Elsevier

Social Science & Medicine

Volume 65, Issue 8, October 2007, Pages 1561-1571
Social Science & Medicine

“How could you let yourself get like that?”: Stories of the origins of obesity in accounts of weight loss surgery

https://doi.org/10.1016/j.socscimed.2007.06.005Get rights and content

Abstract

In the context of the contemporary rhetoric of the “obesity epidemic”, the fat body is easily labelled as lazy, self-indulgent and lacking in discipline. Those who become fat often find themselves needing to account for their size in order to refute the suggestion of moral failure that attaches itself easily to the fat body. Drawing on a series of interviews with 35 weight loss surgery patients in England and Scotland, this paper explores the discursive resources and strategies available to those who are, or who have been, very overweight in accounting for their size. The paper argues that the participants drew on three core discourses in order to resist the construction of their fatness as an individual moral failure: (1) the fat-prone body; (2) childhood weight gain; and (3) life events disrupting weight management efforts.

Section snippets

Accounting for fatness

Two key assumptions underpin the moral evaluation of the fat body in contemporary western society. The first of these is that obesity is a medical, financial and social problem, and that this problem threatens individual, national and global well-being (NAO, 2001; WHO, 2000). It is this perceived risk of future health problems that lies at the heart of the moral imperative at the level of the individual to take preventative action against obesity (Gard & Wright, 2005, chap. 9; Lupton (1994),

Methodology

This paper addresses these questions by drawing on data from a series of qualitative interviews, conducted in 2005–2006, with people who have either had, or were waiting to have, weight loss surgery (WLS). I conducted interviews across England and Scotland with 35 WLS patients (6 men and 29 women); in some cases, family members also joined the interviews. I also conducted one focus group at the beginning of the project with members of a WLS support group in the north of England. The majority of

The fat-prone body

All of the participants in my study experienced their bodies as innately fat-prone, and these biological accounts of fatness focused on two key sites: firstly, genetics; and secondly, metabolism. The identification of a genetic cause for fatness is the holy grail of obesity research (Shell, 2003), with any subsequent therapies promising enormous financial returns in a market hungry for new and sustainable weight loss technologies. However, with the exception of the identification of a small

Childhood

With only a small handful of exceptions, all of the participants in my study identified weight as a problem in childhood, although few described themselves as having been fat. Instead, they drew on a catalogue of familiar euphemisms—stocky, chubby, chunky, well-covered—which are understood as predicting future fatness in adulthood:

Karen: Is this your father? [looking at childhood photograph]

James: Yeah, he's pretty stocky. Again [showing me another photo], that's the same year. That's me there,

Life gets in the way

Although children are increasingly being encouraged and expected to take responsibility for their “lifestyle” and body weight (Evans, Evans, & Rich, 2003; Evans et al., 2004; Rich & Evans, 2005), they are, in general, still perceived as victims of the obesity epidemic rather than its perpetrators. However, as adults, the burden of responsibility is much more easily transferred to the individual—it is they who are deemed to have “let themselves get like that”. Biological disadvantage, and early

Conclusion

This paper has explored some of the ways in which those who have been (or still are) very overweight, and who have turned to surgery in order to lose weight, account for their size. In particular, I have argued that the participants accounted for their weight gain via the contradictory and complementary discourses of the fat-prone body, of childhood events and learned behaviours, and of disruptive life events. These accounts, I argue, enable the participants to distance themselves from the

Acknowledgements

I am very grateful to the Suntory and Toyota International Centres for Economics and Related Disciplines at the London School of Economics, and to the Collaboratory: Social Anthropology and the Life Sciences at Humboldt University, Berlin, for grants to support the field work for this research. I am also grateful to Celia Roberts and Ros Gill for their comments on early drafts.

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