Changing Ideals of Nourishment & Health in Guatemala

A review of The Weight of the Body: Changing Ideals of Fatness, Nourishment, and Health in Guatemala, by Emily Yates-Doerr.

Incidence of metabolic illness in Guatemala has become especially pronounced in the past decade, influencing both how people conceptualize the activities of eating and feeding and how health professionals respond to the problem of growing girths. In particular, obesity ranks high among concerns with dietary health and receives the bulk of attention in nutrition education programs. Yet there are problems with how the content of nutrition interventions, with an emphasis on calories and nutrients, translate in individuals’ efforts to exercise control over diets and to manage weight. Emily Yates-Doerr examines these problems as they unfold in the lives of residents of Xela, a city in the Guatemala highlands located about four hours outside the country’s capital. She collects ethnographic data based on peoples’ perceptions of metabolic illness while staying attuned to how these perceptions shift amidst the dissemination of nutrition education. Her findings problematize common assumptions around these trends in terms of “cultural practice, scientific knowledge production, and biomedical ethics” (p. x). The central argument that Yates-Doerr presents is essentially two-fold: 1) a practice of metricization — evidenced in the application of various unit measures such as nutrients, pounds, calories, etc. — has come to dominate mainstream knowledge and practice around dietary health; 2) current approaches to body weight management, imbricated as they are with metricization, lack efficacy for the reason that “clean calculations do not withstand the complexity of daily life experiences” (p. 14).

In her prologue, Yates-Doerr offers a provocative discussion of both the general challenges facing anthropologists doing fieldwork, and of the specific challenges she encountered at her field site. While providing an overview of the Guatemalan highlands and alluding to the ways that urbanization is taking hold in this part of the world, Yates-Doerr also gives some background to her selecting Xela as her primary research site. Notably, she explains that Xela is the site of a large public hospital that provides many nutritional health services.

The dissertation’s introductory chapter delves into the relatively recent history of the development of the study of economy that seems to parallel the development of the study of nutrition. Yates-Doerr emphasizes that both fields have contributed to contemporary understandings of measurement, currencies, and equivalences. She writes, “Situated alongside the newly established field of the economy — imagined as ‘the sum of every occasion on which money changed hands,’ (Mitchell 2002: p. 98) — was nutrition, which was reframing nourishment as the sum total of human metabolic activity” (p. 11; see Timothy Mitchell, Rules of Expert: Egypt, Techno-Politics, Modernity. Berkeley: University of California Press, 2002). It is also in her introduction that Yates-Doerr outlines her methods. In critiquing methodologies that appear highly systematic and perhaps overly rigid, she suggests that imperfections indeed abound even amidst an assumedly “perfected” research design. Although Yates-Doerr had been travelling to the region of her fieldwork for several years prior, her analysis in the dissertation is based on 18 months of uninterrupted ethnographic research, during which she implemented several strategies of collecting data. These included: living with 12 different families; shopping, cooking, and cleaning with each family’s mother; observing clinical interactions at an outpatient nutrition consult at the local public hospital and conducting follow-up interviews with some patients; conducting 72 semi-structured interviews with “housewives, maids, gym instructors, friends-of-friends, beauty queens, health food store owners, a diabetes medicine vendor, directors of local plastic surgery clinics, and so-on” (p. 29); attending nutrition education lessons, cooking classes, and traveling around with promotoras who were doing nutrition outreach in rural communities; and maintaining affiliation with a nutritional-science research center in Guatemala’s capital. Finally, she also mentions some archival research with the caveat that archival analysis is beyond the scope of this dissertation.

Chapter 1 presents perspectives from residents of Xela, public health professionals, and scientists as they interpret dietary change in the region as well as the onset of “new” (metabolic) illnesses in Guatemala. Yates-Doerr intersperses this discussion with a description of the global food economy that has mapped itself over more “traditional” foodways in Guatemala during the past two decades vis-à-vis free trade agreements, supermarkets, and processed foods. She uses peoples’ narratives of these changes as one mode of challenging a narrative of progress that articulates linear change from traditional to modern, from healthy to unhealthy, and so on: “In emphasizing the historical continuities of contemporary changes in dietary practices in Xela, I do not aim to diminish the impact of these changes on the lives and bodies of people today. Nor do I wish to challenge the assertions of those I spent time with that the 1990s was a decade of profound destabilization” (p. 83).

