Introduction: from measurement to meaning
Consider the following statement, attributed to a medical doctor, from the British Broadcasting Corporation's website (BBC Online 2004):
More than 50% of men in the UK are denting their seats because they are too fat – and the numbers are increasing. You can work out whether you are an OK weight or putting your health at risk by calculating your Body Mass Index (BMI). You can use our BMI calculator to check yours, or perform the calculation by hand: Take your weight in kilograms (kg) and divide it by your height in meters (m) and then divide the result by your height in meters again. Healthy weight BMI=18.5−24.9. Overweight BMI=25−29.9. Obese BMI=30−39.9. Severely obese BMI=40+.
Powerful social institutions routinely present the message, with certainty, that fatness equals badness and sickness and this is a massive and growing problem. This claim is presented as a taken-for-granted fact in societies where fatness is disdained and discredited under the rubric of scientific rationality. Using the BMI, agencies like the World Health Organization (WHO 1998) state there is a global obesity epidemic. Conflating overweight (BMI 25–29.9 kg/m2) and obesity (BMI≥30 kg/m2), which inflates the perceived seriousness of the putative problem, we are told almost ‘everyone everywhere’ (Gard and Wright 2005) is ill, diseased or at risk because of their weight (with ‘weight’ serving as an inexpensive proxy for adiposity).
As with the BBC website and popular anti-obesity books (e.g. Critser 2003), there is much moralising and apparently scientifically justified derision. This obesity ‘epidemic psychology’ (Strong 1990), which, like reactions to HIV/AIDS, is potentially more corrosive than actual biological risks, is also spreading to men, all in their supposed best interests. Indeed, while fat has been described as a feminist issue (Orbach 1997) it is also being very publicly defined as a worrying masculine issue – with masculinity associated with frailty, vulnerability and increased health risk. (See, for example, the front cover of the National Audit Office's (NAO 2001) report.) Using ‘sex difference data’ (Connell 2000), or ‘quantification rhetoric’ (Petersen and Lupton 1998), various organisations state that the current epidemic of ‘excess’ weight is particularly pronounced among men. After presenting the BMI calculation and a height-weight chart, the NAO (2001: 11) write: ‘About a fifth of the population is obese and nearly two thirds of men and over half of women in England are either overweight or obese’. Using more recent data, the UK's Men's Health Forum (MHF 2005), following their Department of Health sponsored conference, report that two-thirds of men in England are now overweight or obese and this is, quite simply, too much.
Despite the equivocal and uncertain status of obesity science (Gard and Wright 2005), these messages are expressed with authority. This reproduces the unacceptability of being seen to be ‘fat’ in visually oriented Western culture. Restated, medicalised measures express and support iniquitous meanings with highly publicised claims about ‘excess’ weight adding to the ‘moral burden of obesity’ (Jutel 2005). This is in a larger society where the fleshy body is an index of the self and the social consequence of perceived bodily neglect is a lowering of one's acceptability as a person (Featherstone 1991). According to the medically ratified view, levels of body mass judged ‘too fat’ constitute a personal and social liability that must be tackled by those who are responsible to themselves and responsible to others. Yet, such healthist claims ignore, among other things, possible discrepancies between medicalised measures and everyday gendered meanings and practices. They gloss over the possibility that ordinary men may be justifiably resistant to medicalised typifications, epidemic psychology and moralised imputations of irresponsibility.
This paper combines a critical take on the obesity debate with qualitative data generated during an Economic and Social Research Council (ESRC) funded project on masculinities and weight-related issues. Rather than propose solutions to a taken-for-granted problem (or apocalyptic problem in the making), it questions the dominant medicalised view. As will emerge, such an approach is possible and indeed wholly necessary even when referring to men who had joined a slimming club and were demonstrably committed to weight-loss. Employing a critical realist approach that is attuned to interpretive, structural and embodied dimensions of social life (cf. Williams 2003), I present different understandings of what is medically defined as overweight and obese. These understandings are related, among other things, to men's displays of moral worth or social fitness in a body-oriented society where ‘fat’ does not ‘fit in’ with the favoured view.
First, some theory, literature and analytic themes
Following recent critical commentary on the obesity debate (see, for example, Volume three, Number four of Social Theory and Health 2005), a critical realist approach is especially apt. This ‘evaluative’ (Porter 1993) approach is able to incorporate phenomenological and micro-interactionist theory (e.g. Goffman 1961, Scott and Lyman 1968, Schutz 1970) and engage with larger iniquitous realities that render bodies incorrect yet correctable. That is important for a humanistic sociology. If the institutionalised war on obesity has negative consequences, such as legitimating intolerance towards heavy people (Jutel 2005, Rich and Evans 2005), then social researchers need to acknowledge potentially constraining structures lest they give ‘consent, through silence, to their oppressive effects’ (Porter 1993: 596). Williams (2003) has recently discussed the value of such an approach. I would refer the reader to that work in order to obtain a more detailed understanding of critical realism: a stance that is often implicit in much writing in the sociology of health and illness.
Embodied sociology is also useful alongside other literature, including recent critical obesity studies (e.g. Campos et al. 2006a, Gard and Wright 2005). This provides an eclectic analytic framework for exploring embodied meanings and practices in a ‘somatic society’ structured around regulating bodies (Turner 1996). It is worth briefly underscoring the import of embodied sociology, as well as other sociologically imaginative approaches (e.g. history, feminism), in relation to this paper's focus before referring to critical obesity literature.
Embodied sociology views bodies as the source, location and medium of society (Shilling 2003). Indebted to feminism, embodied sociology recognises that people are and have bodies (Turner 1996). Here the body is conceptualised as a lived, relational process. Watson (2000), in researching male bodies and health, favours such an approach. When exploring ‘the idea of embodiment’ and indeterminacy, he states that bodies cannot be simply read as objects in relation to culture. Rather, they are experiencing subjects of culture who are able to interact with and resist public health discourses as forms of surveillance (Watson 2000: 115). Extending Connell (1995), Watson (2000) considers various ways of embodying masculinity in relation to what he calls ‘being in shape’. This concept draws from anthropology where reference is made to cultural sensibilities and aesthetics that assert value to embodied meanings. ‘Being in shape’ comprises various ‘modes of construction’. These include normative (presentational), experiential (emotions), pragmatic (the everyday social body) and visceral (hidden biological depths that may be medically visualised). This is a useful typology that will provide analytic purchase when reporting men's understandings of the BMI.
Following the opening extract on the BMI, the institutionalised war on fat is an increasingly medicalised discourse that lends itself well to an embodied sociological critique. For example, if the obesity discourse is interpreted through a Foucauldian optic, then this constitutes a pervasive form of bio-power that is implicated in medicalised (self-)surveillance and efforts to discipline ‘risky’ human bodies. Intolerance towards forms and levels of fatness, even for men, may have recurred throughout Western history (Gilman 2004). However, in epidemic times, medicine – which, especially from the 19th century onwards, has powerfully regulated female bodies (Jacobus et al. 1990) – is intensifying its ‘gaze’ over sexed/gendered bodies. Of course, to reiterate Watson (2000), even medicalised power meets with resistance: an empirical reality explored within interactionist sociology well before Foucault and poststructuralist theory (e.g. Goffman 1961). Yet, men's resistance to medical definitions of ‘appropriate’ weight is unexplored territory within medical sociology.
Whether citing Foucault on the macro-regulation of bodies or Goffman on the micro- interactional construction (and attempted destruction) of embodied selfhood, exploring this uncharted terrain also demands some form of feminist consciousness. This is because the social is a gender-differentiated world, embodied by people hierarchically sexed as male and female. Certainly, men are often urged to lose weight and ‘shape up’ in a moralised context where vocabularies of the discredited body are gender specific (e.g. slob and fat bastard). As discussed by Davis (2002) in relation to cosmetic surgery, however, it would be dubious to claim there is sexual equality in contemporary body norms and practices. Compliance to and endorsements of bodywork are heavily gendered and are inseparable from socially constructed and asymmetrical perceptions of ‘fat’, ‘thin’ and ‘bodily bigness’. This asymmetry, which is shifting and dynamic but has historical antecedents in what Stearns (1997) calls ‘the misogynist phase’ in US dieting culture (1920s to 1960s), manifests itself in gendered inequalities in aestheticised body norms. Here the meanings associated with ‘larger’ male bodies – flesh and blood bodies that comprise variable proportions of fat and fat-free mass (e.g. muscle and bone) – need not ‘spoil’ (Goffman 1968) masculine identities. Indeed, as with male bodybuilders, a big albeit lean body, which would be labelled overweight or obese on BMI, is intentionally developed and valued (Monaghan 2001a). This gendered inequality goes some way in explaining a seeming paradox observed during this research – namely, many men's willingness to lose weight but their refusal to embody a medically defined ‘healthy’ weight: a case of ‘secondary adjustment’ where the man ‘holds himself off from fully embracing all the self-implications of his affiliation, allowing some of his disaffection to be seen, even while fulfilling his major obligations’ (Goffman 1961: 161).
