“How could you let yourself get like that?”: Stories of the origins of obesity in accounts of weight loss surgery
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.
References (60)
- et al.
Childhood obesity: Public health crisis, common sense cure
The Lancet
(2002) - et al.
The myth of the biotech revolution
Trends in Biotechnology
(2004) Fat no more: The answer for the dangerously overweight
(1999)Is a weight-centred health framework salutogenic? Some thoughts on unhinging certain dietary ideologies
Social Theory and Health
(2005)Bountiful women: Large women's secrets for living the life they desire
(2000)Sizeable reflections: Big women living full lives
(2000)- et al.
Bodies out of bounds: Fatness and transgression
(2001) - et al.
Overcoming fear of fat
(1989) - et al.
Food fight: The inside story of the food industry, America's obesity crisis and what we can do about it
(2004) Blinded by BMI
Health at Every Size
(2005)
The obesity epidemic: Can we turn the tide?
Heart
The obesity myth: Why America's obsession with weight is hazardous to your health
The epidemiology of overweight and obesity: Public health crisis or moral panic
International Journal of Epidemiology
Fat and proud: The politics of size
Identity management among overweight women: Narrative resistance to stigma
The anthropology of food and body: Gender, meaning and power
Choosing health: Making healthy choices easier
“The only problem is, children will like their chips”: Education and the discursive production of ill-health
Pedagogy, Culture and Society
Disordered eating and disordered schooling: What schools do to middle class girls
British Journal of Sociology of Education
The doctor's guide to weight loss surgery: How to make the decision that could save your life
The obesity epidemic: Science, morality and ideology
Discourse analysis: Practical implementation
Discourse analysis
Stigma: Notes on the management of spoiled identity
Do we eat less fat, or just report so?
International Journal of Obesity
Collateral damage from friendly fire? Race, nation, class and the “war against obesity”
Social Semiotics
Obesity
Putative contributors to the secular increase in obesity: Exploring the roads less travelled
International Journal of Obesity (advance online publication)
The century of the gene
Cited by (106)
Moral discourse in general practitioners’ accounts of obesity communication
2019, Social Science and MedicineCitation Excerpt :Analysis followed a four-stage process adapted from the method outlined by Parker (1992) and Willig (2001): (1) Sections of the text which alluded to obesity and the challenges of talking about weight were extracted and subjected to a closer analysis; attention was paid to the ways in which GPs' talk cohered around specific understandings of obesity and meanings related to raising the topic of weight. ( 2) Each of the extracted sections were coded for wider socio-cultural discourses which were consistent with a moral discourse of obesity (Jutel, 2005; Throsby, 2007). ( 3) The subject positions (the rights and obligations, and what a person can and cannot say, based on what discourse makes possible) were identified (Davies and Harrè, 1999). (
“I have to go the extra mile”. How fat female employees manage their stigmatized identity at work
2019, Scandinavian Journal of ManagementImmovable subjects, unstoppable forces: Bariatric surgery, gender, and the body
2023, The Contemporary Reader of Gender and Fat StudiesOBESIT Y AS MOR AL PANIC: A THEMATIC ANALYSIS OF EMPIRICAL AND THEORETICAL PUBLICATIONS IN A TEMPOR AL PERSPECTIVE
2023, Zhurnal Issledovanii Sotsial'noi PolitikiThe Ethical Work of Weight Loss Surgery: Creating Reflexive, Effortless, and Assertive Moral Subjects
2023, Culture, Medicine and Psychiatry