372 Evans, Rich, and Davies

JOURNAL OF TEACHING IN PHYSICAL EDUCATION, 2004, 23, 372-391

© 2004 HUMAN KINETICS PUBLISHERS, INC.

The Emperor’s New Clothes:

Fat, Thin, and Overweight. The Social Fabrication
of Risk and Ill Health

John Evans and Emma Rich

Loughborough University
Brian Davies
Cardiff University

Introduction: Fat Orthodoxy

It is now well over 60 years since the publication in Britain of the Board of
Education’s (1933) Syllabus For Physical Training For Schools. It was a remark-
able document, not only for the amount of detail it provided on the teaching of
physical education, no doubt necessary for a teaching force then predominantly
untrained to teach it, but also for the status it was accorded (then called physical
training) in the elementary school curriculum. “The development of a good phy-
sique” and the provision of an “efficient system of physical training” were seen as
nothing less than a matter of “national importance” as “vital to the welfare, even
the survival of the race” (p. 8). The echoes of war, general economic recession,
and widespread social deprivation unsoftened by the supporting structures of a
welfare state had much to do with the Board’s emphasis on the production, promo-
tion, and maintenance of fitness for health. Throughout the syllabus the social and
medical functions of physical training loomed large. An efficient system of physi-
cal training could help compensate, but not correct, alleviate, or act as a “remedy
for all (British economic and social) ills” (Board of Education, 1933, p. 8). Such
was their magnitude that the Board acknowledged (in a manner not always so
prevalent in more recent health reports) that physical training had its curative lim-
its. Even so, it went on somewhat optimistically to claim that the syllabus could,
“if rightly and faithfully used, widely adopted and reasonably interpreted, yield an
abundant harvest of recreation, improved physique and national health” (p. 8).
Physical education has long been associated officially with the development
and maintenance of the health of school children in the United Kingdom (UK), as
in the United States (US) and elsewhere (see Kirk, 1992, 2004). Over the past 20
years this association has become even stronger. Since the 1980’s “health issues”
began to be featured regularly in the physical education literature, first in the form
of expressions of commitment to “health related fitness,” later renamed “health
related education” and, thereafter, increasingly in mainstream physical education
programs in schools (see Fox, 1991; Penney & Harris, 2004). A commitment to
certain elements of health education is now embedded in the National Curriculum
for Physical Education (NCPE) to which all pupils between the ages of 5 and 16
Evans and Rich are with the School of Sport and Exercise Sciences, Loughborough
University, Leicestershire, UK LE11 3TU. Davies is with the School of Social Sciences,
Cardiff University, Glamorgan Building, Cardiff, CF10 3WT.
372
The Emperor’s New Clothes 373

are entitled in England and Wales. Beneath its carapace a variety of health dis-
courses and practices now prevail.
All, in one way or another, express what we have elsewhere described as
“body perfection codes” (Evans & Davies, 2004, p. 207). These generate curricu-
lar and pedagogic modalities that variously focus on the body as:
imperfect (whether through circumstances of one’s social class or poverty,
or self-neglect);
unfinished and to be ameliorated through physical therapy (circuit training,
fitness through sport, and a better diet); or
threatened (by the risks of modernity or lifestyles of overeating and inactiv-
ity);
and, therefore, in need of being changed (Evans, Davies, & Wright, 2004). Since
the early 1980s, these initiatives have been increasingly driven and legitimized by
influences outside and independent of the educational establishment, for example,
the World Health Organization (WHO, 1998), the British Heart Foundation (BHF,
1999), UK central government (House of Commons, 2001), the US Surgeon Gen-
eral (US Department of Health and Human Services [USDHHS], 1996), and United
States Department of Health and Human Services (2001) reports. Drawing on data
from a variety of sources, all have reported increasing health risks facing popula-
tions, not just in Britain and the USA, but globally.
Even as we write, we find yet another report, this time issued by The Royal
College of Physicians (2004), warning of the dire state of Britain’s health and,
specifically, the rising tide of obesity unless action is taken by the central Govern-
ment, the food industries, the medical profession, and the schools to help the popu-
lation take more exercise, eat properly, and lose weight. So serious is this threat in
the UK, it seems, that the Government’s Health Secretary, John Reid, announced
the need for a “White Paper to Tackle Obesity” (2004) and the Media and Culture
Secretary, Tessa Jowell, hinted at a ban on junk-food advertising on children’s
television. Her government department, however, focused attention on the “de-
cline of physical activity among the young, rather than the food they eat,” claim-
ing that “many teachers believe that the government target of schools providing
two hours of organized physical activity a week is impossible in the current cur-
riculum” as the main cause for concern (“White Paper,” 2004, p.1).
Health concerns, specifically the “obesity epidemic,” dominate the discur-
sive terrain and form part of the cultural fabric that defines our daily lives. In one
month, in The Guardian (one of Britain’s more respectable newspapers) for ex-
ample, we find:

1/30/2004: Fat test shows Manchester really is larger than life

1/27/2004: Pressure grows for curbs on junk food ads
1/26/2004: Coke logo banished from British schools
1/18/2004: Celeb mag to tackle UK’s health crisis
1/18/2004: Obese told: It’s up to you
1/14/2004: Jowell: no ban on junk food ads
1/9/2004: Pupils under seven to get free fruit
1/8/2004: Obesity: rising fears of cancer time bomb
1/6/2004: Traffic light” diet helps obese children slim
374 Evans, Rich, and Davies

