In Fat Politics: The Real Story Behind America’s Obesity Epidemic, Dr. J. Eric Oliver challenges the most basic of health assumptions: that to be “overweight” or “obese” is to be unhealthy. In order to convince the reader of this perspective, Oliver analyzes obesity in America as economist, biologist, political scientist, and sociologist. By examining obesity through these different lenses, Oliver makes a strong and easily understood case of why and how obesity has not become the “epidemic” that is purportedly threatening the health and fiscal well-being of the entire country. Instead, Oliver illustrates that the strong focus on weight–both in terms of physical well-being and appearance–belies the real 21st-century health challenges Americans face.

Fat Politics begins with an examination of the clinical definition of overweight and obesity, and how the changes to this definition in the early 1990s sparked media coverage that quickly dubbed the rising weight of Americans an “obesity epidemic.” Then, in Chapters Three and Four, Oliver delves into the anthropology and sociology of fat. He explores America’s cultural animosity to fat people–the last socially-acceptable means of discrimination–while providing a history of Americans’ attitudes towards fatness in order to address “fatism’s” underlying causes. Finally, Oliver examines how the American capitalist system makes progressive weight gain nearly a foregone conclusion.

Oliver defies assumptions about obesity and health with exhaustive research of American food consumption and exercise trends. Oliver challenges the notions that Americans eat more at meals, and are continuing to gain weight because of fast food and an increasingly sedentary culture. In addition, he confronts one of the tenets of modern day health care policy, arguing that confronting children’s health challenges at their schools is ignoring the evidence that parents have the greatest influence on the health of their children, citing a statistic that the best indicator of a child being at a healthy weight is whether or not the child brushed his/her teeth. By challenging so many conventional notions of healthy living, Oliver is able to capture the readers’ strict attention and illustrate his point that when it comes to obesity, even the most basic assumptions are often wrong.

Oliver does not write from the perspective of a physician or biologist; he is a political scientist by trade. Consequently, his expertise lies in social science methods and the political system, and he is clearly more comfortable writing about the role of interest groups in health policy than in addressing the genetic aspect of obesity. However, Oliver’s exhaustive research within both medicine and genetics allows him to effectively analyze health data. As a result, while Oliver does not produce his own clinical data (he did conduct massive social science surveys), he presents his own broad reviews of obesity statistics that he has compiled. The conclusions he draws from reexamining these statistics are the most compelling and powerful of the book, and force the reader to question some of the underlying assumptions one has about what it is to live healthily.

The main area in which Fat Politics is lacking is in how to actually make Americans healthier. Oliver half-heartedly offers guidance on best health practices. However, they sound eerily similar to many of the current initiatives to combat obesity, such as reducing intake of refined carbohydrates and eat more vegetables. The reason for the book’s dearth of solutions is that Oliver is unable to reconcile his claim that America’s focus on obesity is misguided with the reality that many of the initiatives to reduce obesity also combat America’s real health problems, such as diabetes and heart disease. This is because while being overweight or obese (as currently defined) has never been shown to cause significant health problems, it is strongly correlated with many of them. Consequently, initiatives to reduce diabetes or heart disease will result in a corresponding reduction in obesity, and vice versa. The book argues that rather than focus on obesity, health experts, politicians, and the public must look beyond this superficiality in order to truly make America healthier.

The ultimate purpose of Fat Politics, therefore, is not to prescribe a specific lifestyle change or to exonerate Americans’ for their progressively increasing weight. Instead, the book is a remarkable demonstration of how health policy is made in the U.S., and how special interests and the media can obscure underlying health issues.

Book Information

Fat Politics: The Real Story Behind America’s Obesity Epidemic. J. Eric Oliver. Oxford University Press. 240 pages