Circulating Ignorance: Complexity and Agnogenesis in the Obesity “Epidemic”

Abstract

This article examines what is said to be un/known about obesity and the ways in which attributions of knowledge or ignorance circulate in the field of public health nutrition. Risks caused by individual behaviors have been an overstated concern in public health. Obesity, like many of today's complex problems, is determined by myriad nested interactions spanning the political economies of market regulation, modes of agricultural production, the biochemistry of appetite regulation, and changing family structures. Yet public intervention—and the science produced to validate it—remains wedded to a mode of intervening that has limited purchase on the complexity with which it contends. This article draws on scholarship on the social construction of ignorance to argue that the field of evidence in obesity science is fashioned in a way that deflects attention (and responsibility) away from questions of food production and marketing and continues to frame the problem as one of individual responsibility. Rather than discrediting the veracity of evidence produced out of industry‐research partnerships that increasingly dominate public health research, this article examines how the field of evidence has been structured by these relations. It argues that the demonstration of causal relations between political and socioeconomic determinants of malnutrition and measurable health indexes is largely impossible, not simply because of the absence of good evidence but because the existing parameters of good science cannot straightforwardly reveal such relations. This, in turn, is due to the configuration of the knowable in terms of whether knowledge can be made operational.

Information is not knowledge: Cooking and eating as skilled practice in Australian obesity education

“…Employment conditions, and other structural factors (such as gendered caring roles, low incomes, unemployment, poor mental health) all have significant influence on how and what we eat, but are overlooked and not considered as contextual factors in nutrition information (Aphramor et al . ; Sanabria : 136; Dodds and Chamberlain ).…”

“…As Sperber suggests, once the instructions have been given, all you have to do is ‘convert [them] into bodily behaviour’ (Sperber : 61). In her ethnographic analysis of nutrition policy and practices in France and with the World Public Health Nutrition Association, Sanabria suggests that this hierarchical model of knowledge transfer and its implicit assumption that health education messages ‘could impact health behaviours seems quaint’ (Sanabria : 137). Despite repeated claims about the ineffectiveness of this one‐way delivery, why does health education still insist on imparting nutritional information in this way?…”

Von ‚Fehlanpassungen‘ und ‚metabolischen Ghettos‘: Zur Konzeptualisierung globaler Gesundheitsunterschiede im Feld der Developmental Origins of Health and Disease

“…DieT heorie kämpft seit geraumer Zeit damit, dass bisjetzt kein solcherGenotyp alsBasis eineshçhe-renRisikos für Übergewicht identifiziertwerdenkonnte. 53 In denl etzten zwei Jahrzehntens indi nD OHaD neue Erklärungsansätzef ürg lobale Gesundheitsunterschiedea ufgekommen, dies t ärker aufd ie Rolle derI nteraktion zwi-schenG enom undU mwelta bstellen. DOHaDa ls Forschungsfeld hats ichi nitial in Folge derArbeitvon DavidBarkerbegründet,der in den1980erund 1990er Jahren an derU niversity of Southamptoni ne pidemiologischenS tudien einenZ usammenhang zwischen niedrigemGeburtsgewicht underhçhtemRisikofürkardiovaskuläre undmeta-bolischeE rkrankungeni mE rwachsenenaltern achgewiesenh at.…”

When places come first: suffering, archetypal space and the problematic production of global health

“…This is not to say that critical medical anthropologists have not concerned themselves with the embodiment and experience of non‐communicable diseases (see for example Bunkenborg ; Mendenhall ; Mendenhall and Norris ; Mendenhall et al . ; Sanabria ; Whyte ), but the discipline undeniably lags behind other social sciences, including geography. This disciplinary disconnect only reinforces the need to dwell further on the complexities of suffering and its significance for the spatial contours of the global health endeavour in broad terms.…”

“…As should thus be achingly clear to health geographers, they are not a distracting frivolity from the real biomedical spaces of global health, but rather crucial and alternative archetypal spaces where suffering and pleasure collide in complex ways that are too often antithetical to good health. They are also intensely political spaces, where commercial exigencies, vested interests and public health aspirations crash into the individual freedom to consume (see for example Bell and Ristovski‐Slijepcevic ; Sanabria ). These spaces thus represent an uneasy addition to the architecture of global health, not just because of the financial entanglements between some of the ‘commercial vectors of disease’ and major global health players such as the Gates Foundation (McGoey ; Stuckler et al .…”