‘One can never be too thin or too rich.’
Wallis Simpson, Duchess of Windsor1
ON THURSDAY 23 June 1809, a most unusual funeral took place in the small Lincolnshire town of Stamford, some ninety miles north of London. The elm coffin was six feet long, four feet wide and fitted with wheels. Daniel Lambert, the 39-year-old who lay within, weighed 52 stone and was England’s fattest man. In order to remove Daniel’s body from his lodgings, a window and wall of the building had to be demolished. So heavy was the load that, at the cemetery, a gently sloping trench had been excavated to enable the sweating pall-bearers to push the massive coffin into the grave, rather than attempting to lower it. Even so, it took twenty strong men ninety minutes to manoeuvre Daniel into his final resting place.
What is interesting about the story of Britain’s fattest man is not so much how he managed to become so obese as the way he was perceived by others.
As a youth, Daniel had been tall and stocky but by no means overweight. He was an active young man who could walk for miles without effort and who enjoyed lengthy swims. At the age of eighteen he had, like his father before him, worked as a jailer at the local prison. It was from this time that his weight rapidly increased, although quite why it did so remains a mystery. The doctors who examined him could find no medical reasons for his prodigious girth and Daniel himself always insisted, and the contemporary literature confirms, that he drank and ate modestly, never having ‘more than one dish at a meal’.2
Surprisingly, given his size, he appears to have remained fit. He was reported as being in ‘perfect health: his breathing was free, his sleep undisturbed, and all of the functions of his body in excellent order’. After his death, he was remembered as ‘a man of great temperance.’3
Whatever the cause of his obesity, by the time the jail was closed and he lost his job, Daniel was too fat to find further work in his home town. In the hope of finding employment further afield, he travelled to London, where he soon fell on hard times. Almost destitute, he was obliged to exhibit himself in public.
It cost a shilling (5p) to visit him at his London home, to ask him questions and stare in astonishment at his prodigious size and marvel at the size of his clothes – six grown men were able to fit inside his waistcoat at the same time.
Intelligent, knowledgeable and a witty conversationalist, Daniel soon became a fashionable attraction. One banker was so intrigued he made twenty visits, while a party of fourteen made the trip all the way from Guernsey. He was even invited to an audience with King George III.
After a few years, he had become sufficiently wealthy to return to Leicestershire, spending his few remaining years breeding and selling hunting dogs. He died suddenly, on 21 June, at his lodgings in the Wagon & Horses on Stamford High Street. Friends and admirers raised the money to pay for a funeral and provide a headstone on which they had carved: ‘Remembrance of that prodigy in nature Daniel Lambert, a native of Leicestershire who was possessed of an exalted and convivial mind and in personal greatness had no competitor: He measured three feet one inch round the leg and weighed fifty two stone eleven pounds. He departed this life on the 21st June, 1809, Aged 39 Years.’
As this memorial testifies, Daniel was regarded by his contemporaries not as a glutton to be condemned but as a ‘prodigy of nature’ to be admired. During the early decades of the nineteenth century, as for several centuries before, being extremely fat was not merely acceptable – it was fashionable. Being overweight symbolised power, dominance, wealth and even hypersexuality; it could be seen as a source of pride, not a cause for dismay.
‘Obesity’, observes historian Peter Stearns of George Mason University, ‘was . . . associated with sound health in a period when many of the most debilitating diseases, such as tuberculosis, led to the body wasting away.’4 In Britain during the last decade of the eighteenth century, the fashion for gluttony and obesity was led from the top by the Prince Regent, later to become George IV. By his forties a combination of heavy drinking, vast banquets and lack of exercise had taken his weight to more than 17 stone (245 lb) and his waist to 50 inches (130 cm). Edward VII, the son of Queen Victoria, who followed his mother to the throne after her death in 1901, was almost equally stout, so much so that he was apparently unable to fasten the bottom button of his waistcoat. The story goes that to make their monarch feel better about this, his court followed suit, setting a fashion which endures to this day.
Where women were concerned, being plump and voluptuous, with milk-white skin – ‘Rubenesque’ – demonstrated not only that you were wealthy enough to eat in excess but also that you were able to lead a life of ease.
