Moon on Bitar, 'Diet and the Disease of Civilization'

Adrienne Rose Bitar. Diet and the Disease of Civilization. New Brunswick: Rutgers University Press, 2018. 244 pp. $95.00 (cloth), ISBN 978-0-8135-8965-7; $24.95 (paper), ISBN 978-0-8135-8964-0.

Reviewed by Sarah Moon (University of Connecticut)
Published on H-Nutrition (June, 2019)
Commissioned by Molly S. Laas (Department of Medical Ethics and Medical History, Goettingen University Medical School)

Printable Version:

In Diet and the Disease of Civilization, Adrienne Rose Bitar mixes cultural studies and literary criticism in her analysis of diet books of the past three decades. Establishing the grounds for her project, Bitar argues that the obesity epidemic of the past twenty-some years has led to a shift in the cultural significance of dieting. With the rise of obesity, “weight loss suddenly became an American concern, with the health of the nation at risk” (p. 5). While her introduction traces dieting texts from some of their earliest manifestations, starting with William Banting’s 1863 Letter on Corpulence, Addressed to the Publicthe four categories of diets in her book are based on the most popular dieting books of the 1990s, 2000s, and 2010s. Diet and the Disease of Civilization brings a unique perspective to scholarly criticism surrounding diet books. Though several scholars have examined the gendered conceptions around dieting, such as Hillel Schwartz, R. Marie Griffith, and Susan Bordo, Bitar argues that the labeling of some diets as frivolous, and others serious and worthy of study, “explains volumes about how scholars and cultural critics have overlooked some of the bestselling books of the twentieth century” (pp. 5-6). Bitar argues that diet books consistently top the best seller lists, but have not been analyzed in terms of how the stories they tell reflect American culture. Bitar explains that she reads diet books like scripts through which readers reconsider who they are in the world and who they might be.

Bitar breaks these diets up into four groups: Paleo diets, Eden diets, precolonial diets, and detox diets. In each corresponding chapter, she shows how each type of diet hearkens back to some site of perceived superior health in our past: the cave, the Garden of Eden, the precolonial paradise, and the preindustrial world. Bitar ultimately shows how diet books have “precipitated the politics of the alternative food movement” (p. 161), but she does not make clear whether she believes the mainstreaming of the alternative food movement will subsume dieting or whether diet narratives will continue to have significance in our culture.

Bitar focuses first on the Paleo diet, which broke into the mainstream in 2002 with the publication of The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat by Loren Cordain. A 1985 article in the New England Journal of Medicine by S. Boyd Eaton and Melvin Konner, medical doctors with anthropological training, put forth the two claims at the foundation of the Paleo movement: the first is that the human body “has remained essentially unchanged since the Paleolithic era” and the second is that Paleolithic humans were, on average, six inches taller than humans living post-agriculture (p. 33). Bitar posits that diet books make the body into a utopic space, “a living measure by which utopian dreams are realized” (p. 36). In the case of Paleo diets, this utopia is the distant past of the cave, and the diet is a means through which we can move our bodies back in time to that past. It is clear the diet and the narratives it employs have had wide popular appeal. In 2013, “Paleo” was the most searched for form of diet on Google and today Mark Sisson’s Paleo blog, “Mark’s Daily Apple,” receives 2.5 million unique visitors each month (p. 34). Bitar makes a point to illustrate how the Paleo diet has sought to separate itself from typical gendered notions of dieting as feminine and disempowering to women. Though people tend to associate Paleo with men, she notes that an Ancestral Health Society Survey actually found that there were more female than male Paleo practitioners. Paleo proponents, Bitar writes, have claimed it to be not so much a diet as a whole lifestyle. Bitar notes that many Paleo dieters see a connection between their diet and the health of the planet, seeing food as one way to be in a more balanced relationship with the earth. Authors of Paleo diet books recreate a “pre-Edenic life of ‘closeness and interdependence’” that stresses the ample leisure time of our earliest ancestors (p. 44). Bitar’s rendering of the “Paleolithic paradise” painted in some of these books suggests that many of its adherents are not only seeking health, strength, and physical well-being, but are also longing for greater simplicity and togetherness in their daily lives. Paleo dieting ultimately rests on hope, a hope that we might achieve a more ideal world through perfecting our bodies. It seems, though, that Bitar leaves untouched some big questions about the appeal of the Paleo story. The desire to go so far backwards in human history is indicative of a rejection not only of contemporary foodways but also of most of human culture. It feels as though some of these narratives appeal on the basis of a desire to start over from scratch, to the dawn of homo sapiens, to establish a new trajectory. The literary criticism approach to the narratives in Paleo diet books that Bitar begins here could yield many more insights about the Paleo subculture and its relationship to mainstream culture if pursued further.

