History of Obesity

Body, Mind, & Health
27 June 2013

Prevention Over Treatment for Obesity
Obesity is an important issue because of the staggering proportions that this disease has reached. Doctors are prescribing patients to lose weight, exercise, eat healthy, and in extreme cases, go under the knife, but none of these recommendations are making a dent in lowering the rate of obesity. Rather, the number of people obese in the United States steadily increases at an alarming rate. But why? This paper explains the medicalization of obesity throughout history. After the medicalization of obesity, it becomes clear that treatment measures dominate preventative measures. Our fixation on treatment is evident when looking at popular culture and the evidence supporting the rise of obesity is explained through the statistics on epidemiology. This paper suggests that practice of prevention for overweight and obese individuals needs to be implemented in American Society rather than continuing to emphasize treatment measures if public health officials want to see a decline in obesity.

History of Obesity
Clinical medicine changed in the nineteenth century when German laboratories identified the fat cell and then in 1846 when Arthur Hassall’s published The Microscopic Anatomy of the Human Body in Health and Disease, in which he described the structure and growth of fat cells. In his observations of a human fat vesicle, Hassall states that their presence, “is to be regarded as an indication that decomposition has begun to affect the contents of the cells” (Hassall, 48). From his understanding of the fat vesicle, Hassall explains that, “a certain degree of fatness argues a healthy and vigorous condition of the system, while its excess or inordinate accumulation denotes either a degree of weakness of constitution or a peculiar and unexplained state of the system” (Hassall, 230). The findings of the German laboratory and the description provided by Hassall identified the fat cell as the “pathogen” in overweight individuals. The fat cell serves as the pathogen because, even though small quantities of fat cells were organic and essential to life, it had the ability to multiple based on voluntary eating habits. This unique characteristic of the fat cell separated it from the other cells within the human body.
In the early 1900’s scholars began to understand the life-threatening effects of obesity, which led to the medicalization of obesity. According to a Medical News article in 1900, obesity was caused by a “disturbance of the balance of nutrition” (Report 4). In 1902, Atwater developed a scientific basis for connecting food composition, dietary intake, and health, and emphasized the importance of variety, proportionality, and moderation in healthful eating. Atwater stated that, “unless care is exercised in selecting food, a diet may result which is one-sided or badly balanced…. The evils of overeating may not be felt at once, but sooner or later they are sure to appear… perhaps in actual disease” (Atwater, 45). Atwater is the first to frame the factors that cause obesity as a disease. He explains the importance of a balanced diet in order to maintain ideal health and that an unbalanced diet could lead to a disease. A 1912 study done by actuaries of insurance policy holders continues to frame obesity. The study provided height, weight, and mortality figures that became the database for actuarial tables used to determine, for the first time, that there was a relationship between body weight, health, and mortality (Lieberman).
The naming of obesity took place in the 1940’s when scientists define obesity as “over-fatness,” American’s start to conceptualize the difference between being overweight and being over fat. The naming and framing of obesity most likely was a result of the increased awareness of the harmful affects that being “over-fat” could have on a person’s life. The diagnosis became clearer with the development of skin-clippers, which allowed Dieticians to measure body fat (Lieberman).
Public health responses, which occurred in the 1950’s, marked the beginning of the focus on treatments for obesity rather than prevention. This point in history is when scholars could have focused on preventative measures, but instead they focused on treatments. There were attitudinal changes about dieting and weight control. Due to a high demand, supermarkets began to offer a variety of low-calorie and diet products (Lieberman).
Awareness of obesity continued to increase and the introduction of motion pictures with their frequently slim and elegant movie stars led to the popularity of a new treatment was introduced, weight-loss diets. Jean Nidetch founded Weight Watcher’s in 1966. Nidetch experienced personal success in the weight loss battle due to a crucial source of motivation, support groups. Nidetch established Weight Watchers with the idea that support groups could prove to be a successful weight loss treatment based on her personal experience. Weight Watcher’s offered an outlet for individuals to connect with others facing similar struggles and it did prove to be a very successful weight loss aid because it provided a new kind of treatment. (Hellmich). In the 1980s, awareness and the development of treatments continued to grow. Americans began to focus on physical fitness and exercise as a way to promote good health. Articles on dieting appeared in newspapers and popular magazines, along with information on how to increase activity levels. However, even with the increase of awareness and increased efforts to diet, the rates of obesity continued to rise. In 1990, the Nutrition Labeling Act of 1990 was passed. The law was a public health response to further increase awareness about the nutritional impacts of the food being consumed. The law gives the Food and Drug Administration authority to require nutrition labeling on most foods regulated by the Agency. It also requires that all nutrient content claims and health claims meet the Food and Drug Administration regulations. Even with the great awareness of the effects of food on one’s health and of the disease obesity, rates of obesity continues to climb. Current estimates of the prevalence of obesity indicate that it has reached epidemic proportions in some populations (Lieberman). Cures for obesity range from the standard dieting to surgery and drugs. Dieting is a routine aspect of life for many Americans, even for some who are not obese. Along with dieting is the importance of exercise. Exercise has been proven to increase lean body mass and increase metabolic rate. Exercise also has psychological benefits including self-esteem, modulation of mood, and improved body image. In cases of extreme obesity, or when there is a fear of comorbidities associated with a central distribution of fat, drug therapy may be administered. However, the drugs used for treating obesity have not been used with large populations long enough to assess long-term benefits and these drugs don’t come without risks (Lieberman). The history of obesity describes the predominance of treatment programs developments in American society. Scholars have tended to focus on treatment procedures, when instead they should be focused on preventative measures because the development of different treatments has yet to signify a decline in obesity rates.