Chapter 2 examines the content and modes of dissemination of public health nutrition education while also arguing against the nutritional reductionism evident in contemporary interventions to dietary health. Yates-Doerr criticizes the overwhelming appearance of discrete categories such as “vitamins” in the language of nutrition education as these do not adequately represent the complexity of relationships found in practices of eating and feeding. In noting how such categories are incongruent with the complexities of social life, Yates-Doerr suggests that a “metabolic logic” found in mainstream forms of nutrition education further obfuscates people’s understanding of dietary health. She even alludes to certain “unhealthful,” perhaps even pathological, dietary behaviors that result from peoples’ exposure to the reductionist knowledge they gain through these forms of education: “reductionism in nutritional knowledge produces understandings of nutrition that can be — given rising rates of metabolic illness in Guatemala — dangerously opaque” (p. 93).

Chapter 3 explores different notions of beauty, ethics around care for the body, dieting norms, and industry and government endorsements of dieting for country to demonstrate how body weight management is being conditioned as a morally-inflected category. Specifically, Yates-Doerr argues that body weight management is now emerging as a social exercise in self-care: “We are left not with the individual or the social; the moral individual produced through the notion that one must care for oneself for a common good exemplifies the mutual dependence of “the individual” and “the social” upon one another,” (p. 170). Thus, dieting as a social practice reveals much about the construction of subjectivity. She explains, “[E]ven the most “western” of dietary practices that I observed — those which divided people from their surroundings, transformed bodies into things, and focused attention upon oneself — created selves who, by caring for themselves, imagined they were also caring for their families, communities, and country” (p. 180).

Continuing from the arguments presented in chapter 3, chapter 4 examines the “techniques by which people are trained to embody a body-weight habitus” (p. 187). Yates-Doerr discusses the moral influence of these techniques on peoples’ subjectivities: “Paradoxically, in a time in which eating was becoming logistically ‘easy,’ it was also becoming the moral problem that it had not been in the past. What should we eat to keep ourselves and our children healthy? Are we making mistakes in our diet that we don’t even know about? What will we do if we become sick? How can we keep our illnesses under control?” (p. 208, italics in original). Yates-Doerr thus turns to advertisements, print journalism, and the advice of nutritionists as sites in which such techniques are administered. She argues that social shaming is a primary technique of conditioning a body-weight habitus. She illustrates how people are encouraged to exercise dietary control and to diffuse risk to metabolic illness through prevention: “In matters of nutrition, the corollary to risk is prevention — a notion built upon calculation, and by extension, control” (p. 210). Yet the dominant model of disease prevention tends to neglect how people are structurally constrained: “the implication that people can prevent illness by consciously changing what they eat imagines people to be independent, rational agents, with freedom to choose the best among many options for themselves. It ignores that the available options are far from endless. It can have the effect of saddling people with the responsibility for preventing their illnesses, without providing the resources that make this prevention possible” (p. 212). It is also in this chapter that Yates-Doerr begins to articulate her concept of “metricization.”

Chapter 5 continues with the theme of metricization in analyzing the practice of body weight management in a nutrition clinic. Yates-Doerr illustrates how the nutrition clinic subscribes to a notion of balance predicated on the homeostatic ideal of metabolic zero; in other words, equilibrium in the body is established through an ingestion of calories that equals the amount of calories expended. This practice parallels with, and diverges from at times, practices of market exchange thereby imploring clinical patients to adopt a metric-based conceptualization of the body in following the dietary prescriptions (recetas, also noted by the author as the term for “recipe”) provided by nutritionists. Particularly interesting in this chapter is Yates-Doerr discussion of how weighing oneself has been until recently an unfamiliar practice to many until recently.