Nor did ‘fat pride’ completely disappear as improved public health and medical science began to banish wasting ailments. In 1903, a group of American travelling salesmen established the Fat Men’s Club of Connecticut, such was their pride in being overweight. Membership was only open to men weighing at least 200 lb, and members competed to see who could put on the most weight from one year to the next. The club, whose slogan was ‘We’re fat and we’re making the most of it!’ survived until 1925 – several years longer than most of its founding members!5
However, concerns about the consequences of being seriously overweight did begin to surface during the late nineteenth century. In 1863 William Banting published one of the Western world’s earliest diet books, Letter on Corpulence Addressed to the Public. It was a first-hand account of how he, a successful, middle-class undertaker (his firm made the coffin for the funeral of the Duke of Wellington) had lost 35 lb by going on a diet. Such was the popularity of his book, in which he reported, ‘I can honestly assert that I feel restored in health, bodily and mentally’ that the word ‘banting’ quickly became synonymous with dieting in much of Europe.6 In Swedish bantna still means ‘to diet’.
Of course, Banting’s book was not the first to advocate dieting; the word diet comes from the Greek diatta, meaning the ‘manner of living’, and discussions of the importance of good diet first appear in the writings of the early physicians such as Hippocrates and Galen. And the world’s oldest cookery book, the ten-volume Roman Apicius, dating from the fourth or fifth century ad, contains much dietary advice which still applies today.
One volume, devoted to pulses (legumes), comments on the benefits of a vegetarian diet, as expressed in The Book of Daniel (1:8–16). We learn how Daniel and other children from Judaea, after being brought to the palace of Nebuchadnezzar, King of Babylon, were offered meat and wine. They asked, instead, to be allowed to eat their traditional meal of pulses. Their guard, the prince of the eunuchs, feared that by doing so the youngsters would look less well-nourished than other children eating meat and drinking wine, and that if this proved to be the case he might lose his head. Daniel suggested an experiment. He and his companions would consume pulses and drink water for ten days, after which the king should compare their apparent state with that of ‘the children that eat the king’s meat.’ This was agreed and, at the end of ten days, ‘their countenances appeared fairer and fatter in flesh than all the children which did eat a portion of the king’s meat’ (Daniel 1:15).
Centuries later we hear of a very famous man attempting another kind of diet. In 1067, the year after he had invaded England and defeated King Harold and his army outside Hastings, William the Conqueror became one of the first notable names in history to try to lose weight by going on a liquid diet. He did so by retiring to bed and drinking only alcohol!
‘With the publication of De re Medicina in 1478 in Florence, Italy, diet became an important part of medical practice,’ write June Payne-Palacio and Deborah Canter in their book The Profession of Dietetics. ‘Medicine was divided into three branches – diseases treated manually, diseases treated by medicine, and diseases treated by diet. In 1480, the first printed cookbook appeared, containing reference to quality and variety of meat, fish, fruits, and vegetables; information on how they nourish the body; and directions on how they should be prepared.’7
So, Banting’s book was really part of a long discourse on dieting that had been going on for centuries. However, despite the rapid growth of books on dieting following this bestseller, and despite increasing scientific interest in the topic of obesity, being fat remained a desirable trait amongst an exclusive circle of the powerful and influential; an indication that the individual could be trusted and relied upon.
There are still many countries in which being overweight remains fashionable because it is associated with social status and good health. In South Africa, for example, where nearly 40% of men and 70% of women are overweight or obese, a recent survey found that almost nine out of ten people (88%) believe ‘fat is beautiful’. The plumper a woman, the more sexually attractive and healthy she is considered to be. A man with a big belly (in Afrikaans a boep) is similarly viewed as healthier, wealthier and more successful than a slender male, whose thinner frame is regarded as a sign of poor health and a lack of financial success.8
But in much of the world, the attitude towards heavier people is far from being this positive.
Although the word ‘obesity’ first appeared in a French-English dictionary in 1611, attitudes towards being fat only started to change significantly during the early years of the Roaring Twenties. This was the decade that saw the emergence, in the West, of a ‘new breed’ of young women. Known as ‘flappers’, they wore short skirts, smoked and drank heavily, drove cars, listened to jazz and enjoyed casual sex. They were active and favoured an androgynously slender physique.
