Review of Fat in Four Cultures: A Global Ethnography of Weight By Cindi Strutz Sreetharan, Alexandra Brewis, Jessica Hardin, Sarah Trainer, and Amber Wutich. Toronto, Canada: University of Toronto Press. 2021. pp. 222.

Reviewed Book

Fat in Four Cultures: A Global Ethnography of Weight By Cindi Strutz Sreetharan, Alexandra Brewis, Jessica Hardin, Sarah Trainer, and Amber Wutich. Toronto, Canada: University of Toronto Press. 2021. pp. 222.

Cover, with text "Gordura Lapo'a Futotteru Fat in Four Cultures" against a muted orange plain background
Cover of Fat in Four Cultures (2021)

Arianna Huhn

California State University, San Bernardino

In Fat in Four Cultures: A Global Ethnography of Weight, five anthropologists endeavor to provide a cross-cultural, comparative, and collaborative analysis of how fatness is framed and experienced around the world. The volume is part of the University of Toronto Press’s Teaching Culture: Ethnographies for the Classroom series, which is specifically aimed at using “urgent issues faced by people around the globe today” (About the Series n.d.) to introduce undergraduate students to the methods and theoretical frameworks that guide ethnographic research.

The “urgent issue” at stake in Fat in Four Cultures is not totally clear, as Cindi Strutz Sreetharan, Alexandra Brewis, Jessica Hardin, Sarah Trainer, and Amber Wutich rely on the connection between fatness and disease in articulating their rallying cry for structurally-focused obesity interventions and simultaneously draw from fat studies to question the widespread vilification of largeness. In addition to clarity of issue, given the aims of the Teaching Culture series, a reader might expect to find in Fat in Four Cultures accessible language, compelling case studies, impeccable methodologies, and careful analysis. While the book is an easy read (a slim volume and adequate for introducing undergraduate students to cross-cultural difference in medicine), and it is also an impressive example of transparency in (collaborative) protocols for data collection and analysis, the book falls short of expectations.

Fat in Four Cultures is made up of eight chapters and five appendices. The heart of the book is four case studies focused on Osaka, Japan (chapter 3), the state of Georgia in the United States (chapter 4), the town of Encarnación in Paraguay (chapter 5), and the capital city of Apia in Samoa (chapter 6). For a volume purporting to offer a “global ethnography,” perspectives drawn from Europe, the Middle East, South Asia, the whole of Africa, the Caribbean, and Central America are notably absent. The authors of the volume—five cisgender white US-passport holding women who “do not consistently identify as fat” (34)—have prioritized and implemented a single research protocol to identify common “meta-themes” across field sites. In this way, the authors envision the volume as following in the footsteps of other multi-sited studies like Brigitte Jordan’s Birth in Four Cultures (1978) and other collaborative projects like the Six Cultures Study (see LeVine 2010). The authors take their team-based approach seriously, to the point where the data-centered chapters are written in the third person (for example, instead of “I took the train” it would read “Cindi took the train”) to reflect the collective processes of research development, analysis, and writing.

In short form, the authors of Fat in Four Cultures argue that medicalization of largeness and individualization of responsibility for weight management (both associated with the Global North) have been “transmitted around the world” (142). In other words, where bodies, food, and eating may have had localized meanings in the past, there is evidence of a biomedical model of obesity, repugnance toward larger bodies, and ambivalence toward community and tradition in all four sites, such that “shared beliefs about fat” (123) can be identified. These shared beliefs are articulated in chapter 7 as: (1) fat is one’s own fault, (2) fat is a social failure, (3) fat is unhealthy, (4) fat is harder for women, (5) fat is an outcome of structural shifts, and (6) fat marks insider/outsider status.

This narrative, along with data about the proliferation of public health messaging that presents obesity as a danger and a personal fault at each site, seems to support a story of cultural homogenization. But the data also hint at a more complex story. The authors note that the body is seen as a community achievement in Samoa, that individual responsibility is mitigated by a sense of communal care in Paraguay, that classic neoliberalism is concerned with large people draining social resources in the United States, and that women are burdened with keeping families (and the nation) healthy in Japan. But this nuance and complexity is flattened in favor of more comparable data; while the authors state their aims as theorizing common patterns across sites while simultaneously capturing the distinctness of each locale (14), the weight in this volume feels unevenly balanced toward the former.

The narrowness of the resultant focus—and resemblance to “nutrition transition” literature, which the authors critique as presenting an “overly simplistic narrative about the global march toward modernization,” glossing over individual experiences (14)—may lessen the value of this volume for teaching undergraduate anthropology students. But it is unclear, despite the Teaching Culture series aims, that students are even the target audience for this volume, as the authors self-identify their objective as reaching “practitioners and scholars, health professional, and critical activists” (15). A “recommendations and insights” section (Appendix E) also provides more attention to health professionals, policy makers, and intervention scientists than students. Most of the recommendations listed in Appendix E, for all audiences, also lack clear connection to the content of the ethnography.

The transparency in research methodologies in Fat in Four Cultures is laudable and of value for students and scholars considering the logistics of multi-sited and collaborative research. But, providing such extensive information also leaves the project open to detailed scrutiny and critique, and some readers will no doubt accuse the research team of using leading questions that are embedded in biomedical (or perhaps public health) frameworks for understanding weight in relation to body size, dietary quantity and quality, and fitness. Likewise, the skew toward women participants, unexplained division of participants below and over 45 years for purposive sampling, unaccounted for instances where participants were selected via theoretical sampling, and inclusion of only white participants for the Georgia case study each cast doubts on the results as representative of the surveyed regions.

A bright spot of this volume is its attention to structural factors that impact choices related to food. At times, these perspectives are drawn from interviewees talking about things like food deserts, financial hardships, and land displacement, and at times these factors are elaborated by the researchers. In each case study, the authors also reveal a complicated relationship with “traditional” foods as connected to health and at the same time implicated as a source of ill health or fatness. It is clear from these data that norms are in flux and that this connects to local and global inequalities.

Likewise, there are tantalizing mentions of emergent phenomena at each site: the popularity of fat female comedians and the measures large people take to minimize perceptions of nuisance in Japan; Zumba classes offering exercise but also social support and friendship in Samoa; dieticians cooking meals for clients and the character of dietary adjustments following land displacement in Paraguay; the emergence (or perhaps spread) of fat positivity in the United States; and the connections in each case between largeness (or smallness) and national identity. Lack of alignment between the prevalence of obesity and that of fat stigma (26, Table 2.2) is another novel point. But each of these observations is mentioned in passing only and not put into dialogue with relevant literature.

In the end, Fat in Four Cultures aims to demonstrate how “disparate people in very different locations around the world tackle the question of what it means to be fat in today’s world, how one becomes fat, and what sorts of consequences subsequently emerge” (21). The volume succeeds in presenting one, unified answer to this question but only at the expense of sidelining others.


About the Series. Nd. University of Toronto Press. Accessed 5/11/2023.

Jordan, Brigitte. 1978. Birth in Four Cultures: A Crosscultural Investigation of Childbirth in Yucatan, Holland, Sweden, and the United States. Montreal: Eden Press Women’s Publications.

LeVine, Robert A. 2010. “The Six Cultures Study: Prologue to a History of a Landmark Project” in Journal of Cross-Cultural Psychology 41(4): 513–521.