Some women in Quarryville have a message for the U.S. senators who will be charged with confirming surgeon general nominee Dr. Regina Benjamin.
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These women don't want to hear any nonsense about Benjamin's weight. They don't care if her surgeon general's uniform will be a size 18 or 20. They don't want to hear about Benjamin's full figure or full cheeks — they are more interested in the fullness of her resume.
A half-dozen or so women, who exercise together five mornings a week at Curves in Quarryville, said they were displeased by the treatment Benjamin received in the media after she was introduced as President Barack Obama's choice for surgeon general.
Benjamin's nomination will be considered by the Senate Committee on Health, Education, Labor & Pensions, but not until after the Senate returns from its summer recess in September.
Benjamin already has been through a baptism by media fire.
A former editor of the New England Journal of Medicine has been quoted as saying that Benjamin's size "tends to undermine her credibility." Fox News host Neil Cavuto opened a segment on Benjamin by describing her as "brilliant, dedicated, experienced, and, oh yeah, fat." Cavuto then discussed Benjamin's weight with a male guest wearing a "No Chubbies" T-shirt.
None of this sat well with the early-morning exercisers at the Quarryville Curves.
"They don't criticize men's weight," said Arlene Strauss, one of the Curves regulars. "They only criticize women's weight."
"What does that have to do with her credentials?" Teresa Sawka asked. "We have to look at her qualifications, look at what she's done with her life."
Sawka said she and her friends who work out at Curves were born in the first half of the 20th century. "We understand how hard it is for a woman to become a professional," Sawka said, adding, "And to have (Benjamin) be judged like that makes us crazy."
'Weighty issue'Benjamin has been described most frequently in the media as full-figured — a description which, as some pundits have pointed out, never was applied to C. Everett Koop when he was surgeon general. An ABC News story noted Benjamin's "round cheeks."
Headline writers, columnists and bloggers have resorted to numerous weight-related puns, in covering the so-called "weighty issue" that Benjamin represents.
That issue, as critics of Benjamin see it, is this: The nation is battling an obesity crisis. According to the Centers for Disease Control and Prevention, 66 percent of Americans are overweight or obese, and the medical costs of obesity may be as high as $147 billion annually. In light of all of this, can a doctor whose body mass index exceeds the ideal be a credible advocate for this nation's well-being?
The brouhaha, though, has raised another issue: Are large women judged more harshly than large men?
Few people have disputed Benjamin's credentials. The Alabama physician founded a nonprofit medical clinic for the poor residents of a Gulf Coast village, and she repeatedly rebuilt the clinic after it was ravaged by hurricanes and fire. She was the recipient of a so-called "genius grant" from the MacArthur Foundation. She was the first African-American woman to be appointed to the American Medical Association's board of trustees.
Nevertheless, some people contend that her size might disqualify her from serving as surgeon general.
Joan Ranck, of Christiana, who also works out at the Quarryville Curves, said, "I'm not going to lie — that would be a strike against her for me."
Ranck arrived at Curves just as Sawka, Strauss and the others in their group were heading out for coffee. Benjamin's weight, Ranck said, "does raise a big question mark: Why can't she do what she would promote for other people?"
"This is a legitimate issue," she maintained. "If it was going to be the drug czar, and the drug czar took drugs, wouldn't that be a legitimate concern?"
Ranck said she knows that women are judged differently than men, and she also understands how difficult it can be to lose weight. But she said that any "heavy-set doctor" would have a credibility problem when it came to weight issues. "I wouldn't think that they could talk to me about weight," she said.
Doctors as modelsDr. Monty Duke, senior vice president and chief physician executive at Lancaster General Hospital, said that physicians often have to counsel patients on healthy habits. He said he thinks a doctor's personal fitness can have an effect on patients.
"When a patient comes into the office, and you're trying to counsel them on healthier lifestyles, and they saw you getting a cigarette during the break, and have a half-eaten bagel and cup of coffee on your desk ... patients see that," Duke said. "They may not say anything, but it does have an impact."
Duke said there are some physicians who have zero body fat, and who run marathons, but he's not one of them. Duke said he "could stand to lose 15 pounds."
A physician's lifestyle, he maintained, does not lend itself to optimal fitness. "We work long hours, we have our sleep interrupted, we eat out quite a bit, we do not have a regular schedule," Duke said. "Lunch is whatever I can wolf down in five or 10 minutes. ... Our work schedule doesn't often lend itself to healthier choices."
