No genealogical starting point
First, neither of the participants could clearly identify a genealogical starting point for their weight gain. Obesity was rather experienced as something that has always been present:
“Pummelig war ich eigentlich schon mein Leben lang. Das (2) begann schon bei der Geburt, wo ich .. über 5000 Gramm war” (C90GM5, l.011).
“I’ve always been chubby, actually my whole life. That (2) began when I was born when I .. had over 5,000 grams”
In some cases participants were able to provide more precise periods of time in which they gained weight. However this did not change their assessment that overweight could not be attributed to an initial life event:
“Also, .. ich war mit drei schon übergewichtig, also irgendwie immer” (J56CL1, l.017)
“Well, .. I was already overweight at three, actually I have somehow always been”
Even if certain temporal markers were added, most of the time this had no real implication. They were just part of the subjective story line but were not understood as a genuine part as such:
“Also, ich war schon immer dick, also auch als Kind, als Fünf-, Sechsjähriger hat das angefangen laut meinen Eltern” (A12ZY1, l.139)
“Well, I have always been big, even as a child, as a five-, six-year-old it started according to my parents”
This result can be found throughout all samples and was independent of age, gender or level of education.
Life events as catalysts
Though no initial meaning was attributed to the life events for the genesis of obesity, they seem to function as catalysts for the further increase of weight in a significant way. These life events were perceived as fateful on the one hand, but were at the same time determined as possible chances of intervention. At this point, it is crucial to make clear that the participants did not primarily understand such means of intervention as interventions concerning their weight. Instead they understood their eating and mobility behaviour as reactions and strategies of coping with the problem seen as primarily responsible. By the participants, interventions were only considered as having a chance to succeed if they primarily focus on the priority impairments and thus only indirectly address disposing with the eating and mobility disorder.
The analysis shows the following relationships between the different life events and the weight increase: First, the individual life events may accumulate and cannot always be clearly separated from one another. Second, many participants considered excessive eating as an act of defiance towards the family and simultaneously as a very important factor in the respective story lines. Various possible events, such as experiencing domestic violence, the separation of the parents or the death of a family member were considered as leading to these acts of defiance:
“… Erwartungen, die ich halt so .. an ’n Vater gestellt hab, also von – Vater hatte – (2) kam nie rüber – also Desinteresse v o n Vater, Missachtung von der Mutter, .. zum Teil auch häusliche Gewalt von der Mutter. (O23DY9, l.120-124)] und [.. Und deshalb wusst ich halt nie, wie ich’s verarbeiten sollte, außer halt .. mit ’m Essen und (2) meistens mehr als (2) eigentlich der Magen haben wollte (O23DY9, l.126-127).
“… expectations, which I had, as I said, .. of my father, well had from – father – (2) never came across – well disinterest f r o m father, disregard from the mother, .. partly domestic violence from the mother, too.] and [.. and therefore I, as I said, never knew, how I should process it, but, as I said, .. with eating and (2) most of the times actually more as (2) the stomach wanted to have.”
“… wir hatt’n nu’ häusliche Gewalt zuhause und dann be – hat mein Vater mich auch ’n paar Mal geschlagen, eben Johanna Jäckl 22. September 2014 12:29: weil.. er irgendwie ganz entsetzt war, wieso ich denn auf einmal so dick bin, .. ähm, und mit meiner Mutter, ähm, die hatte irgendwie so ’ne Angst, dass mich irgendwann selbst aufgebe, und das war halt das Körpergewicht oder, äh, s – das Indiz ((verhalten auflachend)) dafür. (J56CL1, S.6, Z.151-155.)] und [dann jedes Mal bei Familienfeiern und so, dann wurden wir praktisch in jedem Satz beleidigt wegen unsr – unsres Gewichtes … (J56CL1, S.7, Z.157-158)”
“…we had domestic violence at home and then sta - my father also hit me a couple of times, just because .. he was somehow really appalled, because I was suddenly this big, .. um, and with my mother, um, she somehow had this fear, that I could give up myself eventually, and for this was, as I said, the body weight or, uh, s - the indication ((restrained laughing))] and [then each time at family celebrations and so on, we were being insulted practically with each sentence because of ou - our weight…]”
Excessive eating was often a means for compensation for these life events which were perceived as severe and threatening. While this behaviour was sometimes understood as open protest, for example to call for attention to the particular problem, it served at the same time as an internal strategy of dealing with the problem. Such a separation, however, proves to be rather artificial concerning the progress of the whole storyline. In fact, there are often transitions in the temporal perception of the respective modes of behaviour:
“Ähm und (2) dann, äh, is mein .. Vater auf Kur gegangen, .. im selben Jahr und is dann, äh, nach der Kur, .. ähm – .. hat uns dann verlassen, also er hat sich von meiner Mutter getrennt und .. is weggezogen und, .. ähm, ja dann .. war sehr viel Trauer in der Familie und, äh, .. ich, ja, ich konnte (?den dann) nich so ganz bewältigen zu dem Zeitpunkt und hab mich dann sehr zurückgezogen, .. hab dann auch angefangen, exzessiv am Computer zu spielen, und, .. ähm, zu dem Zeitpunkt hatt ich au’ nicht mehr sehr viel soziale Kontakte wegen .. Vorfällen davor, .. wo sich mein Freundeskreis, äh, sehr ausgedünnt hat.] und [Hm, .. also, ich glaube, wenn (2) – wenn mein Vater damals, ä h, sich nich entschieden hätte dazu, ähm, .. uns zu verlassen, .. denk ich, wär ich auf ’m guten Weg gewesen, .. hm, nicht so viel zuzunehmen, weil i – ich war damals, .. sag mal, relativ schlank .. füm–, äh, für meine Verhältnisse und, .. ähm, ich bin ’n halbes Jahr aus ’er Kur draußen gewesen, es war – es war alles relativ gut gelaufen und, .. ähm, .. ja, aber ich bin halt, wie gesagt, in’n sehr tiefes Loch gefallen, als er hier so weg war, und, äh, (2) ich denke, wär das nich passiert, dann wär ich jetzt, äh, nich hier, dann hätt ich jetz wahrscheinlich ’ne Ausbildung und .. würde wahrscheinlich selbstständig leben.” (F49RT2, l.015& l.077)
