Eating in the Panopticon: Surveillance of Food and Weight before and after Bariatric Surgery

ABSTRACT

In this article, we explore the processes by which surveillance of eating and weight is coupled with popular and medical ideas about discipline, responsibility, and moral worth for individuals identified as fat/obese. We then follow these individuals through bariatric surgery and weight loss, paying attention to what discourses and practices shift and what remain unchanged. We argue that weight loss does not temper the intensity and constancy of surveillance, because it is at the core of ideas concerning good citizenship and personal responsibility. Accompanying judgments do shift, however, as the perceptions of failure at disciplined “healthy” eating associated with fatness give way to more diverse attitudes post surgery. This analysis also highlights the fact that public and clinical perceptions of “troubled eating” often rely not on eating practices but on the types of bodies that are doing the consuming.

KEYWORDS:

• Bariatric surgery
• eating
• fat
• food
• obesity
• surveillance

Acknowledgments

We wish to thank all of the patients and clinic staff within the bariatric program at MC, especially Tonya Benjamin (N.P., C.N.P.), Joyce Logvin (R.D.N.), and Lori Roust (M.D.). We also thank Liza Kurtz for assistance with transcript coding.

Funding

We are grateful for the support of the Virginia G. Piper Foundation for the Obesity Solutions Initiative, which has advanced an innovative research partnership between ASU and MC.

Additional information

Funding

We are grateful for the support of the Virginia G. Piper Foundation for the Obesity Solutions Initiative, which has advanced an innovative research partnership between ASU and MC.

Notes on contributors

Sarah Trainer

Sarah Trainer is a post-doctoral research fellow affiliated with Obesity Solutions, a joint initiative between MC and Arizona State University. She completed a PhD in medical and biocultural anthropology at the University of Arizona in 2013. Her research interests focus topically on food and nutrition, obesity, body image, and stigma, and geographically, in the Middle East and the American Southwest.

Amber Wutich

Amber Wutich is a faculty member in the School of Human Evolution and Social Change at Arizona State University. She teaches in the Anthropology and Global Health programs and has been awarded the Carnegie CASE US Professor of the Year Award for Arizona and ASU’s Award for Excellence in Classroom Performance. Her research examines the nexus of injustice, resource insecurity, and adaptability, with a focus on water and food in Bolivia, Paraguay, and the United States. She directs the Global Ethnohydrology Study, a multiyear, cross-cultural study of water knowledge and management, and is Associate Editor of the journal, Field Methods. She also is on the faculty of the National Science Foundation’s research methods programs in cultural anthropology.

Alexandra Brewis

Alexandra Brewis is President’s Professor in the School of Human Evolution and Social Change at Arizona State University. She teaches in the Anthropology and Global Health programs, and serves as the Co-Director of the MC-ASU Obesity Solutions Initiative. Trained as a medical and biological anthropologist (PhD 1992, Arizona), she has led major field-based projects in the Pacific islands, Mexico, and the United States. Currently, she is conducting a global study of weight-related stigma, examining why it is spreading and deepening, and what the implications of this are for physical and emotional health.