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Health Care

An Uptick In Non-Jews Choosing Jewish Circumcision? Maybe.

CommonHealth (WBUR) - Tue, 06/23/2015 - 1:08pm

Reporter Jessica Alpert may have stumbled on a trend: non-Jews choosing to have their infant sons circumcised by traditional mohels, Jews trained to perform the ritual procedure, rather than doctors.

Alpert, a frequent CommonHealth contributor, writes in the current Atlantic:

Finch isn’t the only non-Jew who has felt a connection to the religious elements of the procedure. Nationwide, circumcisions have decreased over the last few decades—from 64.5 percent of newborn boys in 1979 to 58.3 percent in 2010, according to Centers for Disease Control data—but among those opting to circumcise their sons, some non-Jews are forgoing the hospital or doctor’s office and requesting Jewish mohels for reasons both practical and religious. (Reliable statistics on religious circumcisions are hard to come by, but several mohels I talked to said they’ve noticed an uptick in their popularity in recent years.)

Preparing for a circumcision (Cheskel Dovid/Wikimedia Commons)

Whether or not the practice is taking off, Alpert suggests that this co-mingling of religious and non-religious realms may have “tricky implications for mohels performing non-Jewish circumcisions,” and raise thorny legal questions:

The right to perform brit milah is protected under the First Amendment, but when it’s no longer a religious ritual, mohels may run up against laws that forbid the practice of medicine without a license, explains Marci Hamilton, a church-state scholar and professor at the Cardozo School of Law at Yeshiva University. There is no legal gray area for mohels who are also health professionals—these mohels can perform the procedure on non-Jews as part of their medical practice, even if the primary purpose is religious rather than medical. But others, Hamilton says, may be subject to prosecution when they perform the procedure outside of its religious context.

When it’s a non-Jewish family using a mohel, “The mohel is not acting as a religious participant, and therefore his acts are not protected as free exercise,” she explains.

“This is really a medical business transaction, not a religious transaction.”

Last year, a study published in the Mayo Clinic Proceedings concluded that the health benefits of newborn male circumcision outweighed the risks. However, that data did little to sway critics of the practice who have called it “a disservice to American parents and children” (and worse) in remarks posted on the American Academy of Pediatrics web site after the group published a policy statement supporting insurance coverage for the procedure and also underscoring the health benefits.

Categories: Health Care

Dietland: A Fat Heroine, And The Politics Of Weight

CommonHealth (WBUR) - Tue, 06/23/2015 - 12:57pm

By Jean Fain

The heroine is the news in Dietland, the new novel by Sarai Walker. That’s because she’s got the rarest of qualities in a female protagonist: she’s fat.

Also, she has next to no sense of self, and expects to remain selfless until she can afford weight-loss surgery and find her true self as a thin person. In the meantime, Plum Kettle, our heroine, works as a ghostwriter for the slender, glamourous and self-absorbed editor of a teen magazine called Daisy Chain. In short, Plum’s got no life of her own.

Plum’s transformation from fat girl to full-bodied rebel with a cause is the narrative arc of Walker’s provocative and insightful book. Like Alice in Wonderland, Plum’s sense of self gets turned on its head by a cast of oddball characters, from the daughter of a famous diet guru and her feminist cohort to a murderous terrorist cell of women avenging crimes against women. When the daughter of the diet guru offers Plum $20,000 to postpone her surgery and confront the real costs of beauty, the plot and subplot blend and thicken.

Despite the rave reviews from my inner circle and the world at large, I didn’t expect to be drawn in by the writing. But, truth be told, it’s fresh, playful and sometimes hilarious: the parody of the diet industry is spot on. I also didn’t expect to be touched by the rejection and humiliation the 300+ pound Plum encounters along the way to finding herself.

Most unexpected of all: I kind of looked forward to spending my evenings with a fictional someone desperately seeking weight loss. Generally, if I’m desperate for anything at the end of the day with clients (I’m a therapist specializing in eating disorders and food issues), it’s non-diet-related downtime.

