Fat: A Cultural History of Obesity

Sander L. Gilman.  Fat: A Cultural History of Obesity.  Cambridge
Polity, 2008.  237 pp.  $64.95 (cloth), ISBN 978-0-7456-4440-0;
$22.95 (paper), ISBN 978-0-7456-4441-7.

Reviewed by Corinna Treitel (Washington University - St. Louis)
Published on H-German (April, 2010)
Commissioned by Benita Blessing

Making Obesity History

In his long and illustrious career, Sander Gilman has taken on many
roles: literary analyst, cultural historian, and even public
intellectual. In his new book, _Fat: A Cultural History of Obesity_,
he operates as all three. Trained in _Germanistik_ (German studies),
he wrote an important study of the novelist and poet Klabund (the nom
de plume of Alfred Henschke) in 1971. His scholarly interests
broadened in the 1980s to the cultural study of topics as diverse as
insanity, psychoanalysis, and Jewish self-hatred. By the 1990s he was
pioneering the new field of body history, contributing several
important works including _The Jew's Body_ (1991) and _Making the
Body Beautiful: A Cultural History of Aesthetic Surgery_ (2001). The
book under review here clearly belongs to this third phase, yet also
shows Gilman pushing towards a global vision of cultural studies. As
a work of history, it is far from convincing. Yet as an essay on the
cultural components that make up our current obesity epidemic, it
offers an engaging and suggestive reading with which all historians
of fat, food, and modern dietary regimes will want to engage.

_Fat_ tackles important questions concerning how, when, where, and by
whom obesity came to be seen as an epidemic disease. Strictly
speaking, Gilman points out, obesity is not a disease. Rather, it is
a "phenomenological category which reflects the visible manifestation
of bodily size, which in turn can have multiple (or multifactorial)
causes" (p. 18). Obesity itself does not kill, but it may be a
tertiary cause of diseases that do: via diabetes, for instance, which
can lead to vascular disease. Doctors, news outlets, and public
health agencies, of course, speak otherwise. After decades of
resistance, for instance, Medicare declared obesity a disease in
2004, thus opening the way for recipients to access a spectrum of
treatments from diets to surgery to psychotherapy. "Epidemic" became
attached to "obesity" even earlier, and it is now common to hear talk
of a global obesity epidemic that stretches from the United States,
to the United Kingdom, to Canada and Australia, and then over to
China. Obesity, Gilman points out, has been constructed as the major
public health threat of the twenty-first century. This does not mean
that obesity was simply invented, but it does mean that a real
pathological experience--"excess weight"--has been reframed in new
terms. Gilman's project is to investigate that reframing.

Perhaps his most interesting claim is that obesity has now become the
object of a global "moral panic." "Obesity," he notes in his
introduction, "presents itself today in the form of a 'moral
panic'--that is, an 'episode, condition, person or group of persons'
that has in recent times been 'defined as a threat to societal values
and interests'" (p. 9). We see obesity as "a national rather than an
individual problem ... not only because of epidemiological evidence,
but also because of the meanings now firmly attached to the expansive
waistline" (p. 3). Our concern about the social implications of
obesity for national health and wealth helps render obesity an
epidemic disease. In other words, our anxiety precedes the disease,
not vice versa. Gilman develops this intriguing claim in five
chapters that tackle different aspects of our present moral panic.

In a first chapter on "epidemic obesity," Gilman argues that obesity
became an epidemic before it became a disease and indeed that its
framing as an epidemic in the 1980s allowed it to emerge as a disease
by the turn of the century. He traces the origins of the term
"epidemic obesity" to the 1860s, when American media outlets used it
with reference to cattle. But it was only in the 1980s that the term
was transferred to humans in the American news media, where doctors
and public officials began to warn of a new obesity epidemic that
threatened the nation's health, particularly that of children, whose
excess weight put them at risk for developing diabetes.

