In her introduction, Elizabeth Williams explains that the chosen focus of her book is based upon twin assumptions: that ‘troubles of appetite’ are involved in our current widespread ‘nutritional disarray’ and that thinking about appetite in society has been shaped by scientists and doctors. Unfortunately, however, in the 269 pages of text and sixty-two pages of notes that she devotes to exploring ‘appetite’ in science and medicine from 1750 to 1950, she amply demonstrates that, among most of the disparate actors she discusses, ‘appetite’ has not been a subject for prolonged and focused research and theorizing. Given the ‘appetite study disarray’ that she illustrates, it may be asked whether, had Williams studied the question of what ‘appetite’ in wider culture owes to science and medicine, she might have come up with a different answer to the assumption that forms part of the rationale for the book. ‘Appetite research findings’ have made no impact upon modern food cultures comparable, for example, to the impact of vitamin science or research on energy requirements.
It is clear from Williams's account that there was no community of appetite scholars closely engaged with one another and therefore no clear and sustained paradigm shifts, as a result of which Williams is left with inventing arbitrary fifty-year blocks of time to order her material, which correspond to four parts of the book. However, the material is not so easily disciplined: in Section Two, for example, covering 1800–1850, she spends the first chapter discussing appetite in the thought of Erasmus Darwin and Xavier Bichat, both of whom died in 1802.
But Williams displays remarkable skill and encyclopedic knowledge in mining the output of scholars and practitioners in a wide range of fields for their thought and research on appetite. Sometimes she has to rely on what amounts to passing remarks on appetite in large bodies of writing. She covers physiology, clinical medicine, psychiatry, psychology, psychoanalysis, natural history, ethology and anthropology (some in more detail than others). Except in, for example, the discussion of the work of Jacob Moleschott, the field of public health is largely omitted. Occasionally there is a wistful tone in which Williams explores what some actors might have had to say about appetite, had they been more interested in it (Bichat being a case in point). During the two-century period discussed the positions of actors continuously revolved around whether appetite is a somatic or psychic/moral phenomenon, around whether it is under the control of nerves or a more diffuse bodily mechanism (latterly hormones), around distinctions between hunger and appetite and the role of instinct, and around appropriate interventions for maladies such as obesity, peptic ulcers and anorexia nervosa. But Williams identifies one ‘gain’ by 1950 among physicians concerned with appetite: at least some of them, she says, had come to regard the ‘ills of appetite’ as highly complex and not treatable by a pill or injection.
Williams does her best to make her content as digestible as possible for the reader with introductory sections for each part – which are almost the only places where the wider contexts of each of the fifty-year periods are mentioned – and summaries at the end of each part. But in place of a concluding chapter reviewing the content of the book, Williams ends with an opinionated epilogue entitled ‘Appetite after 1950’. Here she first races through an account of appetite research since 1950, before ending with a series of remarks which have only tenuous connections with the content of the book. While observing that it is not the business of historians to make policy, Williams launches an attack on ‘nutritionism’, targeting the use of BMI to assess degrees of obesity, questioning the existence of an obesity epidemic and the alleged risk of diabetes and heart disease for those classified as obese, and condemning those who have waged a ‘war on obesity’ for the ‘anxiety’ it causes. In conclusion she urges those responsible to be quiet. Instead, Williams suggests that studying the history of appetite ‘encourages us to value our own appetite and to find our own way to health and healthy eating’.
It seems apparent from Williams's introduction and concluding remarks that she is much motivated by modern societal concerns with obesity, and if it was her intention to arrive at some conclusions in this connection, she might have done better not to have chosen the nebulous theme of appetite for her research. It may well be, in any case, that it will not be through a better understanding of appetite but through, for example, the redistribution of wealth and improvements in educational opportunities that an abatement of the ‘obesity epidemic’ will be achieved. And had she been writing at the time of the coronavirus pandemic, one wonders whether Williams would have made so light of the alleged health consequences of obesity, and whether, perhaps, she would have dismissed the reported links between obesity and risk of dying from coronavirus as fake news.
Apart from the issues identified in the framing of this study, it must be admitted that Williams's book is carefully researched and that she has provided a great resource for anyone interested in expanding the history of appetite, or anyone interested in related fields such as the history of nutrition.