While these proposals are ostensibly driven by a desire to promote health, they might also be described as the result of increasing anxiety about health, and in particular as the result of the often hyperbolic manifestations of concern about a national obesity “epidemic.”48 Over the past two decades, media outlets and have grown increasingly interested in the topic of obesity. Scholars such as Abigail Saguy and Paul Campos now argue that obesity constitutes a “moral panic,” characterized by attention to an issue that is disproportionate to the seriousness of the problem because it is implicitly or explicitly understood to be a threat to social values and
47 Jane E. Brody, "Attacking the Obesity Epidemic by First Figuring out Its Cause," New York Times, September 13
2011, http://www.nytimes.com/2011/09/13/health/13brody.html.
48 As an example of the sometimes hyperbolic perspectives associated with concern about obesity, in a Times
interview, obesity researcher, Dr. Thomas Robinson, explained “To gain 15 lbs in a year, you only have to have an imbalance of 150 calories per day, which is one soft drink…even a Lifesaver has 11 calories. An extra Lifesaver a day is an extra pound per year.” Kolata, Gina. "While Children Grow Fatter, Experts Search for Solutions." New York Times, October 19, 2000. Accessed September 12, 2015. http://www.nytimes.com/2000/10/19/us/while- children-grow-fatter-experts-search-for-solutions.html?pagewanted=1. See also: W. Wayt Gibbs, "Obesity: An Overblown Epidemic?," Scientific American 292, no. 6 (2005). Paul F Campos, The Obesity Myth: Why America's Obsession with Weight Is Hazardous to Your Health (Penguin, 2004). Michael Gard and Jan Wright, The Obesity Epidemic: Science, Morality and Ideology (Routledge, 2005).
interests.49 Academic studies of discourse surrounding overweight people have found that the
media consistently sensationalize the issue of obesity by emphasizing studies with dramatic findings, employing alarming metaphors, providing exhaustive lists of health risks associated with obesity (including those only tenuously linked to obesity), and ignoring scientific debates over the extent to which obesity represents a serious problem.50The discursive patterns that characterize the obesity epidemic include exaggerating the extent of the epidemic by, for example, including overweight individuals in discussions of health effects linked exclusively or predominantly to obesity.51We see these traits at work in near-universal coverage of a recent study that suggested that obesity could decrease the average American life span by eight years, and in coverage of the most preliminary and tenuous links between obesity and conditions from infertility to hearing loss.52
Scholars in cultural studies, sociology, women’s studies, and fat studies have drawn on social constructionist theory to further challenge the discourse of the obesity epidemic by linking it to “powerful interests and cultural values about fatness that are historically rooted and socially constructed.”53 Critics link anxiety over obesity to moral concerns about sloth and gluttony,
49 Abigail C Saguy and Rene Almeling, "Fat in the Fire? Science, the News Media, and the “Obesity Epidemic”" Sociological Forum 23, no. 1 (2008), 74; Paul Campos et al., "The Epidemiology of Overweight and Obesity: Public Health Crisis or Moral Panic?" International Journal of epidemiology 35, no. 1 (2006).
50 Natalie Boero, "All the News That’s Fat to Print: The American “Obesity Epidemic” and the Media," Qualitative sociology 30, no. 1 (2007); Campos, The Obesity Myth: Why America's Obsession with Weight Is Hazardous to Your Health; Gard and Wright, The Obesity Epidemic: Science, Morality and Ideology; Gibbs, "Obesity: An Overblown Epidemic?."; Matt Patterson and Josée Johnston, "Theorizing the Obesity Epidemic: Health Crisis, Moral Panic and Emerging Hybrids," Social Theory & Health 10, no. 3 (2012); Saguy and Almeling, "Fat in the Fire? Science, the News Media, and the “Obesity Epidemic” 2."
51 Boero, “All the News That’s Fat to Print.”
52 "Obesity Linked with Hearing Loss," HuffPost Healthy Living (2013); Reuters, "Half of Us Women Are Overweight During Pregnancy, Study Finds," Fox News, July 1 2015.
53Patterson, Matt, and Josée Johnston. "Theorizing the obesity epidemic: Health crisis, moral panic and emerging
hybrids," Social Theory & Health 10, no. 3 (2012): 266; Campos, The Obesity Myth: Why America's Obsession with Weight Is Hazardous to Your Health; Susie Orbach, "Commentary: There Is a Public Health Crisis—Its Not Fat on
aesthetic concerns about ideal bodies, and social and political concerns about personal
responsibility and laziness. Among these critics, some reject outright the association between obesity and poor health outcomes.54 Others suggest that scientific knowledge about weight gain is, if not entirely objectionable, at least imperfect and unbalanced, and that public perceptions and media coverage of obesity dramatically overstate the significance and soundness of medical work on obesity.55
Regardless of the extent to which our understanding of obesity as an epidemic is shaped by social and cultural variables, scholars argue that how we think about obesity has significant consequences in the social world.56 If, for example, we think of obesity as a biomedical problem, we might call for medical research on causes and treatment of obesity, place the blame for obesity largely on biology, and view obesity as a problem facing individuals and communities (as we do other epidemics). If instead we view obesity as soft drink companies suggest, as a result of individuals exercising their right to make choices in a free market, we would likely protect the right of individuals to make choices that we see as unhealthy (while still judging those whose choices result in obesity), and view obesity as a problem facing individuals.57
Critics of the obesity epidemic have also highlighted the economic incentives of researchers and activists who receive funding from the pharmaceutical and weight loss
the Body but Fat in the Mind and the Fat of Profits," International Journal of Epidemiology 35, no. 1 (2006); Esther D Rothblum, Sondra Solovay, and Marilyn Wann, The Fat Studies Reader (New York Unviersity Press, 2009); Saguy and Almeling, "Fat in the Fire? Science, the News Media, and the “Obesity Epidemic”"; Marilyn Wann, Fat! So?: Because You Don't Have to Apologize for Your Size! (Random House LLC, 1998).
