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Obesity, Stigma and Reflexive Embodiment: Feeling the ‘Weight’ of Expectation
Transcript of Obesity, Stigma and Reflexive Embodiment: Feeling the ‘Weight’ of Expectation
Feeling the ‘Weight’ of Expectation
Obesity, Stigma and Reflexive Embodiment
University of Leicester
Social Science APPlied to Healthcare Improvement REsearch
Four mechanisms through which obesity stigma reinforces/promotes weight gain/high body weight:
(1) direct behaviour change
(2) indirect effects of psychosocial stress
(3) indirect effects via changes in social relationships
(4) indirect structural effects of discrimination
Obesity and Inequality
Origins of Obesity Stigma are in Individualisation
Social Drivers of Obesity
Individualisation as Victim Blaming
Strong association between national inequality and obesity prevalence
Inverse social gradient in obesity and associated health behaviours (e.g., diet and physical activity) (Newton et al 2017; Buck and Frosini, 2012; Drewnowski, 2009)
Those of low socioeconomic status = disproportionately affected by:
(1) overweight and obesity
(2) weight-based stigma
Biopsychosocial approach suggests people get caught in 'COBWEBS'
Cyclic OBesity/WEight-Based Stigma model
The need for an embodied account
'Internalization' of Obesity Stigma
Theoretical Limitations in the Literature
Medical Sociology and the Body
Social constructivism and the discursive body
Phenomenology and the lived body
Williams (2006): field marrying two main strands of thinking on body matters
...but, argued critical obesity work still not here yet
A cognitive process whereby endorsement of anti-fat attitudes and acceptance of weight-based stereotypes and blame leads overweight and obese people to perform detrimental behavioural norms
: refers principally to the fear of enacted stigma, but also encompasses a feeling of shame
(Scambler and Hopkins 1986)
(Murray 2012; Probyn 2009; Warin 2015)
Reflexive Embodiment and Phenomenology
How does obesity stigma get under the skin and what does it
‘...human bodies exist in two dimensions. We are our bodies (being) but sometimes perceive them as an object that we possess (having)’ (Crossley 2006)
An ethnography of...
Single-sex weight-loss groups
30 mins weigh-in
60 mins physical activity
Approx 144 hours
Purposive sample n=17
what participants did (practices) and what they said (narratives)
Feelings of being considered inferior = adopted in people’s habits and perceptions but within research on obesity and felt stigma insufficient attention has been paid to people’s practices -
the field is limited by a reliance on narrations and statements drawn from interviews
(Barlösius and Philipps 2015)
Limited by Methods?
Embodied Obesity Stigma
and responding to moral judgement
Two main themes
How obesity stigma became an embodied feeling that confused the objective and subjective experiences of group members’ bodies
i) The 'Weight' of Expectation:
ii) Sweat as Salvation and Finding 'Certainty' in Carnal Cues:
How physiological responses to exercise were ascribed moral and social significance that provided ‘certainty’ in the form of carnal cues to combat this confusion
Interviewer: So is living a healthy lifestyle as simple as – eat less, move more, live longer? What do you think?
Jackie: It should be, I think it should be because that’s what we’re trying to do now is eat less […]
Interviewer: So when you say it should be…
Jackie: Why isn’t it? [Laughs] Because things creep in […]
Interviewer: So you do feel that there is a responsibility to be healthy?
Jackie: I feel that you are responsible for yourself, nobody else is are they really.
The Weight of Expectation
Personal Responsibility and Low-SES
Knowing you've put on weight
Interviewer: Ho do you know you've put on weight before you've even been weighed?
Alf: Well, I know because I’ve had a bad week at home ‘avn’t I? [laughs] I’ve been eating things I shouldn’t do. I know that if I didn’t go to the gym and play squash with Rob and all the rest of it this week and then I had fish and chips and stuff, I know pretty well that next week I’ll have put weight on.
How do you know?
Moralised Behaviours + Logic of the Energy Balance Equation
Feeling the Weight of Expectation
Jackie: It’s just the feeling, you feel heavier somehow. I don’t know, I can’t explain how.
Ethnographic insight revealed psychosomatic dissonance
Fran comes in and sits down. Even though no one is getting weighed she does not get up to be weighed herself. Eventually Melanie [group leader] says to her “Are you getting weighed then Fran?” to which she replies “No” and laughs. Fran had been telling us beforehand
“I know I’ve put on. You can just feel it can’t you. I was at a barbeque at the weekend with Steph and boy did we eat, we didn’t stop eating.”
Melanie convinces Fran to get weighed by saying “You can have a sneaky peak before I look” meaning that she can decide whether or not she wants it written down on her card [a record of weekly weights]. When Fran gets weighed it turns out that she actually lost a bit of weight and she says
“I can’t believe that. All that stuff we ate”
and then rolls off a list of things she had
“Spare ribs, two big pieces of gateau with cream…”
She then goes on to say
“I could feel it, you know when you can just feel that you’ve put on. Even my belly looked bigger. I’ll probably put it on next week now”
Shirley agrees with her and says “That’s normally how it works yeah”
Finding 'Certainty' in Carnal Cues
Physiological Signs of Exertion as Evidence
However, most participants maintained relatively stable (over-)weight...
One Way Logic
Weight-management and Perpetual Uncertainty
‘Yeah well just don’t get confident because, you know what they say, when you get confident you’ll put on the next week’
Instructors Generally Accepted Advice
Getting a 'Sweat On'
Interviewer: How do you feel after a session if your clothes are wet with sweat?
Amy: I feel as though you’ve done something [laughs]. We quite often say ‘I’m soaking wet, at least we feel as though we’ve done something tonight’. There’s been times when we’ve walked out and thought that we’ve not done anything […] You feel much better when you’ve sweat and you feel tired, you feel as though ‘ok that was a good one, I’ve done something worthwhile’
Interviewer: Ok, so I hear some of the group talking about activities being ‘bad but good’? How do you feel about these activities?
Becky: I like them.
Interviewer: You like them. Why?
Becky: Because of what they
, like how you
the next day,
the next day and
it feels like you’ve actually done something
Interviewer: So when you say productive you mean?
Becky: You’ve done something to your body;
your body is aching so you must be doing some good
like you’ve worked something. Whereas sometimes you can do it and you don’t feel like you’ve done anything and you leave and it’s almost like you’ve pranced around for an hour.
Being 'Knackered' and 'Knowing'
The 'Bad but Good' Activities
I ache therefore I am...
better able to manage obesity stigma
A pedagogy of danger is combined with a pedagogy of recommended practices in a spiral of:
control > anxiety > control > anxiety
Crawford (2004; 2006)
Support not Stigma
In Summary, we need...
Obesity stigma is both ineffective and immoral
There is a need for an embodied analysis of the effects of obesity stigma
A phenomenological analysis helps to demonstrate how obesity stigma gets under the skin and detrimentally influences the efforts of people of low socio-economic status to effectively manage their weight
Obesity stigma confused group members’ objective and subjective experiences of the body so as to redefine the felt effects of gravity and render physical activity a largely compensatory practice
Thanks for Listening