Like Paleo diets, Eden diets present a shift in eating habits as a means of achieving a better world, but for their adherents, an explicitly Christian one. The best seller The Daniel Plan (2013) promises not just weight loss but to help dieters “‘awake to the beauty and miracle of life’” (p. 83). And The Jesus Diet (2013) vows that it will “‘redeem us as individuals from a common destiny of disease and death’” (p. 83). Bitar recognizes the notes of hucksterism and moneymaking behind some of the blockbuster Eden diet books; she writes that the hope in these diets for a better world “is most piercing in modest books, self-published by small-town pastors or full-time housewives” (p. 83). She points out that there is a sincerity behind at least some of these books and certainly in many of their readers. In this point, Bitar shows the degree to which she herself was transported by the narratives within the Eden diet books, suggesting that theirs may be the most persuasive of the four categories she explores.

One of the best-selling of this genre is Jordan Rubin’s 2004 The Maker’s Diet. Bitar writes that Rubin “believes modern life has created a modern body racked by false hungers, trapped in a fallen world, and overwhelmed by sadness, sickness and stress” (p. 67). Devotional diets, Bitar illustrates, lean heavily on a “jeremiac” sense of time, humans today being strung somewhere between the fall of humanity and a future, promised paradise. Contemporary, processed foods become a stand-in for Eve’s apple, setting up a scene in which consuming these foods replays the fall. Bitar notes that though these books heavily reference the fall, the diets they advocate tend to take a different tack than associating overeating with sin. Instead, they delve into the pleasure of eating God-given foods. Bitar shares that Rachel Marie Stone asks in Eat with Joy: Redeeming God’s Gift of Food, “‘And why did God make eating so pleasurable?’” (p. 75). Stone answers that “‘God made eating sustaining, delicious and pleasurable because God is all of those things and more’” and calls for Christians to revel in the “‘simple pleasures of smelling, tasting and chewing’” (p. 76). Bitar notes that Eden diets stand out for describing “the aesthetics of food,” seeking to help readers appreciate God’s glory in the natural foods of the earth. While the Paleo diets rest on a vision of rewinding to “the cave” and more instinctual human appetites, these diets work with an “imagination of Eden” and God’s perfectly delicious creations to inspire dieters to untrain their culturally conditioned appetites. 

Connecting the spirit of the primitive diets to that of the Eden diets, Bitar shares that French explorer Louis de Bougainville wrote of the Tahitians, “‘I never saw men better made…. I thought I was transported into the Garden of Eden’” (p. 100). The key difference between the attitude of the two diets may be that the Eden diets see food from nature as a link back to God whereas the precontact diets are secular. Rather than construe nature as God, these diets stress the physical significance of the severed relationship between humans and nature. These diets also rest on the fact that the Western diet has hit native populations especially hard. Bitar cites a 1971 study that found half of Pima Indians over thirty-five had type-2 diabetes. She notes that “medical publications often categorize the Pima and Pacific Islanders together to show how rapid rates of modernization increase diabetes risk among genetically similar populations” (p. 88). Bitar argues that these diets seem to be influenced in part by what anthropologist Renato Rosaldo calls “imperialist nostalgia” in which “‘agents of colonialism long for the very forms of life they intentionally altered or destroyed’” (p. 88). Bitar informs us that researchers interested in native diets have looked at people in Arctic regions, remote Pakistan, and the Pacific Islands, but only the Pacific Island native diet has entered into the realm of popular weight loss diets. Bitar calls 1997’s The HawaiiDiet by Dr. Terry Shintani, based on what Hawaiians would have been eating before Captain Cook’s 1778 arrival, the “best example of a mainstream Pacific Islands weight loss diet” (p. 92).

Bitar points out a significant issue, though, with primitive diet narratives, which is that they suggest that some ethnicities are “less compatible with civilization” (p. 94). She also notes that some of these books confuse Pacific Islanders from one island to another. She writes, drawing a correlation between the diets and literature about people of this region, “Popular diet advice does flatten and disrespect the diversity of the Pacific Islands, but these inaccuracies reveal debts to the literary and intellectual legacies that similarly misunderstand the Pacific” (p. 95). Asserting her purpose is not to critique the accuracy of these texts, but consider how they work as grand narratives, Bitar asserts that “diet books are best read not to call out ignorance but rather to understand myths” (p. 96). Yet despite this clarification of her purpose, Bitar returns to a critical evaluation of these diets’ treatment of Pacific Islanders later in the chapter. Though this discussion is an interesting and important one, it felt somewhat tangential to the work as a whole.