Were we to look at the headlines of the more populist tabloid newspapers in

the UK, we would find an even more alarming/alarmist take on “the crisis” puta-
tively blighting (or about to blight) our lives. For example, “War on Obesity. Docs
Fight New Black Death” (2004, p. 11). The magnitude of the problem, “in 2002,
70% of men and 63% of women are either overweight or obese,” along with a
catalogue of risk factors: “the terrifying increase in the number of children with
Type 2 diabetes,” “early death, heart disease, breast cancer, diabetes, colorectal
cancer” (the list goes on), is paraded across the cultural landscape. The language is
as proud with fact and certainty as it is loaded with emotion and intention to en-
gender alarm and fear. These discursive tendencies are not peculiar to the UK of
course. In Australia the Labor party has similarly announced plans for a healthier
and more active lifestyle (Lundy & Gillard, 2003), and from the US we learn that
“Overweight and Obesity Threaten US Health Gains” (Thompson, 2001, p.1).
Although not reaching the emotive depths of the British tabloids, we suspect
that we would find close equivalents of the kind of reporting described previously
in these and other countries too. Along with central government action, further
restraint on the food industry, better diets, and schools are invariably identified as
“key settings for public health strategies to prevent and decrease the prevalence of
overweight and obesity,” in the US (USDHHS, 2001, p.18), the UK, and else-
where. More health education, more time for intensive physical activity, and better
school diets have become the mantras of the vast industry of health “experts” (in-
cluding politicians and teachers) who operate in and outside the schools.
We have no wish to impugn the good intentions, expertise, or core senti-
ments of those who report health problems; or contest the view that obesity can be
and often is a serious problem in some parts of the world. In the rest of this article,
however, we want to highlight the potential implications for the physical educa-
tion profession, its curriculum, pedagogies, and, more importantly, the identities
and well-being of children in schools, of adopting an unthinking and uncritical
attitude towards the modern discourse of ill health. For, typically, there is precious
little mention in the pages of the previously mentioned reports and none at all in
the versions recycled through the many media agencies, government spokesper-
sons, and experts who trade in the news, of any of the methodological limita-
tions, or the ambiguities, uncertainties, and contradictions that reside in the
data bases of the primary research field that informs them (see Gard, 2004 a,
2004b).
Nor is it our intention to pit one sort of data or evidence against another, for,
as others have pointed out, statistics (like all other forms of data) can be used and
abused to tell whatever ideological tale we care to tell (Gard, 2004b). It is simply
to note that the problems and questions we seek to solve through the curriculum of
physical education are inextricably tied to the way in which they have been con-
structed and defined in the first place and to the methodologies then used to ad-
dress them. Thus, in subsequent sections of this article, we reasonably ask: Are the
contemporary conditions of obesity and overweight real, or are they mere artifacts
of the different methodologies and thresholds used at different times and places to
construct them, and which constructions form the basis for the previously men-
tioned reports? Is a culture of risk and fear being nurtured in society by such re-
ports and creating new “hierarchies of the body” that potentially damage the
identities of children and young people in schools? In our view, in the cacophony
of emotional reporting that accompanies reports, ideological assertion and political
The Emperor’s New Clothes 375

expediency have become poor substitutes for the research evidence and opinion
that should define the knowledge considered as legitimate in the public domain.

Good Food, Bad Food—Good Citizens, Bad Citizens!

Why are these discursive trends so worrying? Even a cursory reading of the
reports mentioned previously reveals that moral as well as medical overtones litter
their pages; incantations of the right amount of exercise, the right diet, the correct
body shape. It is hardly surprising then, that we find alongside obesity discourse a
data set suggesting that levels of body disaffection and eating disorders, such as
anorexia nervosa and bulimia, especially among women and young girls, are higher
than ever and not just in the UK (Grogan, 1999). Indeed, in the UK it is claimed
that the data on obesity is revealing a new class divide around eating. On the one
hand, the obesity crisis, on the other, the slimming of Britain, and is revealing the
real story of a divided nation. Reflecting the somewhat patronizing and evaluative
overtones that characterize this field, the diets of some children in “the lower so-
cial classes” are “scandalous” according to Professor Philip James, Chairman of
the International Obesity Task Force based in London, and “social division[s] in
health are getting worse” (Fit or Fat, 2003, June 8, p.14). In this view, there has
been a “proletarianization of fat” in which “the overweight,” once admired, are
now despised. Whereas 20 years ago fat was a feminist issue, today it is a class
issue (Fit or Fat, 2003, p.14). While the working classes get fatter from lack of
exercise and bad diets, the middle classes get thin, or so it seems.
The simplicity of these arguments that caricature value systems around eat-
ing, fat, and exercise is deeply disturbing and belies the complexity of the research
evidence. It not only obscures the desires that the classes may have in common, to
eat well, exercise, and get healthy (Schools Heath Education Unit, 2003) but also
the way in which such opportunities to achieve these things are differently loaded
by social location and wealth. Indeed, in the US
the relationships between socio-economic status and overweight in girls is
weaker than it is for women: that is, girls from lower income families have
not consistently been found to be overweight compared to girls from higher
income families (USDHHS, 2001, p. 14).
We are hardly yet in a position to claim certainty on such matters in the UK. Again
our point here is not that class differences are not important; to the contrary, we
believe data on weight, exercise, and food should be located socially and cultur-
ally if it is to be properly understood. But at the moment uncertain facts are traded
as certainties with a strong evaluative overtone in research of this kind.
Given these cultural tendencies, it is not a good time to be fat in the UK or
elsewhere in the Western world for that matter. For, although the aetiology of obe-
sity is described neutrally in the biomedical research and reports of the kind men-
tioned earlier as essentially a positive imbalance between energy ingested and energy
expended, as a social practice it is regarded as neither innocently neutral nor value
free (Cogan, 1999; Evans, 2003). Indeed Saukko (1999) argues that theories of
obesity and anorexia, like many other theories of deviant behavior, tell us more
about the norms of our times, which currently idealize individual independence
and strength, than about eating. As Ritenbaugh (1982, p.352) pointed out, the terms
obesity and overweight have become “the biomedical gloss for the moral failings
376 Evans, Rich, and Davies

of gluttony and sloth. Important themes in American society, we are told, are indi-
vidual control and fear of non-control—obesity is a visual representation of non-
control.” Such a culture is now equally evident in the UK and elsewhere (Evans,
Evans, & Rich, 2002; Gard & Wright, 2001). In the blame-the-victim culture that
this nurtures, fat is interpreted as an outward sign of neglect of one’s corporeal
self: a condition considered either as shameful as being dirty or irresponsibly ill, in
effect, reproducing and institutionalizing moral value beliefs about the body and
citizens. At the extreme, it exhorts people to develop embodied relationships based
on fear, anxiety, guilt, and regulation (Gordon, 2000, 2001). Little wonder that we
have witnessed, alongside the obesity panics, obsessive attention to self-control
through diet, exercise, or more extreme measures to achieve contemporary, slim
ideals. “If you are not slim and perfect then you are considered not to be a real part
of society.” Fourteen-year-old Lauren Hartley, on why she wants to have plastic
surgery (“Talking Heads,” 2004, p.16).
In the UK, then, we are purportedly getting simultaneously fatter and
thinner—or rather some are getting fat while others are getting thin; we are either
eating too much or too little, exercising in excess or not enough. Moreover, the
vast majority, 60–70% at the latest count, are simply overweight and at risk, stand-
ing on the edge of the obesity abyss unless they eat the right food and take proper
measures to exercise and get thin.

