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Fat Politics
This page intentionally left blank
Fat Politics
The Real Story
Behind America’s
Obesity Epidemic

J. ERIC OLIVER

2006
Oxford University Press, Inc., publishes works that
further Oxford University’s objective of excellence
in research, scholarship, and education.

Oxford New York

Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto

With offices in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Thailand Turkey Ukraine Vietnam

Copyright © 2006 by J. Eric Oliver

Published by Oxford University Press, Inc.

198 Madison Avenue, New York, NY, 10016
www.oup.com

Oxford is a registered trademark of Oxford University Press

All rights reserved. No part of this publication may be reproduced,

stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.

Library of Congress Cataloging-in-Publication Data

Oliver, J. Eric, 1966–
Fat politics : the real story behind America’s obesity epidemic / J. Eric Oliver.
p. ; cm.
ISBN-13: 978-0-19-516936-2
ISBN-10: 0-19-516936-0
1. Obesity—United States. I. Title.
[DNLM: 1. Obesity—United States. 2. Health—United States.
3. Health Policy—United States. 4. Prejudice—United States.
5. Social Perception—United States. WD 210 O48f 2005]
RA645.O23O45 2005
614.5’9398—dc22
2005012983

987654321

Printed in the United States of America

on acid-free paper
For Thea
This page intentionally left blank
 Contents

Acknowledgments ix

Introduction—A Big, Fat Problem 1

One What Is Fat? 14

Two How Obesity Became an Epidemic Disease 36

Three Why We Hate Fat People 60

Four Women, Fat, and the Sexual Market 79

Five Fat Genes and the Obesity Blame Game 100

Six Food and Weight Gain: Super Sized Misperceptions 122

Seven Sloth, Capitalism, and the Paradox of Freedom 143

Eight Obesity Policy: The Fix Is In 159

Nine Unmaking the Obesity Epidemic 181

Notes 191

Index 220

vii
This page intentionally left blank
 Acknowledgments

This was not the book I intended to write.

When I first became interested in obesity, I, like most Americans,
assumed it was a major health problem. At the time, I was on a post-
doctoral fellowship at Yale University sponsored by the Robert Wood
Johnson Foundation. The fellowship is aimed at getting young political
scientists, like myself, interested in doing “health-related” research. In
trolling for a topic, I happened across an article that described the soar-
ing growth of obesity and its catastrophic consequences. I became in-
trigued and soon had all sorts of questions about how the “obesity
epidemic” might be handled as a political issue. Yet when I went to look
for some answers to these questions, I found that very little had been
written. Politically speaking, obesity was largely uncharted terrain.
Luckily for me, Yale also happens to be the home of Kelly Brownell,
one of the nation’s leading obesity researchers. Ever generous, Kelly
helped get me started in my research and put me in touch with numer-
ous other experts who were equally helpful, including James Hill, Steve
Blair, Jon Peters, and William Dietz. In the summer of 2001, I was able
to bring these researchers together with other social scientists for a mini-
conference. Many of the participants, including John Cawley, David
Cutler, Rogan Kersh, Taeku Lee, James Morone, and Abigail Saguy, pro-
vided many great ideas. After three days of discussions, I had a clear
idea about a book I wanted to write: how was America going to over-
come the political challenges posed by the obesity epidemic? Soon af-
terward, I drafted a proposal and got a contract from Oxford University
Press to write this book.
Then I started to do the research. In early 2002, obesity was only
beginning to emerge as a major news item and so my first task was to

ix
x | Acknowledgments

prove that it was, in fact, the major health and economic threat I pre-
sumed it to be. I started to read through the research papers and sci-
ence journals. Although I had no advanced training in medicine or
biology, I had done a lot of graduate work in statistics and even though
much of the terminology was obtuse, I could still evaluate the basic
estimates and the data on which many of the health claims were made.
And that’s when my mind began to change—for the more papers I
read and the more experts I interviewed, the more I realized that there
was a real problem with my basic argument. Most of the claims about
obesity were based on very shaky evidence. (I didn’t know it at the
time, but, independently, Paul Campos, author of The Obesity Myth, was
coming to a similar conclusion.) I was astonished about how weak most
of the statistical claims really were. Public opinion researchers, like
myself, often get accused of drawing unwarranted conclusions, but what
we did paled next to the breathtaking inferential leaps that were regu-
larly made in many of the top medical journals. Based on the statistics,
most of charges saying that obesity caused various diseases or that obe-
sity caused thousands of deaths were simply not supported. Yet consis-
tently, these pseudofindings were promulgated as fact.
I also discovered another dirty secret about obesity research; many
of the scientists who were sounding the alarms about the “obesity epi-
demic” were also on the payrolls of various pharmaceutical and weight-
loss companies. In the course of my interviews, I started hearing stories
about contradictory research that was hushed-up, bogus numbers be-
ing reported by health agencies, and shifty “scientific” organizations
that were no more than fronts for the pharmaceutical industry. The
politics of obesity were more different and interesting than I first knew.
What I thought was an epidemic began to look at lot more like a po-
litically orchestrated campaign to capitalize on America’s growing
weight.
Around this time I also started to confront my own fat prejudices.
Early on in my research, I heard about fat rights groups, including the
National Association to Advance Fat Acceptance, who argued that obe-
sity was not a health risk. Like many people, I had largely dismissed
them as a fringe and marginal group; after all, who was this weird bunch
of people who were actually proud of being fat? But once I realized they
were right about a lot of the junk science on obesity, I started to seriously
consider their other arguments, particularly about the pervasiveness of
 Acknowledgments | xi

