Published by Oxford University Press on behalf of the International Epidemiological Association
Book Review |
The Obesity Myth: Why America's Obsession with Weight is Hazardous to Your Health. Paul Campos. New York: Gotham Books, 2004. pp. 290, $25 (HB), ISBN: 1592400663
In this book, the obesity epidemic in the United States is examined from a unique perspective. The epidemic itself is put ‘on trial’, with the author serving as ‘an advocate for truth’ and the readers serving as the jury. The book contains 18 chapters divided into three sections that examine the science, culture, and politics surrounding obesity in the American context. This is the first book on the topic by this author, who is a professor of law and also the author of a weekly newspaper opinion column. The intended audience for the book is presumably laypersons.
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As suggested by the title, the topic of this book goes against the mainstream view of professionals who work in obesity-related fields. The central idea is that a person with a heavier-than-average body weight faces a minimal elevation of health risks compared with a person with an average body weight. The idea is then developed that the emphasis placed on the problem of excess weight among Americans by the government, researchers, physicians, and industry is thus largely unwarranted and, furthermore, often detrimental to people's health. Written in a breezy and rambling style, the book is fairly easy to read despite the tendency towards repetition. It has an extensive notes section that contains references and further commentary on the references by the author.
The first section provides an overview and interpretation of selected scientific literature (primarily epidemiological studies) to provide evidence for the hypothesis that the risks associated with excess body weight are minimal. In this section, results from studies that demonstrate health risks associated with overweight and obesity are discounted in two main ways. First, a series of criticisms of epidemiological research are presented. These include the well-known facts that these types of studies cannot prove causality and often do not adequately adjust for confounding variables. Second, non-specific terms such as ‘average weight’ and ‘above-average weight’ as well as a few well-placed caveats that exclude people ‘at the extreme statistical margin’ of body weight are used to recast study results. Subsequently, study results are reinterpreted for the reader and presented to show that excess body weight is minimally associated with health risks.
In the second section, which comprises 12 chapters of the book, the detrimental psychological, sociological, economic, and racial implications of obesity in America are examined. Drawing upon a variety of sources, ranging from women's fashion magazines to television talk shows and a series of personal testimonials by women with weight problems, the pervasiveness of the discussion about weight in America is illustrated. Hidden within this is an interesting discussion about social class, race, and obesity in the US, although much of the message is diminished by the use of inflammatory prose and poorly chosen examples. The message is that, in this era of political correctness, when racial and ethnic discrimination is no longer tolerated, discrimination toward obese people has taken its place and somehow fills a societal need to have a group to ostracize.
The third section of the book aims to discuss how perceptions of appearance negatively influence interpersonal, workplace and even national politics in the US. A series of examples are given, but the logic that guided either their choice or their order of presentation is not apparent. The section opens with a lengthy discourse on how former President Clinton was impeached because he was ‘fat’, and then segues into a personal rant against ‘infotainment’ reporters. Finally, it ends with a personal narrative about the author's problems with his weight and how this affected his relationships. Although the aim of the section was potentially interesting, it did not deliver a meaningful or topical discussion.
One strength of the book was the glimpse it gave into how the discussion and focus on the obesity problem has permeated nearly every aspect of life in America. Another is that it provided a reminder that obesity in America is also a marker for many other factors that put people at risk of poor health, such as having a lower level of education, being poor, and being non-white. However, the author's oversimplification and subsequent reinterpretation of results from scientific studies created a false impression. Although perhaps entertaining, the preponderance of examples given from Hollywood to illustrate the cultural effects of the obesity epidemic detracted from the interesting and important message about social class, race, and obesity. Disappointingly, the last section did not deliver a coherent or logical message about weight and politics. Overall, the book provided an interesting look at how the obesity problem is perceived in America by one non-researcher, but there are better options if one is interested in this topic.
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