Reading the Obesity Literature1—You Can Not Be Serious!

How on earth are we to read this literature and wade through the quagmire of
facts, ideology, and assertion that trade as knowledge in the health fields? (see
Austin, 1999; Evans, 2003; Gard, 2004a, 2004b).
Perhaps the first thing to note when discussing health education develop-
ment in the UK, the US, and elsewhere is that a subtle but significant shift has
occurred in the discourse that has underscored and legitimized developments in
schools over the last 2 decades or so. This is well reflected in the titles of the 1996
and 2001 Surgeon General Reports in the US. Whereas the USDHHS (1996) re-
port Physical Activity and Health focused essentially on increasing levels of activ-
ity in the population in the USA, the USDHHS (2001) report Call to Action to
Prevent and Decrease Overweight and Obesity centered on weight as the prime
topic of concern. What began in the early 1980’s and 90’s as concerns for physical
activity and exercise levels has, it seems, been reduced essentially to the business
of making people eat properly, get active, and, ideally, become thin. At one level
this “slippage” is perhaps unsurprising. Given the difficulties that have been regis-
tered in the intervening years of measuring activity and defining the levels at which
it is beneficial to health,2 it is understandable that policy makers should turn their
attention to what, on the surface, seem more objective and reliable measures of a
person’s or nation’s health: their individual or collective waist line or body mass.
What better indices of the efficacy of public policy on education and health than
whether it has made people less heavy and manifestly more thin?
As we have elsewhere pointed out (Evans, 2003), it is vitally important when
reading the obesity literature to remember two things. First, whereas fat can be
considered at least in part a physical/visceral condition, weight, overweight, and
obesity can not. They are each a social arbitrary, measured constructions in the
thinking of someone (for example, researchers or the medical profession, or the
The Emperor’s New Clothes 377

insurance companies for whom indices of the body mass index [BMI] type were
originally designed). Second, even when a threshold has been set for defining the
point at which “weight” becomes “over,” it is another thing entirely to then claim
that this condition is a causally related problem for a person’s health. So, for ex-
ample, the claim that 60–70% of the population are now to be considered over-
weight, which is intended to set alarm bells ringing, is in itself of no more
significance as a statement of a population’s health (unless it is considered in con-
junction with a host of other data on exercise levels, diet, lifestyle factors, such as
poverty, or smoking, etc.) than saying that its members also for much of the time
stand on two legs. A weight-range norm is pathologized and classified as a poten-
tially life-threatening condition.
Although defining obesity is straightforward, measuring it is not. As others
have noted, simply stated obesity refers to an excess of body fat. It is to be distin-
guished from overweight, which refers to weight in excess of some standard. “Mea-
suring weight is easy and inexpensive, while measuring body fat is not.
Consequently, overweight is often used as a proxy for obesity” (Brownell, 1995, p.
386). Brownell also points out that the precise point at which scientists and health
officials believe increasing weight threatens health ranges from 5% to 30% above
ideal weight, a considerable spread (Brownell, 1995, p. 386).
Despite these serious difficulties, however, the differences of opinion and
scientific uncertainties expressed in the field of primary health research (see
McGinnis & Foege, 1993, for a US take on this issue), the health industry (health-
education experts, government agencies, teachers, and academics) has wholeheart-
edly embraced the highly questionable concept of ideal weight, “the idea that weight
associated with optimum health and longevity could be determined by height”
(Seid, 1994, p.7). As readers will be aware, obesity is now typically defined as a
body mass index (BMI) of 30 kg/m2 or higher (weight in kilograms divided by
height in meters squared, World Health Organization, 1998).
BMI, however, is also acknowledged (at least by some) to be thoroughly
imprecise. For example, it overestimates fatness in people who are muscular or
athletic, does not register fat distribution, and is an extremely poor measure for
children and adolescents. Nevertheless, it is widely accepted and used in the medi-
cal profession and by teachers in schools. As Professor Ian Macdonald, coeditor of
the International Journal of Obesity, stated that the simplicity of the BMI makes it
a godsend for researchers looking at trends, but it is also something of a broad-
brush tool. Doctors like it and use it, he added, simply because they might have
neither the time nor the resources to apply the more sophisticated measures avail-
able and necessary to provide more accurate and meaningful measurements of
individuals’ weight and health (reported in Hann, 2002).
The use of the data on childhood obesity is even more alarming and unre-
flective. Although researchers working in this field have acknowledged the diffi-
culties of measuring children’s weight, especially noting, for example, that
“comparison of data concerning obesity in children and adolescents around the
world is difficult because of the lack of standardization of the classification of
obesity and interpretation of indicators of overweight and obesity in these age
groups” (Seidell, 2000, p.26), the apparent increase in the prevalence of obesity
among children and adolescents in many countries is still considered and presented
by some as a particularly alarming fact (The Royal College of Physicians, 2004).
Thus, it is emphasized that prevention of obesity “should be amongst the highest
378 Evans, Rich, and Davies

