The Weight of Medical Authority: The Making and Unmaking of Knowledge in the Obesity Epidemic

Concern about the growing rate of obesity in the United States and globally has been constructed as a public health problem referred to as the “obesity epidemic.” Massive public health efforts have been marshalled to address this concern, all premised upon a hegemonic idea about the meaning, measure, and etiology of obesity. This meaning of obesity is presented to the public as a matter of settled science. However, a close reading of the scientific literature reveals multiple, ongoing disputes and controversies within the field of weight science around the meaning, measurement, and control of obesity. This dissertation applies a Science and Technology Studies (STS) lens to the obesity epidemic. Using social worlds analysis and the STS tradition of controversy studies to analyze multiple, on-going debates within weight studies with their resultant contests over authority, validity and meaning-making around obesity I trace the history of three debates within weight-science: the crisis of evidence around long-term weight maintenance, the “obesity paradox,” and the growing support for a Health At Every Size approach to weight. I further investigate the public impacts of knowledge production around obesity through a discussion of weight-related stigma and an ethnographic analysis of fat activist online spaces (sometimes referred to as the Fat-O-Sphere). These groups represent both implicated others and lay-experts in knowledge production about the obesity epidemic