One of these days I'll have to send Frank Pasquale a thank you card for his endless supply of rich blog fodder. His latest post addresses the recent study that pronounced obesity an epidemic in the sense of contagion:
The study reminded me of the troubled place of metaphor in contemporary reasoning. I recall reading many libertarians who dismissed the idea of an obesity "epidemic"--who felt this designation unduly alarmist and politically manipulative. An "epidemic" unfortunately calls to mind quarantines, panic, and an uncontrollable disease vector. But the ideas of "contagiousness" and "communicability" provide useful frames for thinking here, like Dawkin's translation of natural genetics into cultural memetics. (For the legal implications, check out Balkin or Cotter.)
A key question here is: would the "epidemic metaphor" be valid without the empirical study to back it up? I think so, because the "transmission mechanism" here appears to be a change in individuals' understanding of obesity
We've pointed out that the significance of metaphor in making meaning of illness experiences is an integral and fundamental point of inquiry in medical humanities discourse. It's one reason narrative studies has proven so significant in thinking about health and illness, such that Rita Charon -- a physician herself -- argues that narrative thinking is quite literally therapeutic.
Of course, metaphors are so powerful that they can be used for great good or great mischief, as Sontag makes so artfully clear. And Deborah Stone -- no mean scholar of health policy herself -- argues quite persuasively for the importance of metaphor in animating policy discourse.
The use of the metaphor of "epidemic" is heavily value-laden, of course, and carries with it a host of social, political, and social concretions. Gard and Wright make a compelling case for this in their recent book aptly (and ironically) entitled The Obesity Epidemic.
The use of the metaphor of epidemics is highly strategic from myriad discourses -- policy, moral, cultural, etc. -- and perhaps the best demonstration of such power is Camus's The Plague, which characterized an epidemic of plague but was quite advertently used by Camus as a metaphor for Vichy occupation (another excellent example of the use of illness metaphor to make political statements in Solzhenitsyn's Cancer Ward).
Finally, given the stigma that is so pervasive in thinking about fatness, I personally exercise caution in accepting such findings at face value. What does it really mean for obesity to be contagious? That the root causes of the condition are grounded in social practices which are more likely to be shared among intimate groups of peers and family members? This strikes me as significantly unsurprising if one thinks deeply about the social determinants of health.
So the literal results of the study hardly break new ground, IMO. What is novel is the characterization of obesity as truly and literally contagious. And given the history of contagion as a trope for stigmatizing behavior, and the significant stigmatization of fatness in general, I think caution is warranted in accepting such claims at face value.
BLOGVERSATION: Kate Harding's Shapely Prose.
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