priorities in public health” (Seidell, 2000, p. 28). The conditions these measure-
ment tools discursively produce, overweight and obesity, combined with a physi-
cally inactive lifestyle, are then presented as a major global health threat, being the
most prevalent risk factors for chronic disease in most countries of the developed
world, that is, with established market economies. These conditions are reputedly
the product of global forces, essentially comprising increased wealth, sedentary
lifestyles, and altered eating habits. The wide variations in the prevalence of obe-
sity and overweight within and among countries that casts doubt on some of these
core claims is noted (see the National Audit Office [NAO], 2001 report) but hardly
explained (see Gard, 2004a & 2004b; Le Fanu, 1999; Stearns, 1999).
As readers of this literature, we are then left in little doubt that we are at risk
and in the midst of an overweight and obesity epidemic. Data from almost all of
the countries of the industrialized world and even data from the third world, it is
claimed, reveal that a growing proportion of children and adults is either over-
weight or obese and, therefore, by definition in this perspective, unhealthy
(Bouchard, 2000, p.12). Bouchard, for example, notes alarmingly that about 50%
of adults in the United States and Canada and some of the western European coun-
tries have a BMI of at least 25 (the threshold for overweight), and that the preva-
lence of frank obesity in childhood and adolescence has more than doubled since
the 1960s. Bouchard goes on to speculate that the worst scenario is that these
increases in childhood obesity will translate into an even greater prevalence of
adulthood obesity than is currently observed. And because there is no easy cure for
this overweight/obesity disease, prevention is seen to lie in targeting young chil-
dren, adolescents, and young adults through intervention programs in schools and
persuading the wider population to adopt a more physically active lifestyle associ-
ated with a low fat diet. What better rationale for physical education and related
health professionals armed with skin callipers and BMI tables than to become the
front-line saviors of (fat) humankind? Sound knowledge, opinion, or nonsense of
the first order? (Evans, 2003).
Consider another example: the House of Commons (HoC) Public Accounts
Select Committee Ninth Report (House of Commons, 2001) entitled Tackling
Obesity in England. Having received views from a variety of “expert sources,” the
report states, emphatically and unequivocally, that
Most adults in England are overweight, and one in five—around 8 million in
total—is obese. The prevalence of obesity is increasing world wide and, in
England, has nearly trebled in the last 20 years. The most likely causes are
an increasingly sedentary lifestyle combined with changes in eating patterns
(House of Commons, 2001, p.1).
The report concludes, “Obesity is a major public health concern which is increas-
ing throughout the world and for which there are no easy or short term solutions,”
claiming that “unless effective action is taken, over 20% of men and 25% of women
could be obese by 2008, with important consequences for the NHS (National Health
Service), the economy and the people involved” (House of Commons, 2001, p. 1).
Although the detailed National Audit Office (2001) Report on which these state-
ments are based is far more circumspect in what it claims about obesity and health,
for example, noting the problems of measuring and classifying obesity in adults
and children, the difficulties associated with determining the aetiology of obesity,
and alluding to the complex demography of obesity in England (suggesting that
The Emperor’s New Clothes 379

there might be important socioeconomic and ethnic differences in relationships to

weight and being obese), these cautionary caveats are not reflected in the House of
Commons report.
Nor, for that matter, are they reflected explicitly in the recommendations of
the NAO report that also effectively reduces explanations of the obesity problem
essentially to a weight concern, the product of “less active lifestyles and changes
in eating patterns” (NAO, 2001, p.1). The data is then rationalized to generate
policy recommendations that are intended to influence the practices of health ex-
perts in local health authorities, government agencies, and teachers concerned with
personal, social, health, and physical education in schools. A more recent variant
of this literature, namely the Report—Obesity Prevention: The Case for Action
(Kumanyika, Jeffrey, Morabia, Rittenbaugh, & Antpatis, 2002) further illustrates
the discursive leanings of the obesity field. The Report, published in the Interna-
tional Journal of Obesity, quickly gets into conventional stride. Without recourse
to qualifying cautionary statements pointing either to the uncertainty, ambiguity,
or cultural specificity of the evidence available in the primary research field, we
are told, “overweight and obesity represent a rapidly growing ‘threat’ to the health
of populations and an increasing number of countries world wide”. Search as we
might for the basis of this claim, we find that it seems to rest on reference to other
expert opinion rather than primary research evidence.
This is not, of course, to suggest that there are no reliable facts and data in
this discourse or that rising levels of obesity and associated mortality rates are
mere illusion. For some individuals, amongst some factions of the population, and
in some countries, it may be a major concern. Our point here is only that in this
discourse, as in that mentioned previously (House of Commons, 2001), it is sim-
ply presented as axiomatic that weight (gain) is a (universal) problem, rather than
an expected element of normal growth and maturation, or a product of near global
contemporary improvements in diet and health. Here, too, is the language of threat,
risk, and uncertainty: individually, nationally, globally. Our health and economic
well-being are threatened by the spread of the obesity disease. As the story unfolds
(Kumanyika et al., 2002, p. 425), overweight joins obesity (to swell numbers, we
guess) and add weight (sic) to the problem espoused. Weight, especially the notion
of putting it on, an otherwise neutral concept and a quite useful practice in many
cases and places, achieves the significance of a modern-day disease, and, by nasty
extension, of a social and moral sin. Albeit unintentionally, the potential is created
for stigmatizing those, for example, the lower socioeconomic and ethnic groups
defined in the NAO (2001) report as most at risk to falling prey to the obesity
disease, as pathologically unable to look after their bodies (by exercise and better
diets) and therefore in need of intervention, rescue, and care.

Just Who is at Risk?

It is worth reminding ourselves that, when reading the presentation of epide-
miological research findings, in epidemiological terms risk is a probabilistic con-
cept rather than a deterministic one, and as such it is inappropriate to talk in terms
of either causality or certainty. Such a cautionary perspective, however, seems
strangely absent in the Kumanyika et al. (2002) Report as in other literature of its
kind (NAO, 2001). Even before we get past the first page of the Report, for ex-
ample, we are led to believe, without any qualifying noises, that “obesity is a ma-
jor contributor to the global burden of disease and disability” (Kumanyika et al.,
380 Evans, Rich, and Davies

