Isabel Fletcher

Defining an epidemic: the body mass index in British and US obesity research 1960-2000.

Between the 1970s and the mid-1990s the body mass index (BMI) became the standard means of assessing obesity both in populations and in individuals, replacing previously diverse and contested definitions of excess body weight. This article draws on theoretical approaches from the sociology of standards and science and technology studies to describe the development of this important new standard and the ways in which its adoption facilitated the development of obesity science, that is, knowledge about the causes, health effects and treatments of excess body weight. Using an analysis of policy and healthcare literatures, I argue that the adoption of the BMI, along with associated standard cut-off points defining overweight and obesity, was crucial in the framing of obesity as an epidemic. This is because, I suggest, these measures enabled, firstly, the creation of large data sets tracking population-level changes in average body weight, and, secondly, the construction of visual representations of these changes. The production of these two new techniques of representation made it possible for researchers in this field, and others such as policymakers, to argue credibly that obesity should be described as an epidemic.

Beyond regulatory compression: Confronting the liminal spaces of health research regulation

ABSTRACT Biomedicine and the life sciences continuously rearrange the relationship between culture and biology. In consequence, we increasingly look for a suitable regulatory response to reduce perceived uncertainty and instability. This article examines the full implications of this ‘regulatory turn’ by drawing on the anthropological concept of liminality. We offer the term ‘regulatory compression’ to characterise the effects of extant regulatory approaches on health research practices. With its focus on transformation and the ‘in-between’, liminality allows us to see how regulatory frameworks rely on a silo-based approach to classifying and regulating research objects such that they: (1) limit the flexibility necessary in clinical and laboratory research; (2) result in the emergence of unregulated spaces that lie between the bounded regulatory spheres; and (3) curtail modes of public participation in the health research enterprise. We suggest there is a need to develop the notion of ‘processual regulation’, a novel framework that requires a temporal-spatial examination of regulatory spaces and practices as these are experienced by all actors, including the relationship of actors with the objects of regulation.

Charting regulatory stewardship in health research: Making the invisible visible?

This section focuses on the ethical, legal, social, and policy questions arising from research involving human and animal subjects.

Sustainable diets: How ecological nutrition can transform consumption and the food system

B o o k R e v ie w S The last section allows Chou to shine her bright epidemiological light on the links between fast food and obesity and on solutions such as healthy and local school lunches and other hopeful programs, but will that be enough? After all, healthy choices on menus don’t necessarily change ingrained habits. Chin Jou asks smart questions and readers would benefit from her ideas about how to transform the urban franchisor-franchisee business model. Even more insightful would be her addressing these reforms in light of the new healthy food quick service outlets. Supersizing Urban America is an historical docu-drama with a hint of filmnoir’s dark morality. Like a good cinema visit, it leaves you wondering how to process what you have learned. Readers will never quite look at the ubiquitous fast food franchise in the same way again. In addition to an appealing writing style Jou’s deft use of statistics throughout the book help compare and contrast the historical and current urban experience. Her work is important for anyone interested in health, social, business and food histories.

The Rise of Obesity in Europe: A Twentieth Century Food History: Edited By Derek J. Oddy, Peter J. Atkins and Virginie Amilien

This edited collection developed out of the twentieth International Commission for Research into European Food History symposium “From Under-Nutrition to Obesity: Changes in Food Consumption in Twentieth Century Europe” held in 2007. The chapters are organized around three broad themes: trends in food consumption, industrial and commercial influences on food consumption, and social and medical influences on food consumption. The aim of the collection is to establish the chronology of twentieth-century changes in European body weights and identify the obesogenic factors that have led to secular increases in average bodyweights. Perhaps because the collection is in English, there is a Northern and Central European bias with the UK, Germany, Russia and France well represented but Southern Europe largely absent, apart from one chapter from Spain. Despite this caveat, it is unusual to read writing on this topic from such a wide range of national contexts. Such a range is valuable in allowing for comparisons of the different ways in which nutrition science interacts with policy in contrasting political contexts. A hundred-year perspective is shorter than usual for these symposiums—normally they cover 250 years. In most areas of social theory, however, 100 years would be considered a long-term view of a topic. This extended historical perspective is unusual in contemporary writing on obesity. As the editors explain in their helpful introduction, the first section on trends in food consumption contains chapters that cover contrasting European contexts: east versus west, market versus state economies, newly industrializing countries versus urban industrial ones. Josef Nussbaumer and Andreas Exenberger give a detailed description of the change from hunger to plenty in the Tyrol in Western Austria, outlining the catastrophic effects of the First World War, the depression of the 1930s and the Second World War on a poor and largely agricultural area. It was not until the Wirtsschaftswunder [economic miracle] and the growth of tourism from the 1950s that living standards, and average nutrition, improved. Now, as in many other areas of Europe, the authors argue that overrather than under-nutrition is a public health problem. Tatiana Voronia’s analysis of changes in food consumption in twentieth-century Russia is inevitably a broader brush overview of the topic, in which she contrasts the “peculiarities” of Soviet cuisine with the problems of unequal access to food in the New Russia after 1991. Her chapter, like many others in this collection, describes the dietary deprivation of the first half of the century and especially the effects of the Second World War, as well as the 1932–3 Russian famine resulting from the forced collectivization of agriculture. Maja Godina Golija discusses the transition to mass consumerism in Slovenia, describing how, as a poor and mostly agricultural population, Slovenes remained largely dependent on