The Anthropology of Obesity in the United States

Anna Bellisari

• Publisher: Routledge
• Year: 2016
• Print ISBN:
  9781138927858
• eBook ISBN:
  9781317402497
• Topic: Social Sciences
• Subtopic: Public Health, Administration & Care
• Index: Social Sciences

This volume examines the biocultural dimensions of obesity from an anthropological perspective in an effort to broaden understanding of a growing public health concern. The United States of America currently has the highest rates of obesity among developed countries, with an alarming rise in prevalence in recent decades which promises to affect the nation for years to come. Bellisari helps students to grasp the complex nature of this obesity epidemic, demonstrating that it is the consequence of many interacting forces which range from individual genetic and physiological predispositions to national policies and American cultural beliefs and practices. As much a social problem as an individual one, the development of obesity is in fact encouraged by the pattern of high consumption and physical inactivity that is promoted by American economic, political, and ideological systems. With a range of up-to-date scientific and medical data, The Anthropology of Obesity in the United States provides students with a comprehensive picture of obesity, its multiple causes, and the need for society-wide action to address the issue.

1

INTRODUCTION

Obesity in America

The problem of obesity

The United States faces an epidemic of obesity, an alarming rise that far exceeds levels for a healthy life. About 35 percent of American adults have obesity (Ogden et al. 2014b), the highest prevalence among high-income nations. The epidemic continues unchecked, despite continuing concern and advice from biomedical and public health experts. It is having a severe impact on the health and wellbeing of Americans, contributes to already disproportionate health care costs, and promises to affect the nation for years to come. In a constant stream of scientific and media messages Americans are alerted to the widespread impacts of the obesity epidemic.

• Military leaders report that more than 60 percent of all young Americans are ineligible to serve in armed forces because of criminal records, inadequate education, and overweight and obesity (MissionReadiness.org). In five states 75 percent or more are ineligible.

• The fashion industry has inflated clothing sizes so that a former size 12 dress is now labeled size 8 (Brody 2004).

• About one-third of incoming and current U.S. firefighters have obesity; heart attacks cause more firefighters’ deaths while on the job than any other cause. In Oklahoma 15 percent of new police recruits in the state’s five largest cities failed the physical agility test (Levi et al. 2011).

• A nine-year-old boy was removed from his mother’s custody when his weight reached 200 lbs, but he was returned to her after losing 50 lbs (Sheeran and Franko 2012).

• Teenagers’ trendy clothes, hotel beds, restaurant and theater chairs, and children’s car safety seats have expanded in size, as have hospital beds, stretchers, wheelchairs, and MRI and CT scanners (Fountain 2002; Haskell 2002; Perez-Pena and Glickson 2003; Trifiletti et al. 2006).

• Longer hypodermic needles for intramuscular injections are required to reach the gluteal muscle in patients with thick fat layers at the injection site (Nisbet 2006).

• Compared to 1994, 10 times as many stomach-reduction surgeries were performed in 2005 to promote weight loss in individuals with extreme obesity (Robinson 2009).

• The London Royal Opera House canceled the contract of a famous American opera star because she had become too large for the role of Ariadne of Naxos (Pogrebin 2004).

• A potential 2012 Republican primary election candidate for president was subjected to media evaluation of his weight and pronounced “too fat to be President.” He did not enter the race (Bruni 2001).

• To avoid the embarrassment, individuals with obesity can now attend yoga classes for large persons only at Buddha Body Yoga or Mega Yoga in Manhattan and in many other establishments in the US (Eckel 2009).

• Ohio pet dogs and cats are growing fatter along with their owners and for the same reason – a glut of tasty foods and lack of opportunity to run around outdoors. Outcomes for the animals’ health are similar to those for humans with obesity (Frolik 2012).

• Support organizations for persons with obesity are springing up all around the country to counter “fatism,” prejudice, and discrimination against large people (Goldberg 2000).

• Movies like “Shallow Hal,” “Shrek,” and “Fat Girl” attempt to sensitize Americans to fat bias, while “Supersize Me” and “Food, Inc.” warn of the dangers of American mass-produced food (Kuczynski 2001).

