The Ruling of Weight: An institutional ethnography exploring the work of growing up in a larger body

  • Author / Creator
    Ferdinands, Alexa R.
  • Childhood obesity is a key target of public health intervention and research. However, dominant weight and health discourses shaping public health efforts tend to reduce obesity to a case of too many calories and too little exercise. For decades, researchers have highlighted how overly simplistic framing of obesity as a personal responsibility has worsened weight stigma—the labelling, stereotyping, prejudice, and discrimination of people in larger bodies—in Canada and other Western countries. Experiencing weight stigma early on can adversely affect children’s physical, mental, and social health into adulthood, contributing to increased morbidity and mortality at the population level. Yet, young people have had few opportunities to share learnings from their lived experiences or propose recommendations for weight stigma reduction. Further, the focus of most weight stigma research has been confined to the individual level (i.e., attitudes and beliefs), overlooking how social structures (i.e., institutional policies and practices) coordinate people’s everyday lives.
    To fill this literature gap, I uncovered the social organization of young people’s work of growing up in larger bodies, using Dorothy Smith’s institutional ethnography (IE) as my method of inquiry. As per Smith, work was defined generously as any activity requiring thought or intention. Smith designed IE to reveal ruling social structures which, hidden from individuals at the standpoint location, organize their local experiences. Embedded throughout IE is a pragmatic concern to help actual people better understand the world in which they live. To do this, we map out how something happens, as opposed to abstracting or theorizing why. In this study, I conducted individual in-person interviews with my standpoint informants: 16 young people (14 young women, 2 young men) aged 15-21 who had grown up in larger bodies, chiefly recruited from University of Alberta undergraduate student listservs. In our conversations, I asked open-ended questions like “what did it feel like to grow up in your body?” To supplement interview data, I analyzed weight-related talk in 45 YouTube videos on body image alongside two research assistants. Data generation and analyses (coding, mapping, writing narrative accounts) were concurrent and iterative processes. Preliminary analyses suggested gendered aspects of informants’ experiences; therefore, I decided to dive deeper into young women’s accounts, conducting five group interviews with five young women aged 18-21, who were also previous interviewees. Here, I used member reflection to gauge informants’ reactions to initial analyses, ensuring we were generating meaningful data that accurately reflected their experiences, always keeping my standpoint informants in view. In these groups, we also created recommendations for parents, educators, and healthcare providers about navigating weight-related issues with young people, which were disseminated as infographics and an open letter.
    I wrote three manuscripts detailing IE findings. First, I investigated the social organization of young people’s body weight surveillance work, paying particular attention to how health and weight discourses shape institutional policies and practices in the home, healthcare, and education. Second, I analyzed how young women’s weight work (e.g., dieting) was socially organized by text-mediated discourses in media and fashion. Noticing the lack of larger bodies in these industries, young women learned what their bodies were “supposed” to look like. Third, I reflected on my experiences using IE in collaborative research with young people, discussing the strengths, limitations, and innovation that can result from fostering spaces for their critical engagement and empowerment. While many researchers have examined weight stigma as a theoretical construct, by using IE I was able to show how it actually happens, deconstructing it. I mapped out how local, taken-for-granted activities, like regular self-weighing, were coordinated by institutional policies and practices, like classroom teaching on the body mass index.
    I recommend that public health researchers and practitioners pay closer attention to the seemingly mundane, everyday practices in homes, schools, healthcare, fashion, and media which perpetuate weight stigma in ways that we may not have been previously aware. We have an ethical responsibility to constantly reflect on our attitudes, beliefs, and practices to avoid unintentionally enforcing oppressive ruling relations, as we all play a role in maintaining the status quo. Future research should continue to engage and listen to young people in larger bodies to disrupt and transform the stigmatizing weight and health discourses that shape their everyday lives.

  • Subjects / Keywords
  • Graduation date
    Fall 2021
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.