The global cultural obsession with losing weight is spreading rapidly, as attested by the hundreds of "miracle" diets, the thousands of weight-loss products, and the near-universal excitement over the claimed discovery of the "fat gene." Hardly a day goes by without some headline story about obesity. And in fact, although fat is not all bad-it performs important functions, such as cushioning, insulation, and energy storage-in excess, fat rightly causes much concern. Particularly when bodies become obese, fat is associated with a worrisome list of health problems. The World Health Organization (WHO) reports a "greatly increased risk" of diabetes, gall bladder disease, hypertension, dyslipidemia, insulin resistance, breathlessness, and sleep apnea; "moderately increased risk" of coronary heart diseases, osteoarthritis, hyperuricemia, and gout; and "slightly increased risk" of cancers, reproductive hormone abnormalities, polycystic ovary syndrome, impaired fertility, low back pain, increased anesthetic risk, and fetal defects (arising from maternal obesity). And worldwide obesity levels are on the rise. WHO reports that while there were an estimated 200 million obese adults worldwide in 1995, there are now over 300 million. Such is the concern internationally that WHO launched the International Obesity Task Force in 1996.
Despite the alarm, there has been little discussion about the wider context of fat or its mobilities: the ways fat moves around. We want to turn attention away from obesity to look at obecity, that is, the processes through which fat travels through bodies, infrastructures, and cities, and the growing problems that encounters with fat generate. The social geographer David Harvey argues that "cities are constituted out of the flows of energy, water, food, commodities, money, people, and all the other necessities that sustain life." What role does fat play in this context? Can fat literally block up the city? Has the balance between fat as a resource and fat as a waste product become disrupted? And if so, what strategies are in place to tackle obecity? We argue that to understand the mobilities of fat in a city context metaphors of urban metabolism become important. This article discusses the wider crisis of fat that is blocking up the city and the close interconnections between strategies for slimming down bodies, infrastructures, and the city as a whole.
The United States leads the world in the incidence of obesity. Official figures suggest that one in five children is overweight, 60 percent of the general population is overweight, and 21 percent is obese. Obesity has more than doubled in the last two decades and is now rising by 5 percent per year. However, obesity is not evenly distributed; more than half of black women in low socio-economic groups are obese, for instance. Obesity is estimated to account for 12 percent ($100 billion) of U.S. health care costs. The United States provides a dubious benchmark for the rest of the western world, suggesting where other countries might be heading.
In response to these trends, the health magazine Men's Fitness set out to measure, city by city, "the relative environmental factors that either support an active, fit lifestyle, or nudge people towards a pudgier sedentary existence." Using existing surveys and data, the magazine's analysis ranked the 50 largest U.S. cities according to per-capita numbers or rates of several factors, including gyms and sporting-goods stores, health club memberships, exercise, fruit and vegetable consumption, alcohol consumption, smoking, television watching, junk food outlets, and recreation facilities. Obesity levels were scored by drawing on data from the Centers for Disease Control and Prevention and the Center for Chronic Disease Prevention and Health Promotion.
One result is that, ever since the survey was launched, U.S. cities have been jostling to escape top honors as fattest city. New Orleans was ranked as the fattest city in the first year of the survey in 1999; in 2000 it was Philadelphia, and then Houston took the lead for the next two years. These rankings were not ignored. When Philadelphia was on top, a headline in USA Today ran, "Blame the Cheese Steak: Unfit Philly Wins Flab Crown." The article reported a spokesperson for the city initially saying, "This just proves what we've been saying all along, because Philadelphia has the best restaurants of any city in America, and apparently we've got the evidence to prove it."
A more considered response followed from the mayor, John Street, who appeared on The Oprah Winfrey Show to discuss Philadelphia's new status as fat capital. The mayor enrolled the city in a strategy of collective weight loss. He appointed a Health and Fitness Czar (or Fat Czar, as the media reported it) and launched a program called "76 Tons in 76 Days" with the support of the professional basketball team the Philadelphia 76ers. The city was challenged to lose a collective 76 tons of weight (69 metric tons) in 11 weeks. When the official tally was taken on July 3, 2001, 26,000 people were reported to have lost an average of 5.3 pounds (2.2 kilograms) each. Strategies for collective weight loss included support groups for dieting and ritual weighing-in, line-dancing programs for city employees, urging restaurants to provide healthier food, and free fitness programs. The mayor's Office of Health and Fitness now reports that since the initial strategy was adopted in January 2000 a range of actors has signed on to a coalition for improving the health of Philadelphia: "citizens, the Department of Health, private corporate and community organizations, institutions of higher learning, public and private schools, communities of faith, hospitals, health systems, health clubs and gyms, pharmaceuticals, media outlets, local, state, and federal government agencies, nonprofit health agencies and sports teams." Philadelphia dropped to seventh position in the rankings in 2004.
