The Story Behind “Fat in the Fifties”

There is a story that fatness, widespread at least among modern historians, became a morally and discredited condition pretty recently – perhaps in the 1980s, when female models began to grow thinner and male models more muscular. Before that was the era of curvaceous beauty as exemplified by Racquel Welsh and Marilyn Monroe. Perhaps there was parenthetical acknowledgment that slimness had seen a short-lived vogue in the 1920s; otherwise, buxom Gibson Girls were the ideal. That story dovetails nicely with what medical sociologists think of as the neoliberal era of perpetual self-improvement. And, further dovetailing, one will find a standard narrative in the medical sociology literature of the gradually-increasing stigmatization of fatness over the twentieth century, becoming severe only toward its end.

Thus I was surprised, while researching the history of amphetamines a little more than 10 years ago (for my book On Speed), to discover that by the early 1950s not only was there massive prescription consumption of these drugs—the first antidepressants—as weight loss medications, but that these two main ‘indications’ for amphetamines were tightly linked. The antidepressant was thought effective as an anti-obesity medication largely because obesity reflected a neurotic condition akin to depression. Thus fatness was considered a mental illness; in this way it was already heavily stigmatized in the 1950s, and—in pharmaceutical advertising to doctors at least—it was a deadly menace of epidemic proportions in the United States. Nothing in the history or public health literature had prepared me for the idea of an obesity epidemic in the 1950s.

In Fat in the Fifties: America's First Obesity Crisis, I pursue that discovery. The pharmaceutical advertising was merely echoing a high-profile campaign of the US Public Health Service, launched in 1951 with the endorsement of the American Medical Association, to fight the “greatest problem in preventive medicine” of the only nation in any position to suffer an obesity epidemic at the time.  I learned that this campaign had originated in two decades of world-leading epidemiological research by the insurance industry into the likely causes of heart disease, which had by the 1920s become the leading killer of Americans by far. One of its key thrusts was to promote group psychotherapy among overweight people to help them manage their neurotic eating—overeating theorized, in then-fashionable Freudian terms, as an inward-looking oral substitute for more mature forms of satisfaction in the public realms of work and reproductive heterosexuality. Furthermore, the group therapy intervention caught on, evolving into a range of self-help diet groups from Overeaters Anonymous to Weight Watchers, engaging millions of Americans every year ever since.

All these surprises only led to further questions, some with equally surprising answers and some still puzzling. Who stood to gain, and who to lose, in this declaration of war against fatness of the early 1950s? Why was group therapy weight loss the American public health community’s chief intervention into the causes of heart disease, even granting the trendiness of psychiatry in the 1950s? Did it work at all – that is, did Americans, 25% of whom were classed as clinically overweight or obese by the insurance industry, actually lose weight? And most of all, when and how did the notion of an obesity epidemic vanish – only to resurface, of course, in the present day.

Nicolas Rasmussen is a professor in the School of Humanities & Languages at the University of New South Wales. He is the author of Fat in the Fifties: America's First Obesity Crisis, Gene Jockeys: Life Science and the Rise of Biotech Enterprise, and On Speed: From Benzedrine to Adderall.