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Extending the obesity debate, repudiating misrecognition: Politicising fatness and health (practice)

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Abstract

Debating obesity can be difficult. For example, critiquing obesity discourse might be (mis)read as a criticism of individual doctors, or a failure to appreciate public health, which ostensibly seeks to avoid victim blaming with its focus on ‘the obesogenic environment’. In extending the obesity debate and politicising fatness and health (practice) more generally, this article responds to such criticisms as expressed by a ‘sceptic’ who has otherwise sought to challenge obesity science. This, in turn, helps to ‘clear some ground’ for critical weight studies and alternative clinical paradigms. After engaging relevant literature and repudiating the misrecognition of some of my own research, the article concludes with some reflections on how the debate might proceed amidst the flak and ‘friendly fire’.

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Notes

  1. The term ‘sceptic’ connotes a doubting attitude towards the validity of that which purports to be factual or truthful, similar to a postmodern sensibility. However, the term does not capture the various critical approaches towards ‘the war on obesity’ – approaches that may be much more evaluative not only of discourses but also of ‘beneath the surface’ social structures and other (in)transitive realities as part of a broader commitment to social justice, tackling health inequalities and promoting ethical clinical practice. I have previously discussed the value of ‘exercising healthy scepticism’ when researching the war on obesity, though I also deemed the institutional ‘attack on fat’ objectionable on critical realist or corporeal realist grounds (Monaghan, 2008).

  2. Following Bhaskar (1989, p. 60), I would add that facts cannot simply be defined as ‘true assertions’ or ‘statements’ since ‘we do not make facts [they] pre-exist their discovery as results to be achieved (just as they pre-exist their statement as achievements)’.

  3. Such words do, of course, counter ideas pertaining to the ‘civilised body’ (Elias, 2000), which is well-groomed, mannered and exercises self-restraint. Interestingly, aspects of the civilising process – which include the historical development of table manners in Europe – were commonly rationalised in terms of health and hygiene but, in practice, there were entirely different ‘sociogenetic’ factors in operation. Similarly, the anti-obesity offensive is irreducible to biomedical health and may have a great deal to do with middle-class efforts to civilise bodies which, regardless of their actual weight, are deemed to lack ‘social fitness’ (Monaghan, forthcoming).

  4. I go to great lengths to clarify and qualify my use of biomedical terms (see Monaghan, 2008, pp. 21–25). Furthermore, my book on ‘big fellas’ only contains three references to so-called ‘ “obese” people’: once in relation to an exercise physiology study (which found people categorised as ‘obese’ and physically active had lower mortality risk than ‘normal’ weight sedentary people), once in relation to general societal stereotypes and once in relation to proponents of the anti-obesity offensive who want to fight stigma but offer a circular line of reasoning that unintentionally reproduces stigma. These references do not support Gard's (2009b, p. 235) review where I purportedly berate ‘obesity medical science’ for hating so-called ‘obese people’.

  5. At the same time, I have a recurrent interest in critiquing ‘ideal typical’ obesity epidemic entrepreneurs who enjoy greater standing on the hierarchy of credibility and authoritatively denigrate fatness. Ideal types are not real, concrete individuals; rather, the ideal type is a heuristic device. In Monaghan et al (2010), we also refer to ‘modes of entrepreneurship’ insofar as we seek to explore and critique configurations of social interests and practices, rather than specific individuals. Even so, some individuals enthusiastically enact the ideal type when pontificating on the obesity epidemic. Jamie Oliver, as described by Warin (2011), would be typified as a supporter in our schema, that is, those entrepreneurs who seek to mobilise ‘solutions’ through campaigning, education and perhaps exploiting commercial opportunities. They seemingly have humanitarian concerns, though opportunists, a sub-type of supporter, have more naked economic interests.

  6. Unfortunately, such an observation may have little impact on some factions of the public health community. For example, Bayer (2008, p. 471) believes that if public health interventions unavoidably and even intentionally stigmatise people then this may be defended on ‘moral grounds’. In rejecting Bayer's argument, Burris (2008, p. 475) writes: ‘stigma is a barbaric form of social control’.

  7. In this regard it is interesting to note the role of money in the US political system, a system that is widely considered corrupt given the enormous (discrediting) sums spent on lobbying (Klein, 2012). Yet, in the context of those relationships that emerge between lobbyists and congressmen it is possible (probable) that ‘decent souls [can] come together to create an indecent system’ (ibid.). Interestingly, as explained by Klein, between 1998 and 2011 the health care industry spent the most on lobbyists ($4.87 billion), slightly more than the widely reviled finance, insurance and real estate (FIRE) sector ($4.85 billion).

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Acknowledgements

A version of this article was presented at the Aix Marseille School of Economics ‘Risk in Health’ workshop, Marseille, 22 May 2012. I am grateful to the School for the invitation and hospitality. The ESRC funded my research on men and weight-related issues (grant number: RES-000-22-0784), and the UK Fat Studies and HAES Seminar Series (co-applicant; grant number: RES-451-26-078-A). I am also grateful to Micheal O’Flynn, Lucy Aphramor, Bethan Evans, Rachel Colls, Samantha Murray and Jonathan Gabe for commenting on earlier drafts of this article. The late Micheal Hardey also shared his thoughts with me on this article in early 2012. Mike's recent death is a terrible loss to his family, friends and the sociological community more generally. He will be sorely missed.

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  1. Department of Sociology, University of Limerick, National Technology Park, Limerick, Ireland

    Lee F Monaghan

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Monaghan, L. Extending the obesity debate, repudiating misrecognition: Politicising fatness and health (practice). Soc Theory Health 11, 81–105 (2013). https://doi.org/10.1057/sth.2012.10

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