• The Goliath Casket Company of Lynn, Indiana specializes in the manufacture of triple-wide coffins for deceased persons with obesity, raising standard burial costs by as much as $3000 (St. John 2003).

• Some airlines require passengers with obesity to purchase two seats for a flight, or even refuse to carry them (Higgins 2010).

• A survey of male active duty Army personnel found that from 1988 to 2007 their average body weight had increased 6.7 kg (15 lb), with no increase in average body height. The changes in weight and other body dimensions necessitated development of a greater range of size categories for uniforms and equipment (Bradtmiller et al. 2009).

• Pittsburgh’s Water Limo had to reduce the number of passengers carried to Pittsburgh Steelers games from 49 to 39 per boat since the U.S. Coast Guard issued new rules that reflect an increase in the average weight of boat passengers from 140 lbs to 185lbs (Maher 2012).

The novelty of such news items has worn off because Americans have become accustomed to obesity in the US. Obesity rates have continued to climb for several decades and are now rapidly increasing in other parts of the world as well. Despite the plethora of scientific discoveries and their dissemination through numerous scientific journals dedicated to obesity research, such as Obesity Reviews, Journal of Obesity, Obesity Research, International Journal of Obesity, International Journal of Obesity and Related Metabolic Disorders, and many others, most Americans lack access to accurate information about obesity and are unaware of its associated health problems.

Most scientific investigations of obesity focus on intrinsic biology and individual unhealthy behaviors. The “upstream” environmental influences that interact with the “downstream” genetic and physiological factors involved in human energy acquisition and metabolism have until recently received little attention. For a full understanding of human obesity, and particularly the U.S. obesity epidemic, the obesogenic environment and its influence on human biology and behavior deserves more scientific attention (Hill et al. 2003). Although the prevailing perception is that individual Americans are responsible for their own personal health and weight control, it is abundantly clear that external factors beyond individual control may be even more important. The U.S. obesity epidemic is the consequence of many interacting forces, ranging from individual genetic and physiological predispositions to national policies and American cultural beliefs and practices. All of this information must be considered to develop effective ways of stemming the harmful and costly obesity epidemic.

Obesity development in America

There have always been at least a few “corpulent” individuals in every human society in history and prehistory (Figure 1.1).

FIGURE 1.1 The Hohle Fels female figurine. The earliest-known human female representation, 35,000 years old, from Aurignacian deposits in southwestern Germany. A loop for hanging from a string replaces the head of the figurine carved from mammoth ivory (Conard 2009).

Photo: H. Jenson. Copyright: University of Tübingen. Reprinted with permission.

As long ago as the 5th century BC, Hippocrates of Kos, the “father of medicine,” had noticed unusually high numbers of sudden deaths among individuals with obesity, and had linked obesity with disease (Hu 2008). But only in the last four decades has obesity risen to worrying population levels in many parts of the world, particularly in the US and other developed countries. Why did this happen, and why are obesity rates higher in the US than in any other industrialized country?

In contrast to countries that joined the global marketplace relatively recently and saw a very sudden increase in obesity rates, the American obesity epidemic began gradually during the 19th-century Industrial Revolution when increasing wealth created a growing middle class and a consumer-based economy. Greater spending power and more inexpensive, mass-produced, commercially distributed foods allowed for steady replacement of meals prepared at home. Food industrialization is now strongly implicated in the current American obesity epidemic (AP 2006; Cutler et al. 2003). Key historical events in food industrialization include the establishment of the first grocery chain in 1859, the sale of Coca-Cola beginning in 1886 in Atlanta, marketing of the first Fritos Corn Chips in 1932, and openings of the first Dairy Queen in 1940 and McDonald’s in 1955. In 1967 high-fructose corn syrup (HFCS) was developed for commercial purposes and became the primary sweetener for foods and beverages in the US. Between 1962 and 2000 caloric sweetener use increased by 83 calories per day (Popkin and Nielsen 2003). Each year Americans eat even more new commercially prepared and vigorously marketed ready-to-eat food products, known to contain more calories and fewer essential nutrients than home-cooked items prepared from scratch (Tillotson 2004).