"As a physician, you don't always have control over your schedule or your lifestyle," Duke said, adding of overweight physicians, "Does it mean they aren't quality physicians? Does it mean that they don't have a quality relationship with their patients or that they're not smart?"
He said that some patients might respond to an overweight doctor's counsel to lose weight with the question, " 'Geez, Doc, if it's so easy, why don't you do it?' "
However, he said he thinks that having struggled with weight issues since childhood has made him a more empathetic doctor, who is "more understanding of the changes that need to be made, and how hard it can be."
Duke doesn't see obesity as a failure of will or discipline. "I don't think it's because people like to sit down and eat Ho Hos. It's more than that," Duke said.
Obesity, he said, "is a very prevalent, challenging and, in my view, complex condition that affects a lot of people."
He said he thinks Benjamin probably is "very, very sensitive to the fact that this is a public health problem" and has an understanding of "how difficult it can be to control."
Experience is keyRosemary Search, a registered nurse and manager of community health and wellness at Lancaster General, said people should be focusing on Benjamin's resume. "Her ability to influence behavior and really make a change is key," Search said.
Jayme Trogus, coordinator of the Wellness and Women's Center at Millersville University, said that when choosing her personal health care providers, she is less interested in the physician's physique than in the doctor's experience.
The peer educators she hires for the center at Millersville are not all thin either, she said, noting that thinness doesn't always equate to fitness and perfect health.
She does not think Benjamin's size should preclude her from becoming surgeon general.
"It's pretty obvious that we're a country of people who are overweight," Trogus said, noting that perhaps Benjamin will "inspire some people to address their health and lifestyle."
"Is she supposed to be this female spokesperson who looks great?" Trogus said. "Does she have to be what our society deems to be beautiful, this perfect size, and look a certain way?"
"If she was a man, and overweight, would the controversy still be there?" Trogus asked, adding, "There's so much pressure on women to be a certain shape and size. ... What message are we sending to young females?"
Sharlene Hesse-Biber, professor of sociology and director of women's studies at Boston College, said women are judged foremost on their appearance.
"If a man is overweight, well, then, so what? It's not important," contended Hesse-Biber, author of the book "The Cult of Thinness."
"We define women as their bodies," said Hesse-Biber, noting that a woman "must prove that she is feminine. She must prove that she fits in the right body, and if she doesn't, she's suspect."
While men are cut some slack, "people feel that women's bodies are up for public scrutiny," she said.
Negative attributes — laziness, lack of self-control — often are assigned to people who are overweight, she said, and women bear the brunt of this judgment.
Men may be questioned if they're underweight, but if they're large, they're generally seen as powerful, Hesse-Biber said. Powerful, large women, by contrast, are seen as threatening, she said.
The professor said that it's true "we live in an obese culture," and the surgeon general, clearly, should be aware of the effects of obesity on health. But, she added, "as many overweight people tell me, you can still be fit and be overweight."
If this griping over girth were applied equally to men and women, she said, it might be valid. But "it's not equally applied," she said, so "I don't buy it."
If Benjamin "was a thin, beautifully proportioned woman, the message would be, 'She can't be that smart. She got as far as she has on her looks,' " Hesse-Biber asserted.
The professor said she is not arguing that "we shouldn't lose weight." What she is saying, she said, is that people are using Benjamin's weight "in the service of something else, and that's insidious."
"What, do they want this surgeon general to be a Barbie? What do they want from her? What is it that they're not happy with?" Hesse-Biber asked. "What is everybody afraid of? They're afraid of a powerful big woman."
She said she worries that young women, observing the firestorm over Benjamin's weight, are going to conclude that seeking power isn't worth the public humiliation. Many young women, she said, are going to think, "I don't want what's happening to her to happen to me. If I have to be accountable about my body, I don't want to go there."
Teresa Sawka said the media bombards girls and young women with dangerous messages about body image. She said she taught her two daughters to rely on what's inside of them, rather than on their looks.
She and her early-morning Curves exercise mates said they see Benjamin as "one of us." They said they know what it's like to battle weight issues, and to battle societal expectations of women, and they said they appreciated that Benjamin seems to live in the real world.
One of the women, Peggy Borrelli, stated it plainly: "I'd rather have somebody who looks like me — rather than some skinny Minnie."
Suzanne Cassidy is a staff writer for the Sunday News. Her e-mail address is scassidy@lnpnews.com.
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