“Fat is your fault”. Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity

Opening Access but Concealing Contact: A First Study of Over-The-Counter Hearing Aid Consumer-Facing Communications

Hearing loss is a prevalent chronic health condition with approximately 40 million Americans living with mild to moderate hearing loss. Yet, only about 20% will ever pursue hearing interventions. To broaden uptake the FDA approved over the counter (OTC) hearing aid (HA) options in October 2022. A stigmatized health topic, it is both necessary and well-timed to explore how HAs are depicted in consumer-facing communications, which has not been formally studied to date. The present study examines social media posts across a one-year time frame (six months prior and six months following the FDA announcement) from the three most-followed OTC HA brands. With the shift to OTC, HA companies are responsible for communicating directly with consumers. Through the lens of Contact Theory, we explore three mechanisms by which these messages enact stigma, through contact with (1) people, (2) HA products, and (3) a larger brand community. Overall, only 22% of posts discussed OTC in any capacity. Contact was similarly limited, with only 9% of posts showing a person wearing an HA. However, following the FDA announcement, the number of posts depicting people or social relationships doubled (23% to 58% and 13% to 36%, respectively). To overcome stigma and increase uptake of these essential health products, it is important to promote contact with hearing aids and those who wear them. Timely implications for health communication research and practice are discussed.

Socio-cognitive barriers to healthy eating among mothers: A segmentation analysis in Argentina, France, and Denmark

The prevalence of childhood obesity has increased at an alarming rate despite several actions to reverse this trend. It is important to focus on tackling the constraints for healthy food provisioning. We focus on identifying segments of mothers in relation to factors acting as barriers to healthy eating. Five hundred mothers in each country (Argentina, France and Denmark) completed an online survey. In each of the three countries, four segments are identified, varying mostly on working and socio-economic status, self-efficacy and attitudes to health experts. Segments of mothers who are skeptical to nutrition advice from health professionals were identified. Another important finding is that staying-at-home mothers might face more barriers to healthy eating than mothers who work outside the home. We provide suggestions for targeted interventions addressing healthy eating behaviors among mothers with different profiles.

Public Understanding of Childhood Obesity: Qualitative Analysis of News Articles and Comments on Facebook

Childhood obesity has become a major focus of public health and subject to increased news coverage. News can shape public understanding of childhood obesity by selective reporting (framing) which can affect policy support and weight stigma. As news is consumed on social media, comments on articles present a novel method to explore public understanding. This study examined how childhood obesity is framed by news articles on Facebook and how individuals commenting understand and react to these articles. This study used a qualitative research design. Facebook pages of 11 national UK news outlets were searched for news articles on childhood obesity published between May 2015 and May 2020. Of those, 30 articles were randomly selected. Framing analysis was used to determine whether childhood obesity was portrayed as a behavioral, societal or medical issue. Responding comments (N = 1,104) were grouped according to the dominant frame of the corresponding article and analyzed using qualitative content analysis. Of the 30 articles, 28 mentioned societal, 26 behavioral and 18 medical aspects of childhood obesity, highlighting that most articles included more than one frame. Three themes were generated from responding comments: Culprits and Remedies, Appraising Childhood Obesity and Making Sense of the News Article. Findings showed that comments related to Appraising Childhood Obesity differed between differently framed articles, while the other themes did not. This study highlights the need for improved communication on childhood obesity to address weight stigma and improve understanding of news articles.

Gender roles, generational changes and environmental challenges: an intersectional interpretation of perceptions on healthy diets among iTaukei women and men in Fiji

OBJECTIVE

To investigate perceptions of iTaukei Fijian women and men around diet and the ability to consume a healthy diet.

DESIGN

Six focus groups were conducted with women and men separately. Six to ten women and men participated in each group. Discussions were recorded, transcribed, translated and thematically analysed. Themes were mapped to an intersectionality framework to aid interpretation.

SETTING

Four villages in Viti Levu, Fiji.

PARTICIPANTS

Twenty-two women and twenty-four men.