2002, p. 425) and the boundaries between contributory and causal quietly disap-
pear. It is claimed that “overweight and obesity are important ‘risk factors’ for a
wide range of medical conditions including . . .” (p.425).
But what does this mean? What level of risk is being talked about here—the
normal, the insignificant, the something to worry about slightly, the statistically
significant, or the serious kind? We don’t know, nor do the authors it seems. To
make matters worse (the facts less certain), the Report goes on to assert (p. 426)
that the “risk of developing these conditions (of ill health) is greatest when the
majority of excess fat is located around the abdomen (central obesity) rather than
around the hips and thighs.” A similar point is made by the NAO (2001). Yet the
tool for measuring obesity (the BMI index) does not differentiate in this way, and
we do not know whether the tools used to measure obesity globally (as a basis for
the Report and the NAO) did so either, so we cannot say whether the spread of
global fatness is of the healthy or unhealthy kind. One can only guess that a sig-
nificant number of the people measured (for example, some women for whom the
spread of fat is mostly around the hips and thighs) are therefore overweight but
relatively healthy or, if not healthy, then not at too much of a risk.
Moreover, it is asserted that
non communicable diseases threaten to overwhelm care services world wide.
Communicable maternal, perinatal and nutritional disorders (the traditional
enemies) are expected to account for 10.3 million deaths a year in 2020—a
decline from 17.2 million deaths in 1990.Over the same period, deaths from
non-communicable diseases are expected to rise from 28.1 million to 49.7
million a year—an increase in absolute numbers of 77%. (Kumanyika et al.,
p. 426)
Everyone has to die of something, of course. If communicable deaths go
down, then noncommunicable deaths go up, the latter rising starkly as people live
longer as a result of steadily improving diets and health. Even to the ill-informed
mind the figures suggest that if there were a dramatic decrease in communicable
diseases, one would expect to find a statistically significant rise in the incidence of
the noncommunicable kind. And how do we arrive at these expected figures? We
cannot know how the forecasts are being made because the underlying methods
and data are not presented. Even if they were, modeling and forecasting of this
kind over such time periods is of a nearly worthless kind. And even if accurate,
would they automatically signal an increased cost to the health service or merely a
change in priorities and foci? There is simply not enough data there to draw con-
clusions of this kind. As for assertions of “prevalence, trends, and economics”
(Kumanyika et al., p. 427), let us take them for what they are: assertions and no
more.
“The prevalence of obesity is increasing world wide at an alarming rate. . . .
A clear relationship exists between average BMI and the prevalence of
obesity in a population (Kumanyika et al., p. 427).” Of course a clear relationship
exists. Since obesity is defined as a given BMI value of 30, any shift of a distribu-
tion by increasing the mean will, unless there is a dramatic (and highly unlikely)
decline in variance, lead to more of the distribution falling above the cut off of 30.
There is certainly a relationship but not of a causal kind. So, how are we supposed
to read this data? Is it legitimate to read a normal increase in weight (contingent
upon improved diets) as a startling trend and evidence of an endemic disease?
The Emperor’s New Clothes 381

Unfortunately, the evidence on childhood (Kumanyika et al., p. 428) is even more

alarming and alarmist in its reporting but equally meaningless and shallow given
what we know of the vagaries of the maturation process and the difficulties of
measuring children’s weight. One might note in passing, however, that we should
simply respond to the statement “approx. 22 million children under 5 yr are ‘over-
weight’ across the world” in one of two ways: first, we should ask “So what?” and
then “Compared with what and when?” while noting that life expectancy has also
increased in most of the countries mentioned, leaving us to ask, “Does overweight
and obesity, therefore, lead to prolonged life or vice versa?”
Let us be clear: morbid obesity can be a serious health problem, especially
in cultures that stigmatize it. We have no more wish to undermine the commitment
of those who strive to address this condition than we would those who deal with
eating disorders at the other extreme, such as anorexia nervosa and bulimia nervosa.
It is to be acknowledged, despite the methodological problems in many individual
studies, that there is a body of evidence suggesting a relationship between obesity
and adverse health outcomes, including life expectancy (Jonas, 2002) when medi-
ated by other complex conditions, among them levels of activity in a person’s life.
In short, none of these conditions of the body can or should be reduced simply to a
problem of weight concern. To do so not only diminishes our understandings of
the body and health in contemporary culture but also our thinking in the direction
that health can be achieved by overweight people without dieting and weight loss
(Jonas). Our point here, however, is that the dominant discursive features of the
obesity literature, the cautionary voices, ambiguities, and uncertainties evident
within the knowledge base of biomedical research (see Gard & Wright, 2001; Le
Fanu, 1999), tend to be transformed unequivocally, sanitized, and cleansed when
used by state agencies (such as the World Health Organization, House of Com-
mons Committees, health experts within academia and elsewhere). They become a
discourse of conviction and certainty where none is deserved. It is simply pre-
sented as axiomatic that there is an epidemic of fatness afflicting the world. Given
the way that overweight and obesity is defined, measured, and conflated, half the
population of the US, Europe, and the developing areas of the world is inevitably
pathologized.

Constructing Ill Health

One is reminded here that health beliefs and perceptions and definitions of
illness are constructed, represented, and reproduced through language that is cul-
turally specific, ideologically laden, and never value free. We fabricate and en-
dorse beliefs about health and illness continually through the narratives of such
texts, and they have particular import as they enter the policies and the practice of
health experts. Indeed, one has to note the form, function, and content of such texts
to appreciate their potential significance as a cultural toxin: a powerful influence
not only on policy and practice in health-promotion agencies but also on the public
psyche and on the mind set of teachers in schools and, ultimately, on the lives of
the young people they teach.
First, these beliefs are presented as the voice of biomedical expertise; the
experts have authority, power, and authenticity, and there are no uncertainties in
the narrative. Without recourse to the ambiguities and conflicts of opinion and
evidence in the primary research field, the reader is asked to accept as a given, for
382 Evans, Rich, and Davies

