that though the fat suit used in the movie may be superior to previous ones, it is still not an accurate depiction: "The creators of The Whale consider its CGI-generated fat suit to be superior to tactile fat suits, but we don't. The issue with fat suits in Hollywood is not that they aren't realistic enough. The issue is that they are used rather than using performers who actually live in bodies like the ones being depicted. If there is a 600-pound character in a movie, there should be a 600-pound human in that role. Rather than concentrate on the hype around the fake fat body created for The Whale, we want to see Hollywood create more opportunities for fat people across the size spectrum, both in front of the camera and behind the scenes."
Prosthetics vs Reality?
Nece says she understands the controversy surrounding the use of fat suits but believes that it was not done in poor taste.
"OAC got involved with the movie after Brendan was already chosen for the part, and we never would have gotten involved with it had the prosthetics or fat suit been used to ridicule or make fun of people with obesity, which is usually the case," she explains.
"But we knew from the start that that was never the intent of anyone involved with The Whale. And I think that's shown by the fact that Brendan and Darren Aronofsky, the director, reached out to people who live with obesity on a daily basis to find out and learn more about it and to educate themselves about it," Nece continues.
In a Daily Mail article, Fraser credited his son Griffin who is autistic and obese with helping him understand the struggles that people with obesity face.
Rachel Goldman, PhD, a clinical psychologist in private practice in New York City and a professor in the psychology department at the NYU Grossman School of Medicine, notes that there are other considerations that played into casting. "I know there was some pushback in terms of could, a say 600-lb individual, even be able to go to be on set every day and do this kind of work, and the answer is we don't know."
"I'm sure Darren chose Brendan for many reasons above and beyond just his body. I think that's very important to keep in mind that just as much as representation is very important, I think it is also about finding the right person for the right role," adds Goldman, who served as a consultant to the film.
Fat Suits, Extreme Weight Gains All to Play a Role
About 42% of adults in the US have obesity, according to the 2017-2020 National Health and Nutrition Examination Survey, but that reality is not reflected in films or television.
A study of 1018 major television characters found that 24% of men and 14% of women either had overweight or obesity — far below the national average. And, when characters with obesity are portrayed, actors often wear prosthetics, like Gwyneth Paltrow in Shallow Hal or Eddie Murphy in the Nutty Professor.
But unlike Fraser, some actors gain weight quickly instead.
This practice is unhealthy, says Jaime Almandoz, MD, an associate professor at the University of Texas Southwestern Medical Center, Dallas, and a nonsurgical weight management expert. In interviews, actors have shared how they increased calorie intake by drinking two milkshakes per day, going to fast food places regularly, or, in Mark Walhberg's case, consuming 7000 calories per day to gain 30 lb for his role as boxer-turned-priest in the movie Father Stu.
This method provides their bodies with excess calories they are unable to burn off. "Then the amount of sugar and fat that streams into the blood as a result creates problems both directly and indirectly as your body tries to store it. It basically ends up using overflow warehouses for fat storage, like the liver for example, so we can create a condition called fatty liver or in the muscle and other places and this excess sugar and fat in the bloodstream cause several factors that are both insulin resistance causing," Almandoz explains.
Though gaining weight helps the actor understand the character's life experience, it may also be risky.
"To have an actor deliberately put his own health at risk and gain a certain amount of weight and whatever that might entail, one - that's not necessarily the safest thing for that actor - but two, it's also important to highlight the authentic experience of someone who has dealt with this chronic disease as well," says Disha Narang, MD, a quadruple-board certified endocrinologist, obesity medicine, and culinary medicine specialist at Northwestern Medicine Lake Forest Hospital, Chicago.
These extreme fluctuations in weight may create problems. "It is typically not something we recommend because there could be metabolic damages as well as health concerns when patients are trying to gain weight quickly, just as we don't want patients to lose weight quickly," says Kurt Hong, MD, PhD, board-certified in internal medicine and clinical nutrition at the University of Southern California, Los Angeles.
Hong notes that it may be difficult for individuals to experience sudden weight gain because the body works hard to maintain a state of homeostasis.
"Similarly, to someone trying to gain weight you overeat, initially your body will try to again, maybe enhance its metabolic efficiency to hold the body stable," Hong adds.
Dietary choices that may contribute to insulin resistance or promote high blood sugar can contribute to inflammation and a number of other adverse health outcomes, notes Almandoz. "The things that actors need to do in order to gain this magnitude of weight and they want to do it in the most time effective manner is often not helpful for our bodies, it can be very problematic, the same thing goes for weight loss when actors need to lose significant amounts of weight for roles," says Almandoz.
And Hong explained that for patients trying to lose weight, they may cut calories, but the body will try to compensate by slowing down the metabolism to keep their weight the same.
'Your Own Worst Bully'
In The Whale, Charlie appears to suffer from internalized weight bias, which is common to many people living with obesity, Nece says.
"Internalized weight bias is when the person of size takes all that negativity and turns it on themselves. The easiest way to describe that is to tell you that I became my own worst bully because I started believing all the negative things people said to me about my weight," Nece adds.
Her hope is that the film will bring attention to the harm that this bias creates, especially when it derives from other people. "There's no telling whether it will, but what Charlie experiences in bias and stigma from others clearly happens. It's realistic. Those of us in large bodies have experienced what he is experiencing, so some people have said the movie is fatphobic, but I see it as I can relate to those experiences because I have them too, so they are very realistic."
Nece notes that it is important for clinicians to understand that obesity is a multifaceted and sensitive topic. "For those medical professionals who do not already know that obesity is complex, I hope the film will begin to open their eyes to the many different facets involved in obesity and their patients with obesity, I hope it will help them empathize and show compassion to their patients with obesity," she concludes.
Ashley Lyles is an award-winning medical journalist. She is a graduate of New York University's Science, Health, and Environmental Reporting Program. Previously, she studied professional writing at Michigan State University. Her work has taken her to Honduras, Cambodia, France, and Ghana and has appeared in outlets like The New York Times Daily 360, PBS NewsHour, The Huffington Post, Undark Magazine, The Root, Psychology Today, Insider, and Tonic (Health by VICE), among other publications.
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Cite this: The Whale: Is This New Movie Fat-Phobic or Fat-Friendly? - Medscape - Dec 09, 2022.