Alexandra Brewis

Body Norms and Fat Stigma in Global Perspective

While slim-body ideals have spread globally in the last several decades, we know comparatively little of any concurrent proliferation of fat-stigmatizing beliefs. Using cultural surveys and body mass estimates collected from 680 adults from urban areas in 10 countries and territories, we test for cultural variation in how people conceptualize and stigmatize excess weight and obesity. Using consensus analysis of belief statements about obese and fat bodies, we find evidence of a shared model of obesity that transcends populations and includes traditionally fat-positive societies. Elements include the recognition of obesity as a disease, the role of individual responsibility in weight gain and loss, and the social undesirability of fat but also the inappropriateness of open prejudice against fat. Focusing on statements about fat that are explicitly stigmatizing, we find most of these expressed in the middle-income and developing-country samples. Results suggest a profound global diffusion of negative ideas about obesity. Given the moral attributions embedded in these now shared ideas about fat bodies, a globalization of body norms and fat stigma, not just of obesity itself, appears to be well under way, and it has the potential to proliferate associated prejudice and suffering.

Perceptions of body size in Pacific Islanders

OBJECTIVE: To assess attitudes to body size and obesity in Samoans, a Pacific island group characterised by very high levels of obesity and traditionally strong positive cultural views of large bodies.DESIGN: Cross sectional study of Samoan adults in Samoa and New Zealand.SUBJECTS: 84 female and 77 male Samoans in Samoa and 41 female and 24 male Samoans in Auckland, New Zealand, aged 25–55 y.MEASUREMENT: Body mass index (BMI), standardised survey questionnaires of perceptions of bodyweight and health, diet and exercise, and perception of body sizes on a continuous scale.RESULTS: Although Samoans in both countries display high population levels of obesity, ideal body sizes are slim and body dissatisfaction and attempted weight losses were apparent. However, women and men above normal weight did not characteristically perceive themselves as obese, were as positive about their body size, weight and health, and obese women were no more likely to be attempting to lose weight than their slimmer peers.CONCLUSIONS: The traditional Samoan veneration of large bodies is not apparent as ideal body sizes are slim. An important difference in values with Western industrialised societies is the absence of a strongly negative view of obesity.

Stigma and the perpetuation of obesity

Even as obesity rates reach new highs, the social stigmatization of obesity seems to be strengthening and globalizing. This review identifies at least four mechanisms by which a pervasive environment of fat stigma could reinforce high body weights or promote weight gain, ultimately driving population-level obesity. These are direct effects through behavior change because of feeling judged, and indirect effects of social network changes based on stigmatizing actions and decisions by others, psychosocial stress from feeling stigmatized, and the structural effects of discrimination. Importantly, women and children appear especially vulnerable to these mechanisms. The broader model provides an improved basis to investigate the role of stigma in driving the etiology of obesity, and explicates how individual, interpersonal, and structural dimensions of stigma are connected to variation in health outcomes, including across generations.

Marital coitus across the life course

It remains unclear whether the frequency of marital coitus does in fact decline universally across the life course, what shape that decay normally takes, and what best accounts for it: increasing marriage duration, womens age or age of their partners. Using cross-sectional Demographic and Health Survey (DHS) data of 91,744 non-abstaining women in their first marriage, a generalized linear model is used to determine if there is a consistent pattern in the life course pattern of degradation in the frequency of marital coitus. Datasets were drawn from nineteen countries in Asia, Africa and the Americas. Use of very large samples allows proper disentangling of the effects of womens age, husbands age and marital duration, and use of samples from multiple countries allows consideration of the influence of varied prevailing fertility regimes and fertility-related practices on life course trajectories. It is found that declining coital frequency over time seems a shared demographic feature of human populations, but whether marriage duration, wifes age or husbands age is most responsible for that decline varies by country. In many cases, coital frequency actually increases with womens age into their thirties, once husbands age and marriage duration are taken into account, but in most cases coital frequency declines with husbands age and marital duration.

Shared Norms and Their Explanation for the Social Clustering of Obesity

OBJECTIVES We aimed to test the hypothesized role of shared body size norms in the social contagion of body size and obesity. METHODS Using data collected in 2009 from 101 women and 812 of their social ties in Phoenix, Arizona, we assessed the indirect effect of social norms on shared body mass index (BMI) measured in 3 different ways. RESULTS We confirmed Christakis and Fowlers basic finding that BMI and obesity do indeed cluster socially, but we found that body size norms accounted for only a small portion of this effect (at most 20%) and only via 1 of the 3 pathways. CONCLUSIONS If shared social norms play only a minor role in the social contagion of obesity, interventions targeted at changing ideas about appropriate BMIs or body sizes may be less useful than those working more directly with behaviors, for example, by changing eating habits or transforming opportunities for and constraints on dietary intake.

