Interpretative repertoires of long-term weight management: negotiating accountability and explaining success

Abstract

Objective

Public health messages encourage maintaining a stable weight and are influential in shaping normative weight management discourses. We studied how individuals with different weight maintenance histories constructed relations to these discourses in their sense-making on weight management.

Design

Our study used critical discursive psychology (CDP) as a theoretical and methodological framework for examining the accounts of 20 lifelong weight maintainers and 20 weight-loss maintainers (altogether 17 men and 23 women, aged 51-74).

Results

We identified three interpretative repertoires the participants used for making sense of weight management. The lifelong weight maintainers and weight-loss maintainers differed in their ways of using three repertoires. The “everyday challenges” repertoire that emphasized external obstacles was most emphatic in weight-loss maintainers’ accounts of unsuccessful weight management, and the “following instructions” repertoire that highlighted control and disciplined behavior in their accounts of success. The “lifestyle and personalized routines” repertoire that stressed customized needs and routinization of practices was most prominent in lifelong weight maintainers’ accounts of successful weight management.

Conclusion

Our findings stress the importance of alternative ways of talking about and supporting weight management to prevent stigmatization. In conclusion, we suggest employing morally neutral language by focusing on lifestyle and wellbeing instead of weight.

Keywords:

• Long-term weight management
• critical discursive psychology
• weight-loss maintainers
• lifelong weight maintainers
• interpretative repertoire
• subject position

1. Introduction

The maintenance of a healthy weight is one of the key targets of public health policies (Frederick et al., 2016; Ulijaszek & McLennan, 2016). In Western societies, dieting and weight concerns are common and are portrayed as normative, also among individuals with no medical need for weight loss (Gotovac et al., 2020; Sares-Jäske et al., 2019). Normative pressure to watch one’s weight and transform one’s body may be particularly salient for women because appearance and health issues are highly gendered: the socially acceptable presentation of femininity is more dependent on bodily appearance than the construction of hegemonic masculinity (Tischner, 2013). Gailey and Harjunen (2019) observed these expectations in a cross-cultural study that explored experiences of Finnish and North American women with obesity. The study showed similarities in the employment of normative discourses across Finnish and North American contexts, as the women framed fatness as a temporary “phase” that should be left behind. Thus, public debates on obesity, weight and dieting play an essential role in shaping people’s understanding of weight management (actions to influence the stability of weight), and are tied in intricate ways to individuals’ experiences of their bodies and weight (Edley, 2001; Stanford et al., 2018; Tischner, 2013; Tischner & Malson, 2012a; 2012b).

Successful weight management and the meanings ascribed to it are constituted through various social and cultural discourses. In other words, like with any other socially significant phenomenon, several competing discourses give meaning to and explain weight management and its successful accomplishment (Edley, 2001; Locke & Budds, 2020). Nevertheless, some discourses tend to hold a more prominent position in our contemporary context. The “war against obesity” rhetoric, “obesity epidemic” discourse, and “weight-centered health promotion” framings all share a similar ideological base that offers a typical, prevailing way of understanding weight and weight management in Westerns societies (Blackburn & Stathi, 2019; Frederick et al., 2016; Rich & Evans, 2005; Stanford et al., 2018, Tischner, 2013). They rely on the medical approach based on the energy balance model and highlight the risks posed by overweight bodies. They consider individuals as personally responsible for their weight (Blackburn & Stathi, 2019; Gotovac et al., 2020).

As researchers drawing on post-structuralist and critical discourse studies have observed, a typical feature of these wider cultural understandings is their emphasis on slenderness and weight loss being a universal good (Rich & Evans, 2005; Tischner, 2013). They provide body images and body ideals to which people compare their own bodies and normalize one particular body shape – a slender shape –over others, creating beauty standards that everyone should purportedly meet (Joy & Numer, 2018; Malterud & Ulriksen, 2010; Tischner & Malson, 2012b). They also offer practices and advice on how to meet these standards and become thinner or healthier: exercise more and eat less (Bombak et al., 2019; Tischner & Malson, 2012b). Within these approaches, weight management is viewed as an individual’s tool for reducing their risk of obesity or for curing it through behavioral practices.

Consequently, as Tischner’s (2013) findings and several other post-structuralist and critical studies have demonstrated, these individualizing frames conceptualize body size and weight as the markers of health, and create expectations for people to adopt lifestyle behaviors that prevent weight gain and resist diseases (Crawford, 1980; Hervik & Thurston, 2016; Malterud & Ulriksen, 2011; Tischner, 2013). In short, weight is seen as the result of logical choices (Jiménez-Loaisa et al., 2020). These models portray people as rational, independent and responsible individuals whose lifestyle choices are no longer viewed as personal choices but a way of saving society’s health costs. A discursive study of people with eating disorders showed worrying side-effects to linking weight and health, as the participants rationalized their bulimic practices to pursue a healthy weight and lean body and positioned themselves as responsible citizens (Burns & Gavey, 2004). Therefore, weight is also understood as a moral issue (Malterud & Ulriksen, 2011; Tischner, 2013). It is common to blame individuals with obesity or overweight for their weight and to categorize them as lazy, having poor willpower, or lacking self-discipline (Bombak et al., 2016; Gotovac et al., 2020; Malterud & Ulriksen, 2010). Through a socialization process, people learn the norms from which they differ or in which they engage, and form their identities in relation to these norms (Goffman, 1959, 1963). These moral aspects and weight stigma guide people’s behavior as they seek social acceptance. As a result, everyone is part of this healthy weight discourse, which has widely resulted in a desire to control weight.

