Gluttony & Sloth: the Moral Politics of Obesity Discourse
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Gluttony & Sloth: The Moral Politics of Obesity Discourse William James Hoverd A thesis submitted to the Victoria University of Wellington in fulfilment of the requirements of the degree of Doctor of Philosophy in Religious Studies Victoria University of Wellington July 2011 Abstract In this dissertation, I investigate why „official obesity discourse‟ discusses obesity in terms of the sins of gluttony and sloth. This question leads me to survey the moral politics of „official obesity discourse‟ in New Zealand between 1997 and 2009. I claim that „official obesity discourse‟ is not neutral, and contains various ideological biases. I map the overall range of these ideologies onto a schema of three models of obesity causality. I demonstrate that each of these three models corresponds to certain general policy positions of respective governments; to certain specific health policies (issued by the Ministry of Health); and to certain medical understandings of causality. I further show how each ideological model moralises obesity, in a manner that casts various groups and forces in the role of scapegoat. Finally, I argue that the three models of obesity causality I have identified discriminate against people on low incomes and in certain ethnic groups. My study concludes with a research model which can be used by other researchers to reveal the ideological and moral dimensions of obesity discourse in their own contexts. 2 Acknowledgements Kosal Kong, Thank you for all your love, patience and support during the dissertation process. Without you I could not have faced all early starts or the dark nights of doubt. This thesis is as much yours as it is mine. Dr Michael Radich, Thank you for being an exemplary mentor. You consistently challenged me to improve, be clearer, more disciplined, and to always work towards my best. You perfectly balance your academic expertise, challenge, and, rigour with patience, support, and kindness. One could not ask for a better role model. Prof Paul Morris, You have guided all of my academic study over the long years. Your passion for knowledge is inspirational. Your ideas, teachings and intellectual tradition are instrumental to my academic study of religion. Thank you for always welcoming me into your office whenever I knocked. Alan and Barbara Hoverd, thank you for your long suffering support for my postgraduate study. I love you both very much. Dr Chris Sibley and A/Prof Marion Maddox, your guidance and friendship were essential to this dissertation. Dr Stefanie Head and Jan Bunting, thank you for reading and discussing my drafts with me. Mr Leon Grandy and Aliki Kalliabetsos, I can‟t begin to count the ways you have supported me. Thanks also to Negar Partow, Rebecca Frost, Prof Chris Marshall, Annie Mercer, Dr Mike Lloyd, Dr Rick Weiss, and Dr Geoff Troughton who have particularly supported this process. I also want to formally acknowledge the people who have generously provided me with the emotional, logistical, collegial, and critical support that I drew upon to write this document. Elise Hoverd, Alex Hoverd, Kevin Francis, Dr Andrew Robertson, Philippa Robertson, Akvilina Cicenaite, Lisa Eyre, Dr Rob Keyzers, Charlotte Boyer, Dr Michael Grimshaw, Dr Joseph Bulbulia, Brook Powell, Kate Thomas, Amanda Crump, Charlotte Glynan, Emmett Gracie, Nick Milne, James Stewart, Glen Burfield, Brendan Partington, Mike Mawson, Jonathan Brookes, Thom Appleton, Dr Sophie Parker, Kim Dixon, Dr Scott Carver, A/Prof Jim Veitch, Prof Rosalind Hackett, Dr Matt Gerry, Dr Kirsty Weir, Prof Kevin Dew, Dr Heather Kavan, Dr Michael Symons, Prof John Davidson, A/Prof Matthew Trundle, Prof Charles Crothers, Dr Cat Pause, Aaron Jones, Prof Bob Wear, David Wallace, Allan McShane, Jonny Clifford, Dr Michael Gard, Susanne Liebich, Anushka Perinpanayagam, Tim McVicar, Katja Strehle, Eda Czarnecki, Amy Searfoss, Caitlin Dalzell, Daniel Dowling, Atsushi Iseki, and Chris Slane. Final thanks to my extended Kong Family. My research was assisted by: Victoria University of Wellington Postgraduate Scholarship for PhD study Reverend William Wallace Gibson Memorial Prize for Religious Studies Victoria University PhD Submission Scholarship 3 Contents Gluttony & Sloth: The Moral Politics of Obesity Discourse 1 Abstract 2 Acknowledgements 3 Contents 4 Glossary of Acronyms, Abbreviations, Definitions and Terms 8 Chapter One: Why do Modern Commentators Ascribe Obesity to the Sins of „Gluttony and Sloth?