RESULTS

Seven overarching themes were identified, including generational changes in food behaviour, strong-gendered beliefs around food and food provision, cultural and religious obligations around food, the impact of environmental change on the ability to consume a healthy diet, perceptions of the importance of food, food preferences and knowledge. Participants across focus groups identified that it was the 'duty' of women to prepare food for their families. However, some women reflected on this responsibility being unbalanced with many women now in the formal workforce. Changes between generations in food preferences and practices were highlighted, with a perception that previous generations were healthier. Power dynamics and external factors, such as environmental changes, were identified by women and men as crucial influences on their ability to eat a healthy diet.

CONCLUSION

Embedded traditional perceptions of gendered roles related to nutrition were misaligned with other societal and environmental changes. Given factors other than gender, such as broader power dynamics and environmental factors were identified as influencing diet, viewing nutrition-related issues through an intersectional lens is important to inform equitable food policy in Fiji.

Incorporating a gender lens into nutrition and health-related policies in Fiji: analysis of policies and stakeholder perspectives

Background

Gender equality, zero hunger and healthy lives and well-being for all, are three of the Sustainable Development Goals (SDGs) that underpin Fiji’s National Development Plan. Work towards each of these goals contributes to the reduction of non-communicable diseases (NCDs). There are gender differences in NCD burden in Fiji. It is, however, unclear whether a gender lens could be more effectively included in nutrition and health-related policies.

Methods

This study consisted of three components: (i) a policy content analysis of gender inclusion in nutrition and health-related policies (n = 11); (ii) policy analysis using the WHO Gender Analysis tool to identify opportunities for strengthening future policy; and (iii) informant interviews (n = 18), to understand perceptions of the prospects for gender considerations in future policies.

Results

Gender equality was a goal in seven policies (64%); however, most focused on women of reproductive age. One of the policies was ranked as gender responsive. Main themes from key informant interviews were: 1) a needs-based approach for the focus on specific population groups in policies; 2) gender-related roles and responsibilities around nutrition and health; 3) what is considered “equitable” when it comes to gender, nutrition, and health; 4) current considerations of gender in policies and ideas for further gender inclusion; and 5) barriers and enablers to the inclusion of gender considerations in policies. Informants acknowledged gender differences in the burden of nutrition-related NCDs, yet most did not identify a need for stronger inclusion of gender considerations within policies.

Conclusions

There is considerable scope for greater inclusion of gender in nutrition and health-related policies in Fiji. This could be done by: 1) framing gender considerations in ways that are actionable and inclusive of a range of gender identities; 2) undertaking advocacy through actor networks to highlight the need for gender-responsive nutrition and health-related policies for key stakeholder groups; 3) ensuring that data collected to monitor policy implementation is disaggregated by sex and genders; and 4) promoting equitable participation in nutrition related issues in communities and governance processes. Action on these four areas are likely critical enablers to more gender equitable NCD reduction in Fiji.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-022-01745-x.

Cultural Scripts Underpinning Prostate Cancer-Literacy in Japan

In a country where cancer has been dubbed a “national disease” (kokumin bio) that mostly affects Japanese men, this article presents a reading of the cultural scripts underneath prostate cancer—one of the “Western type of cancers” (ōbeigata no gan). The reading is grounded in an adaptation of the “sexual scripting theory,” the construct of cancer-literacy, and the analysis of 3,092 newspaper reports published from 2005 to 2020, in three Japanese newspapers with the largest circulation in the country. The analysis is presented in line with three axes: cancer-self, cancer-biopedagogy, and cancer-economics to indicate that a cancer-self largely entails the subjectivity of a Westernized, married, heterosexual man who undergoes andropause, needs to understand what bladder somatics is, and depends on his family and the feminization of care to cope with cancer. The chances to prevent and/or survive the disease chiefly hinge on adopting a form of cancer-biopedagogy, which entails a composite entanglement of knowledge and health-related practices underpinned by the ethnicization of cancer through the consumption of “traditional food” (washoku) and the assumption that turning into a “healthy self” is determined by Japanese ethnic traits. Cancer-economics is concerned with costs of testing and treatments, health care insurance policies, and food and dietary supplements that serve to commodify a cancer-self who deals with prostate and urinary-related issues.