Aesthetic inequality is neatly captured by Campos (2004) who draws from Wolf (1991) and other feminists when critiquing ‘the obesity myth’. His words also resonate with Connell (1983) who states ‘[t]o be an adult male is distinctly to occupy space, to have a physical presence in the world’ (cited by Morgan 1993: 72). Campos (2004) comments that if Jennifer Aniston had the same BMI as Brad Pitt, who is technically overweight, she would weigh approximately 55 pounds (almost 4 stone) more than she does. Both these actors embody contemporary Western ideals of physical attractiveness. However, if Jennifer's BMI matched Brad's, she would clearly transgress hegemonic femininity and risk social stigma (regardless of whether her extra body mass comprised muscle or fat). Gender and ‘naturalistic’ (Shilling 2003) conceptions of the sexed body are thus central when exploring men's ability to accommodate a level of body mass that medicine labels overweight or obese. Of course, to borrow from and extend Watson's (2000) research, this is not only about ‘the look’ or normative modalities of embodiment. Other embodied concerns are also pivotal for men, including emotional wellbeing and metabolic health as constructed and experienced within gendered fields of power.
Importantly, there is nothing natural or inevitable about accommodating a larger male body (a body that need not be seen as fat despite medicalised claims to the contrary). While sexual divisions ‘appear to be in the order of things’ they are socially constructed, ‘functioning as systems of schemes of perception, thought and action’ (Bourdieu 2001: 8). In discussing masculine domination and the social construction of bodies among the Berbers of Kabylia, Bourdieu (2001: 9) states ‘[t]he strength of the masculine order is seen in the fact that it dispenses with justifications’. Yet, in times of perceived social crisis, it is not always easy for men to take their bodies for granted (Morgan 1993) just as, within late modernity, the fashioning of identities and bodies is seldom an unreflective given (Giddens 1991). Men's bodies, if (self-)identified and negatively typified as ‘overweight’ or ‘obese’ or ‘fat’ in contemporary Anglophone culture, become accountable action problems to be excused, justified, corrected and/or accepted. Extending an analysis presented elsewhere (Monaghan 2006), this paper honours men's justificatory ‘accounts’ (Scott and Lyman 1968) that challenge the BMI and associated moral positioning. Such accounts, where responsibility for the questioned is accepted and its pejorative status challenged, constitute vocabularies of accommodation for bodies that could be labelled too heavy or fat. In interpreting men's words, I argue these should be respected rather than corrected, not least given the more general problems associated with the medicalised obesity discourse.
Specific problems with the BMI aside (e.g. it does not actually measure adiposity), some readers, such as health professionals, may be inclined to interpret and dismiss men's non-conforming words within a different idiom that is legitimated by medical science. However, recent academic literature also seriously challenges medicalised understandings of overweight and obesity (e.g. Aphramor 2005, Campos et al. 2006a, Gard and Wright 2005). As well as questioning the ethics of the dominant obesity discourse, such as size discrimination and oppression (Rich and Evans 2005), contributors question the certainty of the primary research field from which obesity epidemic claims emanate. Gard and Wright (2005) make an extremely important contribution to this debate. They offer a well-informed critique of obesity science in order to challenge, among other things, the idea that vast numbers of people are necessarily ‘sick’ or ‘diseased’ because of their weight. They convincingly argue that the science of bodyweight is shot through with contradictions, questionable assumptions and uncertainties. They add that this field is inseparable from ideology and morality with those claiming there is an obesity epidemic routinely presenting empirically unsubstantiated arguments. These authors, along with Ross (2005), state that despite the certainty and simplicity of obesity epidemic thinking, the connection between bodyweight and health is complex, tenuous and contradictory (especially at an individual level). They add that given the ethical implications of fat fighting, there is a need for measured reasoning rather than unreflectively reproducing age-old habits of mind (e.g. narratives of gluttony and sloth that potentially shame and blame individuals). Of course, if the fight against fat proceeds regardless then what we are dealing with here is a complex mix of cultural prejudice and other social, economic and political considerations rather than ‘pure’ science.
Other recent literature, which again draws from the primary scientific field rather than everyday life, affords a critical and humanistic edge to my work. Such literature provides an informed rationale for not viewing so-called laymen, like those contacted for this research, as necessarily in need of correction when they resist dominant understandings (a resistance that for them is more often related to identity than science). Space constraints mean this literature can only be briefly mentioned. However, commentators such as Campos et al. (2006a, also, see Campos 2006b), in a recent point-counterpoint piece in the International Journal of Epidemiology, seriously challenge the orthodox view. Their sociologically imaginative paper includes reference to up to 35 years of non-conforming scientific evidence that contradicts the claim that overweight and obesity per se are significant risk factors for illness and death. Unsurprisingly, given the powerful vested interests in this field, some of their arguments are simply dismissed by others; i.e.‘anti-obesity activists’ (Saguy and Riley 2005) who fail to reference, or perhaps choose to ignore, other critical work that also seriously challenges their moralised position (e.g. Gard and Wright 2005, Aphramor 2005). However, regardless of whether or not readers agree with everything Campos et al. (2006a, b) state (certainly, greater emphasis could have been given to social structural rather than lifestyle factors in relation to health), this important literature highlights the degree to which obesity science is highly equivocal and open to serious contestation within the primary field.
Although important, prescient and drawing from sociology, this literature could be expanded upon and complemented in other sociologically imaginative ways. There is a need to engage with, while stepping beyond, obesity science and to do so with reference to everyday gendered meanings using a qualitative methodology. A multidirectional critique of the obesity discourse should also incorporate insights from below, the ‘underbelly’ of social life. This paper does precisely that, helping to redress the virtual lacuna of empirical studies on men's everyday understandings (Monaghan 2005a). In so doing, I do not force men's accounts into a pre-established rejection of the orthodox biomedical view. Rather, their words are interpreted within a theoretically informed take on the currently truncated obesity debate (Monaghan 2005b, Aphramor 2005). Such an approach recognises that there are situationally good reasons why ordinary people may enthusiastically endorse healthism and slenderness though there may be better reasons for rejecting or modifying such thinking even when people seek to fulfil its major obligations.
In formulating this research I wanted to engage with the obesity debate and bring men's ‘missing voices’ into the discussion. However, given the problems associated with a singular focus upon so-called obesity (Cohen et al. 2005), data were generated on issues that could be related to, but which were not always directly about, weight. Qualitative data were generated on the meanings of health, physical activity through the lifecourse, food and diet, body image, slimming and other sociologically relevant concerns (e.g. relationships with family, friends and colleagues). These are issues that all men are able to talk about regardless of whether or not they have adopted a ‘fat identity’ (Degher and Hughes 1999).
Various methods were employed and contexts explored. Some of this research, which has been published elsewhere (Monaghan 2005a), included a conscious altering ‘virtual ethnography’ (Hine 2000) of, in and through online size acceptance and admiration groups. Offline research, which informs this paper, included nine months ethnography at a mixed-sex commercial slimming club in Northeast England. I undertook four months fieldwork at three classes and a research associate undertook five months fieldwork at two classes. Classes were held by a slimming organisation, which I call Sunshine (names of people, places and organisations are pseudonyms). Published literature from Sunshine reports a national membership of 250,000. A rival company, Fat Fighters, was also approached as part of an overt research strategy but they refused access. While observation was not undertaken there, former or current members were interviewed: some dissatisfied members switched their allegiance to Sunshine, just as some members from Sunshine subsequently joined Fat Fighters.
Weekly classes were, with the exception of one, held in a church hall. Sandy headed three classes. Like other consultants, Sandy also regulated her weight through diet. Classes met for approximately one hour each week. Members, the consultant and other workers (who were often unpaid members volunteering their services) aimed to support each other as they embodied potentially disappointing rationalising processes, i.e. measurable weekly weight-loss through a modified diet. Consultants undertaking ‘emotional labour’ (Hochschild 1983) sought to make classes as pleasant as possible for their members and there were commonly shared rituals across sites. These included cheering and clapping when members’ weight-loss was publicly announced and quasi-religious group ‘therapy’ sessions. During therapy members shared ideas and confessed their dietary misdemeanours with the goal of obtaining practical knowledge, assuaging guilt and reaffirming individual and collective commitment to the plan. Even so, there was a high rate of attrition in line with clinical observations that most dietary approaches to weight-loss fail (Aphramor 2005).
Slimming clubs are predominantly female spaces, though one of Sandy's classes regularly attracted up to 20 men each week out of approximately 30 attendees. The typical male slimmer was from a working-class background, White, in his forties or fifties and presenting as heterosexual. As far as was practicable, informed consent was obtained from participants in line with the British Sociological Association's code of ethics. Sandy was particularly helpful in that respect, acting as a gatekeeper and locator who made proper introductions to her members. Other ethical considerations in the field included being respectful to people and circumspect about using potentially stigmatising labels such as ‘obesity’– a term which respondents often avoided or rejected (Monaghan 2006). As with ethnography more generally, discussion was framed using their terms of reference (e.g. bigness, weight, size). Apparently neutral yet morally loaded biomedical terms such as overweight and obesity were used cautiously and we never introduced these as direct personal referents.
