An ethnographic investigation of lifestyle change, living for the moment, and obesity emergence in Nauru

The Republic of Nauru, a small Pacific island nation, has one of the highest obesity rates in the world. Obesity emerged rapidly in Nauru during the 1970s, a period characterised by political independence and unprecedented economic growth resulting from lucrative phosphate mining. In the mid-1970s, the Nauruan population was one of the first in the world in which obesity, diabetes mellitus and cardiovascular disease – co-morbidities associated with obesity – were identified as significant public health concerns. Such ‘lifestyle diseases’ continue to have debilitating effects on the Nauruan community.
Obesity is generally understood to result from an energy imbalance; that is, people eat and drink more calories over time than they expend. This biomedical paradigm is implicit in the majority of research relating to obesity, such that the lifestyle to which obesity is attributed is limited to diet and activity. Yet in practice, lifestyle is much more than this. The lifestyle of a particular group is related to political, legal, religious, economic and value systems, modes of education, communication, transport and healthcare, and styles of art, music and entertainment. In this thesis I draw on ethnographic participant observation carried out in the Republic of Nauru during 2010-11, life history interviews, and diverse historical materials to answer three questions. First, what characterises the Nauruan lifestyle? Second, in what ways did the Nauruan lifestyle change over the second half of the twentieth century, the time period during which obesity and diabetes rapidly escalated? Finally, how might these changes be linked to the emergence and persistence of ‘lifestyle diseases’ in Nauru?
I focus on one characteristic that stood out prominently in many different aspects of Nauruan life: ‘island time’, or the suggestion that there is ‘No Action Unless Really Urgent’. In theorisation of obesity, such living for the moment has been interpreted as laziness, pleasure-seeking or lack of self-control. However, a deeper analysis reveals that island time emerged gradually in the latter half of the twentieth century as Nauruans incorporated market-derived moral values into their everyday lives. This has led to profound changes in the way people feel when engaged in social exchanges, and is linked to temporally-shorter and more spatially dispersed social networks. I thus recast living for the moment as representative of a social trend rather than individual self-interest, and obesity as a phenomenon associated with the space between bodies rather than within each one. This leads me to consider more closely the links between social relationships and health. In Nauru, as in many societies, it is difficult to disentangle the biological and the social; the same feeling of unhealthiness, for example, is associated with being clinically ill and having a fight with a loved one. Yet many activities that are associated with tightening social networks, and which are prominent in the lifestyle characterised by island time – eating, drinking, or sitting and gossiping, for example – are also associated with obesity emergence. As a result, being biomedically healthy and feeling healthy are now somewhat incompatible in Nauru. In concluding, I argue that the adoption of economic rhetoric into everyday life has re-shaped moral values, everyday social relationships, and the demographic health profile on Nauru.

Keywords: Nauru
economic anthropology
emotion
exchange
social relations
moral values
obesity
diabetes
lifestyle disease
economic change
time
ethnography
Advisor: Ulijaszek, S
Hsu, E