A Systematic Review of Responsibility Frames and Their Effects in the Health Context

Responsibility frames potentially shape the public perception of health issues such as obesity, diabetes, or mental illness, specifically regarding responsibility attributions for their causes and treatment. Which responsibility frames prevail in the health context, and the responses they may elicit from audiences, has not been studied systematically. This systematic review includes studies with different methodological approaches published between 2004 and 2019 (N = 68). Content analyses (n = 56) show that different media attribute health responsibility most frequently, but not exclusively to individuals. Individual responsibility was especially emphasized for obesity, which was also the most studied health issue. Tendencies toward societal attributions of responsibility emerged over time, particularly regarding health risks for which the frames describe a specific cause (e.g., sugar, trans-fat). Experimental studies (n = 12) indicate that individual responsibility frames reduce policy support. The effects of responsibility frames were, however, not as clear-cut as expected with research gaps regarding behavioral and affective outcomes. Overall, there is a clear emphasis on noncommunicable diseases in this field. Finally, the conceptual focus on individual vs. societal health responsibility distracts from social network influences as another relevant health determinant. The implications for health communication are discussed.

Bringing disgust in through the backdoor in healthy food promotion: a phenomenological perspective

Obesity has been pointed out as one of the main current health risks leading to calls for a so-called "war on obesity". As we show in this paper, activities that attempt to counter obesity by persuading people to adjust a specific behavior often employ a pedagogy of regret and disgust. Nowadays, however, public healthcare campaigns that aim to tackle obesity have often replaced or augmented the explicit negative depictions of obesity and/or excessive food intake with the positive promotion of healthy food items. In this paper, we draw on a phenomenological perspective on disgust to highlight that food-related disgust is connected to the character and behavior of a perceived individual even in the context of promoting healthy food items. We argue that the focus on "making the healthy food choice the easy choice" might be an important step towards the de-stigmatization of people that are affected by obesity. However, so we suggest, this focus threatens to bring back an image of individuals affected by obesity as disgusting "through the backdoor". It does so not by portraying bodies with overweight as disgusting, but instead by implying that lifestyle choices, character and habits of people that are affected by obesity are markers of a lack of control. We argue that the close relationship between disgust and the perception of self-control in the context of obesity should be taken into consideration in the context of assessing the implications of new health promotion strategies to minimize the risk of stigmatizing people.

Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

Background

Maternal obesity is associated with health risks for women and their babies and is exacerbated by excess gestational weight gain. The aim of this study was to describe women’s experiences and perspectives in attending a Healthy Pregnancy Service designed to optimise healthy lifestyle and support recommended gestational weight gain for women with obesity.

Methods

An explanatory sequential mixed methods study design utilised two questionnaires (completed in early and late pregnancy) to quantify feelings, motivation and satisfaction with the service, followed by semi-structured interviews that explored barriers and enablers of behaviour change. Data were analysed separately and then interpreted together.

Results

Overall, 49 women attending the service completed either questionnaire 1, 2 or both and were included in the analysis. Fourteen women were interviewed. Prior to pregnancy, many women had gained weight and attempted to lose weight independently, and reported they were highly motivated to achieve a healthy lifestyle. During pregnancy, diet changes were reported as easier to make and sustain than exercise changes. Satisfaction with the service was high. Key factors identified in qualitative analysis were: service support enabled change; motivation to change behaviour, social support, barriers to making change (intrinsic, extrinsic and clinic-related), post-partum lifestyle and needs. On integration of data, qualitative and quantitative findings aligned.

Conclusions

The Healthy Pregnancy service was valued by women. Barriers and enablers to the delivery of an integrated model of maternity care that supported healthy lifestyle and recommended gestational weight gain were identified. These findings have informed and improved implementation and further scale up of this successful service model, integrating healthy lifestyle into routine antenatal care of women with obesity.

