Thomas Samantha L, Hyde Jim, Karunaratne Asuntha, Herbert Dilinie, Komesaroff Paul A
Centre for Ethics in Medicine and Society, Monash University, Melbourne, Australia.
Health Expect. 2008 Dec;11(4):321-30. doi: 10.1111/j.1369-7625.2008.00490.x. Epub 2008 Jul 28.
To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity.
Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index >or=30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included.
Seventy-six individuals (aged 16-72) were interviewed. Most had struggled with their weight for most of their lives (n=45). Almost all had experienced stigma and discrimination in childhood (n=36), as adolescents (n=41) or as adults (n=72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of 'blame' against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight.
There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities.
深入了解肥胖的生活体验以及社会文化因素对肥胖者的影响。
采用定性研究方法，对社区中肥胖成年人样本（体重指数≥30）进行深入的半结构化访谈。社区抽样方法辅以立意抽样技术，以确保纳入各种不同类型的个体。
共访谈了76人（年龄在16 - 72岁之间）。大多数人一生大部分时间都在与体重问题作斗争（n = 45）。几乎所有人在童年（n = 36）、青少年时期（n = 41）或成年后（n = 72）都经历过耻辱和歧视。约一半人表示他们因体重受到健康专业人员的羞辱。参与者觉得自己有责任减肥，许多人尝试极端的节食方式来减肥。参与者描述了媒体和公共卫生信息所导致的针对肥胖者的“指责”文化日益盛行。80%的人表示他们讨厌或不喜欢“肥胖”这个词，宁愿被称为“胖”或“超重”。
有四个关键结论：（i）肥胖的经历各不相同，但存在共同主题；（ii）肥胖者听到了相关信息，但难以据此行动；（iii）干预措施应根据个体和社区需求进行调整；（iv）我们需要重新思考如何开展肥胖干预措施，以确保避免重现有害的社会刻板印象并加剧社会不平等。