Bitar’s final chapter focuses on detox diets, pointing out that these diets serve as a bridge between the realm of dieting and the “political discussions of food, health and obesity in the United States” in recent years (p. 119). Bitar posits Michael Pollan’s groundbreaking Omnivore’s Dilemma (2006) as a direct outgrowth of the detox diet approach. Detox diets differ from other diets, Bitar notes, in that they are not just for the overweight, but are relevant for everyone, as many people are concerned about exposures to agricultural chemicals in the food they eat. Detox diets are also unique among the four categories in connecting the food we eat to “larger systems of global capital, industrial development and social structures” (p. 121) and have become hugely popular in just the last ten years. Bitar writes that the food movement and the detox diet began to merge with the publication of The Great American Detox Diet in 2005 by Alexandra Jamieson, the girlfriend of Super Size Me creator filmmaker Morgan Spurlock. She notes that by “by 2005, the concept of a ‘diet’ may have seemed faddish, fake, and decidedly antifeminist” because of its tendency to emphasize weight loss over actual health (p. 139). Detox diets turned against those prior associations and aligned themselves with the political and environmental concerns of the food movement, taking up the concept of “voting with your fork.” The detox diet, then, speaks not just to the eater, but to the consumer, appealing to people on the basis of principles that go beyond the food and its breakdown into component parts.

Bitar says the detox diet is utopian like the others, but unlike her discussion of the three other types of diet, there is little in this chapter about the site of “former health” that inspired detox diets; perhaps it is because it is not there in the texts. In contrast with the other diets, the imaginative content of detox diets rests more on the negative, what is bad in the food people are consuming, than the positive. But Bitar does not explore this contrast; rather, she closes the chapter with a vague assertion that “the discourses of toxicity create a beautiful, wistful vision of history and reveal how many Americans have dreamt of health and purity in a world too often seen as sick and ugly and sad” (p. 148). While Bitar acknowledges the content of some of the detox diet texts and their recommendations to be lacking in the face of the real political problems behind our food system, she does not touch on the risk of its adherents developing obsessive or compulsive behaviors about food. Bitar does mention the new psychiatric term “orthorexia” to denote an eating disorder in which a person displays “‘a pathological obsession with proper nutrition,’” but only in brief and does not connect it to detox diets (p. 151). 

In her conclusion, Bitar seeks to suss out the future of social attitudes toward food based on the most recent trends of healthy lifestyle and food politics. She shares that a women’s magazine in 2016 proclaimed “‘The Diet Is Dead,’” with “the pursuit of a ‘healthy lifestyle’ having taken dieting’s place” (p. 151). Bitar’s analysis of these four diet movements shows that dieters in the past three decades have been inspired to change their bodies not only for personal benefit but because of a longing for a more perfect world. With the exception of the detox diet, each type of diet seeks out a different time or place in the past as its model of an ideal, and additionally shares the rejection of heavily processed foods and the pursuit of unprocessed whole foods. As Bitar shows, these diets begin to naturally overlap with the contemporary food movement. Bitar’s assertion is that it is all to the good. But I think that there are significant pitfalls not addressed here, which include eating disorders, particularly associated with detox diets, and old-fashioned tribalism where dieters of particular persuasions become devoted acolytes who begin to look down upon those who don’t practice their faith, such as Paleo dieters’ attacks on vegetarianism. In addition, Bitar never directly addresses whether she personally believes that “dieting is dead” and, if so, what it means for the narrative appeals behind these four types of diet. Just last week, the New  York Times published an op-ed titled “Smash the Wellness Industry” in which Jessica Knoll writes, “The diet industry is a virus, and viruses are smart. It has survived all these decades by adapting, but it’s as dangerous as ever. In 2019, dieting presents itself as wellness and clean eating, duping modern feminists to participate under the guise of health.”[1] I think given the growing backlash to the merging worlds of alternative food and dieting, further study of diet narratives should seriously consider the ways in which words and symbols can be abused to promote destructive behaviors and attitudes.

Overall, Diet and the Disease of Civilization is an important first foray into a critical analysis of contemporary diets that takes a cultural studies and literary criticism approach. I commend Bitar for bringing a new lens to this material and agree that these texts, and their corresponding subcultures, offer rich fodder for further study. 

Erratum: This review has been amended to correct errors in spelling, accuracy of quoted text, and the professional identity of Loren Cordain, author of The Paleo Diet, who holds a PhD but is not a physician.


[1]. Jessica Knoll, “Smash the Wellness Industry,” The New York Times, June 8, 2019,, accessed June 12, 2019.

Citation: Sarah Moon. Review of Bitar, Adrienne Rose, Diet and the Disease of Civilization. H-Nutrition, H-Net Reviews. June, 2019.

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.