The Genius of Metaphor: Obesity “Epidemic”

A fascinating recent study has found that obesity “can spread from one person to another like the flu or a fad:”

The researchers found that when one spouse became obese, the other was 37 percent more likely to do so in the next two to four years, compared to other couples. If a man became obese, his brother’s risk rose by 40 percent. The risk rose even more sharply among friends — between 57 and 171 percent, depending on whether they considered each other mutual friends.

The study reminded me of the troubled place of metaphor in contemporary reasoning. I recall reading many libertarians who dismissed the idea of an obesity “epidemic”–who felt this designation unduly alarmist and politically manipulative. An “epidemic” unfortunately calls to mind quarantines, panic, and an uncontrollable disease vector. But the ideas of “contagiousness” and “communicability” provide useful frames for thinking here, like Dawkin’s translation of natural genetics into cultural memetics. (For the legal implications, check out Balkin or Cotter.)

A key question here is: would the “epidemic metaphor” be valid without the empirical study to back it up? I think so, because the “transmission mechanism” here appears to be a change in individuals’ understanding of obesity. Consider the case of Mauritania:

For decades, the Mauritanian version of a Western teenager’s crash diet was a crash feeding program, devised to create girls obese enough to display family wealth and epitomize the Mauritanian ideal. Centuries-old poems glorified women immobilized by fat. . . .

I’m not saying that metaphor holds the key to addressing the issue. But I think it plays a powerful role in sophisticated debates on the topic–such as the exchange in the Georgetown Law Review between M. Gregg Bloche (Obesity and the Struggle Within Ourselves) and Richard Epstein (What (Not) To Do About Obesity: A Moderate Aristotelian Answer). As Bloche argues:

We perceive, or construct, myriad patterns (or stories about the world) based on our own preconceptions, fears, and hopes, as well as surrounding cues. These patterns or stories both open up and narrow our options: they thus direct our decisions and actions, often unconsciously.

The notion that patterns of perception and understanding drive decisions and actions is consistent with findings from behavioral economics. Myriad studies in this field show that decisions depend on perceived context. People choose differently depending on how options are framed and whether prior information “anchors” their expectations. People’s preferences sometimes reverse when the same options are presented in different sequences or groupings. Many other reference points for choice have been studied, named, and found to influence experimental subjects’ preferences: these include the endowment effect, loss aversion, and social comparisons. Economists and behavioral psychologists have tried mightily to model these effects in quantitative terms. . . . But they are also understandable in qualitative terms, as cases of causal connection between patterns of perception and people’s decisions. (93 Geo. L. J. 1335, 1338).

I don’t know if I agree with Bloche’s promotion of “health-oriented advocacy that builds on widely-held ideals about attractiveness”–many of these ideals are themselves suspect. But his understanding the issue is an admirable example of the type of integration of psychological, sociological, economic, and moral theory necessary for sound policy.

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