Houston, meanwhile, was moving the other way. An ABC News headline summed it up: "Houston, You Have a Problem: A Big, Fat Problem." Houston took the lead from Philadelphia and for 2002 and 2003 was ranked first. This provocative identity was not something Mayor Lee Brown wanted "as a distinction of our city." Houston's response-to seek advice from Philadelphia-led to the appointment of a former Mr. Universe as Fitness Czar, who began a "Get Lean Houston" campaign. This included a "fat drive," in which participants pledged to lose weight; the result was a collective loss of 17,000 pounds (7,700 kilograms) by 2,000 participants. Again, a range of different organizations took part. Perhaps most notable was McDonald's, an "official restaurant sponsor," which rolled out a "Salad and More" menu across all of its 253 Houston-area restaurants. By 2004, Houston could boast that it had dropped to second place, behind Detroit-the result, according to Men's Fitness, of better scores for sports participation, alcohol consumption, and nutrition.
Some of this may appear common sense. But this conversation about fat, and the metaphor of the Fat City, have also provoked renewed interest in the relationship between bodies and cities. For example, papers published in American Journal of Health Promotion and American Journal of Public Health in 2003 reported a series of studies that were among the first to "link shopping centers, lack of sidewalks and bike trails, and other features of urban sprawl to deadly health problems." One paper reported that "people who live in sprawling neighborhoods walked less and had less chance to stay fit...[and] weighed 6 pounds more on average than the folks living in compact neighborhoods where sidewalks are plentiful and stores and shops are close to residential areas." In such areas, obesity is reported as more prevalent. The geographer David Sui also wrote in 2003 that "Fat City depends on the fatness of the body...And the fatness of the body depends on the fatness of the city, since it develops as a result of the automobile-dependent, privatized spaces of the fat city."
As Men's Fitness notes, the rapid rise in obesity in the last 100 years cannot be explained simply by genetics but must be a consequence of changing environmental circumstances. People living in city environments-where healthy food and places to exercise are hard to find, the weather discourages exercise, smoking rates are high, long commutes steal exercise time, health care is poor, and junk food is easy to hand-are more likely to be fat. This analysis has the effect of shifting the focus from the state of obesity in a city (the current prevalence in the population) to the structures and processes that lead to obesity.
The obsession with fat in the body and the prevalence of obesity in city populations misses the significance of fat within the city metabolism. The rise of the fast-food industry and the growing numbers of people dining out have had consequences for human and urban fat-processing systems alike, and there are ironic parallels between the metabolism of fat in human bodies and the capacity (or incapacity) of city waste systems to handle the increasing volumes of fat wastes. Sewer blockages and overflows in cities across the United States are becoming more frequent because restaurants often pour cooking residue into drains and because local governments lack the resources to monitor grease disposal and enforce the relevant regulations. The solidification of fat, oils, and grease, as writer Randy Southerland put it in American City & County, "chokes pipelines, eventually clogging them and causing them to cough up rivers of raw sewage." (The volume of restaurant grease alone has reached 3 billion pounds, or 1.4 billion kilograms, a year in the United States.) Southerland notes that the U.S. Environmental Protection Agency in 2001 sued Los Angeles for 2,000 sewer spills over five years; 40 percent of them were caused by fat. Wall Street Journal reporter Barry Newman has noted that in New York there are about 5,000 fat-based back-ups a year. For reasons that range from the decline in global markets for waste fat and the increased costs of fat disposal following Mayor Rudolph Giuliani's crackdown on the garbage mafia, more grease is illegally dumped into sewers, and trouble ensues.
Newman: "Fat won't pollute; it won't corrode or explode. It accretes. Sewer rats love sewer fat; high protein builds their sex drive. Solids stick in fat. Slowly, pipes occlude. Sewage backs up into basements-or worse, the fat hardens, a chunk breaks off and rides down the pipe until it jams in the machinery of an underground floodgate. That, to use a more digestible metaphor, causes a municipal heart attack."
One such infarction, a wayward grease blob in Cobb County, Georgia, diverted 600,000 gallons of sewage into the Chattahoochee River.
While there are fat hotspots in and around city restaurant areas, there are also sewer fat problems in residential neighborhoods, particularly where large numbers of multi-family units are located and where residents discharge their grease into drains. And in some cases attention is turning to schools and prisons. Just as with obesity, then, there are different distributions of sewer fat problems across different publics.
As when doctors attempt to locate coronary occlusions, actually finding the hotspots in sewers remains a challenge for local authorities. A variety of techniques has been developed, including closed-circuit television, smoke infrared thermography, and even radar and sonic (sound) technology. Having made fat visible, cities then face the problem of breaking it up. High-pressure hoses can remove blockages but dislodged blocks of fat may then cause new problems downstream. Large vacuum trucks are also used to either suck or blow fat out of congested sewers. New York routinely uses an enzyme product that reduces grease build-up, and a liquid emulsifier can now tackle larger build-ups. At least one other locale has experimented with a bacteria developed by a biotechnology company to metabolise the grease, breaking it apart into water, carbon dioxide, and free fatty acids, which can be washed away from metal, concrete, and brick.
