Response to “The Weight of Obesity”

So much of current obesity discourse relies on conceiving the body as fixed and bounded, to be represented numerically, and compared to the average. Increasingly made known through measurement and calculation, this particular conception of the body produces an entity that can be owned, sold, worked on, or worked against. Crucially, this way of thinking about the ‘problem’ of obesity is not only infused with an economic logic, but a capitalist ideology. The Weight of Obesity offers a plethora of wide-ranging ideas that emerge powerfully from an ethnography that is subtly grounded on the rupture of political change and the inequities of a global political economy.

One of the key anthropological messages is that local context can radically alter what might be taken to be a universal absolute—such as, ‘there is no iron in sugar’, or ‘carrots are better for you than crisps’ and ultimately that ‘weight is bad’. In other words, within a particular context these claims might not, in fact, be true. But rather than this simple being dispersed geographically, as though some places are more ‘local’ than others, universal claims remain vulnerable, wherever they are made. The point is that claims concerning healthy eating are always going to be perilous—not because they are necessarily in conflict with capitalism and the constant production of cheap and convenient foods, but because now that health has become one of the selling-points in many products that sit on supermarket shelves, it can be manipulated just like any other ingredient. So the forces of economic logic help divide the body from the person—not as completely separated entities, but entities bound together in a relationship of need and aspiration: Capitalism has focused increasingly on making its new market the desires of the self, as distinct and internal needs that can be fulfilled by new products and services.

A common feature of this is that food is imagined to make the body in its own image—rich, fatty, sweet and hedonistic foods create a body accordingly: obese, sedentary, slovenly, heavy. In contrast, the same cultural machinery that sells unhealthy sauces under the guise of authentic home cooking, heralds the physically active, super-lean, toned body—its owner is agile, adept, light footed, a player. So it is not surprising that fasting, starvation, and constant dieting are all now ways to both be seen, and to be successful; it is not simply that the healthy body is now conceived of being made from such foods, but that a successful person chooses to make these foods (and not others) their own. So it is equally not surprising that so many weight-loss interventions are designed to promote ‘physical activity’ and ‘active transport’ and address the new evil—‘sedentarism’. The target is not merely obesity and ill-health, but the itinerant deviant behaviour of people who have surrendered. Once again, Public Health and commercial capitalism find places to align.

One might assume that the idea of nutritional balance, much like a similar homeostatic model of metabolism, runs counter to these static depictions of the body. But through a particular language of inputs and outputs, and the central place of zero between pluses and minuses, Emily shows that even this kind of balance is only ever achieved through a series of deft abstractions. The point is that this version of ‘balance’—as a summative calculation—can only occur outside and beyond—when the ongoing realities of living are sufficiently bracketed off such that they don’t suddenly intervene to undo the maths. Such moments of ‘balancing the books’ are consequently, paradoxically, static, requiring everything to be spread uniformly across a single table or spreadsheet.

An alternative view is that balancing is, by its very nature, a dynamic state. From this perspective, it is not only a constant process, but enlists lots of diverse elements to continuously fine-tune a centre of gravity. So balancing is achieved not by demarcating the body from its environmental, but instead by constantly being in dialogue with it. And is here the full force of the Weight of Obesity: it does not only penetrate the cultural construction of categories, but describes in rich detail the situated ways in which diverse activities and materialities become entangled together.

Reading this book has helped me think about how semantic orderings of the world—often built upon ideas of continuums, opposites, and absolutes—seductively take shape. And it has made me think about the central place of stability and constancy in biomedical knowledge, and how rigid categories not only fail to do justice to complexity and interaction, but their application can do violence to the inherent variability of people’s everyday lives—wherever they are. What Emily’s book shows is that it is not simply that our job is to draw on ethnography to show others alternative ways to think about health problems and solutions, but that, in addition, it can show the extent to which variations already exist, and that the compulsion to put everything into a singular order through the application of static categories and universal calculation strips away the inter-relational richness, the contradictions and ambiguities, and the different histories and presents, of people’s everyday lives.

 

Simon Cohn is Professor of Medical Anthropology at the London School of Hygiene and Tropical Medicine. His research focuses on issues related to diagnosis, contested conditions, and chronic illness in the UK and other high-income societies. He has recently become fascinated by the role of fluids, both inside and outside the body: how they relate to health, their general absence in medical anthropology and sociology accounts, and the extent to which their constant movement and flow might demand a new way to think about old problems.