Trial registration

This trial is registered with the Australian New Zealand Clinical Trials Registry (no.12620000985987). Registration date 30/09/2020, retrospectively registered. http://www.anzctr.org.au/

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-04034-7.

Individual responsibilities, collective issues: The framing of dietary practices in Latvian media

Topics concerning food and diets have gained prominence in academic writing, policy debates and media coverage, not least due to public health problems, sedentary lifestyles, and concerns regarding dietary habits and the impact of food production on climate change. The purpose of this paper is to reveal the ways dietary practices have been framed in the media through an analysis of Latvian print and digital media articles. A selection of 192 media articles published between 2014 and 2019 were analysed through the perspective of framing. The analysis identifies three prominent frames found in Latvian media: (i) a biomedical frame, (ii) a psychological frame, and (iii) a social practice frame. The frames are connected by several cross-cutting themes: individualisation, self-disciplining, gendering, and medicalisation. The results suggest that the media portray unhealthy dietary as the responsibility of individuals, whilst ignoring, with some exceptions, the impact of broader societal and food system processes. These results call for more attention to be paid by media content creators to the diversity of actors involved in food production, consumption and distribution and their inter-connections, as well as the impact that food systems have on economic, social, and ecological sustainability.

"You Can't Ignore a Number This Big": Gender, Risk, and Responsibility in Online Advocacy for Women's Brain Health

Alzheimer's disease affects more women than men and has therefore been highlighted as a women's issue. However, there is much debate regarding the nature of this gap, with some studies pointing to sex/gender differences in longevity to explain the disparity. Against this background of empirical uncertainty, we ask how online women's brain health campaigns position women as specifically at risk of developing the disease. Using a multimodal approach, we examine how these platforms relate womanhood to risk, prevention, and responsibility. Four main themes emerged: risk quantification, risk management, risk dispersion, and the gendering of risk. We confirm previous studies that identified a dual discourse in which Alzheimer's is represented as both a catastrophic threat and as a fate that individuals can and must prevent. We find that both constructions are intensified on women-oriented platforms compared with nonspecific websites. Ethical implications of the individualization and gendering of risk and responsibility are discussed.

"I Feel Like Less of a Mom": Experiences of Weight Stigma by Association among Mothers of Children with Overweight and Obesity

Background: Parents of children with higher weight are blamed and shamed for their children's weight. However, parents' experiences of this form of stigma, termed weight stigma by association, are poorly understood. The objective of this study was to investigate the sources, forms, and impacts of weight stigma by association among mothers of children with overweight or obesity. Methods: In this qualitative study, mothers who reported concern about their children's weight participated in semistructured interviews administered by the research team. A coding scheme was developed and reliably applied to interview transcripts. Mothers' self-reported sociodemographic information, and height and weight were measured. Results: Thirty-four mothers (Mage: 43.4 years; 26.5% non-Hispanic Black or African American, 70.6% with obesity) participated in the study. Mothers reported that family members were a common source of negative comments about their children's weight; these comments were often critical of mothers' parenting and in some cases contributed to negative affect among mothers. Many mothers also reported negative experiences during children's physicians' visits as a result of their children's weight. Almost all mothers expressed guilt and sadness for their perceived role in their children's weight status, expressing regret that they did not parent differently. Conclusions: Mothers of children with overweight and obesity are frequently the target of weight stigma by association and experience negative cognitions and emotions regarding their perceived role in their children's weight. Continued research is needed to elucidate the impacts of stigma by association due to child weight on parents' health, the parent/child relationship, and children's health.

