musings on women's health

Once an obstetrician, always an obstetrician. I am recently retired, admittedly, but I nonetheless carry with me the joys and expectations of those days -everything from a mother’s sudden, relieved smile, to the first cry of her baby as it emerges wet and glistening from her birth canal. No less, the gradual changes in the woman herself as she evolves from Girl to Mother as the being she carries develops in the inexorable way of life. A time when her self-image expands to an us-image, and the mirror -once no friend, perhaps- becomes a welcome calendar of change: a map on the journey.

None were more surprised, I think, than Julia. I had first seen her, in my dual role as gynaecologist, for various adolescent challenges as she worked her way through her formative years. She was always an attractive, although excessively thin woman, and yet she continued to worry about her figure. In fact, I worried she was teetering on the edge of an eating disorder, and each successive time I saw her, she seemed to be staring even more intently into an abyss. Eventually, despite multiple attempts at specialist referrals, she disappeared from my practice for several years.

She resurfaced one summer, a changed woman. Now in the mid-trimester of her first pregnancy, she glowed with the prospect of motherhood, and seemed delighted in her new and ever-changing shape. No longer the angular stick-figure of her early years, gently flowing curves now softened her hips and rounded her growing abdomen. Each time I saw her, the smile on her face had grown as well.

“It’s all very interesting, don’t you think?” she asked me, one time as she neared her delivery date.

“What’s interesting, Julia?” I said, as I measured her abdomen and checked the position of the baby inside.

“The roundness…”

I smiled. “The baby, you mean?”

She shrugged. “Everything…” Her voice trailed off as she thought about it some more. “I used to like all of the angles in my body. I used to think it was beautiful to see my hip bones when I was in a bathing suit…” Her smile enlarged and suddenly she giggled. “Interesting, eh?”

I suppose we’re all biased against one thing or another, aren’t we? At my age, though, it’s hard to keep track anymore. I seem to blunder into something whichever way I turn, no matter my intent. I have no quarrel with political correctness, or anything -I am quite happy to be correct- it’s just that, well, some of this stuff is invisible at first or even second glance. Effectively camouflaged in the background of my everyday life, it’s a Where’s Waldo that’s getting harder and harder to solve.

Maybe I should watch more YouTube, or follow the news on Facebook more closely, because (blush) I do neither. Of course, that’s how you learn about what’s trending in the biasphere -if you really care, that is. I suspect I don’t. I just try to be polite and considerate to all and sundry; only occasionally does my naïveté surface to any noticeable, and hopefully harmless, extent.

So I have to confess, to being caught amidships with an essay in the BBC Future series that somehow makes its way unaided to my inbox from time to time: http://www.bbc.com/future/story/20181115-anti-fat-bias-round-shapes-are-sold-to-overweight-customers It would seem that we all have cleverly disguised anti-fat biases -and were I a salesman, I would apparently be less likely to meet the eyes or smile at someone of that persuasion.

And, believe it or not, ‘An undercover shopping experiment has now shown that this  bias even extends to the shapes of products that customers are recommended: customers of a greater weight are encouraged to buy rounder items… the researchers found that when wearing [a] prosthesis [to make the actor seem obese], the actor was recommended rounder watches and rounder bottles of perfume… Online experiments with study participants who weren’t shop assistants confirmed the bias Vallen [the study author Beth Vallen, a researcher at Villanova University in the US] and her colleagues measured in the real-life setting. Participants were shown a picture of a potential customer and asked to recommend products, selecting from pairs of images that were either round or angular. “We wanted to show that this was a bias that reflects the thoughts and decisions processes of all people, not just sales people,” says Vallen. This turned out to be the case: they found the same effect of matching rounder products to people with a higher BMI. It also held across different types of products – from watches to mirrors, lamps and candles. And it happened whether the imaginary customer was male or female.’

I must live in a protected bubble, I guess. My watch, for example is round -I didn’t think they came any other way, to tell the truth. Anyway, ‘The bias goes beyond an urge to match people of a particular body type with a particular shape of product… it is the stereotypes associated with the product and the people that are at play. In particular, one stereotype is that overweight people are friendlier. Rounded shapes are also seen as friendlier.’ Come on, eh? ‘actors were recommended more rounded products when they were smiling than when they were stern-faced – an effect that held whether they were wearing a body prosthesis or not.’

This rather idiosyncratic finding seemed to take the researchers by surprise: ‘“We don’t find any evidence that overweight people themselves prefer round products, or that normal weight people prefer angular products,” says Vallen.’

So is this telling us anything important -other than that grant money must be getting easier to come by? It made me remember the Julia of so many years ago, and I wondered whether or not Vallen might be on to something -something so ancient that it was locked, like Bluebeard’s secret, in a room we had not dared to enter in all these years. When I think of Julia, I can appreciate what Vallen may have inadvertently uncovered. But, far from the horrors of Bluebeard’s skeletons, it may be an atavism that can speak to us in modern times: maybe rounded shapes are somehow friendlier…