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Fat Studies and Health at Every Size

Detailed Context for the Seminar Series

Introduction

In the last 10 years there has been widespread concern about fatness/weight/obesity in the UK and there have been numerous policy reports, reviews and white papers commissioned over this time, each one beginning from the assumption that fatness is fundamentally unhealthy and damaging to the national economy (e.g. House of Commons (HOC), 2004; Foresight, 2007). Numerous interventions have therefore been developed to tackle the 'problem of obesity' through attempting to literally reduce individuals' bodies (Department of Health (DH), 2008). The basis for these concerns about fatness is broad population level associations and correlations between body mass (most commonly measured using the Body Mass Index or BMI) and a range of illnesses (such as coronary heart disease, cancer and diabetes). However, there remains significant medical uncertainty surrounding these correlations since some illnesses are associated more with higher, and some with lower, BMI (BBC Radio 4, 2007). Additionally, there is little consensus about the 'best' way to measure body size (Hacking, 2006), and the mechanisms resulting in these associations are unknown (e.g. weight gain may be an early symptom of, rather than cause of, diabetes) (Ernsberger, 2004; see also Franzosi, 2006; and Romero-Corral, et al., 2006 on cardiovascular health). Moreover, as the Department of Health acknowledge, 'there are no obvious cut off points at which there is a clear link between BMI and a change in risks of morbidity and mortality' (DH, 2006:6-7) and there is little evidence to support claims that weight loss will improve health (in fact the opposite may be true) (see Aphramor, 2005). Critical geographical and sociological research has therefore argued that the universal obesity 'truths' underpinning obesity policy (that fatness is inherently unhealthy and that it can be treated through individual body work) are reliant on moral and cultural ideologies about fatness to mask the underlying uncertainties in biomedical knowledge (e.g. Boero, 2007; Cooper, 1998; Evans, 2003; Evans, 2006; Gard and Wright, 2005; Le Besco, 2004, Monaghan, 2008). Others have questioned the extent to which this knowledge is itself produced through particular political-economic relations within which powerful actors (e.g. the diet industry and the pharmaceutical industry) have a vested interest in the continued assertion that fatness is universally bad (Campos, 2004).