The importance of language in engagement between health-care professionals and people living with obesity: a joint consensus statement

Obesity is a chronic condition that requires long-term management and is associated with unprecedented stigma in different settings, including during interactions with the health-care system. This stigma has a negative effect on the mental and physical health of people with obesity and can lead to avoidance of health care and disruption of the doctor-patient relationship. Considerable evidence exists to suggest that simply having a conversation about obesity can lead to weight loss, which translates into health benefits. However, both health-care practitioners and people living with obesity report apprehension in initiating this conversation. We have collaborated with stakeholders from Obesity UK, physicians, dieticians, clinical psychologists, obesity researchers, conversation analysts, nurses, and representatives from National Health Service England Diabetes and Obesity. This group has contributed to the production of this consensus statement, which addresses how people living with obesity wish to have their condition referred to and provides practical guidance for health-care professionals to facilitate collaborative and supportive discussions about obesity. Expert stakeholders consider that changes to language used at the point of care can alleviate the stigma of obesity within the health-care system and support improved outcomes for both people living with obesity and for the health-care system.

Pregnant women's perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research

Excess gestational weight gain has numerous negative health outcomes for women and children, including high blood pressure, diabetes, and cesarean section (maternal) and high birth weight, trauma at birth, and asphyxia (infants). Excess weight gain in pregnancy is associated with a higher risk of long-term obesity in both mothers and children. Despite a concerted public health effort, the proportion of pregnant women gaining weight in excess of national guidelines continues to increase. To understand this phenomenon and offer suggestions for improving interventions, we conducted a systematic review of qualitative research on pregnant women's perceptions and experiences of weight gain in pregnancy. We used the methodology of qualitative meta-synthesis to analyze 42 empirical qualitative research studies conducted in high-income countries and published between 2005 and 2015. With this synthesis, we provide an account of the underlying factors and circumstances (barriers, facilitators, and motivators) that pregnant women identify as important for appropriate weight gain. We also offer a description of the strategies identified by pregnant women as acceptable and appropriate ways to promote healthy weight gain. Through our integrative analysis, we identify women's common perception on the struggle to enact health behaviors and physical, social, and environmental factors outside of their control. Effective and sensitive interventions to encourage healthy weight gain in pregnancy must consider the social environment in which decisions about weight take place.

The Role of Parental Misperception of Child's Body Weight in Childhood Obesity

To investigate the accuracy of parental perceptions of their child's weight status and also the relationship between parental perceptions and the prevalence of childhood obesity in Mississippi.

DESIGN AND METHODS

Data from multi-year surveys (2009-2012) with random samples of public school parents (N=14,808). Descriptive statistics and multiple logistic regression were conducted with quantitative data to examine the relationship between parental perception and childhood obesity.

RESULTS

More than 2 out of 5 parents misperceived the weight status of their child (k-12). The greatest difference occurred with kindergartners, 83.9% of parents categorized them as "healthy", when only 28.3% actually were. Parents who misperceived their child's weight were almost 12 times more likely of having an obese child.

CONCLUSIONS

Only half of the children in this study had a healthy weight (54.5%). Health care providers, nutritionists, social workers, teachers, and school health councils could play an important role in educating parents and children on how to recognize an unhealthy weight.

PRACTICE IMPLICATIONS

The strongest predictor of childhood obesity was parental misperception of their child's weight status.

The influence of parent's body mass index on peer selection: an experimental approach using virtual reality

Relatively little is known about the influence of psychosocial factors, such as familial role modeling and social network on the development and maintenance of childhood obesity. We investigated peer selection using an immersive virtual reality environment. In a virtual schoolyard, children were confronted with normal weight and overweight avatars either eating or playing. Fifty-seven children aged 7-13 participated. Interpersonal distance to the avatars, child's BMI, self-perception, eating behavior and parental BMI were assessed. Parental BMI was the strongest predictor for the children's minimal distance to the avatars. Specifically, a higher mothers' BMI was associated with greater interpersonal distance and children approached closer to overweight eating avatars. A higher father's BMI was associated with a lower interpersonal distance to the avatars. These children approached normal weight playing and overweight eating avatar peers closest. The importance of parental BMI for the child's social approach/avoidance behavior can be explained through social modeling mechanisms. Differential effects of paternal and maternal BMI might be due to gender specific beauty ideals. Interventions to promote social interaction with peer groups could foster weight stabilization or weight loss in children.

