Out of something of a fluke, I ended up reading three very different books with very similar themes and topics (in this case, fat) in very quick succession while I was visiting my family for Christmas. I suspect this was the byproduct of working through my TBR backlog and hitting the vein of fat acceptance/health at every size/body positivity books that I had added to the list in 2017 or so, but still a bit weird for the cookie to crumble in just that way! But since they were anthropological nonfiction, a YA novel, and a dishwater attempt at satire aimed at adults, I decided there wasn’t much to be gained by combining them. At least for review purposes.
The first in this Fat Triptych is Susan Greenhalgh’s Fat-Talk Nation: The Human Costs of America’s War on Fat. It isn’t impenetrable by any means, but it’s definitely an academic and scholarly approach that’s a cut or two above more popular science fare. Greenhalgh is an anthropologist (specializing in China, apparently, which was not at all apparent to me reading Fat-Talk Nation!) and admits in the introduction to the book that she fell into writing about this topic basically by accident. Class discussions in a course on feminism she was teaching brought diet culture and fat shaming into her awareness when before it had largely been absent for her; being a person of average weight, she explains, meant she hadn’t personally been subject to body scrutiny. Stories from students prompted her to conduct an entire research project that eventually became Fat-Talk Nation.
The bulk of Greenhalgh’s material here consists of student essays, the majority of which from her own students (writing such an essay was an optional piece of extra credit for a class she was teaching). She may have followed them up with personal interviews as well? I’m writing this three months after the fact and some (many) things have since slipped my mind. But all the participants included in the book give informed consent, names and so on are changed, and Greenhalgh situates their stories in the context of diet culture (local to Southern California but also nationally), biology, and so on.
(Expertise in China might have surprised me, reading her biography now several months later, but “the entanglements of state, corporation, science, and society, and their consequences for human health and social justice writ large” are very much part of Fat-Talk Nation.)
Much of the book centers around BMI, both itself as a concept and also a wedge or vanguard for larger discussions about what Greenhalgh calls “biocitizens” in arenas like doctor’s visits or public schools. Reading these initial chapters brought back memories of countless gym and health classes where we dutifully learned to crunch our own numbers to see if we were fit or not; embarrassing visits to the school nurse for check ups. My second grade teacher posted our photos, heights, and weights on the bulletin board for a month or two. It was dressed up in the cutesy way elementary school teachers do bulletin boards (I think maybe we were all, like, apples hanging on a tree?) but I still wanted to melt into the floor. The second-fattest kid in the entire class.
And all that misery without BMI!
In retrospect it seems so pointless. Everyone can see who the fat kids are, including the fat kids themselves. What good does it do to also tell them that, according to this metric, you are going to keel over dead?
Greenhalgh also uses the BMI categories to structure the book, looking at the experiences of students according to whether they were underweight, average, overweight, or obese. This is the bulk of the book and, for me, is a compelling case for empathy. (Granted, I went into this book biased.) There are plenty of absolutely brutal stories about how parental anxieties and concerns about (bodily) perfection in their children strained or even ruined family relationships. Greenhalgh makes the point that the appearance of scientific legitimacy given to BMI makes it easy to stoke concern in parents who might say or do horrible things out of genuine concern for their child’s health. At least one of the respondents in the underweight and overweight categories talked about how their parents had never been worried about their weight, or were even aware of the metric, until the school nurse sent home some kind of note or comment about the child’s undesirable weight.
Upon reflection I would say that the focus on BMI is maybe the book’s only flaw. It’s not that I think Greenhalgh is on a hobby horse or anything, far from it. When you’re looking at “the entanglements of state, corporation, science, and society,” then BMI becomes the most obvious marker for that in a discussion about obesity. It looks quantifiable and objective, it’s easy to calculate, it’s used everywhere under the guise of being “scientific.” It’s more that our pop-science understanding of obesity, and the terms we use to discuss it, have evolved. It’s only in the last section that I think Greenhalgh has overstated the case, waxing overly optimistic about the potential good of taking BMI out of public discussions—and, indeed, about the overall potential of the body positivity movement.
This is also an Obama-era book, so Michelle Obama’s various First Lady initiatives to reduce childhood obesity get mentioned a lot—relic of a bygone era. It would certainly be interesting to see an updated version or even a sequel, a full ten years later. I can’t help but think that Ozempic and other GLP-1 drugs would replace BMI as the locus of state, science and biocitizen discussion.
Even though Fat-Talk Nation feels a little, or very, out of date in places when it comes to discussions of policy, overall it holds up because of the survey responses. People’s lived experiences will never feel dated in the same way that reading about First Lady Michelle Obama does. I’d also like to think that those are the most persuasive sections of the book, but I’ll be the first to admit I’m a big ol’ softie.
On the off chance you’re curious about this one, be aware that there are several books with “Fat Talk” in the title that come up when Googling. Double check the full title.
