A Fat Chance in Health: Examining the relationship between 'obesity' discourses, fatness, and conceptions of health

Abstract

The broad assumption that a person’s weight has a direct link to their overall health and wellbeing is pervasive in Western cultures. In particular, there is grave public concern over the potential link ‘obesity’ has with other ailments such as hypertension, diabetes and cardiovascular disease, and a focus on reducing rates of ‘obesity’ on the premise of lowering the incidence of these other diseases. As such, governments, non-governmental organisations, and various industries have funnelled billions of dollars into researching, controlling, and attempting to tackle the global ‘obesity epidemic’. These factors have made it difficult to have ‘health’ as a fat person. Indeed, the contemporary framing of fatness as a disease manifested through poor lifestyle choices reduces many conversations about health and fatness to the effective elimination of fat people through weight-loss. This thesis examines the complex relationship between discourses of ‘obesity’ and experiences of health and fatness through a fat studies lens. Drawing on eighteen interviews with self-identifying fat people living in Aotearoa/New Zealand, issues of fat identity, fat as deviance, fat ‘health’ and healthcare are critically examined using discourse analysis. These narratives demonstrate that ‘obesity’ discourses play a dominating role in the ways in which fat people construct their identities, understand their health, and experience healthcare. A preoccupation with the moral meanings ascribed to fat labels, bodies and identities, and thus a commitment to a ‘healthy lifestyle’ as a way to subvert harmful fat stereotypes, was common among the people interviewed. In addition, dominant beliefs about ‘obesity’ contributed towards combative healthcare experiences and disrupted fat people’s access to (quality) care. This thesis contributes to the fields of fat studies and the sociology of medicine by providing a critical examination of fat health in Aotearoa/New Zealand, and by generating novel theoretical insights regarding the ways that fat people navigate and negotiate their identities in terms of deviance, stigma and liminality.