Healthy Choices and Heavy Burdens: Race, Citizenship and Gender in the 'Obesity Epidemic'

Abstract The 'obesity epidemic' is widely accepted as a major public health threat in the United States. This paper provides a critical examination of the White House Task Force on Childhood Obesity's action plan that is foundational to First Lady Michelle Obama's 'Let's Move!' campaign. The report reveals ideological anxieties about race, American citizenship, changing gender roles and women's bodies. The framing of obesity as a personal problem and individual failing reflects the merger of American individualism and neoliberalism. Self-regulation and responsibility (and the mother's responsibility for her children) are key in prescriptions to manage obesity, reflecting biopolitical techniques of governance and a new model of 'the healthy American citizen'. Keywords: obesity, gender, citizenship Introduction Testifying before the United States House of Representatives in 2003, U.S. Surgeon General Richard Carmona warned that obesity was 'a health crisis affecting every state, every city, every community, and every school across our great nation' (Carmona, 2003). The 'obesity epidemic' (2) is widely accepted as a major public health threat in the United States, garnering attention from The Centers for Disease Control and the U.S. Department of Health and Human Services. However, Carmona's statement fails to acknowledge that obesity is not a homogenous or uniform phenomenon. The prevalence of obesity varies greatly depending on location, race, gender, age and class. Obesity is most common among African American and Hispanic (3) populations in the southern states of Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia (Centers for Disease Control, 2010b). Black women have the highest rates of any group (4) (Centers for Disease Control, 2009). Compared to whites, the prevalence of obesity is 51% higher in African Americans and 21% higher in Hispanics (Ibid). The 'obesity epidemic' is therefore racialised and gendered, an 'epidemic' that affects certain people in certain places. Interrogating these trends and how they intersect and diverge with other inequalities is crucial to understand obesity. Examining how the rhetoric of the 'obesity epidemic' is mobilized within public health and popular media discourses reveals why the nation's current obsession with obesity is problematic. The widespread concern about obesity is not solely (or arguably, primarily) health based. Rather, it reflects deep ideological anxieties about race, American citizenship, changing gender roles and women's bodies. Obesity is framed as a personal problem and individual failing. This reflects a long history of American individualism (5) as well as more recent articulations of neoliberalism. In the context of neoliberal economic policies that call for lessening the role of the state in healthcare and welfare provision, obesity discourse reveals tensions about who is responsible for public health. Public health interventions increasingly acknowledge the societal foundations of obesity: the growing interest in food deserts and access issues helps illuminate deep systemic issues of racism, poverty and inequality in the United States. But, the media still rarely frames obesity in terms of socio-economic injustice and inequality (Kim and Willis, 2007; Lawrence, 2004). This essay examines obesity discourse primarily through an analysis of the White House Task Force on Childhood Obesity's action plan, which is foundational to First Lady Michelle Obama's 'Let's Move!' campaign. 'Let's Move: America's Move to Raise a Healthier Generation of Kids' was launched in February 2010 and is ongoing. Although the Task Force document is largely gender-blind in its language, I argue that it presents childcare and the work of 'feeding the family' as women's responsibility (DeVault, 1991; Grant et al, 2004; Inness, 2001). A woman's failure to ensure that her children are the 'correct' size is punished socially through 'mother blame' (Boero, 2009). …