Weight Matters: An Investigation of Women's Narratives about their Experiences of Weight Management and the Implications for Health Education
Browne, Lisa Caroline
Thesis or dissertation
University of Exeter
This thesis is an investigation into women’s experiences of repeatedly attempting to lose weight and maintain a weight they find acceptable, and the implications of this for health education. This was an interpretivist inquiry which generated data through narrative interviews. The data was analysed using three different strategies to enable deeper understanding of the participants’ experiences. To set the context health education resources relating to body weight, healthy eating and activity were collected from local community and health settings. A former local practice nurse was also interviewed about her role in assisting women with weight loss. A literature review revealed an emphasis on research and policy that focuses on the dangers of overweight and obesity, prioritising individual behaviour and energy-deficit approaches to losing weight. A qualitative method was used to collect data from a convenience sample of five women. Data from interviews and autobiographical writing were recorded, transcribed and analysed within a narrative analysis framework. Analysis of the findings using three interpretive lenses are presented first as re-storied accounts of the women’s narratives, and secondly thematic analysis addressing issues of control, pleasure and pain, and embodiment and alienation. Finally a relational analysis reveals the ways in which participants position themselves in relation to themselves, other characters and the interviewer in order to build their desired identities. The data shows that the participants had followed a wide and diverse range of diets, eating and exercise plans, none of which had been successful in both reducing their weight and maintaining it at a level they were happy with, even after repeated attempts. Whilst biomedical literature suggests a dividing line between pathological eating disorders such as anorexia nervosa/bulimia and normality, the disordered eating and emotional difficulties described by the participants supports the view that a broad range of eating and body-image problems may be more culturally normative than is generally recognised. Dieting and weight cycling were common experiences. The findings of the thesis suggest that contrary to current public policy, the views of these women who are unhappy with their body weight are complex, idiosyncratic and demonstrate resistance to health messages that target individual responsibility for weight management. Their views are developed from personal experiences - the findings suggest that these women are stigmatised. However, one response to this can be to stigmatise other people whom they see as more overweight than themselves. Normative femininity is increasingly centred on appearance and women who do not comply with the requirements risk alienation and pain. The identities that the women construct are relevant for health education but not taken into account when national policy and strategies are developed to address overweight and obesity. The risks to health of weight cycling are also not addressed by policy. The implications of the thesis are discussed in relation to the embodied experiences and gendered roles of women, the role of health education and its relationship with biomedicine.
EdD in Education