“Um and (2) then, uh, my .. father went to a health resort, .. the same year and then he, uh, after the cure, .. um - .. left us then, he split up with my mother and .. moved away and, .. um, yes then .. there was a lot of sorrow in the family and, um, .. I, well, I could not really cope with it at that time and then I withdrew back into myself, .. started excessively playing at the computer, and, .. um, at that time I didn’t have much social contacts because of .. incidents before, .. where my circle of friends, uh, thinned out quite a lot.] and [Hm, .. well, I believe, if (2) – if my father had, uh, decided differently then, um, .. about leaving us, .. I think I would have been on a good way, .. hm, not to gain that much, because I – I was then, let’s say, relatively lean .. bym-, uh, by my standards and, .. um, I had been out of cure for half a year, it went – it went all relatively well and, .. um, .. well, but I did fall, as I said, into a very deep hole when he was gone here, and, uh, (2) I think if that didn’t happen, then I would, uh, not be here now, then I would probably have an apprenticeship now and .. would probably live on my own.”
In the preceding quote the participant’s explanations patterns can definitely be understood as protest or a strategy of coping with the described life event. Depending on this differentiation of protest or coping strategy, distinct types of intervention were considered adequate. Besides the act of defiance towards their families, another explanatory model for the excessive consumption of food was to regard it as a reaction to changes in the respective stage of life. Changes of the familiar surroundings due to moving or school transition as well as the start of puberty were mentioned most frequently. Whereas the excessive consumption of food was often associated with particular life events, the lack of activity was not. Instead the latter was attributed to continua of experience. Thus, especially the persistent stigmatising experiences – and thus the co-occurrence of labelling, stereotyping, separation, status loss, and discrimination [
35] – within the different life events were the trigger to shift the participants’ focus of interest and life into domestic or also digital worlds. Both, the decreased perception of offers for activity or eventually the active avoidance of any physical activity, were also linked to this. After describing these shifts into inactivity all participants mentioned their attempts to find ways back into activity. Four participants told about specific efforts like joining sports clubs or fitness clubs. However, they stopped their efforts after their environment acted negatively to their endeavours. Comments that were made by the immediate, and again especially domestic, setting were deemed particularly relevant. Possible verbal or gestural expressions of agents of the broader social setting were experienced as less grave.
Taken as a whole, it can be stated that different life events were on the one hand identified as starting points for enormous increase in weight. On the other hand, attempts to either stop further weight gain or starting weight loss were only considered to be reasonable and expedient if the obesity was directly linked to the previously described life events. This aspect was also confirmed by the fact that the participation in different medical programmes for intervention at the very time of these critical life events did not achieve any or just a negligible short-term effect: obviously, they did not address the actual problem nor did they identify it.
Obesity as a threefold family challenge
Closely connected to this second point, there is a third aspect, namely the participants’ view of obesity being mainly a family issue. However, such a localisation is also ambivalent. First and corresponding to numerous existing studies on the connection to maternal and paternal weight [
36,
37] and the importance of the family’s socio-economic status [
38,
39], all participants told about an accumulated occurrence of overweight in the family circle. This involved the closest as well as the extended family circle.
“Äh, schon, .. also, hm, .. meine Mutter ist übergewichtig, meine Schwester auch .. und mein Bruder auch, aber die beiden haben das jetz auch hingekriegt mit Abnehmen .. u n d mein Vater, der is eigentlich auch ’n bisschen moppelig.” (G19MV4, l.113)
“Uh, even, .. well, hm, .. my mother is overweight, my sister too .. and my brother too, but both of them have by now managed to lose weight .. a n d my father, he’s actually also slightly pudgy.”
Second, the view of obesity being a family issue is supported by the fact that all participants pointed out that, from their perspective, the family was the only reasonable setting where a strategy of prevention has to begin. Medical interventions as well as behavioural-preventive measures at kindergarten or at school were less appropriate according to the subjective perspective of those affected. Although they were regarded as important and expedient as flanking measures, they would not address the actual challenge. However, even if intervention within the realms of the family was existent, by focusing (too) strongly on the respective intervention a certain factor of resignation became apparent with the participants:
“das Gewicht und auch das Essverhalten war eigentlich dann wirklich das einzige regelmäßige Thema, über das man so gesprochen hat.” (J56CL1, l.053)
“the weight and also the eating behavior was actually really the only regular topic about which you talked.”
Third, this resignation also had its effect on the evaluation of suggestions for interventions outside of the family. For example, by launching a school intervention concerning the consumption of high-calorie drinks, the subject matter would have been omnipresent not only at the participants’ homes but in their every-day environment which thus constantly pointed at their “problem”.
The focus on the family as the primary setting of intervention, however, didn’t reveal anything about the affective or emotional proximity of the participants towards their families. It can rather be regarded as some relatively pragmatic information for the localisation of the source of obesity: Obesity as a domestic outgrowth. This means that the essential starting point for intervention has to be set within the family.