By Amy McLennan
The Pacific Island nations are home to some of the highest rates of obesity in the world. While there is ongoing debate about the accuracy of the measurement of obesity and the creation of cutoff points for different categories of individual fatness (or thinness), data are useful insofar as they provide a crude indication that population obesity has risen across time and space. Approaching obesity as a social entity whose locus is the population, leads us to consider the broader context in which population health changes. I recently returned from carrying out ethnographic fieldwork in one Pacific island nation with a high rate of obesity. I did not go with the objective of identifying a ‘cause’ for obesity, but rather with the aim of better understanding the shifting political, social and economic landscapes that have been synonymous with a changing health landscape and population morphology.
I originally went into my fieldsite with some concern that my topic of study was obesity, a culturally-defined description of body shape. I was aware of the stigma attached to obesity and did not want to be perceived as just another health researcher who had not problematised the medical category (Alexandra Brewis has recently written an easy-to-read book problematising obesity from a bicultural perspective for an overview of some of the issues). Yet nor could I ignore the devastating comorbidities that are linked to obesity, such as diabetes mellitus and heart disease. Obesity data from the Pacific Islands are frequently cited, especially by the international media, in ways that sensationalize body size or as a means of offering critical commentary about peoples’ lifestyles. Such references are well known to Pacific Islanders, who highlight that foreigners ought to spend more time looking at their own country’s health rather than criticizing others; or if they really must focus on Pacific Island health, then they ought to focus on the real health concerns of the region and not simply aesthetics. I recall one story in particular that I read about my own fieldsite in the UK newspaper The Independent. The author informed readers that a popular local snack was a whole fried chicken and bucketful of Coke (this could not have been much further from reality), implying rather forcefully that people were entirely to blame for their country’s obesity rates. All of this aside, changing body morphology at a population level can inform us about the health impacts of social change, and this was, and continues to be, my central interest.
In my fieldsite, 
during the 1970s and 1980s, I learned that government officials discarded health reports flagging obesity and diabetes as serious issues; every five years another report would be presented to the government, and every five years this report would be disregarded in preference for more pressing matters of international relations, transport and investment. Their interests did not lie specifically in the long-term biological health of their people, but rather in the growth of their nation into a post-Independence ‘citizen of the world’ to ensure future prosperity. Likewise, people disregarded health warnings and pursued corporeal satisfaction and enjoyment. ‘But I feel fine!’ was, and still is, the common refrain. Perhaps population health change is not about the individual feeling fine or not, however, but rather about the society. It is not clear whether social illness is phenomenologically experienced in the same way as individual illness, nor is it clear how, or if, in the case of obesity it impacts health outcomes.
Obesity is intimately associated with the food we eat, and food is a substance which lies at the intersections between global political economy, sociality, sensory experience, human growth and physiological outcomes. So it is possible that obesity has the potential to be an indicator of simultaneously health and social change. It is becoming increasingly clear that obesity (and its co-morbidities) is not simply a product of individual behaviour; rather, obese populations are socially-produced following significant structural, economic, political and ecological changes.
Furthermore, food is not simply a source of energy, but also a means of building and maintaining social relationships, and reinforcing community cohesion. Today, industrial production, global markets and reduced collective consumption has changed the social value inherent in food. How has individualism, for instance, affected not only our consumption patterns, but their social value in our everyday lives? Could it be that increasing consumption is, in part, an attempt to compensate for the decreased social value of food?
In saying all of this, we should not single out Pacific Island countries. While their population obesity figures are high, current trends suggest that many other countries are not that far behind. Valuable lessons could be learned from their experiences.
*Excerpt from original publication – UBVO Opinion Paper Series, University of Oxford, July 2011. Download the complete paper at www.oxfordobesity.org.
**Amy McLennan is a PhD candidate in social anthropology at ISCA, University of Oxford.