Reframing it this way, Gilman argues, legitimated the quest from the
1990s onwards to locate infectious causes and thus render
"infectobesity" a bona fide disease. In 1997, for instance, two U.S.
researchers suggested that obesity could be partially caused by
Adenovirus-36, which had been isolated from fat Bombay chickens, and
that its spread might emulate that of the AIDS (acquired immune
deficiency syndrome)_ _virus. Ten years later, in 2007, another group
of American researchers reported that obesity might stem from
"social" infection. This idea suggested that obese friends or family
members influenced individuals to adopt overeating as a behavior,
leading to obesity. What motivated this intense search for the
infectious causes of obesity during these years? Gilman responds with
a discussion of contemporaneous moral panics about SARS (severe acute
respiratory syndrome), Avian influenza, and BSE (bovine spongiform
encephalitis). In the United States, these diseases of the food chain
seemed to originate somewhere else, mostly Asia. Suddenly, this logic
suggested, the possibility became plausible that a virus had crossed
the species barrier from a fat chicken in Bombay to healthy humans in
the United States.

The origins of our present moral panic about childhood obesity in
nineteenth-century Anglophone literature is the topic of chapter 2,
with Charles Dickens's _Pickwick Papers_ (1836) as the key text. Most
of Dickens's characters were fat, but only one character suffered
from pathological fatness: the servant boy Joe, whose blank face,
excessive appetite, and corpulent body were the physical expressions
of his monumental stupidity, boundless laziness, and moral turpitude.
Gilman traces Joe's afterlife in medical literature, where Joe
"became a case study of pathology" in which a fat boy always hid a
"fat man in waiting" (p. 57). Fat children may have been excoriated
in the nineteenth century as weak-willed, but not as diseased.
Doctors at the time were more concerned with undernourishment than
excess weight, and considered fat babies healthy. This attitude
changed in the 1930s and 1940s, when the Viennese clinician Alfred
Froehlich described a massively obese and sexually infantile
pubescent boy suffering from a pituitary tumor. Soon after,
Froehlich's syndrome became a catch-all term for pathological, as
opposed to moral, readings of obesity. This development, in turn,
allowed doctors to take the Dickensian character Joe in new
directions. Joe emerged in twentieth-century medical literature as a
paradigm for all cases of pathological childhood obesity, from Hilde
Bruch's psychoanalytic approach in _Eating Disorders_ (1973) to
Claudio Rabec's hormonal approach in _Today's Fat Children_ (2006).

Nineteenth-century discourses about fat men and races inform our
current moral panic about obesity, argues Gilman in chapters 3 and 4.
If fat children were not medically pathologized until the
mid-twentieth century, the same cannot be said of fat men, who were
already suffering social stigma a century or so earlier. From William
Banting's autobiographical _Letter on Corpulence Addressed to the
Public_ (1863) to the reinvention of Shakespeare's character Falstaff
in Guiseppe Verdi's opera of the same name, fat male characters in
the nineteenth century sought a cure for their fatness--not because
of feelings of ill health, but because social stigmatization made
them anxious. Gilman gives a similar reading with regard to the
racial dimensions of the story. Nineteenth-century doctors, he
reminds us, regularly labeled Jews a "diabetic race." Jews' supposed
propensity to overeat, become obese, and develop diabetes reflected
doctors' core assumption about the link between fat and "the
'oriental' race" (p. 111). In the 1950s, Hilde Bruch, a German-Jewish
physician who had fled Nazi Germany and settled in the United States,
pushed aside this racial explanation by positing an alternative
psychoanalytic framework that rooted obesity in familial dysfunction,
especially bad mothering. But by the 1970s, the familial and racial
explanations had merged in discussions about fat in African American
communities.

Gilman's final chapters consider the regional dimensions of epidemic
obesity, first in the U.S. South (chapter 5) and then in China
(chapter 6). Medical researchers who investigate the demography of
obesity in the United States today, Gilman charges, perpetuate older
models of ethnicity and race. As evidence, he cites articles
published in 1998 and 2006 by medical sociologist Kenneth Ferraro,
who found Baptists and other Protestants to be the fattest of all
Americans; Catholics, Mormons, and other heterodox Christian groups
to be in the middle; and Jews and other non-Christians to be the
thinnest. This line of research, Gilman claims, "maps historically on
to older models of ethnicity, which in the world of the nineteenth
and early twentieth century were also models of race" (p. 125).

