Obesity has been evident in the human record for over 20 000 years and affected numerous aspects of human life and society (Bray, 2007a; Bray, 2007b). This introductory chapter describes the early history of human obesity, and then reviews how understanding has developed in the basic biology of obesity, its defi nitions and measurement, the complications of the disease, and fi nally its management. Some of the major scientifi c and medical milestones in the history of obesity are shown in Table 1.1.
Human obesity is clearly depicted in Stone Age artefacts, notably numerous fi gurines that have been found within a 2000-kilometre band crossing Europe from South-Western France to Southern Russia. Palaeolithic (Old Stone Age) statuettes, produced some 23 000–25 000 years ago, were made of ivory, limestone or terracotta. Most famous is the ‘Venus of Willendorf’, an 11-centimetre fi gurine found in Austria (Figure 1.1). Typical of many such fi gurines, the Venus shows marked abdominal obesity and
pendulous breasts. Anne Scott Beller (1977) has suggested that ‘obesity was already a fact of life’ for Palaeolithic humans, although one can only speculate about the purpose or signifi cance of these artefacts.
The New Stone Age (Neolithic) period, spanning the interval between 8000 and 5500 B.C., saw the introduction of agriculture and the establishment of human settlements. This era also yielded numerous statuettes depicting obesity, notably the ‘Mother Goddess’ artefacts found especially in Anatolia (modern Turkey). Similar fi gures from this period have been found in many other sites in Europe and other continents. Anthropological studies indicate that hunter-gatherers are typically lean and that overt overweight is unusual (Prentice, Rayco-Solon and Moore, 2005) – although the enhanced ability to store energy as fat would have clear survival advantages. This fact makes these representations of severe obesity all the more striking.
History of Obesity