- Fat in the Fifties: America's First Obesity Crisis by Nicholas Rasmussen
Obesity, Biotechnology, Health Policy, Public Health, Cardiology
In Fat in the Fifties: America's First Obesity Crisis, philosopher, scientist, and historian Nicholas Rasmussen, who has written in the past on the history of the life sciences, biotechnology, and pharmaceuticals, turns his considerable skills to the question of obesity, science, and public health in the United States. Historians of medicine and science alike will find a lot to dig into here, and the book would work well in classroom treatments of public health, health policy, American history, social medicine, and of course the history of science, medicine, and technology.
In this book, Rasmussen argues that the first real "obesity crisis" took place in the 1950s, when new epidemiological research, experimental biomedicine, and policybased approaches to public health took hold, and all three trained their sights for a time on the problem of obesity in the United States. For just over a decade, anxieties about American weights and attendant concerns about disease, lifespan, and costs of living raged, while fat seemed to consume scientific, public health, and health policy conversations. By the end of the 1960s, Rasmussen argues, though waistlines themselves continued to grow, anxieties about obesity in these specific communities waned.
Rasmussen is right to begin his accounting of "fat in the fifties" with the optimistic outlook of public health entities in the 1920s and 1930s, and the volume spends time with a number of other important areas central to building a disease-oriented approach to obesity in the American population. Rasmussen in turns treats the Metropolitan Life Insurance Agency's medico-actuarial mortality reports of the earlier period, the ascendance of endocrinology and the "glandular" explanation for obesity—an area where Rasmussen is an established expert due to his previous work on amphetamines in medicine—and the work of Hilde Bruch and other psychiatrists on mental health and body size, all before arriving at the "Postwar Heart Alarm," as Rasmussen describes it in Chapter Three. Here Rasmussen turns to the primacy of cardiology as a specialty, and heart health as a public health concern, at mid-century [End Page 117] for understanding, and amplifying, the risks of obesity. He then begins deep discussions of Ancel Keys's important scientific contributions as well as the differing policy positions from the Eisenhower and Kennedy administrations and some of the various public health initiatives of the period. Chapters Four and Five follow suit, focusing on 1950s-era epidemiology, the focus on heart disease, the famous Framingham Study, the popularity of calorie counting among doctors as a weight loss technique, and the beginnings of weight loss support groups in the U.S.
This is a well-written, engaging history that packs a lot of content and analytical punch into just over 150 readable yet rigorous pages. Significantly, Rasmussen argues that one of the main lessons of the so-called "first obesity crisis" is that a focus on individual behavior—whether it comes from scientific laboratories, individual physicians, or fledgling commercial weight loss programs—contributes to a culture of stigma around the condition and dissuades policy entities from pursuing crucial, necessary systemic interventions around food access and health care. This is a needed and, in my opinion, entirely correct argument about policy approaches to obesity in the United States.
One of the challenges of charting these rise-and-fall types of histories is drawing out the dynamic relationships among public opinion, politics, funding relationships, and the scientific and medical establishment positions on a given topic. In some ways, it is a bit of a chicken-and-the egg question: impossible to determine which came first—the public panic about the condition, in this case obesity, or the scientific, in this case diagnostic and statistical, evidence about the role of obesity in American life. Rasmussen's account does its best to chart these relationships but ultimately falls a bit short of proving the part of his argument that an obesity crisis emerged, and then disappeared. To the contrary, there are...