Governing Obese Bodies: Examining Bariatric Surgery ‘Post-Op’ Narratives

Abstract

The current obesity ‘epidemic’ arguably represents a growing trend in the medicalisation, pathologisation and regulation of bodies. Where the fat body was once a sign of power, wealth and status within Western societies, it is now defined as the disease ‘obesity’ which ranks bodies in terms of increasing severity and risk using inaccurate measures such as Body Mass Index. Thus, strategies targeted at those who are defined as ‘morbidly obese’ such as bariatric surgery – weight-loss surgery – have been of particular interest as it achieves rapid weight-loss and thus normalises deviant bodies. Relevant qualitative literature on bariatric surgery focuses on the transformative surgical narrative, or on specific life impacts such as: changes in eating practices, body dissatisfaction and psychosocial wellbeing. However, a more general overview of the life impacts of bariatric surgery for ‘post-ops’ was missing in this area of study. Further, critical literature suggests that bariatric surgery is representative of the integration of the ‘thin ideal’ into biomedicine; whereby thinness is the primary and best determinant of ‘health’ and wellbeing and thus fatness is a prime target of biomedical regulation. A key criticism of the literature is that user experience is often ignored, and in this way this study is the first of its kind in New Zealand as it prioritises the voices of bariatric ‘post-ops’. This research addresses the following research questions: what are the life impacts of bariatric surgery, and, to what extent are dominant notions of ‘health’ perpetuated and resisted within the bariatric post-op community, through the analysis of six user narratives collected from two unobtrusive observations of, and one group interview with, a support group for bariatric surgery. The key findings of this thesis mirror that in the literature: participants regularly encounter various forms of medical harm and negligence, have to develop new eating practices and experience both body confidence and dissatisfaction. Despite this, users overall regard their surgery as a success. This thesis argues that dominant notions of ‘health’ such as the importance of thinness were maintained within this community and upheld via rigorous policing and self-surveillance practices. Further, biomedical hegemony is clearly visible in the narratives of medical and lay expertise, and is perpetuated through a form of biopower that this thesis conceptualises as the ‘gift’ discourse. Overall this thesis is an important addition to critical literature on bariatric surgery, and offers a new way of theorising around biomedicine.