‘One can never be too thin or too rich,’ pronounced Wallis Simpson, Duchess of Windsor, and in Britain, at least when it came to slimness, women strove to obey her diktat.
Since then, and despite the obesity pandemic, being fat has increasingly fallen out of favour across the developed world.
Obesity was soon regarded by doctors as a threat to the nation’s health, and by moralists as evidence of the nation’s decadence. Gluttony was one of the Bible’s seven deadly sins; nature’s punishment came in the form of bulging bellies, dimpled thighs and flabby buttocks.
This new puritanism spread like wildfire through Western populations, with people becoming ever more judgemental of the overweight. It is an attitude which remains deeply ingrained to this day; when, in 2004, Sander Gilman from the University of Illinois showed children silhouettes of fat and slender people, she found they were more likely to perceive the former as ‘lazy’, ‘dirty’, ‘stupid’, and as people who ‘cheat’ and ‘lie’. According to Gilman’s research: ‘Physicians are not much better than the children. They describe their obese patients as “weak-willed, ugly and awkward.”’9
This rather dismal view is supported by the findings of a study by Melanie Jay and her colleagues from the New York University School of Medicine. They report four out of ten doctors feel less motivated to help significantly overweight patients whom, they believe, are less likely than slender ones to benefit from their advice.10
Many primary care physicians rated therapies aimed at altering patient behaviour as less effective than treatments such as pharmacological intervention and surgery for nine out of ten chronic conditions relating to obesity, with less than 50% feeling confident in prescribing weight-loss programmes, and fewer than one in six (14%) describing themselves as ‘usually successful’ in helping obese patients lose weight.11 Even health professionals specialising in obesity had an ‘implicit anti-fat bias and are more likely to automatically associate “fat people” with negative stereotypes than “thin people”’.12
In another study, three out of ten (31%) of internal medicine residents reported that treating obesity was futile, with only four out of ten (44%) considering themselves qualified to treat such patients.13
‘There is strong evidence,’ comments Melanie Jay, ‘that physicians do not counsel obese patients adequately and attitudes may be one reason for this deficiency.’14
We live in an age of dietary extremes. While waistlines are expanding fast, all around the world, so too is the number of people obsessed with becoming or remaining thin. Every year, in the UK and US alone, millions of people invest vast amounts of time and money, endure discomfort and suffer pain in the hope of retaining or regaining a slender figure. They go on diets, undergo cosmetic surgery, join gyms and health clubs, send their overweight youngsters to fat camps, pop pills, swallow supplements, consume special foods, smear on lotions, snap up the latest diet books, watch dieting DVDs, browse weight-loss magazines, seek out personal trainers, consult dieticians and join slimming clubs.
In Britain the diet industry is worth £2 billion, only slightly less than the £2.33 billion spent by the National Health Service on its nationwide A&E services.15 In the US, the diet industry is worth in excess of $60 billion.16 In 2009, over 400,000 Americans went under the knife in their quest to, literally, lose weight. This involved 354,015 liposuctions and 713,115 operations for abdominoplasty (tummy tucks). In the UK the figures are more modest: in 2011, 3,581 people underwent liposuction and 3,375 tummy tucks.17
Paul Campos, a law professor at the University of Colorado, has suggested that obesity has become a device to promote intolerance, which shows ‘disturbing similarities to the eugenics movement, with its emphasis on “improving” the species’. He characterises the ‘war on fat’, as a pivotal time in American history, representing ‘the first concerted attempt to transform the vast majority of the nation’s citizens into social pariahs, to be pitied and scorned.’18
‘The things many Americans worship today – “health”, “fitness”, a perpetually youthful body,’ Campos writes in The Obesity Myth, ‘have become so closely associated with staying or becoming thin that, for all practical purposes, what such people worship is a god of perpetual slenderness.’19
Yet, as we explain in Chapter 13, losing weight, and making sure it stays lost, is far from the straightforward task that producers of diet plans and peddlers of slimming pills try to make out. Up to half of the weight shed has often been regained within a year, and in time the vast majority of those whose diets have succeeded in the short term will either have returned to their previous weight or actually become even heavier.20 Over the past thirty-three years, there has not been a single report of a country successfully reducing obesity rates among its population.21
For many critiques of the ‘war against weight’, the emphasis on female slenderness is far from accidental. They argue that the early 1960s, when the dieting movement really took hold (Weight Watchers, for example, was founded in 1961 by an overweight New York housewife named Jean Nidetch), marked the start of the sexual revolution.
