I will first show that public health claims makers have been successful in
transforming in less than 15 years from an individual condition into a
pandemic that threatens the future of mankind. Second, I present the most
important claims in support of this transformation as well as some of the
counterclaims that have been put forward as well. Third, I present the
major explanations for the obesity epidemic put forward by the dominant
public health perspective. I also discuss the implications for the choice of
interventions that are put forward in relation to these explanations.
Fourth, I show how the medicalization of fatness through those interven-
tions offers opportunities for responsibilization and stigmatization. In the
conclusion I summarize my argument and discuss some of its implications.
A GENEALOGY OF OBESITY AS DISEASE AND
EPIDEMIC
Several authors have traced the development of the idea that obesity is a
public health threat of epidemic proportions (Basham, Gori, & Luik, 2007;
Gard & Wright, 2005; Oliver, 2006; Taubes, 2007).^2 Following these
authors I offer a brief genealogy of this idea, adding to it the very recent
step in which obesity is seen as a pandemic and as such integrated into a
global WHO strategy against NCDs. It will perhaps be surprising that this
idea only came to full fruition at the start of the 21st century, even though
the history of obesity as a disease can be traced back for millennia to at
least Greek and Roman times (Gilman, 2010). However, even though this
medicalization idea caught on late, it has been quickly taken up in popular
thought. Predating more recent research,^3 some citizens already thought of
obesity as a contagious disease:
“I came down with obesity two years after I got married,” 41-year-old Oklahoma City
resident Fran Torley said. “I know it was hard for my husband to watch me suffer
from this disease. When he caught obesity a year later, he got so depressed, he couldn’t
do anything but sit on the couch. Some days, we sit and watch television from dawn till
dusk, hoping for news of a [medical] breakthrough.” (The Onion , 2004 )This can be seen as the result of successful claims making by “a small
number of dedicated health professionals, government health officials,
and lobbying groups...with substantial assistance from the pharmaceuti-
cal and weight-loss industries” (Oliver, 2006,p. 37). A first key moment
occurred in the mid-1980s when the National Institutes of Health (NIH)
in the United States and the Royal College of Physicians in the United
120 ROEL PIETERMAN