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Moral discourse in general practitioners’ accounts of obesity communication

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  • Blackburn, Maxine
  • Stathi, Afroditi

Abstract

Obesity is not addressed with a large proportion of patients presenting in general practice. An increasing body of evidence suggests that health professionals view body weight as a sensitive topic to include in routine consultations and face barriers in initiating weight loss discussions. This study examined the discursive power relations that shape how general practitioners (GPs) understand and talk about obesity using a novel methodology to elicit responses from GPs about raising the topic of weight. Twenty GPs from the South West of England reflected upon novel trigger films simulating doctor-patient interactions, in which a doctor either acknowledged or ignored their patient's body weight. Underpinned by a discourse analytic approach, our findings suggest that GPs both reproduce and resist moral discourse surrounding body weight. They construct obesity as an individual behavioural problem whilst simultaneously drawing on socio-cultural discourse which positions body weight as central to social identity, situating obesity within a context of stigma and positioning patients as powerless to lose weight. Our findings highlight a need for increased reflexivity about competing discursive frameworks at play during medical consultations about obesity, which we suggest, contribute to increased tension and powerlessness for GPs. Trigger films are an innovative method to elicit information and discuss competing discourses.

Suggested Citation

  • Blackburn, Maxine & Stathi, Afroditi, 2019. "Moral discourse in general practitioners’ accounts of obesity communication," Social Science & Medicine, Elsevier, vol. 230(C), pages 166-173.
  • Handle: RePEc:eee:socmed:v:230:y:2019:i:c:p:166-173
    DOI: 10.1016/j.socscimed.2019.03.032
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    References listed on IDEAS

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    1. Mah, C.L. & Taylor, E. & Hoang, S. & Cook, B., 2014. "Using vignettes to tap into moral reasoning in public health policy: Practical advice and design principles from a study on food advertising to children," American Journal of Public Health, American Public Health Association, vol. 104(10), pages 1826-1832.
    2. Bombak, Andrea E. & McPhail, Deborah & Ward, Pamela, 2016. "Reproducing stigma: Interpreting “overweight” and “obese” women's experiences of weight-based discrimination in reproductive healthcare," Social Science & Medicine, Elsevier, vol. 166(C), pages 94-101.
    3. Throsby, Karen, 2007. ""How could you let yourself get like that?": Stories of the origins of obesity in accounts of weight loss surgery," Social Science & Medicine, Elsevier, vol. 65(8), pages 1561-1571, October.
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    Cited by:

    1. Hajizadeh, Anisa & Heath, Laura & Ahmad, Aryati & Kebbe, Maryam & Jebb, Susan Anne & Aveyard, Paul & Hughes, Gemma, 2023. "Clinician resistance to broaching the topic of weight in primary care: Digging deeper into weight management using strong structuration theory," Social Science & Medicine, Elsevier, vol. 329(C).
    2. Cupit, Caroline, 2022. "Public health in the making: Dietary innovators and their on-the-job sociology," Social Science & Medicine, Elsevier, vol. 305(C).
    3. Ringel, Megan M. & Ditto, Peter H., 2019. "The moralization of obesity," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.

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