Epidemiology
Obesity has reached epidemic proportions in some populations. Based on a statistic taken in 1980 and a statistic taken in 1995, in both studies, obesity is approximately twice as prevalent among women as men in the United Sates, although the disparity is the most striking in certain populations, such as African Americans, Mexican-Americans, Puerto Ricans, and Western Samoans. In 1987, Brown and Konner have noted that females appeared to become obese with modernization. They suggested that the sex ratio of obesity is a marker for a population on a course of economic development and westernization.
A widely cited statistic of weight was taken by NHANES III based on a random sample of the United States population in 1988. From the results, NHANES III concluded that 31 percent of males and 35 percent of females ages 20 to 74 years were considered overweight. In 1995, the Institute of Medicine of National Academy of Science took an estimate of the percent of overweight and obese in 1995. The results of this study indicate that 59 percents of American males and 49 percents of females are overweight or obese. These numbers display a sharp increase in the rates of obesity in proportion to the time span of these two studies. In another study, the rates of obesity in 1960 were compared to rates of obesity in 2004. The obesity prevalence was relatively low and stable between 1960 and 1980, but more than doubled from 28% in 1980 to 66.2% in 2004 (Nguyen). These studies indicate a dramatic increase in obesity even though obesity has been medicalized, awareness continues to increase, and we understand the pathogen to be the fat cell.
Scholars need to focus on preventative measures rather than developing new procedures for treatment because the focus on treatment in the past hasn’t proved to be an effective method for reducing the rates of obesity.

