Social and Cultural Perspectives on Hunger, Appetite and Satiety
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European Journal of Clinical Nutrition (2000) 54, 473±478 ß 2000 Macmillan Publishers Ltd All rights reserved 0954±3007/00 $15.00 www.nature.com/ejcn Social and cultural perspectives on hunger, appetite and satiety ST Kristensen1* 1Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark The aim of this review is to show how hunger, satiety and appetite can be seen as a central research subject for the social sciences, both as the locus where food consumption is bodily regulated and as the nexus where biology, social praxis and cultural meanings meet and are negotiated by the individual. The number of people developing overweight and obesity is increasing, as is the prevalence of eating disorders and weight preoccupation. These tendencies can be considered as expressions of a polarization of eating habits in modern societies, where lack of control or exaggerated control over eating are still more common phenomena. At the same time the tendencies may be seen as the result of a more general ambivalence in relation to food, which in¯uences the experiences of hunger, satiety and appetite and their regulating effect on food consumption. European Journal of Clinical Nutrition (2000) 54, 473±478 Introduction extent that sensations of appetite are investigated, they are measured by means of VAS-scores (visual analogue Statistical evidence documents that the percentage of scores), which seek to provide a quantitative measure of populations de®ned as obese is increasing (WHO, 1998), subjective experiences of hunger, satiety and appetite in as indeed is the occurrence of eating disorders and related experimental studies. risk behaviour (Nasser, 1997). Social scientists have seen In this paper it will be argued that the subjective these simultaneous tendencies as indicating a polarization experiences of hunger, satiety and appetite in a social of eating habits, in which not only lack of control or scienti®c perspective need to be studied as an existential exaggerated control of eating (Counihan, 1999; Holm & ®eld in its own right. Integrated analyses of phenomeno- Iversen, 1997), but also cyclical eating patterns in which logical and physiological aspects of digestion have been individuals overeat and slim by turns (Lupton, 1996), are undertaken successfully (Leder, 1990), but a yet unex- phenomena that appear to be occurring with increasing plored area of research is variations in individual concep- frequency. It has been argued that the analysis of the tions of `the inner body', seen as a semantic ®eld that may occurrence of obesity and eating disorders should be seen exert a signi®cant in¯uence upon eating habits. Further- partly as a breakdown in the adaptation of human biology more, it will be argued that the subjective experience of to its environment and partly as a cultural crisis (Fischler, appetite in everyday life is embedded in and mediated by 1980). Social and cultural in¯uences upon food consump- social interaction and social representations, as well as tion and its changing patterns have been documented in subjected to attempts at regulation by means of health recent years (Mennel et al, 1992), but the activity and the education. experience of eating in everyday life have hardly been This has some methodological implications which will investigated (Jenkins, 1999). Hunger, satiety and appetite be touched upon at the end of this article. It will be argued can be seen as a central ®eld of research in this context, as that more qualitative methods are needed than have yet the point at which biological factors, social practice and been attempted; when recognized, social and cognitive cultural meanings meet in the individual. factors have so far been treated as comparable to physio- Nutritional research, based on the methods of the natural logical measurements in a quantitative way (see for exam- sciences, focusses on biological factors of appetite regula- ple De Castro, 1996). Methods and analyses both need to tion measuring the intake of calories and genetically conform to a hermeneutic paradigm. This means that determined digestive and metabolic processes. It also results will not be immediately comparable to the results includes more subjective bodily experiences that are recog- provided by scientists working within a positivist paradigm. nized as in¯uenced by cognitive and sensory factors This does not, however, imply that a social scienti®c (Blundell & King, 1996). Still, hunger, satiety and appetite approach is irrelevant to natural scienti®c nutritionists are nevertheless primarily approached as an `explanatory and vice versa. On the contrary, a mutual understanding principle' that can be deduced from observations and ought to give both parties the opportunity to de®ne more measurements of a range of physiological processes, clearly the strengths and the limits of their own academic rather than approached as `speci®c sensations' which endeavour and, thereby, contribute to a better understand- accrue to the desire for