Obese individuals’ perceptions of health and obesity and the lived experience of weight loss, gain, or maintenance over time

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2014, 2014
Bombak, Andrea
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American Journal of Public Health
Background: Obesity is associated with conditions that may affect Canadians’ health status and strain the health care system. Obese individuals are subjected to stigmatization. Most public health programs to date promote weight loss. However, weight loss is rarely sustainable. Insight must be gained into the embodied, lived experiences and lifestyles of ‘target’ populations and their perceptions of and priorities concerning health and wellbeing to develop public health programs that enhance lifestyles and health. Purpose: The purpose of my research was to use critical ethnographic research methods to explore obese individuals’ perceptions of health and obesity and the impact of these assessments, as well as personal weight trajectories, on obese individuals’ health perceptions, lifestyles, quality-of-life, and behaviours. Methods: This study involved one- year ethnography. Data sources included field notes and repeated (every 3-4 months), audio-taped, semi-structured, qualitative interviews with research participants. Subsamples included obese and formerly obese individuals who were 1) pursuing weight loss to achieve health goals, 2) attempting to maintain weight loss, and 3) attempting to get/stay healthy through diet and exercise but were not concerned with weight loss. Participant observation occurred at sites identified by participants as essential to their embodied, lived experience. Results: Three major themes emerged: the importance of function to health and quality-of-life; compulsion, addiction, and the need for validation; and social impacts of various weight trajectories and perspectives. Participants recounted multiple ways in which their ever-fluctuating bodies and related bodily attitudes profoundly affected their social lives and the degree of social acceptance they experienced in coping with their bodies, participants often described highly compulsive food, dieting, and fitness behaviours and a constant search for validation of their health-related endeavours. Significance: The dominant discourse regards obese individuals as ill. This perspective may produce disempowering public health initiatives. To achieve sustainable benefits for Canadians’ quality-of-life, a greater understanding of what constitutes health and wellbeing for obese individuals, and how such factors may change over time and differing circumstances, is essential. This insight will contribute to a salutogenic and holistic approach to health, particularly in populations that may feel stigmatized as a result of health issues.  
Critical obesity studies, Stigma
Bombak AE. 2014. The contribution of applied anthropology to obesity stigma-related public health approaches. Journal of Obesity 2014 (Article ID 267286). doi:10.1155/2014/267286.
Bombak A. 2014. Obesity, Health-at-Every-Size, and public health policy. American Journal of Public Health 104(2): e60–e67. doi:10.2105/AJPH.2013.301486.