Popular Representations in Films Whether geared toward children or adults, more and more television shows are produced either based around our obsession with weight, or have weight as a major theme. Reality shows and adult cartoons tend to focus their attention on warning Americans about the growing obesity epidemic. Movies like, Heavyweights, and reality shows, like The Biggest Loser and MTV’s Fat Camp, are three primary examples of media attention towards obese individuals in American society. Both shows emphasize the power of dieting as a treatment for obesity. Heavyweights , The Biggest Loser, and MTV’s Fat Camp appeal to different audiences, but each emphasize the same underlying preconceived notion: dieting can serve as a treatment for obesity.
In 1995, Walt Disney Pictures released the movie Heavyweights. The movie takes place at “Camp Hope” where all of the campers are overweight. This movie is about a summer fat camp for overweight kids that forces campers to participate in demanding exercises and low-carb diets. After this movie, the popularity of fat camps sparked across America. After seeing this movie, parents of overweight children would pay to send their overweight children to these camps in hopes for a child of normal weight to return. This movie is yet another example of America’s fixation on treatments for obesity.
Contestants on NBC’s the Biggest Loser spend their weeks learning to lead a healthier lifestyle. They change their diet, learn to avoid temptations, and increase their exercise. This show encourages weight-loss and strives to inform America about this growing epidemic as an issue hitting all ages and walks of life. By then end of each season, viewers all across America see the positive results of dieting as a form of treatment for obesity.
MTV is a popular network show for teens and young adults that features several shows emphasizing teens losing weight. MTV’s Return to Fat Camp is a documentary television series that follows the lives of seven young teens that go to Camp Pocono Trails in Pennsylvania in the summer to lose weight. Essentially, this camp is a ‘fat boot camp’, with the Head Instructor of the Camp weighing each individual at the end of the week and having each individual do certain daily exercise classes throughout the day, while providing them with healthy, well-balanced meals. Return to Fat Camp increases public awareness about another treatment procedure for the overweight individuals of America.
American Medicine The history of obesity explains scholars, as well as America’s, fixation on possible treatments for obesity. Soon after German laboratories discovered the fat cell and obesity was medicalized, there has been a huge emphasis on treatments for obesity rather than preventative actions. The Weight-Loss industry is a multibillion-dollar industry and if scholars were to focus on preventative measures instead of treatment measures, the Weight-loss industry would no longer be in existence. It is able to do this because most Americans spend their whole lives trying to lose weight and the diet industry uses this insecurity to make a profit. This suggests that American medicine is economically based.
During the twentieth century, researchers have begun to develop pharmaceutical interventions aimed at treating obesity. However, these treatment inventions, which were supposed to decrease the rates of obesity, have actually resulted in a rise of obesity. The increase in the rates of obesity is clear in the statistics on the epidemiology and the fixation on treatment is displayed in the history of obesity and the popular culture. This paper argues that preventing obesity would be far more sensible than putting untold numbers of people on expensive treatment regimens.

Works Cited
1. Lieberman, Leslie Sue. "Obesity", The Cambridge World History of Food. 1st ed. Cambridge: Cambridge University Press, 2012. 1062-1077. Cambridge Histories Online. Web. 10 July 2013.
2. Hassall, Arthur Hill. The microscopic anatomy of the human body, in health and disease. New York: Pratt, Woodford. 1851. Print.
3. Atwater, Wilbur. Principles of nutrition and nutritive value of food. Washington: Government Printing Office, 1916. Web.
4. “Prevalence of Obesity.” American Periodicals 22 Dec. 1900: n. 983. Web. 12 June 1999.
5. Hellmich, Nanci. “Weight Watchers founder Jean Nidetch Shares Her Start.” USA Today. 22 Feb. 2012: Web.
6. Nguyen, Dang M., and Hashem B. El-Serag. “The Epidemiology of Obesity.” Gastroenterol Clinics of North America 39.1 (2010): 1-7. Web.

Cited: 1. Lieberman, Leslie Sue. "Obesity", The Cambridge World History of Food. 1st ed. Cambridge: Cambridge University Press, 2012. 1062-1077. Cambridge Histories Online. Web. 10 July 2013. 2. Hassall, Arthur Hill. The microscopic anatomy of the human body, in health and disease. New York: Pratt, Woodford. 1851. Print. 3. Atwater, Wilbur. Principles of nutrition and nutritive value of food. Washington: Government Printing Office, 1916. Web. 4. “Prevalence of Obesity.” American Periodicals 22 Dec. 1900: n. 983. Web. 12 June 1999. 5. Hellmich, Nanci. “Weight Watchers founder Jean Nidetch Shares Her Start.” USA Today. 22 Feb. 2012: Web. 6. Nguyen, Dang M., and Hashem B. El-Serag. “The Epidemiology of Obesity.” Gastroenterol Clinics of North America 39.1 (2010): 1-7. Web.