In addition to cheaper, more easily available prepared foods, American corporations market labor-saving devices and gadgets to ease the exertions of work, travel, and not least, food preparation. Automated factories, household appliances, mechanized farming equipment and vehicles, electric tools, computers, and countless devices for leisure time use reduced the need for physical effort and energy expenditure in work and play. By the end of the 20th century, ease, convenience, and passive entertainment characterized the Good Life and constituted a large part of what is known around the world as the American Dream.

At first a gradual, barely noticeable increase in the number of overweight Americans paralleled these commercial developments (Komlos and Brabec 2010). During most of the 19th century the predominant health concern had been the lack of adequate nutrition for America’s growing children and the health consequences of malnutrition and underweight (Dawes 2014). Stoutness was an admired trait, especially in men, in part because it was relatively rare and unachievable for most Americans. The word “diet” had only one meaning then – the nutritional regimen required for good health. But by the beginning of the 20th century young women began efforts to control their weight. “Diet” gained a new meaning – restricted food consumption and constrained eating to prevent overweight and obesity. Yet from 1900 to the 1980s Americans steadily gained weight, at first only an average of one pound, then two pounds per decade (Stearns 2002). By 1960, 10–15 percent of the U.S. population had obesity. Then in the 1980s health professionals noted with alarm a dramatic increase in obesity (Figure 1.2). By 2000, 25–30 percent of Americans had obesity (Hu 2008). Today more than two-thirds of American adults are overweight or have obesity (Flegal et al. 2012).

Significant ethnic disparities became apparent, especially among women. Today women in ethnic minority and low-income groups have the highest rates of obesity, and related disease burdens. They also suffer greater stigma related to overweight and obesity (Muenning et al. 2006) and more employment limitations than men (Tunceli et al. 2006). Among all men obesity prevalence ranges from 31–7 percent, regardless of ethnicity and socioeconomic status. But 59 percent of black women and 44 percent of Hispanic women have obesity, compared with 33 percent of white women (Flegal et al. 2012).

Obesity has also increased among children, especially older children and adolescents. Since 1980, the prevalence of overweight among children aged 2–19 years has tripled to 17 percent (Ogden et al. 2012), with higher rates among black and Hispanic children than among non-Hispanic white children (Figure 1.3). Obesity rates are also very high among pre-school Native American boys and girls (Caballero et al. 2003; Zephier et al. 2006), double the rates of Asian and white children (Anderson and Whitaker 2009). Asian-American adolescent girls have the lowest prevalence of childhood obesity (4 percent) (Wang and Beydoun 2007). U.S. childhood obesity rates first began to climb among black girls born in the 1940s, and then also accelerated in black boys, white girls, and white boys born in the mid-1950s and early-1960s (Johnson et al. 2012; Komlos et al. 2009). The most recent statistics for American children indicate that obesity rates have remained stable since 2003 and even decreased significantly among the youngest, two- to five-year-old children (Ogden et al. 2014a). Possibly because of different methods of collecting information, some national surveys show that U.S. obesity rates continue to rise while others indicate that obesity prevalence among adults and children has remained stable in recent years (Flegal et al. 2012; Ogden et al. 2012; Yanovski and Yanovski 2011). Regardless, obesity prevalence remains very high in both children and adults, and obesity-related diseases continue to increase.

FIGURE 1.2 Shift in obesity among U.S. adults, 1960–2010. The percentage of U.S. adults (≥20 years) who are obese more than doubled between 1960 and 2010.

Adapted from Leonard (2014).

FIGURE 1.3 Obesity rates in U.S. children and adolescents aged 2 to 19 years.

Adapted from Ogden et al. (2012).

Children and adolescents with obesity tend to become adults with obesit...

Table of contents

• Cover Page
• The Anthropology of Obesity in the United States
• Title
• Copyright
• Dedication
• Contents
• List of Illustrations
• Acknowledgments
• 1 Introduction: Obesity in America
• 2 Origins of Obesity in Human Evolution
• 3 The Metabolic Basis of Obesity
• 4 The Toxic Environment
• 5 Obesity in American Society
• 6 The Obesity Epidemic and American Culture
• 7 Conclusion: The Anthropology of Obesity
• Glossary
• Index