Current Trends in the study of Gender Norms and Health Behaviors

Gender norms are recognized as one of the major social determinants of health and gender norms can have implications for an individual's health behaviors. This paper reviews the recent advances in research on the role of gender norms on health behaviors most associated with morbidity and mortality. We find that (1) the study of gender norms and health behaviors is varied across different types of health behaviors, (2) research on masculinity and masculine norms appears to have taken on an increasing proportion of studies on the relationship between gender norms and health, and (3) we are seeing new and varied populations integrated into the study of gender norms and health behaviors.

Capturing Public Opinion on Public Health Topics: A Comparison of Experiences from a Systematic Review, Focus Group Study, and Analysis of Online, User-Generated Content

BACKGROUND

Capturing public opinion toward public health topics is important to ensure that services, policy, and research are aligned with the beliefs and priorities of the general public. A number of approaches can be used to capture public opinion.

METHODS

We are conducting a program of work on the effectiveness and acceptability of health promoting financial incentive interventions. We have captured public opinion on financial incentive interventions using three methods: a systematic review, focus group study, and analysis of online user-generated comments to news media reports. In this short editorial-style piece, we compare and contrast our experiences with these three methods.

RESULTS

Each of these methods had their advantages and disadvantages. Advantages include tailoring of the research question for systematic reviews, probing of answers during focus groups, and the ability to aggregate a large data set using online user-generated content. However, disadvantages include needing to update systematic reviews, participants conforming to a dominant perspective in focus groups, and being unable to collect respondent characteristics during analysis of user-generated online content. That said, analysis of user-generated online content offers additional time and resource advantages, and we found it elicited similar findings to those obtained via more traditional methods, such as systematic reviews and focus groups.

CONCLUSION

A number of methods for capturing public opinions on public health topics are available. Public health researchers, policy makers, and practitioners should choose methods appropriate to their aims. Analysis of user-generated online content, especially in the context of news media reports, may be a quicker and cheaper alternative to more traditional methods, without compromising on the breadth of opinions captured.

Dietary advice for muscularity, leanness and weight control in Men's Health magazine: a content analysis

BACKGROUND

The dietary content of advice in men's lifestyle magazines has not been closely scrutinised.

METHODS

We carried out an analysis of such content in all 2009 issues (n = 11) of Men's Health (MH) focusing on muscularity, leanness and weight control.

RESULTS

Promotion of a mesomorphic body image underpinned advice to affect muscle building and control weight. Diet advice was underpinned by a strong pseudo-scientific discourse, with citation of expert sources widely used to legitimise the information. Frequently multiple dietary components were advocated within one article e.g. fat, omega-3 fatty acids, thiamine, zinc and high-glycaemic index foods. Furthermore advice would cover numerous nutritional effects, e.g. strengthening bones, reducing stress and boosting testosterone, with little contextualisation. The emphasis on attainment of a mesomorphic body image permitted promotion of slimming diets.Advice to increase calorie and protein intake to augment muscle mass was frequent (183 and 262 references, respectively). Such an anabolic diet was advised in various ways, including consumption of traditional protein foods (217 references) and sports foods (107 references), thereby replicating muscle magazines' support for nutritional supplements. Although advice to increase consumption of red meat was common (52 references), fish and non-flesh sources of protein (eggs, nuts & pulses, and soy products) together exceeded red meat in number of recommendations (206 references). Advice widely asserted micronutrients and phytochemicals from plant food (161 references) as being important in muscle building. This emphasis diverges from stereotypical gender-based food consumption patterns.Dietary advice for control of body weight largely replicated that of muscularity, with strong endorsement to consume fruits and vegetables (59 references), diets rich in nuts and pulses and fish (66 references), as well as specific micronutrients and phytochemicals (62 references). Notably there was emphasis on fat-burning, good fats and consumption of single foods, with relatively little mention of dietary restriction.

CONCLUSIONS

Despite the widespread use of scientific information to endorse dietary advice, the content, format and scientific basis of dietary content of MH leaves much to be desired. The dietary advice as provided may not be conducive to public health.

