Sarah Trainer

Translating obesity: navigating the front lines of the "war on fat".

Obesity is treated within medicine, public health, and applied sciences as a biomedical fact with urgent health implications; obesity is also, however, a social fact and one that reveals biomedical concerns can lead to social suffering. Translation of social science‐oriented obesity research for broader public good requires navigation of the space between these polemical and seemingly mutually exclusive positions.

Obese, Fat, or "Just Big"? Young Adult Deployment of and Reactions to Weight Terms

This study expands understanding of how university students use and react to fat-related terms. The study was conducted in three phases: (1) a tool development phase, (2) a survey phase, and (3) an in-depth interview phase. We highlight a few marked trends in attitude towards and use of certain terms and words indicating larger body size, as well as the implications of these trends. Tellingly, some words are considered more negative than others. Perceived negativity significantly impacts how, where, when, and with whom such terms are used. A high degree of awareness that a term is unflattering at best and highly stigmatizing at worst does not appear to result in sensitive use of said term across all social and clinical settings. An important implication of this is that people know fat may be used behind their backs to describe them pejoratively—and regardless of any polite backpedalling in face-to-face confrontations—and this profoundly limits their social health, as well as their potential participation ...

Publically Misfitting: Extreme Weight and the Everyday Production and Reinforcement of Felt Stigma

Living with extreme weight in the United States is associated with discrimination and self‐stigma, creating structural exclusions, embodied stress, and undermining health and wellbeing. Here we combine ethnographic interviews and surveys from those with experiences of living with extreme weight to better explain how this vulnerability is created and reinforced by public cues, both physical (e.g., seatbelts) and social (the reactions of strangers). “Misfitting” is a major theme in interviews, as is the need to plan and scan constantly while navigating too‐small public spaces. The most distressing events combine physical misfitting with unsympathetic reactions from strangers. Sensitivity to stigmatizing public cues reduces with weight loss, but does not disappear. This study explains one basic mechanism that underlies the creation of felt stigma related to weight even after weight loss: the lack of accommodation for size and the lack of empathy from others that characterize modern urban spaces.

Not ‘Taking the Easy Way Out’: Reframing Bariatric Surgery from Low-effort Weight Loss to Hard Work

ABSTRACT Cultural notions equating greater morality and virtue with hard work and productive output are deeply embedded in American value systems. This is exemplified in how people understand and execute personal body projects, including efforts to become slim. Bariatric surgery is commonly viewed as a ‘low-effort’ means of losing weight, and individuals who opt for this surgery are often perceived to be ‘cheating.’ This extended ethnographic study within one bariatric program in the Southwestern United States shows how patients conscientiously perform this productivity. By prioritizing discourses that focus on their own hard work and the inherent value and necessity of their surgery, patients and practitioners alike contest the dominant public views of surgically-induced weight loss.

The Fat Self in Virtual Communities: Success and Failure in Weight-Loss Blogging

Weight and weight loss are major cultural preoccupations in the United States today, and stigma stemming from being socially categorized as fat appears to be steadily worsening. Online spaces and, more specifically, blogs (weblogs) provide a potentially safe and empowering space in which people struggling with weight issues can create new, virtual selves. We report on cross-sectional and longitudinal analysis of the narratives of 234 US-based weight-loss bloggers. Using a novel approach to sample online texts systematically through coding of key themes, we identify some ways in which online narratives resist and cope with weight-related forms of social rejection and marginalization. However, apart from a small subsample of explicitly stigma-challenging, fat-accepting blogs, the majority of the narratives painfully document long-term weight-loss failure. Rather than being empowering, virtual performances of weight-loss struggles reflected in online blogs mostly mirror and reinforce larger antifat social trends.

Eating in the Panopticon: Surveillance of Food and Weight before and after Bariatric Surgery

ABSTRACT In this article, we explore the processes by which surveillance of eating and weight is coupled with popular and medical ideas about discipline, responsibility, and moral worth for individuals identified as fat/obese. We then follow these individuals through bariatric surgery and weight loss, paying attention to what discourses and practices shift and what remain unchanged. We argue that weight loss does not temper the intensity and constancy of surveillance, because it is at the core of ideas concerning good citizenship and personal responsibility. Accompanying judgments do shift, however, as the perceptions of failure at disciplined “healthy” eating associated with fatness give way to more diverse attitudes post surgery. This analysis also highlights the fact that public and clinical perceptions of “troubled eating” often rely not on eating practices but on the types of bodies that are doing the consuming.

Blogs as Elusive Ethnographic Texts

Burgeoning online environments offer completely new opportunities for ethnographic and other forms of qualitative research. Yet there are no clear standards for how we study online texts from an ethnographic perspective. In this article, we identify barriers to the application of traditional qualitative methods online, using the example of a systematic thematic analysis of weight-loss blogs. These barriers include the influence of the technology structuring online content, the fluid nature of online texts such as blogs, and the highly connected and public nature of online identities, which may span multiple social media platforms. We discuss some potential approaches to addressing these challenges as preliminary steps toward developing a tool kit suited to ethical, high-quality online modes of ethnographic research.

Piety, Glamour, and Protest: Performing Social Status and Affiliation in the United Arab Emirates

This article focuses on the fashion choices and performances that female Emirati students attending public university in the UAE create across different social and physical spaces, as well as the ways in which these feed into dynamic and fluid presentations of self. Particular attention is paid to the ways in which these self-presentations are constructed in relation to on-campus social interactions, as well as the novelty of many of these interactions and performances. The university campuses allow forms of socializing, performative interactions, and body adornment to develop that often could not be replicated in other physical spaces, off-campus. In the process, women assess and re-craft important sociocultural values, forms of reciprocity, and ways of being in the world that dominate other areas of their lives.

Shame, Blame, and Status Incongruity: Health and Stigma in Rural Brazil and the Urban United Arab Emirates

Stigma is a powerful determinant of physical and mental health around the world, a perennial public health concern that is particularly resistant to change. This article builds from sociologist Erving Goffman’s classic conception of stigma as a unitary social phenomenon to explore the stigma attached to two seemingly dissimilar conditions: food insecurity in rural Brazil, and obesity in the urban United Arab Emirates. Our analyses underscore that both conditions are stigmatized because they represent a departure from a deeply-held social norm, and in both cases, self-stigma plays an important role. Furthermore, in both cases, the stigma associated with food insecurity and obesity is likely at least as harmful to personal wellbeing as are the biological consequences of these conditions. Finally, evidence increasingly links obesity and food insecurity causally. Our analyses suggest that these forms of stigma transcend individuals and are largely structural in their origins, and therefore that they are most likely to be improved through structural change.