How the insurance industry created obesity

Consuming bodies. The title of the Dr Ulrike Thoms’ talk, which took place at the Faculty of Humanities on Tuesday 19 January left a lot to the imagination: Cannibalism? Sex workers? The fashion industry?
In fact, Ulrike Thoms has something else in mind: obesity and the human body in the light of science.

She is an expert in modern social history, and focuses primarily on clinical trials, body perception and the nutritional history.

In her talk, she presents a chronological insight into the creation of the modern obesity discourse, using both sides of post-war Germany as case studies. Ulrike Thoms is clearly passionate about this subject.

As a historian among medical researchers, she is used to fighting her corner.

Reinventing the wheel

The problem with the field of obesity is that biochemical reasoning dominates, she says, after the lecture.

»Cultural and social studies into obesity are not well received in the medical community. I work at Charité alongside medical researchers. They may read my reports, but they don’t put them into practice.«

She comments that medical research continues to reinvent the wheel every five years or so, as scientists never read any articles or journals that are older than that.

»They just keep on generating more and more data,« she says, »For them, real science takes place in the lab, not in books«.

Oozing the humanities

From the first word, Ulrike Thoms lecture oozes the humanistic approach. She analyses the discourse of moderation and consumption, and examines the creation of the term ‘obesity,’ based on models of normality and ideal weight.

Up to the end of the 19th century, doctors believed that cases concerning overweight or underweight patients ought to be judged individually, based on »general bodily state and the state of individual organs«.

There was no benchmark or chart for how much one should weigh until later. Meanwhile, physical anthropologists began enthusiastically collecting data, weighing and measuring every aspect of the human stature.

The figures were charted and used by insurance companies, in the first instance to judge whether a customer was underweight, and therefore a tuberculosis risk, and should therefore pay higher premiums.

From underweight to obesity

The insurance companies realised the economic value of such data and made more surveys, with the focus shifting in the late 1900’s from underweight to obesity.

This statistical data was made available to scientists and doctors, and the idea of a ‘normal weight’ based on an average figure is replaced by an ‘ideal weight’ – lower than the average – in 1922.

This concept and the weight tables on which it was constructed were used in the medical profession well into the 1990’s.

During the 20th century, obesity and being underweight, in the form of anorexia and bulimia, have been made into deviant behaviours; diversions from the ideal.

Ulrike Thoms points out the use of the term ‘eating disorder’ as indicative of a pathologisation of these conditions.

The order is disturbed and equilibrium must be restored at any cost; even if the bio medicinal solutions of diet pills and light foods create other disturbances and disorders in their own right.

Discourse shapes solutions

Ulrike Thoms points out that this discourse has shaped the solutions chosen on a national and individual level, and that the discourse at times overshadows some of the statistical results.

Even in the 2000’s the danger of heavily changing weight is often ignored, while the risks of obesity can be recited by any school aged child.

Despite the data showing that moderately overweight individuals have the lowest mortality rate, the mantra of ‘slim is best’ prevails.

luci@adm.ku.dk