"It's a balance of just getting things right": mothers' views about pre-school childhood obesity and obesity prevention in Scotland

Background

The high prevalence of childhood obesity is a concern for policy makers and health professionals, leading to a focus on early prevention. The beliefs and perspectives of parents about early childhood obesity, and their views and opinions about the need for weight management interventions for this age group are poorly understood.

Methods

A formative qualitative focus group study with parents of pre-school children took place in eight community-based locations throughout North-East Scotland to explore their ideas about the causes of early childhood obesity, personal experiences of effective weight management strategies, and views about the format and content of a possible child-orientated weight management programme. Study participants were recruited via pre-school nurseries.

Results

Thirty-four mothers (median age 37 years) took part in the study, but only two believed their child had a weight problem. Participants (who focussed primarily on dietary issues) expressed a strong sense of personal responsibility to ‘get the balance right’ regarding their child’s weight, and were generally resistant to the idea of attending a weight management programme aimed at very young children. At the same time, they described a range of challenges to their weight management intentions. These included dealing with intrinsic uncertainties such as knowing when to stop ‘demand feeding’ for weight gain, and judging appropriate portion sizes - for themselves and their children. In addition they faced a range of extrinsic challenges associated with complex family life, i.e. catering to differing family members dietary needs, food preferences, practices and values, and keeping their ‘family food rules’ (associated with weight management) when tired or pressed for time.

Conclusions

The findings have important implications for health professionals and policy makers wishing to engage with parents on this issue, or who are currently developing ‘family-centred’ early childhood weight management interventions. The challenge lies in the fact that mothers believe themselves to be the primary (and capable) agents of obesity prevention in the early years – but, who are at the same time, attempting to deal with many mixed and conflicting messages and pressures emanating from their social and cultural environments that may be undermining their weight management intentions.

Examining the media portrayal of obesity through the lens of the Common Sense Model of Illness Representations

This study examined the Irish media discourse on obesity by employing the Common Sense Model of Illness Representations. A media sample of 368 transcripts was compiled from newspaper articles (n = 346), radio discussions (n = 5), and online news articles (n = 17) on overweight and obesity from the years 2005, 2007, and 2009. Using the Common Sense Model and framing theory to guide the investigation, a thematic analysis was conducted on the media sample. Analysis revealed that the behavioral dimensions of diet and activity levels were the most commonly cited causes of and interventions in obesity. The advertising industry was blamed for obesity, and there were calls for increased government action to tackle the issue. Physical illness and psychological consequences of obesity were prevalent in the sample, and analysis revealed that the economy, regardless of its state, was blamed for obesity. These results are discussed in terms of expectations of audience understandings of the issue and the implications of these dominant portrayals and framings on public support for interventions. The article also outlines the value of a qualitative analytical framework that combines the Common Sense Model and framing theory in the investigation of illness narratives.

Weight stigma and narrative resistance evident in online discussions of obesity

This study sampled 2872 obesity-relevant comments from three years of interest from a multi-topic online message board. An inductive thematic analysis was conducted and three themes were evident: reactions and responses to obesity and obese bodies, diminished status of overweight/obese persons, and narrative resistance to an overweight/obese identity. Obesity stigma was pervasive and the discussion of the issue revealed it to be highly acceptable. Consistent with previous research, dominant representations of obese persons as lazy and unintelligent with poor self-control were evident. The analysis provided valuable insight into experiences of explicit stigma, the social and psychological repercussions of overt stigma and norms regarding the perception of obese bodies. There was a prevailing notion that the opinions and insights of overweight and obese persons on the issue of weight were not credible and were perceived as biased. Furthermore, individuals sought to distance themselves from the undesirable labels of 'overweight' and 'obese' by enacting narrative resistance to negotiate the social meaning of excess weight and endeavouring to place themselves on the 'safe' side of this boundary. These results highlight the pervasive nature of weight stigma and the social acceptability of such attitudes and beliefs. Furthermore, it highlights the richness of data that may be obtained by examining social media interactions as a window into the naturally-occurring discourse on obesity and stigma.