‟ 9 1.0 Preamble 9 1.1 Introduction 14 1.2 The Original Research Question 14 1.3.0 Religious Studies Literature Reviews 16 1.3.1 Sociology of the Body Literature 16 1.3.2 The History of the Deadly Sins 17 1.3.3 Christianity and the Body: The Problem of Context 19 1.3.4 Christianity, Sport, Anorexia and Devotional Dieting 20 1.3.5 Obesity Prevalence and Religious Identification 21 1.3.6 Lessons from the Literature Reviews 22 1.4.0 Critical Analyses of Scholarship on the Obesity Epidemic, and in Fat Studies 24 1.4.1 Critical Scholarship on the Obesity Epidemic 25 1.4.2 Fat Studies Scholarship 26 1.4.3 The Moral Dimensions of Social Scientific Investigations into Obesity and Fatness 27 1.4.4 Critical Literature Summary 29 1.5 Situating My Research as an Investigation into the Moral Politics of Obesity Discourse 29 1.6 Research Methodology 31 1.7 Dissertation Chapter Outlines 32 Part One: The Ideological Dimensions of Obesity Discourse 35 Chapter Two: The Behavioural Causality Model and the Origins of Obesity Discourse 36 2.0 Introduction 36 2.1 The Behavioural Causality Model 37 2.2 The Medical Basis of the Behavioural Causality Model 39 2.3 The Welfare State and Universal Free Health Care 40 2.4 Developing Concerns with Cardiovascular Disease and Population Health 41 2.5 Demographic Studies of the Population: National Diet Survey 1977 43 2.6 Concerns with Nutrition and Physical Inactivity in the 1980s 44 2.7 Individual Responsibility and Lifestyle Disease 47 4 2.8 Changing Nutritional Language: The Life in New Zealand Survey 1989 48 2.9 The Emergence of the Behavioural Causality Model 50 2.10 The Green and White Paper: The Individual as a Consumer of Health Services 52 2.11 The 1993 New Right Health Reforms 55 2.12 Behavioural Causality Policy 1996 -1998 56 2.13 Obesity Emerges as a Significant Health Problem in 1997 58 2.14 Conclusion 60 Chapter Three: The Multiple Causality Model and the Obesity Epidemic as Fact 63 3.0 Introduction 63 3.1 The Multiple Causality Model 64 3.2 The Medical Basis for the Multiple Causality Model 65 3.3 An Inequality Focus and „Third Way‟ Politics 67 3.4 The New Zealand Health Strategy 2000 70 3.5 Development of the Healthy Eating Healthy Action Strategy 73 3.6 HEHA and Multiple Determinants of Obesity 74 3.7 Behavioural Obesity Policy with Environmental Labelling 76 3.8 The Emergence of Full MCM Policy in 2004 79 3.9 Multiple Causality Model Policy 80 3.10 The Obesity Epidemic as Fact 84 3.11 The Historical Revision of the Obesity Epidemic 87 3.12 Conclusion 90 Chapter Four: The Environmental Causality Model: Obesity Budgets and the Select Committee 93 4.0 Introduction 93 4.1 The Environmental Causality Model 94 4.2 Origins of the Environmental Causality Model 95 4.3 The Medical Basis of the Environmental Causality Model 97 4.4 Budget 2006: the Largest Campaign in New Zealand‟s History to Fight Obesity 100 4.5 Soft Drink Advertising: the Transition from the Multiple to Environmental Causality Models 102 4.6 The Select Committee Inquiry into Obesity and Type 2 Diabetes in New Zealand 104 4.7 Anti-Free Market ECM Critiques and the Select Committee 110 4.8 Environmental Causality Model Obesity Policy in 2008 113 4.9 Conclusion 116 Chapter Five: The Politics of Obesity Discourse 119 5.0 Introduction 119 5.1.0 Obesity Policy in the November 2008 General Election 120 5.1.1 ECM Policy – The Green Party 121 5 5.1.2 Educating Individuals About Health Risks – The New Zealand Labour Party 123 5.1.3 Warrant of Fitness Checks - The Maori Party 123 5.1.4 Healthy People/Healthy Economy - New Zealand National Party 124 5.1.5 The Association of Consumers and Taxpayers Party 129 5.2 The Political Spectrum of Obesity Causation Models 131 5.3.0 The Removal of Obesity as a Health Target 132 5.3.1 Healthy Food in Schools - National Administration Guideline Clause Removal 134 5.3.2 New Zealand 3rd Most Obese Country in the World 139 5.3.3 Physical Activity: The Emphasis on Sport 140 5.3.4 Recent Obesity Politics: The Voluntary Schools Beverage Statement 142 5.4 National Coalition Obesity Policy Reversal 144 5.5 Conclusion 145 Part Two: The Moral Dimensions of Obesity Discourse 147 Chapter Six: The Moral Dimensions of Obesity Discourse 148 6.0 Introduction 148 6.1 ECM - Communal Morality 149 6.2 Obesity Burden Language 153 6.3 BCM - Individual Morality 158 6.4 Coexisting Individual and Communal Moralities 164 6.5 Scapegoating the Obese 165 6.6 Moralising against the Obese: “It‟s Your Fault If You‟re A Fatty” 168 6.7 Conclusion 174 Chapter Seven: Obesity Economics, Morals, and, Income Inequality 177 7.0 Introduction 177 7.1 The Economic Burden of Obesity 178 7.2 New Zealand Economics of Obesity 180 7.3 Capitalism and Nutritional Efficiency 182 7.4 Obesity, Class, and Critiques of Capitalism 186 7.5 The Relationship Between Income and Health Inequality 188 7.6 Income and Health Inequality Today 193 7.7 Conclusion 195 Chapter Eight: Ethnic Inequality and Obesity 198 8.0 Introduction 198 8.1 Two Forms of Inequality 199 8.2 Inequality by Ethnic Group 201 8.3 Ethnic Contestations of BMI 203 8.4 The Removal of Ethnic BMI Ranges in the NZHS06/07