When a crisis hits, the problem becomes all too visible in sewer overflows. Just like with bodies, prevention is more problematic. Ultimately cities want to keep fats out of the sewers, but making visible the practices of restaurants and households scattered throughout cities raises different challenges. New "lean sewer" ordinances have been introduced, but the cost of monitoring and enforcement is high. Not surprisingly, then, we see also the emergence of appeals to the city collective once more to reshape the deposition of fat. In New York, for example, the Environmental Protection Department makes the following plea: "Sewer back-ups are a major sewer system problem that damages property and affects public health.... The City needs businesses and individuals to do their part to maintain the system because repeated repairs are disruptive to residences and businesses alike." Cities across the United States distribute brochures promoting "fat free sewers" that show homeowners what they can do to keep grease out of the sewers.
This is just the barest account of the wider problems fat poses for cities. Missing, for example, is the global system of oil and fat production, the international movement and distribution of fats and oils, the production and distribution of foods that incorporate fats and oils, and the social organization of waste oil and fat systems. All of these have interconnected social, economic, spatial, biochemical, and cultural dimensions. However, by touching upon some of these issues it becomes possible to bring into focus how different strategies for dealing with fat-at the level of the body, sewer, or city as a whole-view fat in quite different ways.
The apparently straightforward response to fat-especially if one's outlook is expressed in the disdainful images of unhealthy cities, corpulent bodies, and blocked sewers, which are taken to represent excess and greed-is simple. Be it bodies, sewers, or the whole city population: slim them down, make them lean. And a range of technological devices is at hand to help, from suction machines to the use of drugs, chemicals, and/or biotechnologies. But this could be an endless battle, as sewer managers and public health specialists alike know all too well.
The obvious alternative is prevention. It is not just the overweight who ought to be anxious about fat, but also-as with any other worsening health problem-the general public, which must be made aware of and enticed into fitness and diet regimes, into life-long healthy lifestyles. Likewise with cities where there may be a window of opportunity to maintain infrastructure health, fitness, and leanness and thereby avert crisis. The Men's Fitness campaign has stimulated a renewed interesting in the "re-tooling of the urban environment" to activate bodies in order to ensure that fat remains mobile and that the opportunities for its deposition are limited. As for the sewers, there has emerged a range of promotional strategies, guidelines, and ordinances designed to reduce the deposition of fat and use other waste infrastructures for fat disposal. There is an ironic twist here: the habits of people in houses and restaurants are now being reshaped to protect the health of the sewers!
A less obvious, but hardly ignored, alternative is simply tolerance. The assumption is that the crisis itself needs to be redefined through a strategy of adaptation to the new conditions of fat deposition. Ways of defending fat bodies vary. Some stress acceptance (though not celebration) by learning to live with fat rather than dealing with the constant anxiety of the failure to remove fat. Others actually celebrate fatness; see, for example, the Fatcities website (www.fatcities.com), with its references to "big, beautiful people"and its slogan, "Forget fat acceptance. Fat reality is here." In this context the strategy for intervention is to reframe the way in which fat bodies, sewers, and cities may be understood.
The acceptance of obese bodies has implications for the re-tooling of other urban infrastructures. Journalist Rick Hampson reported several years ago, in a USA Today article titled "In the End, People Just Need More Room," that "Americans' expanding backsides" are driving a trend toward wider public seating. Hampson reported how subways, theaters, airlines, sport stadiums, and opera houses have responded to demands for wider seats, reducing seating capacity to increase individual sitting room. Although seating width had become standardized in the United States (and recognized in building codes) at 18 inches, this standard is coming under question. Indeed, sponsored by the U.S. Air Force and major manufacturers of vehicles and clothing, a project called CAESAR (Civilian American and European Surface Anthropometric Resource) is using scanning technology to measure the contours of 4,000 volunteers and develop new standards. Bodies themselves are also being re-categorized; U.S. standards for overweight and obesity are being revised upwards to normalize larger body sizes. And at the level of the sewage infrastructure, the acceptance of fat deposition as a strategy entails enlarging sewers to accommodate fat deposition or routinely using biotechnologies that eat the fat.
Each strategy for addressing obecity involves different visions of the problem and the ideal solution. A strategy of removal implies that the fat is attacked to ensure that bodies, sewers, and the city can be slimmed down. The strategy of prevention of fat deposition implies a defensive approach in which bodies, sewers, and the city are socio-technically re-engineered to ensure that fat is kept on the move. And a strategy of fat acceptance implies a sense of defeat, tolerance, or perhaps celebration, as society learns to live with fat bodies, sewers, and cities. Each strategy brings fat into focus in quite different but not necessarily mutually exclusive ways-which is why strategies for dealing with fat across these different processes will remain so contentious.
Simon Marvin is Director of the Centre for Sustainable Urban and Regional Futures at the University of Salford, Manchester, and Will Medd is a researcher in the Department of Sociology at the University of Lancaster, both in England.