Obese societies: Reconceptualising the challenge for public health

Abstract

The prevalence of obesity and related health problems has increased sharply in recent decades. Dominant medical, economic, psychological, and especially epidemiological accounts conceptualise these trends as outcomes of individuals’ lifestyles – whether freely chosen or determined by an array of obesogenic factors. As such, they rest on forms of methodological individualism, causal narratives, and a logic of substitution in which people are encouraged to set currently unhealthy ways of life aside. This article takes a different approach, viewing trends in obesity as consequences of the dynamic organisation of social practices across space and time. By combining theories of practice with emerging accounts of epigenetics, we explain how changing constellations of practices leave their marks on the body. We extend the concept of biohabitus to show how differences in health, well-being, and body shape are passed on as relations between practices are reproduced and transformed over time. In the final section, we take stock of the practical implications of these ideas and conclude by making the case for extended forms of enquiry and policy intervention that put the organisation of practices front and centre.