Perceptions of climate change: Linking local and global perceptions through a cultural knowledge approach

Understanding public perceptions of climate change is fundamental to both climate science and policy because it defines local and global socio-political contexts within which policy makers and scientists operate. To date, most studies addressing climate change perceptions have been place-based. While such research is informative, comparative studies across sites are important for building generalized theory around why and how people understand and interpret climate change and associated risks. This paper presents a cross-sectional study from six different country contexts to illustrate a novel comparative approach to unraveling the complexities of local vs global perceptions around climate change. We extract and compare ‘cultural knowledge’ regarding climate change using the theory of ‘culture as consensus’. To demonstrate the value of this approach, we examine cross-national data to see if people within specific and diverse places share ideas about global climate change. Findings show that although data was collected using ethnographically derived items collected through place-based methods we still find evidence of a shared cultural model of climate change which spans the diverse sites in the six countries. Moreover, there are specific signs of climate change which appear to be recognized cross-culturally. In addition, results show that being female and having a higher education are both likely to have a positive effect on global cultural competency of individuals. We discuss these result in the context of literature on environmental perceptions and propose that people with higher education are more likely to share common perceptions about climate change across cultures and tentatively suggest that we appear to see the emergence of a ‘global’, cross-cultural mental model around climate change and its potential impacts which in itself is linked to higher education.

Food, Water, and Scarcity: Toward a Broader Anthropology of Resource Insecurity

Food and water shortages are two of the greatest challenges facing humans in the coming century. While our theoretical understanding of how humans become vulnerable to and cope with hunger is relatively well developed, anthropological research on parallel problems in the water domain is limited. By carefully considering well-established propositions derived from the food literature against what is known about water, our goal in this essay is to advance identifying, theorizing, and testing a broader anthropology of resource insecurity. Our analysis focuses on (1) the causes of resource insecurity at the community level, (2) “coping” responses to resource insecurity at the household level, and (3) the effect of insecurity on emotional well-being and mental health at the individual level. Based on our findings, we argue that human experiences of food and water insecurity are sufficiently similar to facilitate a broader theory of resource insecurity, including in how households and individuals cope. There are also important differences between food and water insecurity, including the role of structural factors (such as markets) in creating community-level vulnerabilities. These suggest food and water insecurity may also produce household struggles and individual suffering along independent pathways.

Absolute wealth and world region strongly predict overweight among women (ages 18–49) in 360 populations across 36 developing countries

This paper proposes a benchmark for comparing SES gradients across countries, based on gross domestic product apportioned to members of differing wealth categories within countries. Using this approach, we estimate absolute wealth in 360 populations in 36 developing countries and model its relationship with overweight (BMI≥25) among non-pregnant women ages 18-49. A simple model based on absolute wealth alone strongly predicts odds of overweight (R(2)=0.59), a relationship that holds both between countries and between different groups in the same country (10 populations for each of 36 countries). Moreover, world region modifies this relationship, accounting for an additional 22% of variance (R(2)=0.81). This allows us to extract a basic pattern: rising rates of overweight in lower and middle income countries closely track increasing economic resources, and the shape of that gradient differs by region in systematic ways.

Disentangling basal and accumulated body mass for cross-population comparisons

Measures of human body mass confound 1) well-established population differences in body form and 2) exposure to obesogenic environments, posing challenges for using body mass index (BMI) in cross-population studies of body form, energy reserves, and obesity-linked disease risk. We propose a method for decomposing population BMI by estimating basal BMI (bBMI) among young adults living in extremely poor, rural households where excess body mass accumulation is uncommon. We test this method with nationally representative, cross-sectional Demographic and Health Surveys (DHS) collected from 69,916 rural women (20-24 years) in 47 low-income countries. Predicting BMI by household wealth, we estimate country-level bBMI as the average BMI of young women (20-24 years) living in rural households with total assets <400 USD per capita. Above 400 USD per capita, BMI increases with both wealth and age. Below this point, BMI hits a baseline floor showing little effect of either age or wealth. Between-country variation in bBMI (range of 4.3 kg m(-2) ) is reliable across decades and age groups (R(2)  = 0.83-0.88). Country-level estimates of bBMI show no relation to diabetes prevalence or country-level GDP (R(2)  < 0.05), supporting its independence from excess body mass. Residual BMI (average BMI minus bBMI) shows better fit with both country-level GDP (R(2)  = 0.55 vs. 0.40) and diabetes prevalence (R(2)  = 0.23 vs. 0.17) than does conventional BMI. This method produces reliable estimates of bBMI across a wide range of nationally representative samples, providing a new approach to investigating population variation in body mass.

Body image, body size, and Samoan ecological and individual modernization

Idealization of slim bodies is a powerful cultural value in economically advantaged Western societies, and this value appears to be taking global dimensions. To examine the relationship between increasing ecological and individual modernity and acculturation to slim ideals, Samoans living in three environments with different degrees of modernization (Samoa, American Samoa, Auckland) were compared on actual and perceptual measures of body size. Women in more ecologically modern settings selected significantly slimmer ideal body sizes, and they also had the largest bodies on average. One significant finding is that the value placed on slim ideal bodies was less pronounced among Samoans who live in environments where they represent the dominant ethnic group. However, disregarding setting, Samoan women who engaged in non‐traditional occupations displayed slimmer ideals than those with traditional womens occupations, but had the same mean body sizes. The male pattern is distinct from that of women, as men in both more and less modernized ecologies selected similar mean ideal sizes of male bodies. Men in non‐traditional occupations and those with more education idealized larger male bodies than their peers, and also had greater average body size. The Samoan case indicates that acculturation to slim ideals may occur rapidly and can occur without the increase in body size that is generally associated with biological modernization of populations. Further, the relationship between modernizing ecologies and changing body image in Samoans appears to be highly sex‐specific, influencing women to a greater degree.