I can’t say I always loved reading Dietland. Violence, even when served as Walker serves it — with sarcasm and panache, isn’t my cup of tea. I also had trouble swallowing the meanness of the male characters, and the complete self-acceptance of the female ones. And yet, my curiosity kept me turning all 307 pages. I wanted to know if Plum would live more happily ever after. Plus, I wanted to discuss the book with members of my mindful eating support group. (Dietland is the group’s first unofficial book club selection.)

At the same time, I kept reading between the lines to learn the author’s story. From the book-jacket flap, I knew Walker writes from professional experience. Before she did her doctoral research on the feminist issue that is fat, she wrote about body image for Our Bodies, Ourselves, the feminist classic by the Boston Women’s Health Collective.

From the author photo, I also knew Walker is a fat woman. And yet, combing through the reviews and interviews, I could find very little about Walker’s personal experience with food and body image issues.

The therapist in me really wanted to know if Walker, like Plum, had tried and failed to lose weight over and again? If she’d been a victim of fat shaming and stigma? If she’d been discriminated against because of her appearance? What was Walker’s story?

My curiosity moved me to set up a Skype interview with the NYC-based author. What follows are questions and answers from that recent interview with Sarai (pronounced SUH-ray) Walker.

JF: You seem to know a lot about food and body image issues even though you’re not a medical person or scientist. What can you tell me about your personal experience in this arena?

SW: Well, I’m a fat woman, and so I think one of the reasons I wanted to write Dietland is I wanted to explore what it’s like to be a fat woman in our contemporary society because I think, while there are some novels with fat heroines, I feel like there aren’t any novels that explore the issue in a serious way.

Author Sarai Walker (Photo: Marion-Ettlinger)

Which is interesting because our society is so obsessed with “obesity.” There was actually an article in the Wall Street Journal a couple of years ago where they wrote about the fact that people are so obsessed with the fat body, but there really aren’t a lot of novels that deal with that subject. So that was kind of my motivation for writing the book, and I felt like I had the kind of personal experience to make it very authentic.

JF: So does that mean you were a dieter and had your own body image issues?

SW: Yeah, I would say that I started dieting as a teenager, so I kind of did all sorts of commercial diet programs, and then diet books, things in magazines, just sort of everything. And so I’m kind of well familiar with the dieting industry and, I think, how diets really don’t work for most people. I’m sure they do work for some people, but I think they’re largely ineffective as calorie-restrictive dieting.

So you’ve been through the diet mill. How about body image issues? What can you say about that?

So I was doing my Ph.D., and then I started to attend Fat Studies conferences, and that sort of introduced me to fat acceptance, health at every size, these different movements. And it was really just a radical transformation in my way of thinking. And as soon as I was exposed to these ideas, it just sort of clicked, that’s what I had been looking for but hadn’t been able to find. So it definitely changed the way I viewed my own body and made me realize that I don’t want to take what people project onto me and internalize it. I can’t help what people say about me or think about me, but I can help how I think about my own body, and that was really a radical shift for me.

That’s fantastic, because this is a really tough culture. It’s toxic. So how would you describe your body image at this point, because it sounds like it’s been kind of a long journey?

I would say that part of it is getting older; I’m not sure if that factors into it as well. Even though I know some great fat activists who are in their twenties or even teens, so who knows. I think for me getting older perhaps helps a bit. I feel more confident, I think. I hate to use the cliché, but knowledge is power. Really understanding the power dynamics of how all of these things work in terms of why fat women are marginalized, treated the way that we are. I think understanding the dynamics at play, at least for me, helps me deal with it. But it very much places the responsibility on the shoulders of individual person. Maybe everybody can’t deal with that; some people may be more susceptible to societal pressure. I don’t want to make it seem like it’s easy, because it’s not. Some people are perhaps more capable of it than others.

You’re not a therapist, and yet one of your characters prescribes a really unconventional therapy to help Plum face her worst fears. I’m curious how you came up with the therapeutic strategies, some of which are a little bit aversive, like getting a full body wax and dating jerky men.