Unlike Stinson (2001), who, in her ethnography of a US slimming club, followed the organisation's weight-loss programme, we openly undertook fieldwork as observers not slimmers. In offering a reflexive note, in line with the requirements of embodied ethnography, I have spent all my adult life engaged in vigorous exercise in order to gain weight. That may strike some readers as an oxymoron, but such is the power of obesity epidemic psychology! By regularly lifting weights over the past 15 years, my not always fully realised intention has been to gain and retain lean muscular weight on an otherwise ‘skinny’ male body (my definition based upon gendered aesthetics). My research associate does not lift weights and describes himself as ‘thin’ verging towards an ‘average build’.
Audio-recorded depth interviews were also undertaken with men (N=37). I conducted 25 interviews and my research associate conducted 12. All interviews were fully transcribed, indexed and analysed. Interviews lasted between one and two hours. Given our focus upon meaning rather than actual measurement, men were not recruited because their BMI was likely to equal or exceed 25 kg/m2. The aim was to understand body-subjects in line with the requirements of interpretive sociology rather than the ‘objectivist’ requirements of medicalised height-weight studies, which, as discussed by Knapp (1983), are open to sustained methodological critique. However, like most men in England (NAO 2001), the majority of interviewees were reportedly at a weight-for-height that medicine deemed unhealthy.
Eighteen interviewees were current or former slimming club members. Five interviewees were also recruited through a fitness centre. They had joined this centre within the previous six months primarily to lose weight. Other men, contacted through different channels (e.g. friendship networks), were not necessarily concerned about losing weight and did not always define themselves as having a weight problem. Respondents’ ages ranged from 16 to 79 and the mean age was 43. All were White, with the exception of two men of Afro-Caribbean origin. Six interviewees were educated to university level (including postgraduate), though only one of these was from the slimming club. Various occupations, including a few professions, are represented. Jobs included: university researcher, nurse, teacher, mechanic, lorry driver, shop assistant, porter and doorman. This small sample is obviously not statistically representative but it offers depth and richness of data. These data were imported into, and analysed using, coding software, Atlas.ti (Muhr 1997).
Before presenting and analysing data I should clarify my intentions. My primary goal is to support a humanistic and sociologically-grounded understanding of health. This approach repositions biomedical bodies as embodied subjects who are situated within and constituted through broader social relationships, processes and structures. It critically engages with medicalised arguments and the largely ineffective and ethically questionable obesity discourse. Moving beyond the confines of sociology, this research has policy relevance and it is my hope, but not necessarily my expectation, that it will encourage a more humanistic approach among those who are inclined to accept, reproduce and act on the basis of morally loaded obesity epidemic claims. Finally, as an antidote to obesity epidemic psychology, I should note that there is ironic scepticism and humour in this study as men embodied a version of social fitness. Even when researching a serious topic, there is a comic dimension to social life (Berger 1963).
Men's critical understandings of ‘appropriate’ weight-for-height
Awareness of the BMI or, more generally, ‘standard’ definitions of ‘appropriate’ weight-for-height, was high among men contacted during this research. Information sources included clinicians, the media, family members and slimming clubs. Sunshine, for example, did not expect members to conform to BMI prescriptions but a chart was included in the back of their slimming handbook while Fat Fighters reportedly ‘told’ members to conform to the BMI.
Men did not always express a precise knowledge of BMI thresholds for ‘excess’ weight (e.g. a man who is 5′10″ and 12½ stone is overweight and at 15 stone is obese according to current BMI definitions). Nor did they necessarily distinguish between the biomedical concepts of overweight and obese in a strict technical sense, though volunteered comments indicated that their definition of ‘obese’ was associated with statistical or visual extremes rather than more inclusive biomedical definitions. In short, these men's interpretive schemes or ‘systems of relevance’ (Schutz 1970) meant that exact knowledge and endorsement of BMI definitions was often uncalled for or avoided. Alongside their more aestheticised evaluations, explicitly discriminatory words like ‘overweight’ and ‘obese’ were primarily used in ways that were compatible with interaction rituals rather than scientific protocol, i.e. being respectful to embodied subjects (self and others) rather than hierarchically grading (degrading) objectified, measurable bodies. To use Bourdieu's (2001) language in relation to imposed domination and symbolic violence, this was a case of cognition rather than submissive recognition. That said, many men offered scientifically compatible commentary on the BMI. Emotions were also sometimes colourfully expressed, especially if exact clinical definitions of overweight and obese were previously unknown and were cited by the researcher. Such occasions challenged their taken-for-granted understandings, soliciting consternation much like Garfinkel's (1967) ethnomethodological breaching experiments.
Before exploring men's critical understandings, it should be acknowledged that everyday talk about, relating to and surrounding the BMI is not always critical and such words do have positive functions. For example, reference to the BMI sometimes serves as a springboard for discussing weight and health-related concerns more generally, enabling men to present themselves in a steady ‘moral light’ (Goffman 1959). For at least some men who were seeking to lose weight, endorsing the BMI enabled them to display a version of social fitness, i.e. doing being knowledgeable about official definitions and being seen to be concerned to achieve a ‘healthier’ if not medically ‘healthy’ weight. However, explicit endorsement of and an expressed intention personally to achieve biomedical norms was exceptional. Only two men, both slimmers from middle-class backgrounds (a retired school headmaster and a retired bank manager), expressed their intention to comply with the BMI. As well as their similar generational and class habitus, both said they had been recently advised by clinicians to lose some weight. Three other slimmers, one of whom was not part of the interview sample, said they complied with the BMI in the past though they subsequently revised their goals.
Most men contacted for this study, including those who reported that their weight or ‘fatness’ was a problem for them (or had been made problematic by others such as clinicians, partners and people in the street) distanced themselves from the BMI, the supposed ‘gold standard’ measure of adiposity (Ruppel Shell 2003: 33). Situational proprieties had to be carefully observed when broaching this issue, but, when discussion did turn to this, men's definitions of appropriate male weight-for-height were often much more accommodating than current yet historically shifting and scientifically contentious criteria (Ross 2005). Indeed, even though some respondents initially expressed their acceptance of height-weight charts this was subsequently qualified (e.g. age should be taken into account, the BMI is no more than a rough guide). It should be stressed that this did not necessarily mean men were unwilling to lose weight. What this did mean, however, was that practically all men were willing to accommodate a level of weight that would be considered medically unhealthy. The following ethnography captures some key themes:
Field diary: Reflections after interviewing Doug (respondent 17). This 55-year-old admin clerk, recruited from a slimming club, initially accepted the BMI which his doctor used, ‘because they must have researched into it’. Such acceptance was unusual, even among men committed to weight-loss, and it initially surprised me: other men I interviewed (including, but not limited to, those attending slimming clubs) were scathing. However, later in the interview Doug said his ideal weight was about a stone above medically recommended levels, which was two stone below his current weight. He then talked about how everybody is different, plus how people his age would look ‘daft’ or ‘ill’ if they weighed the same as they did when in their twenties. Part of his argument was that bodies naturally ‘bulk out’ with age. When saying this he slightly puffed out his arms and glanced at his shoulders. His actions suggested that such weight was more or less acceptable, not least because he subsequently defined ‘obesity’ using his hands to signify a huge mid-section.
Aside from Doug's initial yet subsequently qualified acceptance of the BMI, this extract contains many relevant themes. These include: the discrepancy between medical and everyday definitions of obesity; identifying a personally acceptable weight, which exceeds medically recommended levels; the heterogeneity of bodies, which cannot be standardised; slimness equalling illness, especially for older men; and the more or less acceptable distribution of weight around the divisible male body (e.g. shoulders or abdomen). In an age of risk and uncertainty, where obesity epidemic claims could discredit almost everybody, such talk is related to personal coherence or what Giddens (1991) calls a reflexive project of self. Or, in offering a more gendered reading, these are masculine validating words. They assuage possible imputations of irresponsibility, vulnerability and effeminacy which are stereotypically ascribed to bodies seen to be overweight, obese or fat.
The following elaborates upon some of these, and other commonly expressed, themes. Men's accounts or vocabularies of accommodation, which ‘justify’ (Scott and Lyman 1968) levels of body mass typified as overweight or obese according to BMI, include: (1) the compatibility of heaviness, healthiness and physical fitness; (2) looking and feeling ill at a supposedly ‘healthy’ BMI; and (3) rejecting irrational standardisation. Other themes are also identifiable in my data. For example, a ‘suspicion’ that the ‘untrustworthy’ insurance industry has been pivotal in developing height-weight charts. Or, comparing the BMI with government endorsed guidelines for alcohol consumption that are easily and often exceeded by people wanting to enjoy themselves. However, most critical arguments, which were directly or indirectly levelled at the BMI, could be subsumed under these headings.
Even Arnold is ‘obese’: the compatibility of heaviness, healthiness and physical fitness
I mean, when you consider Arnold Schwarzenegger's BMI is over 30 it makes a complete mockery of it all really (Mitch).