example, that overweight and obese are both fundamentally and inherently very
bad things. Both conditions are conflated in these texts, as in so many others of
their kind, in order to increase the seriousness of the problem and to add impact to
the central health theme that “fat kills.” Rarely, if ever, is the reader invited to
consider that weight gain is normal and to be expected or to question the veracity
of assertions such as “most adults in England are overweight,” despite the impre-
cision of the measurement techniques, the arbitrariness of the thresholds used to
draw “normal weight lines,” and the diversity of expert opinion in the field of
primary research.
We might reasonably ask, “At what particular point does the condition over-
weight become damaging to one’s health? How are thresholds established and
measured? What are we to make of the residue of the population, those who fall
below the threshold, who we assume are either normally healthy or badly under-
weight? In serving the interests of obesity discourse, these texts have nothing at all
to say on these matters. In effect, this is a narrative of certainty and negativity
signaling, as it does, a potential threat to personal, institutional, national, and glo-
bal health and economic well-being. It is also a discourse of immediacy and prox-
imity; it presents a here and now, on-the-doorstep disease. Further, it is a discourse
of risk because all could fall prey to its advances unless appropriate intervention,
investment, and action is taken at all appropriate levels.
As Gard and Wright (2001) have pointed out, by designating these issues as
risky, this discourse is instrumental in helping to manufacture a public health scare.
Rather strategically, it creates a moral panic that requires intervention—in this
case a problem that only surveillance and treatment of body shape, size, and fat-
ness through the primary technology of intervention will cure. In the House of
Commons report, for example, it is recommended that:
practice nurses, dieticians and school nurses can play a valuable role in iden-
tifying patients with weight problems (emphasis added) in providing advice
and support on weight control, but practices vary. General practices should
seek to engage a wider range of health professionals in this work, including
those working in the community and school settings (House of Commons,
2001, p. 7).
The upshot of this is that the social, cultural, psychological, and economic
complexities of obesity are reduced simply to the identification of a weight prob-
lem and its panacea, weight loss and eating proper food. The moral, evaluative,
and regulative overtones of such texts are barely disguised. Consequently, a new
set of value imperatives comes into play. In Gard and Wright’s (2001, p. 546)
view, “the knowledge and practices associated with these discourses serve to clas-
sify individuals and populations as normal, or abnormal, as good or bad citizens,
as at risk, therefore requiring the intervention of the state in the form of the medico
health systems and education.” It is a discourse that allows health experts “to con-
struct those who are overweight as lazy and morally wanting, giving permission
on a daily basis for intervention in people’s lives,” at worst “ridicule and harass-
ment and the right to publicly monitor the body shape of others.” (Gard & Wright,
p. 546)
More sanguine and cautious voices are barely heard (Gaessor, 2003). Brodney,
Blair, and Lee (2000), for example, have suggested that programs concentrating
on weight and dietary change are not only seriously limited in their foci but are not
The Emperor’s New Clothes 383

working. Their painstaking research on the overweight and obese, for example,
suggests that “men who were unfit had a higher relative risk for all-cause mortality
than their fit peers at all body fatness and waist circumference categories” (Brodney,
Blair, & Lee, p. 365). In short, size is not the issue. “Obese men who are at least
moderately fit (physically active) do not have an elevated mortality rate and, in
fact, this group had a much lower death rate than unfit men in the <27 BMI cat-
egory (18.0 compared with 52.1 deaths per 10,000)” (p. 365). They argue that
“public health would be better served with more comprehensive attempts to in-
crease population levels of physical activity, rather than emphasising ideal weight
and ranges and raising an alarm about increasing prevalence rates of obesity” (p.
367). Thus, although overweight and obesity are constructed as pathological, for
many patients there might be little or no relation between their weight and health.
The relationships between obesity and health are more tenuous, complex, and con-
tradictory than the obesity-epidemic discourse would lead us to believe (see Gard
& Wright, 2001).

Pedagogies of Ill Health

There is now a growing body of research that illustrates how the discursive
tendencies outlined previously might be expressed in the curriculum and pedagogies
of physical and health education and in the perspectives of teachers and children in
school (see Burrows & Wright, 2004; Evans, Davies, & Wright, 2004; Evans, Evans,
and Rich, 2002; Evans, Rich, & Holroyd, 2004; Rich, Holroyd, and Evans, 2004).
To illustrate these processes, albeit briefly, we now turn to a study of a number of
young women ages 14–18, all of whom were recovering from the eating disorder
anorexia nervosa at a specialist clinic and who were part of a research project
investigating the relationships between education and eating disorders (Evans, Rich,
& Holroyd). The clinic caters to both males and females between the ages of 11 and
18. At the time of the study, however, only 1 of the 25 young people attending was
male and could not be included in the first phase of research, which reflects broader
patterns in the social spread of eating disorders (see Doyle & Bryant Waugh, 2000).
The young women whose voices are heard in the study are between 14 and
18 years old. All come from middle-class families and have attended what might
be described as high-status, comprehensive grammar or private schools. Bearing
in mind both the multidimensional nature of young people’s lives and eating disor-
ders, the project aimed to understand and highlight the relationships between for-
mal education and wider social practices (e.g., those occurring within the family)
among peers and in relation to leisure and employment, with reference to the aeti-
ology and development of eating disorders. To this end, we employed a qualitative
methodology and used a variety of techniques designed to allow for an examina-
tion of the issues central to the investigation. In line with a growing trend in youth
studies, ours focused on the active involvement of the research participants in the
generation of data (e.g., Christensen & James, 2000). Within the overall research
design, various activity-based tasks, such as memory writing (Lupton, 1996), journal
keeping (Oliver & Lalik, 2000), and drawing tasks (Holroyd, 2003) were combined
with semistructured interviews, focus-group discussions, and life-history work
with varying degrees of success.
The use of both group and individual activities reflects an awareness of the
deep sensitivities of the issues under investigation for some young people. In
384 Evans, Rich, and Davies

addition to these research activities, our ethnographic approach facilitated the con-
struction of a case study of the research situation and a means of identifying and
highlighting prevailing attitudes and practices relating to food, diet, and physical
activity that might have a bearing on attitudes towards the body and self. The data
reported here are drawn largely from group and individual interviews and infor-
mal conversations that took place during October and December 2002 with 15 of
the young women who volunteered to contribute to the research. The data gener-
ated has been analyzed following the principles of grounded theory (Glaser &
Strauss, 1967), an ongoing process of recording, coding, and analysis that pro-
vides continuing direction for subsequent phases of the research.
What we see in their comments is the way in which health and illness are
constructed, reproduced, and perpetuated through the language of the health dis-
courses that dominate contemporary culture. Teachers and subsequently children
get to know about their illness and health through the language of health experts,
such as health educators and teachers in schools.