For the first time, the idea that a purely domestic role – ‘die Kirche, Küche, Kinder’ (church, kitchen, children), as the Germans say – should be the only one a woman should crave, began to be seriously and widely challenged. Women felt able to openly express and explore their appetite for sex.
At the same time, as we have already noted, the emphasis on the importance of physical appearance resulted in fatness being seen as less a health and more a moral issue. It was increasingly stigmatised as a sign of greed, laziness and lack of self-control.
‘If you fail to lose weight you are demonstrating you’re a bad person,’ says Peter Stearns. ‘It’s a big burden. Faced with this additional pressure you are even more likely to end up by saying: “The hell with it! I’m going to get ice-cream. I am such a bad person I need to solace myself.”’22
In 1978, psychotherapist Susie Orbach struck back against this bullying and mockery with her groundbreaking anti-diet book, Fat is a Feminist Issue. She argued that, by becoming obese, a woman was deliberately setting out to challenge gender stereotypes. Thirty years on, the same views continue to be espoused by feminists such as singer Beth Ditto. At 5 feet tall and weighing 15 stone, Beth vocally and publicly rejoices in her weight, challenging culturally prescribed norms and popular notions of what it means to be beautiful. Described by writer Germaine Greer as ‘the coolest woman on the planet’, Beth describes herself as a ‘fat, feminist lesbian from Arkansas’.23 She has posed nude on the front covers of NME and LOVE magazine, launched her own plus-size collection of fashions, and uses her obesity to promote her view that ‘every person is beautiful in their own way’.
In the face of the mounting pressure for women to comply with ridiculous standards of beauty, ‘fat acceptance’ movements such as Fat Liberation, Fat Activism, and Fat Power have garnered widespread support, especially within the US. Programmes such as Healthy At Every Size (HAES) offer support for all those who want to challenge the current status quo. HAES ‘acknowledges that good health can best be realized independent from considerations of size. It supports people – of all sizes – in addressing health directly by adopting healthy behaviors.’ In theory, this should be the health message promoted by all.
Unfortunately, the credibility of many of these movements is undermined by research findings. For example, some groups claim that the risks of weight cycling (where weight is repeatedly shed and then gained once more) are significantly greater than those of being overweight. In fact the exact opposite is true. While weight cycling is certainly by no means ideal, the idea that it contributes to either hypertension or Type II diabetes, as some of these groups claim, has been disproved by studies going back well over a decade.24 Another claim promoted by some fat advocacy groups is that such yo-yo dieting increases the risk of mortality. This too has been exposed as a myth by epidemiological studies, such as one conducted between 1992 and 2008, which involved more than 55,000 men and 66,000 women.25 While it is true that being overweight (but not obese) offers some health benefits to those over 65, once this age qualifier is removed, the purported ‘advantages’ of being excessively overweight disappear.26
Having said all this, it is certainly true that adipose tissue plays a vital role in maintaining good health, and this is something we will examine in greater depth in Chapter 5. But when present in excess it poses grave risks to health. As weight increases, so too does the likelihood of developing Type II diabetes, cardiovascular disease, and a series of cancers. Body dysmorphia (a preoccupation with perceived defects in one’s physical appearance) and the mere idea of Fat Activism reveals a deep misunderstanding about the true nature of ‘health’.
Promoting the supposed benefits of being either too thin or too fat is actively misleading and potentially dangerous. Only by coming to a clear understanding of the risks posed by excess adiposity can we begin to appreciate the very real threats to our health presented by the obesogenic environment in which we live.
In Part Two, we shall explore the biology of obesity to explain some of the reasons why people are becoming so overweight. We start, where life begins, with the newborn. For if being fat is currently out of style with adults, it is still very much in fashion with babies.