Mitch, in displaying moral worth, told me he had been a member of Sunshine for five years. He added that he had lost six stone but he was currently two stone above his personally defined target weight ‘because life gets in the way and you put a bit on when there's things going on like holidays’ (Field diary, slimming club). Mitch, who was in his early forties, explained that his BMI was between 28 and 30. However, he disagreed with this index for several reasons, with his words constituting ‘an apparently natural justification’ (Bourdieu 2001) rather than an ‘excuse-account’ (Scott and Lyman 1968) as with his reference to holidaying. After saying ‘I looked ill when I got down to the ideal weight for my height’ (see next section), he reasoned this index had no credibility because it defined Arnold Schwarzenegger, the former elite bodybuilder and Hollywood action hero, as obese. Mitch, similar to Doug and others quoted below, was not suggesting he was extremely muscular like Schwarzenegger. Rather, given his other complaints and commitments, his talk implied that physical fitness, healthiness and masculine worth were not the preserve of men with a medically ‘correct’ BMI.
Health authorities certainly acknowledge that the BMI does not measure body fat and is problematic when applied to muscular men. For example, the US Centers for Disease Control and Prevention (CDCP) website featured cartoon caricatures of a male bodybuilder and a man with a rotund physique, along with disclaimers about the limitations of the BMI (CDCP 2004). Yet, the weight-centred approach to health was endorsed when it stated: ‘[a]s a person's BMI increases the risk for many diseases increases as well’ (CDCP 2004). Aside from commonsense and obesity science which throw that sweeping generalisation into question (Campos et al. 2006a, Cogan 1999), non-bodybuilders such as Mitch maintain that they too may be healthy even when at a weight that medicine labels overweight or obese. Yet, and certainly for Mitch, he felt obliged to lose weight for aesthetic reasons. While talking to Mitch close to the slimming club weigh-in desk – a ‘zone’ of ‘normative embodiment’ (Watson 2000) where bodies are objectified – he said he originally lost weight to improve his appearance rather than health, which was reportedly good. While his words perhaps say more about his presentation of self (Goffman 1959), and subjective definitions of health, than his physiological status, they are plausible given medical reports of people who are ‘metabolically normal’ yet ‘obese’ (Campos et al. 2006a: 57). Mitch, in invoking ‘visceral embodiment’ (Watson 2000), obviously resented weighty social prescriptions, the moral obligation to embrace slimming culture: ‘I mean, if your health is good within certain parameters, like blood pressure, why should you HAVE to lose weight?’
Metabolic health and ‘the look’ may be distinct, with the pursuit of the latter in its more stylised or exaggerated masculine (muscular) forms attracting criticism from ordinary men (Watson 2000). However, the aestheticisation of men's bodies and the representational significance of health in consumer culture (Monaghan 2001b) are buttressed by the medicalised disparagement of male fatness. There is a rationalisation of the aesthetic, or, to borrow from Watson (2000), within the dominant obesity discourse there is a conflation of normative embodiment with the visceral. This also impacts upon experiential embodiment, masculine identities and the idea of ‘being in shape’ (Watson 2000: 115). This is evidenced beyond my sample. Klein (1996), writing before the intensification of obesity epidemic psychology, may have felt able to assert his masculinity when stating ‘there are times when I value and appreciate my fat [ . . . ] it makes me feel bigger and stronger, more impressive and more serious’ but his words immediately follow his reference to the ascribed medical risks of abdominal fat and then an admitted ‘constant dissatisfaction with my fat’ (Klein 1996: 66). Medicine is inseparable from this moralised, aestheticised and personally experienced ‘degradation ceremony’ (Garfinkel 1956) which has a history comprising the fabrication of the ‘ideal’ male form that normalises, marginalises and stigmatises different groups of men and women (Petersen 1998). Before citing other men, the risks of this bodily degradation are briefly worth reflecting on.
In societies where masculinity is thought to proceed from men's bodies (Connell 2000), the disapprobation of men's bodily bigness as emasculating (sickness producing) fatness potentially spoils moral worth and identities. In interpreting larger men's intersubjective understandings within such a context, I would embody Schutzian phenomenology (1970) and offer the following statement. Possible subordination on masculine hierarchies may emerge as a topically relevant risk (see Watson 2000: 117–8). This risk, though attenuated in face-to-face-interaction with considerate others or ‘the own and the wise’ (Goffman 1968), may be imposed upon consciousness from outside or become thematic through volitional self-interpretation. Correspondingly, the idea of the technically obese yet physically robust man (e.g. the male bodybuilder) has gendered cultural currency even among men who are not strength athletes and, as will be seen below, recognise that ‘excess’ muscle is also likely to be culturally disparaged (but not feminised in the way that fatness often is). This idea element may become motivationally relevant in order to refute the BMI, allowing heavy men to construct masculine selfhood and eclipse the increasingly medicalised degradation of their own and/or other men's bodily bigness as unhealthy fatness.
Similar to Mitch, others mentioned Schwarzenegger, or members of the English World Cup winning rugby team, as a way of critiquing the BMI. If their weight was a problem for them, or had been defined as a problem by others, then such talk helped to negotiate potentially ‘spoiled identities’ (Goffman 1968). The common line among men seeking to regulate their weight was, ‘muscle weighs more than fat’ which could be read as ‘not all of my bodyweight comprises unhealthy (sic) fat, I have muscle too, and that will register on the scales’. I would add that ‘muscle talk’, which reproduces the myth that sport and lean body mass are intrinsically healthy, was not an artefact of my interactions with men and how they may have perceived my body build. My research associate generated similar data. In short, reference to heavy yet physically fit-looking and/or active men was recurrent when critiquing the BMI. And, this was not only voiced by men who defined themselves as having a weight problem. Duncan, a barrister's clerk, who at approximately 5′6″ tall and 12 stone described himself as having ‘no particular weight issue really’, said the following to my researcher when asked about the BMI. Elsewhere this 22-year-old described his body as ‘broad shouldered [with] a relatively short frame’ and while he was not a gym member he said he did press-ups and sometimes lifted free-weights at home:
I don't know when it [the BMI] was put together but it sounds like it might have been of the time when the only people who ever worked out [exercised] were sportsmen and there was no culture to anyone wanting to be more healthy or increased muscle mass or what have you. I mean the thing that highlights it for me, I have never really looked into it a great deal, but I read an article sometime ago about it and it said going by the BMI Jonny Wilkinson [English Rugby hero] was clinically obese [laughing] (Interview 28).
Similarly, consider another of my researcher's interviewees who talked about elite rugby players. Jason, aged 38 and ‘a shade off six foot and probably 141/2 stone’ was a university researcher in the area of social policy and mental health. Similar to Duncan, Jason was interested in keeping physically fit though he differed in terms of body image because he said ‘I'd like to be smaller than I am’. Elsewhere in the interview, Jason said his doctor told him to lose weight but he subsequently gained weight (developed more of a mesomorphic shape) after exercising more. His reported exercise regime included daily eight mile runs and weight-training that, somewhat ironically, meant ‘the fitter I got the more unhealthy I was on the scales’. Jason's additional comments on the unintended consequences of a war on obesity, expressed as a depersonalised cautionary account that extended beyond his personal weight concerns, are also worth citing. Although respectful of medicine, in doing compassionate masculinity he echoed feminist work that ‘reminds of the dangers of messages and other social practices that tell women (and increasingly men) that their bodies are inadequate’ (Gard and Wright 2005: 156). After being asked, ‘what do you think of the government claim that two-thirds of men are overweight?’ he replied:
Yeah. I mean I'm not a medical person. I probably spend most of the time trying to be constructive [but] I don't know what that means. I mean if that's based on the BMI, I mean probably half of the England rugby team are overweight. You know, certainly the packers, forwards are. But I'd like to tell the government to explain to me why they’re unhealthy when they could be, you know, run around and make tackles and running round the field all day. I think you know, I don't know quite what they mean. I don't know whether it's really helpful to kind of cram into that media kind of moral panic. Yeah. I don't know what they expect. Yet the problem with that is maybe there could be a lot of people feel even more inadequate and upset and unhappy with how they are. You know, because they feel they’re unhealthy. Not only do they feel overweight, they feel fat. But now they've been told they’re clinically overweight and now they've got probably a mental health issue and that makes them feel – so what are they going to do? They feel bad about themselves and feel mentally unhealthy amongst other things (Interview 32).