Learning to be Thin
Although few of the young women in our study talked specifically about the
physical or health education contexts or pedagogies, all alluded to the narrow per-
ception of health as a corporeal condition, as an achieved outcome of eating the
right foods, exercising, and being the right size that had emerged from, or at least
been reinforced and endorsed in, schools. (see Evans, Rich, & Holroyd, 2004, pp.
133-135)
She (the teacher) picked out this girl who was literally, like, this thick (point-
ing to a pole in the room) and she said, “Now this looks like a girl who is the
right weight” That really upset me because I just thought I have to get (my
weight) down quick, so yeah, that probably had a big effect on me. (Lydia)
Others—Lauren, Carrie, and Ellie—talked of learning about what food was good
and what was bad not only through Personal, Social, and Health (PSHE) lessons
but also from sources outside of school, such as parents and the media. Lauren, for
example, commented that
you just learn that some things are good for you and some things are bad and
should be avoided. That’s why I find it so hard here when they put a pasty in
front of you because I just think, “fat.” You don’t learn that there are other
things in bad foods that are also good for you, like protein and carbohy-
drates.
Although this conversation was primarily associated with school, there was
also a mention of wider sociocultural pressures—predominantly relating to bodily
ideals portrayed in the media. Lauren was clear that she thought these images could,
in part, be harmful and suggested that in the course of the following exchange.
Carrie: Yeah, and they always have comments from people who say “oh, it
changed my life, I feel like a better person.”
Ellie: And they have before and after pictures of people and they always
make them look really horrible beforehand, like miserable and with bad
clothes.
The Emperor’s New Clothes 385

Carrie: They use pictures of naturally skinny people all of the time, too, so
it gives you the impression that if you do what they say that you will end up
looking like that, and that’s not the case.
Lauren: Not only that but you never see a picture of a well-built teenager in
magazines, they’re always really skinny. . . . I’d love to see someone who
had natural beauty, yeah, but also a natural figure.
Carrie: Oh yeah . . . (and) people have completely lost track of the fact
that low fat and healthy are two completely different things. When they
advertise low-fat diets they’re assuming that they’re healthy, and they’re
not at all.
Lauren: Yeah, I liked everything to be low fat, I doubt if I had 5g of fat a day,
but I was aware that I was having 500 cal and I thought that was enough. I
wasn’t having fat but I had calories.
Carrie: They make you think that having fat in any form or way is bad, but
people then just cut out fat completely. They should advertise more realisti-
cally. A diet where you have to inject yourself several times a day and cut out
protein can’t be healthy. A healthy diet is eating when you’re hungry and
stopping when you’re full.
Indeed, there was disjunction between the expectations of the clinic and those
reported as usual in these girls’ homes and schools. Returning to cultures where
the pressures were to not eat and stay thin created difficulties that were clearly
formidable for these girls. The narratives describe the cultural toxin mentioned
earlier that had pervaded their homes and many aspects of school, from the formal
curriculum to the more informal aspects and spaces of school life, such as play-
ground and peer-group cultures (Evans, Evans, and Rich, 2002).
We have elsewhere gone to some lengths to illustrate the complexity of the
processes by which such disorders are learned and achieved (Rich et al., 2004).
Schools do not cause eating disorders. The voices of these young women, how-
ever, do highlight the powerful ways in which a discourse of certainty about exer-
cise, food, diet, and body size might be taken up in the cultures of school life and
have a powerful bearing on individuals’ developing sense of well-being and self.
Consequently, particular body shapes are recognized as being of high status and
value so that some of the girls are unable to recognize themselves as having a body
and self of any value at all. “Because I had hassle when I was fat. You know, I
wouldn’t get asked out by boys. . . . You know, every time I walked past a mirror I
would hide myself” (Lydia).
Clearly, the pressure to obtain the right body size and shape is not simply
about being healthy but carries moral characterizations of the obese or overweight
as lazy, self-indulgent, and greedy (Gordon, 2000). The corollary of this is that
control, virtue, and goodness are to be found in slenderness and the processes of
becoming thin. Responsibility is placed on the individual to accept that correct
diet and involvement in physical activity are moral, as well as corporeal obliga-
tions. The message these young women hear is that they are to take control of their
health by making healthy choices, particularly in relation to diet, where schools
were teaching them what was good (i.e., fruit and vegetables) and bad (i.e., fat).
Lydia said, “You see fat and sugar and that’s bad.” Carrie commented that she
386 Evans, Rich, and Davies

“honestly thought” that she “was just being healthy by cutting out fats entirely”
and noted that this was how her “eating disorder started.”
In this discourse health is thus constructed either as a personal attribute, an
achievement, or as an individual problem to be addressed. For these children, then,
as for people who are obese, there is a perceived (symbolic) shaking of heads
amongst the food and exercise experts who ascribe the food and exercise decisions
of the “unhealthy” to some flaw in their lifestyle. Given the social sanctions that
go with this discourse, the bullying, stigmas, and labeling these girls talk of in
association with being defined by their peers as fat, it is hardly surprising that
many of these individuals become not only ill because of the drastic action they
take to lose weight but also seriously depressed.
Far from empowering individuals, social practices such as those described
leave some feeling powerless, labeled, and alienated from their bodies, believing
that they have less rather than more control over essential elements of their lives.
At the extreme, these social practices exhort people to develop embodied relation-
ships based on fear, anxiety, guilt, and regulation, and define who can belong, who
is able to achieve status in the eyes of teachers and peers, and, ultimately, who can
achieve health.
There’s a lot of bitchiness, and of course there’s a lot of, “Oh. I look so fat,”
you know there’s a lot of that going around. You know, you have to look
perfect or you’re not going to look good, and the popular girls are just going
to look at you and go (derisive noise), and you know you don’t really want
that . . . you don’t want to be noticed as the fat person, you want to be noticed
as the stunning, skinny person. (Lydia)
In effect, the body has become the outward marker of value in the consumer
culture reflected in schools (Bordo, 1993; Featherstone, 1991). The slim body sig-
nifies romantic femininity, associated with a variety of positive personal charac-
teristics such as self-control, status, and worth (Malson, 1998). For some of these
girls self-starvation had become a way of demonstrating self-control, autonomy,
and individuality and a way to achieve recognition by peers and others as the end
product of disciplined dietary restraint.

