Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Arts and Sciences



First Advisor

Dr. Sarah Lyon


Over forty percent of eastern Kentucky residents are classified as obese. From a biomedical perspective, obesity is linked to a range of chronic diseases, including heart disease, diabetes, and high blood pressure and is caused by particular lifestyle behaviors that lead to an increase in calorie consumption and decrease in calorie expenditure. However, these links – individual behavior leads to obesity which leads to chronic disease - do not take into account a wide range of personal, social, environmental, political, and economic conditions. In addition to the assumptions of what it means to become and be obese, Kentucky is regularly ranked among the unhealthiest states in the country. In other words, assumptions are made about how people live based on their bodies as well as their geographical location. This project explores some basic questions that form the bedrock of these assumptions. I discuss three food aid programs that developed in response to the Covid-19 pandemic in the spring and summer of 2020. Participants received boxes of (mostly processed) foods and expressed both gratitude and frustration. Standardized, shelf stable food, after all, is not the most nutrient dense and often contains one or more allergens. Boxes provided food during a time of fear and uncertainty but undercut the agency of families to determine their own food needs. Next, I dive into the metabolic and anthropometric data collected over three years (2017-2019) from twenty-five participants in a fruit and vegetable walking program. Positive patterns emerged from the data, specifically concerning measures related to diabetes and heart disease. Biology is influenced by cultural products, such as access to medical care and a living wage. To contextualize the walking program and its suggestive but limited findings, I present key concerns from walking program participants and other members of the community. Then I present another factor that contributes to health and disease – disordered eating. Disordered eating is a non-standardized term and phenomenon that affectively moves between bodies. Through a combination of a validated survey (the Eating Attitudes Test) and in-depth interviews, I explore what disordered eating is, how it affects individuals and those around them, and from the various cultural and relational places it emerges. Finally, this project contests the narrative of absence that often overshadows nutritional studies of eastern Kentucky, specifically when it comes to food. Through interviews and farm visits, I paint an alternative portrait of eastern Kentucky as overflowing with gardens and fresh produce in order to encourage a turn towards food sovereignty in program development and implementation.

Digital Object Identifier (DOI)

Funding Information

This study was supported by the following entities: The University of Kentucky Department of Anthropology Susan Abbott Jamieson Award in 2020, the University of Kentucky Food Connection Student Opportunity Grant in 2020, the Appalachian Center James S. Brown Graduate Student Award for Research on Appalachia in 2020. The author is the program manager for the National Institute of Environmental Health Sciences Superfund Research Center Community Engagement Core (P42ES007380) from 2016-present. The content is solely the responsibility of the author and does not represent the official views of NIH.