Muscle or athlete talk, which is obviously not much of an option for most women and children, enabled other men to deflect possible moral opprobrium. This talk, which derives symbolic meaning in relation to sex specific corporeality and the potential for real material practice in a socially divided world, helps to preserve and project appropriate masculinities. Muscle talk also emerged when interviewing Brad, my youngest interviewee, aged 16. In providing additional context, Brad told me about fat-related taunts from his father, friends and others during his recent schooldays – something which may be equally if not more powerful in determining body image and emotional wellbeing than actual bodyweight or BMI (Cohen et al. 2005, Eisenberg et al. 2003). Like Jason, Brad was unencumbered by common gendered role obligations (marriage and fatherhood) and was in a favourable position to use a nearby fitness centre which he had joined five months previously specifically to lose weight. Reportedly peaking at 161/2 stone at 6′3″ tall, Brad had since lost most of his unwanted weight though he regained some during the recent Christmas festivities. Brad was also in the first year of a college sports science course. His studies included fitness tests and ‘objectively’ grading his own and other students’ bodies by weight. He disagreed with this measurement of ‘healthiness’ because it jarred with his embodied experiences and athletic capabilities:
Brad: Looking at our coursework, we had graphs which showed how heavy you are in total and what you should be. I was just above the overweight for your health. But I would consider myself to be quite healthy because I can run quite far distances and can do a little bit of training and stuff. So, according to that I am overweight but I would still say that I am healthy.
LM: What do you think of height-weight charts?
Brad: I think they’re a bit, erm, not quite correct. Because over at that time I built up some muscle and stuff. And muscle weighs heavier than fat [at a given volume]. So that makes you heavier. So you could have somebody like Arnold Schwarzenegger and he would be way above for his height and that, because he has so much muscle. He's going to be heavy (Interview 7).
Similar to Mitch, Brad was not claiming he looked like, or thought he looked like, Schwarzenegger. Although I thought this broad-shouldered young man looked physically fit and strong, his words had a different meaning. Given a history of teasing, and his recent immersion in rationalising yet potentially irrational processes (being negatively labelled on the BMI, monitoring his fluctuating bodyweight), Brad was stating he should not be typified as unhealthy or softly feminine: as well as citing good physical fitness, his physique also comprised muscle that elevated his BMI. Of course, as well as preserving masculine selfhood, such words reproduce embodied gendered hierarchies where the matter of differentially endowed male bodies matters in indeterminate ways. This is indeterminate because the neat distinction between ‘muscular’ and ‘fat’ bodies, while ideologically important, is an empirically questionable dichotomy. Men's physiques are actually highly heterogeneous and changeable in terms of their organic composition. Static ‘typifications’ (Schutz 1970) such as ‘fat’ and ‘muscular’ may be convenient social constructs but there is indeterminacy and overlap between male body types which, within certain parameters, are modifiable. For example, bodybuilders ‘bulk up’ and increase their body fat reserves in-between physique competitions. They also have physiques that are sometimes considered ‘fat’ by non-participants even when relatively lean (Monaghan 2001a).
Similarly, consider Mike's take on the BMI. Mike, who was not part of my slimming club or fitness centre sample, was a 43-year-old school mentor who informed me that he regularly played football at work and had lifted weights in the past. After being told to diet by a doctor, Mike conceded that he needed to lose weight from his stomach. However, he remained dissatisfied with the doctor's blunt pronouncements that he was ‘too heavy’ (seriously unhealthy). Mike stressed that he was physically active, had good fitness or stamina and there was solidity to his limbs from his current and past involvement in exercise. This solidity was taken as an index of muscularity and masculinity. Mike's reference to past weight-training, his highly defined calf muscles from football and his knowledge of champion bodybuilders, buttressed his sense of masculinity when recounting authoritatively imposed vulnerability. Finally, while Mike acknowledged that he carried unwanted weight on his stomach, and clinicians define ‘male abdominal obesity’ as particularly harmful (Haslam 2005), there is exercise physiology which maintains that even when men have a large waist-girth this is not necessarily a risk factor for death (Lee et al. 1999):
Mike: I've seen one doctor and she was quite brutally frank I think. That's the only way I could put it. She said, ‘if you don't lose about four stone you’re going to die’. They were her words. Simple as that. You know? I knew I was heavy [5′6″ and about 17 stone at the time], but I thought, and still think, I'm reasonably fit, although I'm heavy. I mean, all my [unwanted] weight is on my stomach. My legs and that, from playing football, are solid. And I think these weight levels, from top to bottom, are not typical of what maybe someone who trains [with weights], who is going to be massively heavy . . . I've got quite biggish legs from training. I've got the best calves I've ever had. I couldn't get calves like this when I weight trained. From playing football. Brilliant definition [muscle clarity].
LM: So what do you think of height-weight charts?
Mike: I think it's this relevance about what you’re doing. You know, when they done the Mr. Great Britain, or Universe, locally. Some of the lads there were massive. I mean there were some big, big lads. It was when Eddie Elwood was just coming on the scene, ’91 time. And they were massive. Now you cannot tell me, when he gets on the scales, and he's 18 stone of meat, that he's obese . . . I don't think there'd be many people who would say that bodybuilders were obese. They might say that they look grotesque, but I don't think you'd find anybody who would say [they’re] obese even if that's what it says on the BMI. The Body Mass Index (Interview 3).
Bodybuilding is a-typical and constitutes an extreme case. Nonetheless, sport and physical activity more generally are important ‘body-reflexive’ practices for constructing masculinities (Connell 2000). The earlier quote from Klein (1996), for example, on medical risk and masculine presence immediately follows his reference to running, sit-ups and stretching, i.e. disclaiming, as well as gender affirming, talk. Despite negative cultural stereotypes about so-called overweight or obesity, most men who could be medically typified in this way are, or have been, physically active in their lives. In displaying social fitness, men contacted during this research often discursively valued sport and/or physical activity even if they were not currently active. (Physical activity is intertwined with pragmatic embodiment and the fulfilment of gendered role obligations, such as working in a manual job or going for walks with the children and family dog.) Their past or present involvement, and an embodied knowledge of their own fluctuating weight and physical fitness, also provided fuel when dismissing height-weight charts and anybody using these as part of their health-related work.
This point is neatly captured in Henry's account. Aged 67 and about 5′4″ in height, this retired telecom engineer told me he had peaked at 17 stone but set his own target weight at 12 stone when joining Fat Fighters. His target weight was higher than that recommended on height-weight charts and by his slimming club leader for eminently sensible reasons. I found Henry's words humorous. As he argued, an unbridgeable gap existed between external prescriptions and his embodied biographical understandings (these are part of different worlds). While some readers, such as health professionals endorsing the BMI, may question the ways in which some slimming consultants use this index, it remains that the BMI is the standard measure when socially constructing the obesity epidemic and claiming almost everybody is worryingly fat. Following Henry's army reference, it is also worth noting that the British army have just increased their BMI threshold for male recruits from 28 to 32 (i.e. two points above the WHO definition of obese) in order to allow fit, strong men to become soldiers (BBC News Online 2006). That casts an especially critical light on the BMI and dominant constructions of obesity because military settings are deeply intolerant towards men's fatness (see also Stearns 1997: 100):
Henry: According to the books and charts that they [Fat Fighters] use I should weigh 10 stone 5 or 6, which is absolutely ridiculous. Ludicrous. I mean, the fittest that I ever was in my life was when I did national service. I weighed 10 stone 12 when I was 21 when I went in [the army]. I didn't used to do any exercise, apart from going for walks in the country. Nothing strenuous . . . And the corporal said to us, ‘you lot are fat! I want at least half a stone off every one of ya by the time I've finished with ya!’ And we bloody worked hard. We did assault courses. We did rope climbing, we did gymnastics, we ran everywhere and we jumped everywhere. And at the end of three months I got weighed and I was exactly 10 stone 12, which was the same weight I was when I went in. And I pulled this corporal and he said, ‘well, fair enough, though there is no fat on you is there?’ He said, ‘that's the difference’. But at 21 I was 10 stone 12, and super fit for me. I mean, we were doing 20 mile hikes and stuff like that with the full kit on. And it wasn't just walking. You'd run, walk, run, walk. But I didn't change weight. If I was 10 stone 12 then, and I come along now as a 67-year-old and they say ‘you should be 10 stone 5’ I say ‘get off! Get off like’. Ya know? ‘Which planet are you on?’
LM: [laughing] Was she using the BMI chart?
Henry: Yes. She looked in the book, go down, and, dum de dum, that's what weight you should be (Interview 8).
Skeletons, anorexics and anaemia: looking and feeling ill at a ‘healthy’ BMI
If we were all the weight we’re supposed to be, we'd all be bloody skeletons (Howard).
Ethnography on bodybuilding ‘ethnophysiology’ (i.e. subculturally learnt ways of looking at and experiencing the body) describes the embodied pleasures of vibrant physicality, of ‘looking good and feeling good’ (Monaghan 2001a,b). These positive meanings, which relate to what Watson (2000) terms normative and experiential embodiment, contrast with the meanings ordinary men often ascribe to supposedly ‘healthy’ BMI levels: a case of looking ill and feeling ill. The former, presentational modality of male embodiment was clearly expressed by Howard when talking about skeletons. Aged 56 and working as a haulier, Howard said he had ‘a lorry driver's belly’ while other parts of his body, notably his legs, were thin. Howard, who was not recruited through the slimming club or fitness centre, eschewed a stigmatised ‘fat identity’ (Degher and Hughes 1999) and said he had never dieted. He elaborated upon his skeleton comment, making reference to other people's perceptions of dramatic weight-loss and health. I had good rapport with Howard, and his wife of 35 years, Sheila, and he was comfortable being interviewed in her presence:
Howard: I don't consider myself to be fat although I am probably two or three stone overweight if you go by those charts.