food (this distinction is further ing of the phenomena of hunger, satiety and appetite on elucidated in the work of Blundell & Rogers, 1991). To the different levels. *Correspondence: ST Kristensen, Research Department of Human Nutrition, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark. E-mail: [email protected] Three analytical levels Received 17 March 1999; revised 20 December 1999; accepted Social scientists have analysed food and eating in different 3 February 2000 ways: as central to our experience of self and to the manner Social and cultural perspectives ST Kristensen 474 in which we live, and through our bodies (Lupton, 1996; what is termed as qualitative reduction, spatial ambiguity Taylor, 1989); as a symbolic medium by means of which and spatial and temporal discontinuity (Leder, 1990). both the boundaries of social class, religious af®liation, By qualitative reduction Leder means that inner percep- gender and stage of life-cycle are expressed (Bourdieu, tions tend to be vague and to be characterized by the 1984; Douglas, 1975); and as a political ®eld by means of reading of signals in a non-differentiated manner that which control of the body is established in the dieting greatly contrasts with the nuanced manner in which the behaviour of individuals as well as in the formulation of sense impressions of the outer world are differentiated Ð dietary recommendations (Turner, 1992; Crawford, 1984). what we see, hear, touch, taste or smell. According to In the following, these differences of approach are main- Leder, reports of feeling full, having cramps, registering a tained. Social scienti®c studies of hunger, appetite and feeling of biliousness or heartburn are approximately satiety and of ways of presenting and eating food that are exhaustive descriptions of the sensory impressions of the related to the regulation of appetite are presented in a inner body that are usually offered, and which it is possible manner which distinguishes individual, social and political to obtain by enquiry. While this can be queried (and I return appetite as three analytically distinct levels. This distinction to this point), it should be noted that the limited capacity to is inspired by the anthropologists Nancy Scheper-Hughes differentiate inner perceptions is thought to be due to the and Margaret Lock with respect to social scienti®c analyses fact that these impressions are affect-laden. The more of the individual, the social and the political body as three matter-of-fact manner in which the outer world is perceived different levels of analysis (Scheper-Hughes & Lock, rests upon the possibility of distinguishing the observer (or 1987). The presentation is by no means exhaustive. Neither observers) and the observed, a state of affairs that is not will the analytical distinctions introduced here be strin- available to perceptions of the inner body. For this reason, gently pursued, a fact which can partly be seen as a the latter are frequently equated with an emotional state, consequence of the interplay between factors on these taking us as it does `from the inside', the example of different levels as observed in empirical settings. experienced unpleasantness in connection with stomach cramps being a case in point. By spatial ambiguity is meant the poor capacity of inner The individual appetite perception to localize precisely what is experienced. For At the level of the individual body are studies of the instance, many of the internal organs do not register fundamental and immediate experience of being a `body- sensations of pain, such sensations being frequently self'. Studies of appetite on this level include phenomen- expressed and experienced in other parts of the body than ological analyses of the subjectively experienced and the organ in which they originated. Hunger and thirst can experiencing body in relation to food and eating. also be experienced as a mixture of more precisely located The object of observation is somewhat different com- sensations and as a more diffuse feeling in which the entire pared with the one in physiological studies, in so far as a body is involved. Hunger, for instance, is not necessarily number of the mechanisms and processes examined in experienced only as an empty stomach. It can also manifest physiological studies are not accessible to subjective itself as a general feeling of heaviness or dizziness in the experience. Physiology, on the other hand, is not irrelevant body, or as a feeling of longing in the mouth. As such, it is in the perspective of the individual appetite. Leder demon- a complex combination of impressions and feelings which, strates in his analysis of the phenomenology of digestion despite the localized character of particular sensations, that, by describing and conceptualizing parts and functions nevertheless involves the whole body in a somewhat of the body, which are otherwise inaccessible to us, the ambiguous manner. natural sciences can clarify what he terms `the structural Finally, inner perception is characterized by spatio- correlates of our intentional capacities' (Leder, 1990).