What's Wrong with Fat?

Saguy, Abigail C.
Oxford University Press USA,
9780199857081 (pb)

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Cover of book "Mommy, why am I fat?" are the first words that greeted me when opening this book. Frankly, my heart sank. My hopes for a book that (finally) purports to deconstruct, and offer critical insights on the 'war on obesity' were dashed. Scholars of critical perspectives on the social construction of obesity will be familiar with obsenogenic amounts of materials that emanate from the USA, as well as a lack of critical perspectives. Thankfully, despite less-than-favourable first impressions of the US context, and the over-use of the word 'frame' (blame -frame, fashioning -frames) I found I could forgive this. In particular, I came to see how skilfully the book manages a well-crafted and thought-provoking examination of, and problems with, the constructed frame of obesity (there, I'm doing it now…). By using many familiar and well-argued concepts, some borrowed some new (fat-devil!) Saguy makes a compelling case. The pathological framing of obesity as 'epidemic' is iatrogenic in nature, and poses a greater problem than excess calorific intake.

Saguys book is predictably focussed on contemporary USA, and its scientific and cultural reaction to year-on-year increases in obesity levels. The tone of the book is set with detailed, sometimes overwhelming evidence that deconstructs six 'problem' frames from the US experience (p.29). Here this very much in the spirit of a classic sociological 'stage-model' such as Cohen's 1971 stage creation of the folk-devil, here re-framed (...see, I'm hooked now) as a 'fat-devil' (p.20). Saguy seamlessly weaves quite abstract, yet related concepts together into a coherent set of sociological arguments, such as Bourdieu's concept of 'field' (p31). This concept is used well to highlight the competition for control of distinction and influence in specific fields. She further explains how diatribes of immorality and medical pathology have been allowed to dominate framings of obesity. But the difficulty the book has is a lack of clear discussion around obesity, and contemporary control/class dimensions. This is galling, as Saguy only alludes to some class aspects, such as symbolic violence. However, she ignores Bourdieu's clear ideas that care and work of the body, is actually a very middle-class aesthetic, achieved through healthy eating, and active lifestyle management. Even the word underclass is missing from the scant discussion given to class in the book. In my view, this is unforgivable given the way the book sees the imposition of body frame values on one status/economic group, who are seen to be morally lacking by another controlling group.

Despite my initial thoughts, the book will undoubtedly aid undergraduates to raise critical questions about the nature of obesity. I can see students armed with this text, feeling empowered to challenge the ideology attached to the 'obesity epidemic'. The book may allow us - the public, health workers, academics - to reflect on the framing those who are overweight as lazy and morally wanting, through devices, like the moral panic. Crucially, Saguy shows how the frame of obesity gives permission on a daily basis for ridicule, harassment and the right of some, to publicly monitor the body shape of others. She provides a wealth of evidence, albeit sometimes over-powering, for the psychologically damaging culture of self-surveillance. The book shows how this surveillance then produces a lifestyle for many, that Atrens sees 'riddled with needless anxiety' and conspicuously short of fun.

Many issues Saguy raises question social policy and health strategies, which target individuals' behaviours, as though all were at risk. Academics should sit up and take note of the preoccupations of the affluent with the body's appearance. She then sees these being visited on the wider population risking the damaging results of a fear of fat. Despite my minor gripes, this book works well as cautionary reading for any health academic. You won't get fat from reading the book, but you will understand Saguy's message. Obesity is framed to society in such a way that suggests anyone could get fat; Fat Devils await our lapses in self-control.

Steve Woods
University of Northampton