fat prejudice in the United States. I realized that my own preconceptions

coming into this project were shaped more by my own antifat biases than
by any facts. If I was going to clearly examine the nature of America’s
obesity epidemic, I would have to come to terms with what was making
me so judgmental against fat people. Once again, I was fortunate, and I
came into contact with many generous activists including Jennifer
Portnick, Marilyn Wann, and, most important, Lynn McAfee, a long-time
fat activist and perpetual thorn in the side of the obesity research com-
munity. Although not a formally trained scientist, Lynn knows more about
obesity than most “experts” and has a clearer perspective on this issue
than anyone; she is also one of the most courageous people I’ve ever met.
Lynn taught me a lot about speaking truth to power.
I also enjoyed tremendous support from a number of nonprofit or-
ganizations including the Robert Wood Johnson Foundation; the Time-
Share Experiments for the Social Sciences, a program funded by the
National Science Foundation; and the Russell Sage Foundation. The
International Food Information Council provided an invaluable service
with their daily Listserve of obesity news items. The University of Chi-
cago was also supportive, allowing time off to write and letting me
teach a seminar on this subject. Those sources aside, I did not receive
any financial assistance from any food, restaurant, or beverage indus-
try nor any party concerned with obesity policy nor any pharmaceuti-
cal company.
In addition, I have enjoyed critiques, comments, and research help
from a number of academic colleagues and researchers including John
Brehm, Paul Campos, Cathy Cohen, Jeffrey Friedman, Heena Patel,
Bruce Schneider, Gary Taubes, Lisa Wedeen, and Diane Whitmore.
Kathryn Flegal at the National Center for Health Statistics was particu-
larly helpful in steering me through the methodological controversies.
Although some may disagree with my take on this issue, all were ex-
tremely generous and forthcoming with their time and ideas. I am also
grateful to my research assistants Zachary Callen, Andrew Dilts, Shang
Ha, Matsutaka Harada, and Stephan Whitaker, as well as the students
in my obesity seminars at the University of Chicago. My agent, Eliza-
beth Sheinkmen, helped me get the book project started and set me up
with Oxford University Press and its great staff. At Oxford, I was ex-
tremely fortunate in having Tim Bartlett as an editor. The stamp of his
keen insight, patience, and attentiveness appears throughout this work.
 Finally, and most importantly, I could not have written this book
without the unflagging support of my wife, Thea Goodman. Not only
did she provide many keen ideas and much critical feedback, she grace-
fully endured my stress, distraction, and obsession, as well as count-
less dinner conversations dominated by this topic. I promise my next
book will be on something that doesn’t make us feel self-conscious about
what we are eating.
JUNE 2005, OYSTER BAY, NEW YORK
 Introduction:
A Big, Fat Problem

Over the past two decades, a plague has been sighted in our
midst. It is said to afflict one in four Americans and kill as many as 400,000
of us every year. It is purported to cause heart disease, cancer, diabetes,
asthma, hypertension, and numerous other ailments. It is estimated to
cost us 100 billion dollars annually in healthcare expenses and, accord-
ing to some, threatens to overwhelm our medical infrastructure. Surgeon
General Richard Carmona says it’s a greater threat than terrorism and
former heath and human services secretary Tommy Thompson has named
it a public health “crisis.” Congress and numerous state governments
are allocating billions of dollars in search of a cure while the media and
health organizations regularly sound the alarms.
The “disease” I’m referring to is obesity and in the United States it
has become, by most accounts, a full-scale epidemic. This certainly seems
to be borne out by the statistics: in 1980, only about a third of Ameri-
cans were considered overweight and only 13 percent were classified
as obese, rates not much greater than in 1960. But in the past twenty-
five years these numbers have skyrocketed. Today, more than 60 per-
cent of Americans are considered overweight and one in four is obese—a
two-fold increase in less than three decades. Even more alarming is the
rise in juvenile obesity; today, 15 percent of American children are con-
sidered obese, more than twice as many as in 1980. As a result of their
weight, today’s teenagers will be, according to some projections, the
first generation in modern American history to live a shorter life span
than their parents.1
America, it seems, has a big, fat problem.
Or at least this is what I thought when I started writing this book.
Like many people, I, too, believed that America’s growing weight was

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