Fat, Gluttony and Sloth: Obesity in Literature, Art and Medicine (review)

In Fat, Gluttony and Sloth: Obesity in Literature, Art and Medicine, David Haslam and Fiona Haslam offer a timely historical survey of cultural perceptions of obesity. A guiding concept of their book is that "there is not an aspect of obesity today that does not have a relevant backdrop in history" (7). The text is grounded in British culture, with some focus on Europe as a whole and America. A recurrent question is, do gluttony and sloth contribute to the current obesity epidemic? By analyzing cultural responses to dietary excess and obesity as represented in medical discourse, art, literature, popular culture, and film, David and Fiona Haslam show how overindulgence and illness have always been associated with disease and premature death.

Obesity frequently results in diabetes, cancer, high cholesterol, stroke, heart disease, sleep apnea, and depression. Currently, the Haslams state, obesity is responsible for 30,000 deaths in the UK and 300,000 in the United States annually (15). The Haslams expertly weave knowledge of the past with the practices of the present. For example, they point out, just as doctors recognize today, Hippocrates argued that a proper diet and lifestyle can restore health. The ancients also recognized diabetes, then as unquenchable thirst and resultant excessive urination. The Haslams argue that intemperance, imbalance, and illness have always been inseparable in medical discourse, art, literature, popular culture, and later, film.

In their book, the Haslams explore diet, exercise, drug therapy, and surgery as solutions to the obesity epidemic as well as the cultural connections between overindulgence and illness as seen through the veil of religion and morality. Over the ages, excessive alcohol consumption and overeating have been linked to illness and immoral behavior. However, drinking alcohol in moderation was viewed as salubrious (67).

The Haslams expertly present the inherent cultural complexities that inform societal responses to illness and obesity. They point out, for example, that currently there are many drug therapies available to the public to control obesity and its resultant disorders, but because of the bogus and sometimes deadly nostrums offered in previous centuries, such as mercury and arsenic, practitioners and patients alike are now reluctant to embrace modern drugs, such as lipase inhibitors. Additionally, in Chapters 8 and 9, the Haslams show how, while, on the one hand, gluttony and sloth are sometimes numbered among the seven deadly sins, on the other hand, in some societies, corpulence, frequently the result of gluttony and sloth, was associated with wealth and social standing and thinness with poverty and illness. The Haslams note that the connection between overindulgence and obesity was not consistently made in early eras.

In their discussion of art, the Haslams show the changing perceptions of beauty in relation to body size. Sixteenth- and seventeenth-century artists such as Rubens and Renoir celebrated the sensuality of plumpness while Christian artwork emphasized the skeletal slenderness of the ascetics. The classical model of beauty, da Vinci's "Vitruvian Man," captures the beauty of measured proportion, of being neither too thin, nor too large, a physical representation of the beauty of balance, moderation, and health. The Haslams argue that being overweight was attractive in the sixteenth and seventeenth centuries while contemporary models of beauty favor the slim.

In their discussion of film, literature, and popular culture, the authors show how the overweight are frequently parodied, mocked, and humiliated. During the late nineteenth and early twentieth centuries, for example, the overweight were displayed in freak shows and circuses. Discrimination against fat people was and still is socially acceptable. Given that most of the populations of Britain and America are currently overweight, it would seem that models of beauty would change to fit the current corporeal realities, but this, for the most part, has not been the case. There are exceptions. The Haslams discuss movies like Shallow Hal to emphasize that size does not dictate character nor control physical attraction. What is made clear in their book...