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Theorizing the obesity epidemic: Health crisis, moral panic and emerging hybrids

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Abstract

The academic literature on obesity frequently bifurcates into two poles: a realist pole that treats obesity as a biomedical fact, a health risk and an ‘epidemic’, and a second, constructionist pole that adopts a critical view of obesity as a moral panic driven by political interests and cultural values. Drawing on a wide range of literature from epidemiology, medical sociology, public health, political economy, cultural studies and popular journalism, this article maps out a realist-constructionist divide within academia and the public sphere, and examines the insights and limitations of these perspectives. After mapping the main ‘silos’ within obesity studies, we examine two key questions: (1) is the obesity epidemic based on medical fact or political interest, and (2) is obesity a disease or a social identity. Drawing from the metatheoretical principles of critical realism, we argue that obesity scholarship can be advanced by conceptualizing the obesity epidemic as a ‘hybrid’ construction that arises out of the interaction of biophysical, socio-economic and cultural forces. This analysis demonstrates the useful role of social theory integrating diverse analytic perspectives, and bringing clarity to a heated public debate that characteristically points the finger of blame at obese individuals.

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Notes

  1. We acknowledge that significant debate exists over whether academics should be using the term ‘obesity’ or ‘fat’ when referring to particular body types (Saguy and Riley, 2005). In this article we have chosen to focus specifically on obesity because of its dominant position within academic and public discourse on body weight. Our choice does not reflect an uncritical acceptance of medical constructions of body weight. As will be discussed, we see obesity as an important ‘hybrid’ construction that needs to be understood with reference to its biophysical and socio-cultural context.

  2. Crossley, whose work provides important steps in examining the connection between biophysical and social understandings of obesity, nonetheless self-admittedly limits his analysis to a realist conception of obesity while bracketing out constructionist perspectives of ‘obesity’ (2004, p. 230).

  3. It should be noted that studies advancing the weak constructionist perspective often advocate strong constructionism as well (Guthman and Dupuis, 2006; Orbach, 2006; Saguy and Almeling, 2008). Guthman and Dupuis's argument about neoliberalism and obesity (2006), for instance, is not directed towards disproving the existence of the obesity epidemic. Nonetheless, they argue ‘at the outset, we are not even willing to concede the epidemic of obesity in a factual sense’ (2006, p. 428). Despite this tendency, the core argument of weak constructionism – that understandings of obesity have origins and consequences in the social world – does not prove or necessarily imply that obesity has no extra-social existence.

  4. A more recent collection uses the term ‘fat studies’ rather than ‘corpulence studies’ (Rothblum and Solovay, 2009), although the same constructionist principles still apply. As Wann writes in the book's introduction, ‘if you believe being fat is a disease and that fat people cannot possible enjoy good health or a good life, then you are not doing fat studies’ (Wann, 2009, p. ix).

  5. In a critique of the ‘will to innocence’ commonly found within the fat acceptance movement, LeBesco recognizes some of the danger of depicting fatness outside of a larger material context (2004, pp. 111–114).

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Patterson, M., Johnston, J. Theorizing the obesity epidemic: Health crisis, moral panic and emerging hybrids. Soc Theory Health 10, 265–291 (2012). https://doi.org/10.1057/sth.2012.4

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