So in the novel, there’s this diet plan called Baptist Weight Loss that Plum’s on when she’s a teenager. And then as an adult, she meets the daughter of the founder who is this activist who’s trying to undo the damage that her mother did with this weight-loss mega empire that she had. So basically Plum kind of goes through the reverse of a weight-loss program. So the woman in the novel calls it the New Baptist Plan, so it’s a new kind of diet plan. And instead of focusing on the body, making your body smaller, it’s focusing on the more underlying issues of our obsession with thinness. So part of it was trying to open Plum’s eyes and trying to make her angry about the treatment that fat women receive. So basically helping her turn her anger outward rather than at herself. But I’m not a therapist; I just kind of used my knowledge of dieting culture and my creativity to craft this plan.

It’s hard because when you’re a fiction writer you have to be concerned with the story as well. An interesting story, having the readers turn the page. So it’s a lot different than nonfiction, even though it might deal with some of the same issues, where there are a lot of different factors at play. I just made it up myself based on what I thought would be useful.

Over the course of the novel, Plum learns to accept her body without losing weight, which as we’re saying is no small task, especially in this fat-phobic society. How about you? What can you tell me about accepting your body just as it is right now?

I think it’s not like where you get to a place where you say, “Ok, as of today I just accept my body and that’s it.” It’s something that I wouldn’t say is a constant struggle, but it’s a constant issue, something you have to work on a lot. It’s never just one moment where you’re perfect and everything’s fine. Again, having access to fat acceptance, body positivity, health at every size, these different movements I think just are very empowering. And I think it helps a lot to have a community of other people as well, which is essential to Plum in the novel, finding other like-minded women. So if you can find a group of women, or people online, that’s been very helpful to ne, to know that I’m not alone and other people are going through the same thing.

My favorite quote is when one character tells Plum: “There comes a moment when you realize you’ve changed in some irrevocable way, and you’ll never go back to the way you were. Think of it as crossing over to a new place.” Do you have such a moment in your own life?

When I started attending these fat study conferences, it just kind of clicked for me; all of a sudden it made sense. And I knew that while it’s always a process – as I said before, it’s never just one moment where everything’s perfect, it’s a continuing process – there was a point where something inside me, a kind of consciousness raising, and once that happened, something shifted in me, and I knew that I would never go back to the way I was before. So not that everything was going to be perfect, but it was a before and after kind of moment. I wouldn’t say that it was one instant, but it was a period of time when I became exposed to these ideas and it shifted my way of thinking.

Tell me how working on Our Bodies, Ourselves influenced the writing of Dietland, because I could swear I could see little instructional moments that might have ben straight out of that book.

That’s funny because that was about 10 years ago I worked there. For one thing, I wrote the chapter on body image, so that was my first experience writing about the body from a feminist perspective, because before that I had worked at women’s magazines, so that was a big shift for me. But I also think working on Our Bodies, Ourselves made me very comfortable talking about the body in more explicit ways. All day we would deal with all sorts of issues, childbirth, everything, whatever it was, we would have graphic photos and illustrations surrounding us all day long. It made me lose some of the shame I had perhaps when thinking about the body, because I think that’s quite common in our culture, to be raised with this kind of embarrassment or shame about the body.

And after I worked there I lost that, just thinking about the body, talking about those sorts of issues in general. So that’s one of the things I think really helped me with the novel, kind of liberated me in that sense. But I also think Dietland kind of has that spirit of the 70s feminism in it. So of course, Our Bodies, Ourselves was such an integral part of 70s feminism, so I really value that experience. Getting to experience a kind of feminist collective – it’s not really a collective I guess in the traditional sense anymore – definitely influenced me in all sorts of ways I would think.

Anything else you want to tell me about?

The thing about the difference between a novel and nonfiction, for example, because I think most books on this topic are nonfiction, and a novel just functions differently on a more emotional level, a gut level. So I think it’s interesting for me to see how people respond to – particularly people who’ve never been exposed to these ideas before. It’s been fun to see some people are sort of like “Oh, I never thought of that before; you changed my way of thinking.” That kind of shift we were talking about; I love when people experience that after reading the book. So that’s been one of my favorite things so far.


Jean Fain, LICSW, MSW, is a Harvard Medical School-affiliated psychotherapist and the author of “The Self-Compassion Diet.”

Categories: Health Care


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