Conclusion
No matter how well it is configured or how much time is given to it in schools,
physical education has no more capacity or responsibility to make children fit, eat
well, and be thin than have math teachers the capacity or responsibility to make
pupils multimillionaires. Teachers in both subject areas might, of course, want
their pupils to leave school sufficiently numerate and physically literate to become
all of these things, should they so chose. Is, however, the current uncritical alle-
giance to health education and obesity discourse more or less likely to help chil-
dren become active and healthy? Will it leave them feeling confident, competent,
and comfortable with and in control of their bodies? Will they be able to partici-
pate intelligently in the range of physical cultures that potentially feature in their
lives? Will they be equipped with the physical competences to do so? Will they be
critically knowledgeable of how those opportunities may be framed and constrained
by the many vested interests that define their relationships to their bodies and the
The Emperor’s New Clothes 387

physical cultures that feature in their lives? Or will it merely leave them feeling
that they are to blame if they don’t achieve these things?
To suggest that we build a curriculum on the underlying assumption that
individuals are to blame if they get obese, self-starve, become sick, and die is one
of the most pernicious and obnoxious aspects of contemporary health trends and is
particularly hideous when applied to children and young people. To reduce the
aspirations of physical education to the triumvirate of fitness, exercise, and food
and to ask to be judged on these matters alone is to pursue not only illusory but
also dangerous ideals. Once those who evaluate the fiscal efficiency of education
discover that the profession cannot and never will be able to achieve these ideals,
they may begin to consider the subject matter of physical education an expensive
luxury or an unnecessary accessory in the curriculum, rather than an indispensable
educational need. In effect, fitness, exercise, and diet may be in danger of becom-
ing, if they have not already become so in some quarters, the physical education
version of the Emperor’s New Clothes.
Should goals in physical education lie with the pursuit of education or of
making children active, fit, and thin? We share Gard’s view (2004a, p. 69) that, if
nothing else, claims of special expertise demand of physical education a more
critical attitude toward the issue of population overweight and obesity than has
previously been shown.
While others may be excused for taking scientists at their word, a passive
orientation towards scientific knowledge would seem at least out of step
with contemporary discussion about the need for students in universities to
exercise a critical judgment when evaluating the knowledge claims of oth-
ers. (Gard, 2004a, p. 69)
As Piran (2004) has pointed out, teachers’ abilities to establish nonweightist
norms in their classrooms depends a great deal on their own prejudicial atti-
tudes. If they are to help prevent the development of eating disorders and other
forms of body disaffection, then there has to be a shift that will allow them to work
against transmitting weightist prejudices to children. The routine dissemination by
teachers of appropriate information regarding body weight and shape (e.g.,
see Piran, 2004) and the provision of protective values through the daily ex-
periences they provide to students in their classrooms would be a significant step
in that direction.
Finally, perhaps we should again emphasize that none of this should be read
as an attack on well-meaning pedagogues or researchers, for there are many de-
cent and honest ones around doing their bit to throw light on children’s health and
well-being in and out of school. Rather, it is a rail against the way in which re-
search evidence is simplified, sanitized, and, therefore, distorted as it is
recontextualized for public consumption in the form of official reports, academic
texts, and, thereafter, in the curriculum in schools. Science, at its very best (and
obesity research is no exception to this rule), does not offer certainties and we
should be on our guard against those who, for whatever reason, lay claim to having
found them. As professional health educators, teachers, or teacher educators, we
need be vigilant, constantly seeking the truth as best we know it and not accepting
the assertions, ideologies, and opinions that pass for knowledge and certainty in
the obesity field. We should ever be asking how on earth did wisdom such as this
388 Evans, Rich, and Davies

come to supplant a decent philosophical rationale for the discipline and the teach-
ing of physical education in schools?
Schools in the UK, as elsewhere, are increasingly under pressure to embrace
greater responsibilities for the health education of children and young people. For
example, since September 2002 schools in England and Wales are obliged, as a
new National Curriculum requirement, to promote “personal, social and health
education and citizenship” across the curriculum. At the same time, powerful agen-
cies outside schools, influential in the development of school sport, are (with ref-
erence to rising obesity levels) pressing physical education to place health on the
agenda of the sports colleges now flourishing in the UK (Youth Sport Trust, 2002,
p. 7). This could be good news. Children, properly educated, would leave schools
with a profound and critical understanding not only of their unique health needs
but also of the ways in which these have been constructed, manipulated, and per-
haps obfuscated by the interests of the health industry. Health education, however,
that is reduced to and driven by the unreflective rhetoric of obesity discourse is
likely to presage curricula, teaching, and learning in which success and achieve-
ment are defined not in terms of knowledge, understanding, and competence but,
rather, of body shape, size, and weight. New, invidious social and ability hierar-
chies might emerge in physical education and health classrooms, at the top of
which will reside the ill-educated who are able and willing to get active, fit, and
thin (Evans, Davies, & Wright, 2004; Evans, Evans, and Rich, 2002; Evans, Rich,
& Holroyd, 2004). This is not what young people need or deserve.

Acknowledgments
We are extremely grateful to Ken Green, editor, and Sage Publications for their per-
mission to reproduce portions of the following article in this one: Evans, J. (2003). Physical
education and health: A polemic, or, let them eat cake! European Physical Education Re-
view, 9, 87-103.

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Notes
1
The material in this and the next section of this paper is taken from that published in
an earlier paper (Evans, 2003) and appears with the permission of Sage Publications.
2
It is worth reminding ourselves here of Steven Blair’s recent broadside to the Insti-
tute of Medicine Report on new dietary recommendations, in which he comments,
The amount of physical activity required for maximal or optimal health benefits is
unclear. We also are uncertain about the amount of activity necessary to prevent
weight gain, and there is extensive individual variation. For example, some individu-
als never exercise yet also do not gain any weight during their adult years, while
others gain a substantial amount of weight despite daily jogging, such as a certain
aging epidemiologist at The Cooper Institute.” (Blair, 2002, comments reported 23
September via the Australian Physical Education Discussion List. Retrieved Sept.
2002 from http://www. austpe-1@hms.uq.edu.au)