Sheila: [Joking affectionately] You've only got sparrow legs though haven't you?
Howard: Chicken legs [laughter].
LM: What do you think of those charts? Because according to those charts two out of three men – and these are the terms that they use and not what I'd use – are overweight or obese. You said something earlier: if we went off that we'd all be skeletons. I wondered if you had more to say about that?
Howard: Well my height [5′10″] and weight, I should be about 111/2 stone. So I'm 141/2. So that makes me three stone over what my weight should be according to these so-called charts. But if three stone fell off me now you'd think I was . . .
Howard: Poorly . . . If everybody was the weight that the chart says I think you'd be looking at some very thin people walking around. Wouldn't you? I don't know where they get their figures from. I mean, I always – I was like 11½ stone [in his twenties]. And I always considered myself to be on the thin side (Interview 4).
This is distinctly gendered talk. It resonates with Stearns’ (1997) cultural history of fat where, especially during the mid-20th century, being ‘thin’, ‘skinny’ or ‘underweight’ was considered a male problem to be corrected through feeding or bodybuilding. For men like Howard, ‘thinness’ is not prized as it is among White Western women, especially middle-class women (Sobal 1995). Thinness, like fatness, has negative connotations. Although a source of humour among intimates, within this system of meaning being ‘thin’ (or having ‘thin’ body parts) jars with everyday conceptions of robust, healthy masculinities. This is not the same as endorsing ‘fatness’, which, as suggested by Howard's opening disclaimer, is a socially contingent judgement rather than a purely objective scientific fact. Rather, and more ambiguously, it means accommodating and perhaps welcoming a degree of bodily bigness and extra weight around certain parts of the divisible male body.
Other men, who considered themselves to be more on the ‘fat’ than the ‘thin’ side, and who had joined a slimming club, similarly criticised BMI charts by invoking the blackly ironic image of the skeleton. Similar to Howard, Gareth was supported in his views by somebody else who was privy to our conversation. Here resisting standardised measures, through recourse to normative and experiential embodiment, occurred within an interpretive community comprising reasonable others (a role that I was also happy to adopt):
Field diary, Sunshine: I sat with Gareth and Ernie, two regulars. They had just been weighed and were casually chatting while waiting for the image therapy session to start. After leafing through his slimming book, Gareth, who was struggling to get below 18 stone, informed me that he should get down to 12 stone. I asked whether that was his target weight. He said it wasn't, but it was based on the [BMI] chart at the back of the club's book. I asked what he thought of those charts. Gareth looked a little coy then said: ‘I think they’re two stone out. I mean, if I got down to 12 stone I'd be a skeleton. I'd be happy at 13 stone’. Ernie immediately added: ‘The weight you should be is the weight you feel good at. If you’re happy and feel good then that's the right weight’.
Other slimmers shared these men's more accommodating definitions of ‘healthy’ weight, which were intimately tied to their emotionally expressive bodies. Dom, who was about 33 stone when he joined, said the following in the context of our discussion about target weights and BMI: ‘If I felt all right in myself, I'd say “sod the charts”. You know? As long as I, if I felt all right in myself, if I was happy the way I was I wouldn't take any notice of the charts’ (Interview 21). Sunshine employees, for whom weight was both a personal and professional issue, agreed. This included Paul, who joined Sunshine as a member and then became a team manager after losing eight stone. Paul emphasised the experiential and aesthetic dimensions of health, saying he knew he would feel and look unhealthy if he had the recommended BMI, which ‘I don't really look at too much because I don't believe in it’ (Interview 23). Paul initially said BMI charts were ‘all right’ during interviewing, but then immediately laughed:
I think they’re too low. I do. I think they’re far too low. I should be 111/2 stone I think for my height. I'm 13, 6, which if I went to 111/2 can you imagine what I would look like? You know? To me that would not be a healthy, a healthy thing. I would be anorexic [laughs] (Interview 23).
As noted above, Sunshine, unlike Fat Fighters, did not enforce the BMI despite listing it in the back of their slimming book. As with Goffman's (1961) ethnography of institutional life, secondary adjustment to official definitions may be allowed for good organisational reasons. Jim, who was unimpressed with Fat Fighters’ rationalised policy on ‘appropriate’ weight-for-height, welcomed that. Employed as a nurse, Jim stressed visceral, pragmatic and normative modalities of male embodiment when personally refuting this measure:
Prior to actually attending Sunshine my wife had tried Fat Fighters. And I went to Fat Fighters with her. This is going back quite a few years. And according to the guidelines at that time by Fat Fighters I should've been 10 stone 10. If I'd been 10 stone 10 I would've been anaemic. I would have had no energy and I would have looked as if I was emaciated rather than actually fit and healthy (Interview 16).
Rejecting other imposed definitions of ‘healthy’ weight, on the grounds that one would look ill, and possibly feel ill, was commonplace. It was not an artefact of the slimming club, or an orientation peculiar to men like Howard who eschewed dieting and was largely sedentary. Edward, a physically active 73-year-old, who had joined a fitness gym five months previously to lose weight (he originally wanted to go from 16 stone to 14 stone but had not lost any weight), said:
I'd hate to be – I mean, by my height, 5′11″, or thereabout. Me weight should be around the 12 stone mark, I think. To me, if I . . . I thought if I was on, I'd look ill. I'd be gaunt but I mean, you know, oh and this [skin around chin] would be hanging, and God, I would likely look a bloody mess, I think, you know. So no I don't believe in it, me (Interview 9).
Ralph, who was Edward's friend and member of the same fitness centre, similarly stressed the importance of ‘looking’ acceptable and ‘denied injury’ (Sykes and Matza 1957) when justifying his bodily bigness. After commenting upon the non-standardisation of bodies, ‘everybody is not the same, their body structure is totally different’ (see next section), he said: ‘One 5′11″ bloke looks great at 11 stone. I'm 5′11″ and if I were 11 stone I'd look bloody ridiculous. People would think I'm dying. You know?’ (Interview 10). Ralph was 68-years-old and reportedly weighed 17 stone, which, based on BMI, is obese. Contrary to negative stereotypes, however, this retired foreman and current Justice of the Peace told me that he had a very active life, playing golf and bowls most days with his friends.
Even peas in a pod are different: rejecting irrational standardisation
As commented by Ralph, everybody is different with a weight that is appropriate for them. Elsewhere I discuss gendered resistances to rationalisation or ‘McDonaldization’ (Ritzer 2004), stating that lived bodies cannot be standardised like the Big Mac (Monaghan forthcoming). Some of my contacts also offered food analogies when making this point, though, as with Doug, he alluded to more healthy food when we were discussing the BMI. In providing analytic context to this remark, it is worth noting that the BMI is derived from the work of Quetelet, the 19th century father of social statistics. Quetelet is famous for his concept of the ‘homme moyen or average man’ (Ruppel Shell 2003: 33). Of course, Mr Average is a statistical fiction and an old one at that:
It's like two peas in a pod. They’re not the same, same size. Everybody's different, physically and mentally and characteristics. There's nobody the same. You’re different to me, I'm different to my son and I'm different to the neighbour next door. Totally different. Nobody's the same (Interview 17).
Henry, who talked about exceeding the ‘correct’ BMI when he was a fit, young soldier, offered a clothing analogy when criticising others who seek to standardise heterogeneous bodies. The specific numbers in his ethnostatistical talk are, of course, secondary to his ironic argument that standardisation is unreasonable and arbitrary:
I don't think anybody can turn around and say ‘you should weigh such and such’. Generally. Because you’re 10 stone 12, all you 10 stone 12 people should be 5′4″ high. All you 11 stone people should be 6′ high. You know? I don't think that's right. That's like going into a shop for a pair of trousers and saying that everybody 45 years old has a 29″ inside leg . . . It [the BMI] just generalises. I don't think you can do that with health (Interview 8).
Such generalisations are especially problematic in a global context. This is reflected in the obesity literature where there is debate about ‘appropriate’ BMI cut-off points for different ethnic groups (International Diabetes Institute 2000). Biomedical talk about non-standardisation amidst ‘racial’ diversity – which, it should be stressed, is sociologically questionable because it naturalises socially constructed, class-related and historically contingent bodily differences – also emerged during interviewing. The following is from an interview with Lenny, a 33-year-old postgraduate student, who rejected a nurse's definition of his Black body as ‘overweight’. Lenny, who was married to a GP, also brought a BMI chart to our interview. The BMI classification of a man weighing 15 stone at 5′11″ (his bodily dimensions) as ‘almost obese’ was a source of ironic humour during other parts of our interview. In making connections with relevant literature, I would also refer here to Petersen (1998) who critically discusses Eurocentrism, colonialism and racism which have historically regulated ‘race’ relations and ultimately served the supremacy of White, middle-class males:
Lenny: I was joining this new surgery. And everybody has to go through this test, like checking your health and everything. Just like a general, overall check up. And erm, basically, she just basically said that I was overweight after putting me through one of these tests. And, erm, I don't think it would really have been drawn to my attention if I wasn't married to a doctor but she like says, my wife says, ‘you know, at the end of the day, these are like very ancient tests. They’re based on a 1930s ideal idea of what, erm, White, middle-class, men's bodyweight for what was meant to be ideal at the time’. Now, obviously, bodies have shifted through time, what is considered an ideal body has shifted from what it used to be in the 1930s or 20s. So she was just basically saying that it was outdated. And as a Black man as well, it definitely doesn't, erm [pause] how can I put it? [Pause] Black men's bodies are so much different.