In Chapters 6 and 7, Yates-Doerr examines how body weight management articulates with race and gender. Chapter 6 explores the concept of race as it exists in Guatemala. Yates-Doerr claims that the categories used to determine race in Guatemala have proved flexible over time, and that fatness or body size, now ranks among these categories: “Race continues to be embodied, but now within a body viewed as malleable over the course of one’s life and not pre-determined by ancestry. I propose that a new classificatory category of decency and superiority is emerging — that fat, seen as the embodiment of willpower and agency, and as something that can be counted and managed through pounds and portion sizes, is replacing blood as a salient characteristic of race” (p. 280). She argues for a more inclusive discussion of biology in cultural analysis, a way of recognizing how biology is performed through bodily practices. As a marker of social status, fatness, Yates-Doerr concludes, articulates possibilities for social mobility: “Countering ideas about the permanency and immobility of blood-type, emerging discourses of obesity in Guatemala position body weight as a site at which to exercise control over self and ultimately social control” (p. 297).

Chapter 7 explores the gendered aspects of eating and feeding as social activities specifically as these are emerging through expressions of women’s discontent and vis-à-vis the discourse on nutritional epigenetics. Yates-Doerr echoes other research on food and gender by alluding to the ways that women derive empowerment through the provisioning of dietary care but also associate responsibility for feeding with feelings of subjugation. When women talked to Yates-Doerr about cooking, “they spoke of a deep unhappiness and frustration they felt about a life that seemed out of their control” (p. 319). In their role as housewives, women reported feelings of being: “overworked, but also worried they were expendable … they also grew tired under the weight of this responsibility” (p. 318). Yates-Doerr argues that “assisted reproductive technologies of dieting” have allowed for a devaluing of women’s reproductive labors at the same time that women are experiencing dietary health problems of their own. These dietary ARTs have “removed women from a key domain of their authority (cooking/feeding) by recasting their own bodies as vulnerable, and in need of external oversight and vigilant maintenance” (p. 337). With regards to epigenetic research, Yates-Doerr writes that popular media sources and nutritionists “have been quick to translate the implications of epigenetic research into everyday warnings about the responsibilities of motherhood” (p. 341). Through the rhetoric of epigenetics, women’s bodies are constructed as sites of potential toxicity: “metabolic illnesses placed new burdens on women, and women themselves saw their bodies as embodying a particularly modern form of violence. They saw this violence as especially insidious because it destabilized their expertise in a key domain of their authority (cooking and feeding) while also taking place, not in the world around them, but within their own bodies” (p. 322).

In Chapter 8, Yates-Doerr returns our attention to the nutrition clinic for observing how care may be understood as relational. Rather than being entirely power-inflected, care in the context of dietary health is coordinated by nutritionist, family, and the broader community. Yates-Doerr eschews a framework of power in analyzing relations of care, suggesting that this analytical frame is often incomplete. She presents interactions among patients and nutrition clinic staff to illustrate how agency is distributed and shared among many through the construction of intersubjective space. Thus, the weight of responsibility for dietary choices — “The Weight of the Self” (chapter title) — becomes collectivized through relational caregiving.

This dissertation makes several important contributions to the field of medical anthropology as well as to Latin American studies, and critical food, nutrition, and body studies. The concepts of metricization, body-weight habitus, metabolic logic, and assisted reproductive technologies of dieting, for instance, offer much in the way of revising current thinking around food, the body, health technologies, and reproduction. The dissertation also promises to cultivate an interdisciplinary audience, as Yates-Doerr demonstrates a strong grasp of scientific concepts (informed by her formal training in biology) and engages not only with highly influential social scientists and philosophers (i.e., Pierre Bourdieu, Michel Foucault, Anthony Giddens, Bruno Latour, Emily Martin, Marcel Mauss, Annemarie Mol, Nikolas Rose), but also with many historians and nutritional scientists.

Megan A. Carney
Comparative Border Studies Institute
Arizona State University
megcarney@gmail.com

Primary Sources

Ethnographic research in the highland city of Xela, Guatemala

Dissertation Information

New York University. 2011. 452 pp. Primary Advisor: Emily Martin.

Image: Scale used in a Guatemalan public hospital. Photograph by Emily Yates-Doerr.

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