54 See note 54.
55 Boero, "All the News That’s Fat to Print: The American “Obesity Epidemic” and the Media," 46., p. 46 56 Samantha Kwan, "Framing the Fat Body: Contested Meanings between Government, Activists, and Industry," Sociological Inquiry 79, no. 1 (2009); Abigail Saguy, C., What's Wrong with Fat? (New York: Oxford University Press, 2013).
57 Kwan, "Framing the Fat Body: Contested Meanings between Government, Activists, and Industry."; Saguy, What's Wrong with Fat?
industries. Some obesity researchers manage weight loss clinics or offer weight loss counseling services, and have an economic interest in defining obesity as broadly as possible, sometimes exaggerating the dangers of weight gain in order to justify support (regulatory, legislative, and fiscal) of their products and services. For example, The Obesity Society, which has actively lobbied to have obesity formally recognized as a disease, is funded principally by pharmaceutical and weight-loss companies and defends collaboration between scientists and industry.58 Critics
of such relationships echo the concerns of radical second wave feminists who criticized the profit incentives of medical institutions and industries, as well as the tendency for such incentives to encourage medicalization. In identifying ways in which our understanding of obesity is shaped by subjectivity and unscientific motives, they also remind us that our concepts of health are produced through social and political processes.
Advocates of policies further restricting food stamp eligible foods engage in similar discourse. They regularly invoke the language of epidemics and draw direct and scientifically unsound connections between soft drinks and obesity. In their letter to Congressional leaders asking them to institute a “soda ban,” the coalition of mayors noted, “as a result of obesity, this generation of American children is the first to face the possibility of a shorter life expectancy than their parents.”59 Their claim emerged in 2002 when Dr. William Kish of Texas Children’s Hospital told the Houston Chronicle that in his opinion the childhood obesity epidemic could result in children having a shorter life expectancy than their parents. In 2005 the New England Journal of Medicine published a highly publicized study by epidemiologist S. Jay Olshansky and
58 Campos et al., "The Epidemiology of Overweight and Obesity: Public Health Crisis or Moral Panic?."; Theodore Kyle, "Tos Applauds Ama for Recognizing Obesity as a Disease," news release, 2013; Mollie Turner, "The Obesity Society Encourages Science-Industry Collaborations to Support Obesity Science, Public Health," news release, March 24, 2014, 2014, http://perma.cc/2XX7-GN67.
several co-authors supporting Kish’s intuition.60 In light of criticism, including that of the CDC’s
lead author of the Center for Disease Control’s National Vital Statistics Report, one of
Olshansky co-authors, biostatistician David B. Allen admitted that the life expectancy forecasts were only “back-of-the-envelope plausible scenarios.”61 Nevertheless the forecasts continue to be reported by news outlets.62
Media coverage of restrictive food stamp policies, like that of obesity, is frequently sensationalizing. A CNN Money article was headlined, “Food stamp soda ban can save 141,000 children from obesity.”63The highly publicized article found that a soda ban “would prevent at least 141,000 kids from getting fat and another 240,000 adults from developing Type 2
diabetes.” CNN’s coverage greatly overstated the certainty of findings that (as the authors themselves noted) only presented a prediction of possible outcomes of a soft drink ban.64 The
findings were more accurately represented in the title of the academic article, “Ending SNAP Subsidies For Sugar Sweetened Beverages Could Reduce Obesity and Type 2 Diabetes,” which is significantly more subdued. 65
Critics of obesity discourse remind us that how we understand and respond to health problems – including what constitutes a health problem, what conditions we believe promote it,
60 S. Jay Olshansky et al., "A Potential Decline in Life Expectancy in the United States in the 21st Century," New England Journal of Medicine 352, no. 11 (2005).
61 Harriet Brown, Body of Truth: How Science, History, and Culture Drive Our Obsession with Weight--and What We Can Do About It (Boston: Da Capo Press, 2015): 16.
62 Jennifer Warner, "Baby Boomers May Outlive Their Kids," (2010); Pam Belluck, "Children's Life Expectency Being Cut Short by Obesity," The New York Times, March 17 2005; Sreedhar Potarazu, "5 Reasons Why We May Outlive Our Kids," FoxNews, September 5, 2013, http://www.foxnews.com/health/2013/09/05/five-reasons-why- may-outlive-our-kids/.
63 Jennifer Liberto, "Food Stamp Ban Can Save 141,000 Children from Obesity," CNN Money (2014).
64 Sanjay Basu et al., "Ending SNAP Subsidies for Sugar-Sweetened Beverages Could Reduce Obesity and Type 2 Diabetes," Health Affairs 33, no. 6 (2014): 1034.
how severe it is, what should be done to address it, and who is to be blamed – is shaped by social and political context. Or as these critics might say, our understanding of health is socially
constructed. As a result, particular constructions of health are imbued with moral valences and assumptions, and the seemingly objective good of “health” can be used to mask moral, aesthetic, or social motivations. At its most sympathetic, this view still suggests that even those who genuinely desire to improve the health of others may be motivated to address particular heath problems, address health problems in particular (invasive or repressive) ways, or treat those suffering in particular (stigmatizing) ways, because of unscientific, implicit, social and cultural biases. Thus socially constructed views of health shape our social and political world, as they do in the case of policymakers’ efforts to alter the food stamp program to address concerns about obesity.