LM: You’re talking about muscle composition?
Lenny: Yeah, but, I don't . . . well, that's what she said. I don't believe that. But that's just, obviously coming from her, a doctor (Interview 1).
Although Lenny was justifiably circumspect about reifying biological differences between racialised bodies (e.g. men from different ethnic groups may be equally muscular), naturalistic conceptions of the body are influential in contemporary Western societies (Shilling 2003). A recurrent argument with other men who rejected standardisation was that bodily heterogeneity is ‘natural’ and weight is only alterable within certain fixed biological parameters; namely, not all weight is ‘bad’ and while it may be more or less possible to regulate bodyweight not all weight requires, or is amenable to, remedial work. As with the ‘body diversity’ model sometimes expressed in size acceptance groups (Saguy and Riley 2005), men invoked non-negotiable characteristics like ‘body structure’ or ‘build’ when critiquing the BMI. As stated by Noel, a 29-year-old who was employed in customer services: ‘I think with guys, and probably with women as well to be fair, people have got a certain kind of build. And they’re going to be that build no matter what’ (Interview 13). At about 151/2 stone and 5′11″, Noel joined a fitness centre to lose weight but he reported limited success given various contingencies (an excuse account). Similar to others, who said they had their own personally defined ‘fighting weight’ or ‘comfort zone’ (which was independent of a ‘healthy’ BMI), Noel told me he had his own ‘middle weight’ that was related to his ‘natural build’. He immediately added: ‘You can go either side of it, and I think I'm definitely one of them. I'm probably naturally 14½ stone. That's my middleweight. And I can go either a stone up or a stone the other way’. Here accommodating a medically defined ‘unhealthy’ weight did not imply personal irresponsibility or an inability to lose unwanted weight. Noel offered a ‘naturalistic’ (Shilling 2003) justification for setting his own ‘optimal’ weight, a level of body mass that he felt more or less able to control, depending upon his life circumstances and given biological parameters.
This natural ‘build’ invoked by Noel, which cannot be radically changed through self-directed bodywork, also consists of ‘bone density’ that varies between people. The basic argument is that a simple, standardised measure like the BMI does not take this ‘normal’ aspect of ‘body structure’ into account. Correspondingly, it should not be given too much credence or complied with. Darren, who was not from the slimming club or fitness centre but who told my researcher he had recently become ‘slightly overweight’ (reportedly between 13 and 14 stone at 5′10″) said: ‘It [the BMI] just tells you if you’re overweight or not. But how can that be right? Because people's bone structure might be heavier than some, so it could mean it's pointless really’ (Interview 27). Mitch, who talked about Schwarzenegger and illness when mocking the BMI, went from the generic to the personal when telling me he had heavy bones. Such words could easily be dismissed as an unconvincing denial of ‘fatness’ and, within popular culture, are open to discrediting comebacks. However, such talk makes sense within a field of power and regulation. It expresses men's justifiable dissatisfaction with the authoritative view that there are specific measures that they could or should conform to and, by implication, some bodies matter more than others. For Steve, the unacceptability of this was compounded when a Fat Fighters consultant ‘told’ him what he ‘should’ weigh:
Field diary, Sunshine: Steve told me he went to Fat Fighters once but stopped after one week because he thought it was ‘OTT’. I asked him what he meant. He explained that they were telling him what he should weigh. I asked whether this was based on BMI. With an incredulous expression, he said: ‘That's the biggest running joke known to man. For a start it doesn't take into account bone density or anything else for that matter. It's just weight and height’. He added that there was a BMI chart in the back of Sunshine's slimming book but he took no notice of it.
Others offered similar complaints, citing ‘big bones’ and authoritative yet inconsistent prescriptions. Here ‘expressed distance’ (Goffman 1961) is clearly not only about aesthetic body norms but also the hierarchical context within which messages are conveyed. Consider the words of Al, a committed slimmer who weighed over 20 stone at the time of our interview. Al, employed as a mental health assistant, routinely came into contact with doctors as part of his work. He was highly critical of some hospital consultants who ‘stick to their guns’ and are ‘like God in their ivory tower’:
I struggle with these height and weight charts because there is differences in body structure. Some of us do have big bones and I know doctors always deny it, but it's amazing even hospital consultants, when they prescribe the medication, they get that chart out, the height and weight chart, you know. And you think [looks perplexed]. And I challenged one, one day. I said ‘now is that an accurate guide?’‘Oh yes’. You know? So, and I challenged another one. And he said ‘no it's not’. I says ‘oh’ I says (Interview 24).
This talk relates to the idea that the BMI is misaligned with the lived reality of being and having a large male body. Roy, who, at 28 stone, had joined then subsequently left another slimming club that ‘told’ him he should weigh 12 stone 12 pounds (he was 6′1″) recounted what he said to his club consultant in a sarcastic tone: ‘“Aye”, I says, “if you chop my legs off”. I says, “There's no way . . . You are kidding!”’ Roy reportedly lost 11 stone, ‘but to be honest when I was 17 stone I looked thin. I didn't look average or chunky. I looked thin on 17 stone’ (Interview 15). Because attempts to standardise male bodies are considered irrational (ridiculous), current or former slimming club members argued that consultants and organisations must be realistic and accommodate ‘natural’ bodily diversity.
This prescription corresponds with an individualised, personally tailored approach to slimming. This was institutionalised at Sunshine. Members defined their own target weight according to what they felt ‘comfortable’ and ‘happy’ with, alongside other considerations such as activity levels and approval from significant others. As with Stan, who ‘stopped around the 16 stone mark’ after losing almost eight stone for largely pragmatic reasons: ‘16 stone does me. My wife's happy with it, I'm happy with it and my children are happy with it’ (Interview 19). Key workers at Sunshine supported this. After describing how he originally complied with the BMI but revised his views after his mother complained about his emaciated appearance, Danny, a slimming club consultant, said the following:
A lot of people do come up to us and say ‘well what do you think is my ideal weight for my height?’ And I say, ‘well I cannot really say that at the minute’ I says ‘because there's a chart in the book’ I says ‘but I wouldn't go by that’. I think it kind of varies for people (Interview 18).
Danny, in ‘doing’ sensitivity to the everyday social situation of those labelled ‘obese’, explained further the need for an individually tailored approach. That is, an approach that does not necessarily correspond with standardised biomedical definitions. It is worth adding that even extremely sensitive slimming club consultants occasionally and unavoidably enact stigma. This is because they work within a larger engine of anti-fat sentiment and sensibility where rationalisation is more often accepted than rejected (e.g. weighing bodies, counting and measuring foodstuffs):
Danny: A gentleman can be 30 stone and he could lose, I don't know, maybe six, seven, eight stone. He's gonna feel absolutely fantastic but do you still class him as being obese at 22 stone or something like that?
LM: Well the medical profession would wouldn't they?
Danny: Yeah, yeah, of course they would. I think, I mean, I don't know exactly what the [medical] limits are for obesity and whatever but you've gotta be careful as well. He's lost six stone. He's gonna be feeling absolutely fantastic and over the moon. You've gotta be very, very careful there not to say ‘well’ you know ‘you still need to lose more’. Cos he's gonna think ‘what you talking about? I've already lost six stone. I'm feeling quite comfortable’. If they’re comfortable at it, then fine, you know, that's where they wanna be. But you can't stand there and say ‘well’ you know ‘I think you should lose maybe another six or seven stone’ cos they’re gonna be so deflated. They’re gonna think ‘oh my god, I thought I was quite comfortable there, I'm quite happy with that and he's telling me to lose another six stone!’ And it deflates them. And then that's when they can suddenly just walk back into the trap of saying ‘oh comfort eating’ . . . But if you’re comfortable and you’re happy with what you are then fine we’re happy.
