Jim Hyde

Being ! fat" in today" s world: a qualitative study of the lived experiences of people with obesity in Australia

Objective  To develop an in‐depth picture of both lived experience of obesity and the impact of socio‐cultural factors on people living with obesity.

The concept of prevention: a good idea gone astray?

Over time, the definition of prevention has expanded so that its meaning in the context of health services is now unclear. As risk factors are increasingly considered to be the equivalent of “diseases” for purposes of intervention, the concept of prevention has lost all practical meaning. This paper reviews the inconsistencies in its utility, and suggests principles that it should follow in the future: a population orientation with explicit consideration of attributable risk, the setting of priorities based on reduction in illness and avoidance of adverse effects, and the imperative to reduce inequities in health.

'I'm searching for solutions': why are obese individuals turning to the Internet for help and support with 'being fat'?

Introduction  This study explores what types of information obese individuals search for on the Internet, their motivations for seeking information and how they apply it in their daily lives.

The solution needs to be complex. Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity

BackgroundPrevious studies of public perceptions of obesity interventions have been quantitative and based on general population surveys. This study aims to explore the opinions and attitudes of obese individuals towards population and individual interventions for obesity in Australia.MethodsQualitative methods using in-depth semi-structured telephone interviews with a community sample of obese adults (Body Mass Index ≥30). Theoretical, purposive and strategic recruitment techniques were used to ensure a broad sample of obese individuals with different types of experiences with their obesity. Participants were asked about their attitudes towards three population based interventions (regulation, media campaigns, and public health initiatives) and three individual interventions (tailored fitness programs, commercial dieting, and gastric banding surgery), and the effectiveness of these interventions.ResultsOne hundred and forty two individuals (19-75 years) were interviewed. Participants strongly supported non-commercial interventions that were focused on encouraging individuals to make healthy lifestyle changes (regulation, physical activity programs, and public health initiatives). There was less support for interventions perceived to be invasive or high risk (gastric band surgery), stigmatising (media campaigns), or commercially motivated and promoting weight loss techniques (commercial diets and gastric banding surgery).ConclusionObese adults support non-commercial, non-stigmatising interventions which are designed to improve lifestyles, rather than promote weight loss.

A qualitative investigation of obese men's experiences with their weight.

OBJECTIVES To investigate obese mens health behaviors and strategies for change. METHODS Qualitative interviews with 36 men (BMI 30 and over). RESULTS All men felt personally responsible for their weight gain. Sedentary lifestyles, stress, lack of worklife balance and weight-based stigma were all significant causes of weight gain and barriers to weight loss. These factors also contributed to mens unwillingness to seek help for their over-weight. CONCLUSION Addressing the self-blame and stigma associated with obesity is important in developing strategies to improve the health and well-being of obese men.

Do Health Beliefs and Behaviors Differ According to Severity of Obesity? A Qualitative Study of Australian Adults

Public responses to obesity have focused on providing standardized messages and supports to all obese individuals, but there is limited understanding of the impact of these messages on obese adults. This descriptive qualitative study using in-depth interviews and a thematic method of analysis, compares the health beliefs and behaviors of 141 Australian adults with mild to moderate (BMI 30−39.9) and severe (BMI ≥ 40) obesity. Mildly obese individuals felt little need to change their health behaviors or to lose weight for health reasons. Most believed they could “lose weight” if they needed to, distanced themselves from the word obesity, and stigmatized those “fatter” than themselves. Severely obese individuals felt an urgent need to change their health behaviors, but felt powerless to do so. They blamed themselves for their weight, used stereotypical language to describe their health behaviors, and described being “at war” with their bodies. Further research, particularly about the role of stigma and stereotyping, is needed to fully understand the impact of obesity messaging on the health beliefs, behaviors, and wellbeing of obese and severely obese adults.

‘Just Bloody Fat!’: A Qualitative Study of Body Image, Self-Esteem and Coping in Obese Adults

The rise of the ‘obesity epidemic’ in Western societies has led to an increased public gaze on obese individuals. Yet there is limited research that explores through qualitative methods the increased impact it has had on obese individuals’ perceptions of self, body image and coping strategies, using their own words. This paper presents the findings of interviews with a community sample of 142 obese adults in Australia. We examined how obese individuals felt about themselves and their bodies, what influenced these feelings, and the subsequent coping strategies employed. While participants were able to identify many positive characteristics about their inner self, the vast majority used negative language to describe their physical appearance. Many participants described feelings of ‘guilt’, ‘shame’ and ‘blame’ associated with their weight. Coping strategies included striving for perfection in other areas of their life, social isolation, maximising aspects of their appearance and ‘fat’ acceptance. This study shows that, while different groups of obese adults experience, cope with and compensate for the influence of weight-based stereotyping in many different ways, they still feel an unrelenting otherness and difference associated with their weight.

Parent and child interactions with two contrasting anti-obesity advertising campaigns: a qualitative analysis

BackgroundSocial marketing has been proposed as a framework that may be effectively used to encourage behaviour change relating to obesity. Social advertising (or mass media campaigning) is the most commonly used social marketing strategy to address the issue of obesity. While social advertising has the potential to effectively communicate information about obesity, some argue that the current framing and delivery of these campaigns are ineffective, and may cause more harm than good.MethodsWe used a qualitative advertising reception study. 150 family groups (comprised of 159 parents and 184 children) were shown two Australian government anti-obesity advertisements: Measure Up (focused on problems associated with obesity) and Swap It (focused on solutions for obesity). Families were engaged in a discussion about the visual appeals, verbal messages and their perceptions about the impact of the advertisements on behavioural change. Open coding techniques and a constant comparative method of analysis was used to interpret the data.ResultsMany parents had strong personal resonance with the visual imagery within the campaigns. While Swap It had strong ‘likeability’ with children, many children believed that the messages about overweight and obesity were less personally relevant because they did not perceive themselves to be overweight. The content and delivery style of the verbal messages (the serious risk focused message in Measure Up compared to the upbeat, fun practical message in Swap It) influenced how different audiences (parents and children) interpreted the information that was presented. Parents assimilated practical and instructive messages, while children assimilated messages about weight loss and weight gain. Parents and children recognised that the campaigns were asking individuals to take personal responsibility for their weight status, and were at times critical that the campaigns did not tackle the broader issues associated with the causes and consequences of obesity. The lack of practical tools to encourage behavioural change was a key barrier for obese parents.ConclusionsWell-funded, targeted social marketing campaigns will play an important role in the prevention and management of obesity. It is important that these campaigns are comprehensively evaluated and are backed up with structural supports to enable and encourage population subgroups to act upon messages.

The development of Australian tertiary education to 1939

Some accounts of Australian education have suggested that the growth of mass public education has been the result of two factors. First, mass public demand, in the wake of the development of an industrial society which gave the working man more leisure, a rising standard of living, and an appreciation of the benefits of education. Second, the concern of more enlightened sections of the upper class for the welfare of the working class. The development of education is seen as linked with the development of the liberal democratic state. Other accounts have linked educational development with the development of capitalism in a more direct way. They suggest that schools developed with factories, wage labour and work dependence as agents of socialization, and for basic skill transmission, in the face of the declining influence of the church, family and artisan.