Gilman also draws these lineages by consulting novels about the
South, such as Margaret Mitchell's _Gone with the Wind_ (1936) and
John Kennedy Toole's _A Confederacy of Dunces_ (1980). In the first,
"black" Irish Catholics become "white" by using their ethnic vigor
and sturdy (not fat) bodies to rebuild the South after the Civil War.
In _A Confederacy_, a spectrum of ethnic whites try to become fully
white, but sink into obesity and ethnicity instead.

Chapter 6 takes the story to China, where western researchers
categorized new obesity problems there as a result of the
"pathological 'Occidentalization' of China and the Chinese" (p. 138).
Today, Chinese medical officials speak of a looming obesity epidemic
in which economic growth and American fast food (especially
McDonald's) are the culprits, with China's fat "little emperors"
under particular threat. "China, like America," Gilman notes, "is
suffering from a new epidemic, but one that documents its modernity;
no model of oriental, primitive infectious diseases here. Rather, a
claim of 'invasion from the West... Obesity and its treatment may
both be understood as parts of a system of modernization, with all
the pitfalls recognized and the 'cure' in sight" (p. 163). A short
conclusion on the "globesity" epidemic declared by the World Health
Organization in 2001 provides an occasion for Gilman to reiterate a
major point: our current anxiety about a global obesity epidemic is
but "the most recent iteration of an obsession with control of the
body and the promise of universal health" that has characterized
modernity (p. 164).

What are scholars who want to write obesity's history to make of this
bold and wide-ranging book? _Fat_ is certainly suggestive. Gilman
succeeds in highlighting some of the key building blocks that make up
our current obsession with an "obesity epidemic: its genre (moral
panic), its racial and ethnic tags, its roots in changing and
culture-bound understandings of "excess weight" stretching back at
least to the nineteenth century. He also shows us again how
intellectually profitable it can be to juxtapose sources from widely
different genres, especially imaginative literature, which did so
much to shape the way doctors and scientific researchers speak and
think about obesity today.

But as a work of history, _Fat _is not persuasive. It claims too much
on the basis of too little. This problem becomes clear through
Gilman's rhetoric and use of sources. Gilman frequently refers to an
undefined "we." On the final page, for instance, he observes that,
"[m]aybe at the end of the day our desire to control and reform our
bodies is what is truly 'modern', and the obesity epidemic is only
proof of our desire to undertake this quixotic task of absolute
bodily control" (p. 174). Yet, most of the book is about the United
States, and the entire book draws almost exclusively on
English-language sources, including the chapter on China. Gilman's
claim to be speaking for a global community is thus tenuous at best.

A similar problem emerges at the level of secondary sources. Gilman
does not engage with the vast literature on this and related topics,
although these works appear in his bibliography. Consider, for
example, Peter Stearns's 2002 work _Fat History: Bodies and Beauty in
the Modern West_. Stearns's comparison, limited to the United States
and France, concludes that twentieth-century moral anxieties about
fat in the United States had no parallel in France. Stearns's case,
which directly challenges Gilman's universal statements about "our"
global obesity epidemic, would have nuanced _Fat_'s generalizations.

Other important works for the American context do not appear at all.
Joan Jacob Brumberg's _Fasting Girls: A History of Anorexia Nervosa_
(2000) addresses the other side of gender and obesity with its
discussion of fat girls and obese women. Works from non-Anglophone
contexts are entirely absent. From the German literature, which
Gilman could be expected to engage with, Sabine Merta's _Wege und
Irrwege zum modernen Schlankheitskult: Diätkost und Körperkultur
als Suche nach neuen Lebensstilformen 1880-1930_ (2003) or Michael
Wildt's _Am Beginn der "Konsumgesellschaft": Mangelerfahrung,
Lebenshaltung, Wohlstandshoffnung in Westdeutschland in den
fünfziger Jahren_ (1994) offer regionally differentiated readings of
obesity, health, hunger, and abundance in the twentieth century.
These are serious criticisms, of course, but should in no way
discourage readers from picking up this book. Gilman may not have
succeeded in making obesity history, but he has certainly pointed out
the paths by which others might do so in the future.

Citation: Corinna Treitel. Review of Gilman, Sander L., _Fat: A
Cultural History of Obesity_. H-German, H-Net Reviews. April, 2010.
URL: http://www.h-net.org/reviews/showrev.php?id=30052

This work is licensed under a Creative Commons
Attribution-Noncommercial-No Derivative Works 3.0 United States
License.


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