For Paul, the other slimming club employee I interviewed, this emphasis upon experiential embodiment rather than normative rationalisation was a key selling point for Sunshine. Organisational resistance to the BMI, or, perhaps more accurately, the willingness of these and other consultants from Sunshine to permit men's ‘secondary adjustments’ (Goffman 1961), made economic sense. It also made personal sense for Paul, who had lost eight stone and who struggled daily to maintain most of this loss. He said the following after I asked whether he could suggest anything that might inform health professionals and policy makers who are concerned about weight-related issues among men. It is also significant that Paul stressed subjective definitions of personal health, though, elsewhere in the interview, he confidently stated he would undergo medical tests to confirm his belief that he was very healthy (tests undertaken when he was clinically obese reportedly confirmed a normal metabolic profile):
What we were saying about that BMI and that is be a bit more realistic. That's the good thing about the slimming club and you choose your own target. And you can change your target. If you feel you’re too thin you can take it up a bit or if you don't feel you’re thin enough you can take it down a bit. You know? It's up to the individual. And I think it should be up to the individual of whether they are healthy or not healthy, rather than they’re saying I should be 11½ stone, at which [joking] I don't think I was that when I was born [i.e. that weight is too light and unnatural for him]. You know what I mean? So I think that would be the only thing that I would try to put across to them (Interview 23).
It could be argued that if health authorities are not ‘realistic’ then they could risk undermining their own credibility. Indeed, perpetuating ethnocentric body classifications could render health authorities vulnerable to strong criticism and condemnation. Consider one last extract. It is with an implicit reference to Campos's (2004) ironic talk about Brad Pitt being classed as overweight, as well as explicit reference to a BMI chart, that I had the following exchange with Adrian. This 31-year-old had joined a fitness centre to lose weight in preparation for his wedding. When starting at the fitness centre he reportedly weighed 15 stone 8 pounds at 5′8″ tall, which clinicians would label ‘obese’ on the BMI. After losing 10 pounds he was feeling good about himself even though he would still be medically classed as obese:
Adrian: Excuse the French [sic]. That's bollocks [the BMI chart]. It really is [laughter]. You ask any – everybody I know will tell you that that's bollocks. I've got no mates in the right height-to-weight ratio at all. I don't know anybody that's like that. The only people I know like that are on the screen in the cinema in Hollywood because that's what society says they've got to look like.
LM: But actually, if you’re looking at – yeah maybe women but not men – Brad Pitt would be categorised as overweight, George Clooney –
Adrian: [immediately interrupting me] Brad Pitt overweight? You’re jesting aren't you?
LM: On this [BMI chart]. But I mean – OK well let's think – their definition of obese is a BMI of 30. Dividing weight by height [squared] and it gives you a number. But in everyday language, what does obese mean? What does overweight mean?
Adrian: Aye. If I see a bloke or a woman going down the street with a huge gut I think ‘well that's a bit obese’. And if I see a bloke in the pub with a bit of a cupboard, a bit of a pot, I think ‘that's a bit overweight that like’. I don't know. I mean, that's the way I see it (Interview 12).
Adrian's way of seeing overweight and obesity was not peculiar. Adrian was part of a much larger interpretive community. The specifics of Geordie terms notwithstanding (e.g.‘bit of a cupboard’ to refer to ‘abdominal obesity’), I am aware from virtual ethnography and international connections that this community extends way beyond Northern England. However, in restricting my substantive claims to those data reported above, this group of men clearly forged meaningful definitions of ‘appropriate’ weight that often clashed with ‘scientific’ measurements and pronouncements. These everyday definitions were far less inclusive than standardised, biomedical definitions that pathologise bodies under the rubric of medicalised rationality. Moreover, such everyday understandings made sense and were inseparable from men's displays of moral worth or social fitness.
Conclusion: exercising healthy scepticism
The BMI is the linchpin of the obesity industry and the most commonly used proxy for adiposity when authorities claim there is a public health crisis. It serves as a basis for claiming most men in nations such as England, the USA and elsewhere are overweight or obese and therefore ill, diseased or at risk. As noted in the introduction, respected and publicly funded institutions also use the BMI to position men as deservedly discredited and even open to ridicule. Yet, there is justifiable resistance to medicalised notions of ‘appropriate’ weight-for-height as understood by men within their embodied life worlds. Certainly, some men may situationally endorse the BMI or height-weight charts in order to demonstrate healthist concerns, a moral image of selfhood. Particularly for those seeking intentionally to lose weight, such endorsement could be interpreted as an additional indicator of responsible selfhood in a society where fat may as well be a four letter word. During this research, however, this conformist model of masculinity (conformist to largely middle-class ideals of social fitness) was the exception rather than the rule. As described above, men's vocabularies of accommodation included talk about the compatibility of heaviness, healthiness and physical fitness; looking and feeling ill at a putatively ‘healthy’ BMI; and, the irrationality of standardisation.
One might assume that resistance is likely among men whom health professionals would label overweight or obese and who have no intention of slimming – men who might also be presumed to be ignorant of the BMI, unconcerned about, blind to or in ‘denial’ about their putative fatness. However, during this research, resistance was common among men who were well aware of the BMI and were seeking to lose weight. This is significant because many of the men recruited for this study, such as slimming club members, were demonstrably committed to being seen to be doing ‘the right thing’ and yet even they claimed height-weight charts were too restrictive. Importantly, while intentional weight-loss is often laudable in a shame and blame culture where fatness is authoritatively equated with emasculating sickness, that does not mean male slimmers necessarily feel they should achieve a body mass that medicine defines as healthy (BMI 18.5 to 24.9 kg/m2). The suggestion that men should conform to such standards was often described as ridiculous. Consultants at Sunshine slimming club also resisted medicalised definitions of appropriate weight-for-height. Drawing from Goffman (1961), this constitutes a secondary adjustment to the gendered culture of slenderness. Despite formal reproduction of the BMI in Sunshine's handbook, it also made economic sense for the organisation to authorise men's expressed distance.
It may seem contradictory for men to seek to lose weight while also rejecting medical definitions of (un)healthy weight but this is normal, reasonable and understandable. It makes sense given the discrepancy between biomedical and life world definitions of men's fatness. This discrepancy – as understood, seen and felt within the masculine habitus – has implications for men's social relationships, including self-body relationships. It also has implications for health promotion and policy which, if it is to be credible and creditable, must connect with everyday meanings (as well as obesity science which contains much non-conforming evidence). More specifically, this discrepancy has a bearing upon whether or not medical definitions of ‘inappropriate’ weight (BMI 25≥kg/m2) are deemed problematic by and for people in everyday life and thus whether overweight and obesity need to be accounted for and/or corrected. While fatness often is a problem for many people, or, more accurately, it is often made into a problem by and for many people, levels of weight that medicine defines as too heavy need not be defined as or felt to be a problem in everyday life. In short, men may be clinically overweight or obese but not view themselves as such even when aware of and acknowledging height-weight charts. Accommodating a larger body is possible because what is ‘seen’ as ‘fat’ is a contingent social judgement that is inseparable from gendered aesthetics and embodied feelings; namely, modalities of normative and experiential embodiment which may also be buttressed with reference to the visceral and pragmatic (Watson 2000).
It should be stressed that such resistance cannot be dismissed as a product of deficiency, pathology or irrationality among men who risked being discredited as too heavy or fat. Resistance is a meaningful response to imposed domination and symbolic violence associated with sizism and malevolent assumptions about risk, disease and irresponsibility to self and others. Given the multi-dimensional status of health as a social construct, the equivocal status of obesity science and the potentially harmful fallout from a war on obesity, I would argue that such resistance is healthful. Within micro-social contexts, such words could be viewed as a socially fitting response to obesity epidemic psychology and its potentially defiling effects on embodied masculine identities.
In referring to what I term obesity epidemic psychology and everyday healthy scepticism, it is clear that this paper does more than simply focus upon members’ situated accounts. Rather than adopt a position of ethnomethodological indifference, of eschewing an evaluative approach to the social, qualitative data were interpreted as part of a critical realist take on the obesity debate. This research, in adding qualitative data to emerging critical obesity studies, constitutes a theoretically and empirically informed critique of the war on obesity. It does not criticise ordinary men, some of whom had told me about the emotional pains of being stigmatised as fat. Rather, in moving beyond a reductionist focus on fat and the putative failings of those who could be medically typified as overweight or obese, this research remained mindful of larger iniquitous social structures, meanings and processes. These are authoritatively reproduced and worked on and through lived bodies but they are also more or less resisted through masculine schemes of perception, thought and action.
The approach taken in this research obviously contradicts the usual stance observed within mainstream obesity literature and health promotion. It is also discrepant with critical men's studies where moralised judgements are sometimes levelled at men who are deemed inadequate or essentially in crisis. An obvious affinity exists between the pathologising obesity discourse and the ‘centring’ approach to men's perceived shortcomings as evidenced in at least some social studies of men and masculinities. However, there is no need for reifying an individualised and pathologised image of modern men, a proportion of whom are showing signs of damage in a war on obesity (Campos 2004). It should be clear from this paper that I am not interested in criticising (educating, correcting, meddling in the lives of) everyday men. Rather, I am interested in exploring what the institutionalised war on fat means in everyday life using a critically informed interpretive framework. This is necessary because the war on obesity is a symbolically violent act that is ostensibly legitimated under the rubric of scientific or masculinist rationality. A critical study of masculinities and bodyweight, I would contend, should take that as its point of contention rather than accept the idea of ‘fat’ as a taken-for-granted construct and unreflectively reproduce the putative problem of overweight and obesity in academic, policy and everyday discourse.