However, some alternative ways of understanding weight management do not attribute the accountability to individuals but highlight the factors influencing body weight that are beyond individual control, such as genes or living environment (Swinburn et al., 2011). These competing frameworks have also been discursively identified in weight-loss studies in which patients and health professionals both reproduced and resisted the moral discourse surrounding weight (Blackburn & Stathi, 2019; Wiggins, 2009). The obesogenic environment seems to play a role in the development and maintenance of obesity: instead of poor self-control or willpower, people may be responding to the impacts of their environment (Medvedyuk et al., 2018; Townshend & Lake, 2017). This view does not blame individuals; it calls for collective responsibility and governmental actions concerning food regulation and marketing (Ulijaszek & McLennan, 2016). “Health at every size” and “fat rights” frameworks have also been identified in the literature (Bombak et al., 2019; Cooper, 2010; Harjunen, 2017; Saguy, 2013; Tylka et al., 2014). These perspectives promote respect for diversity in body shape and size to end weight discrimination and stigma. To summarize, this sociocultural understanding of obesity is associated with less negative attitudes toward people with obesity than the dominant medical approach (Bombak, 2014; Bombak et al., 2016; Frederick et al., 2016; Tylka et al., 2014).

Nevertheless, today, the leading research approach in the obesity and weight management research field is still medical, and uses quantitative methodologies (Paixão et al., 2020; Varkevisser et al., 2019). The critical literature on body size and weight has challenged the current dominant take on “obesity” from the medical perspective (Saguy, 2013; Tischner, 2013). The present study contributes to this line of research by adopting critical discursive psychology (CDP) as its theoretical and methodological framework (Edley, 2001; Wetherell, 1998). This approach is particularly useful because of its capacity to illuminate the wider discourses around weight, health, and morality that are shared across nations, including Finland (Gailey & Harjunen, 2019). Furthermore, the patterns in ascribing meaning to both successful and unsuccessful weight management provide a backdrop for the routines and practices that people adopt and are considered socially acceptable (Edley, 2001; Wetherell, 1998). Therefore, in addition to illustrating the discursive practices of accounting and making sense of weight management, understanding these patterns can be highly informative in terms of the actual weight management activities that people assume in their everyday lives.

Some previous studies have employed a slightly similar approach to studying weight management, but have focused on weight-loss management only (Jallinoja et al., 2008; Seymour-Smith et al., 2020; Wiggins, 2009) or individuals with eating disorders (Burns & Gavey, 2004). It is also well-known that weight-loss management is challenging, and weight fluctuations and regaining are common and “normal” experiences for many people (Varkevisser et al., 2019). However, to enrich the current knowledge on successful weight management, we focused on only weight maintainers. By examining both lifelong weight maintainers (LMs) and weight-loss maintainers (WMs), this study provides a unique angle on how individuals with different weight maintenance histories frame their weight management successes or past failures. A comparative dataset is crucial, as these two groups, despite sharing a similar end result in terms of weight maintenance, are nevertheless positioned differently in relation to normative weight discourses, and thus, may have distinct needs to negotiate their accountability for weight management and their possibilities for success. The specific aim of this study was to describe how individuals with different weight maintenance histories employed various culturally and socially available, common weight management explanations in their sense-making on weight management.

2. Methods

2.1. Theoretical and methodological approach

CDP is one of the approaches under the umbrella of the discursive methodologies rooted in social constructionism (Locke & Budds, 2020). These approaches see language as constructing versions of social reality rather than as an accurate representation of an individual’s opinions or thoughts (Burr & Dick, 2017). CDP combines elements from both micro-analytical discursive psychology, which focuses on the local use of discourses, with those from post-structuralist approaches, which concentrate on the macro level of wider discourses (Edley, 2001; Locke & Budds, 2020; Wetherell, 2007). Thus, CDP enables us to consider how socio-historically available and prevalent forms of sense-making influence the understandings and experiences of weight and weight management (Edley, 2001; Locke & Budds, 2020). The approach also highlights the two-fold relationship between existing understandings and the people who draw upon them in their sense-making; people are thereby seen as both the “products and producers of discourse” (Edley, 2001, p.190). Thus, it sees speakers as active agents who draw upon particular discursive formulations and the associated understandings for a reason. In other words, people are viewed as skilled social actors who use language to create useful identities (Potter & Wetherell, 1987). For example, there are different ways of talking about weight and weight management, and speakers need to decide which to use. However, despite being able to choose which discourses to draw upon, the availability of the different discourses varies: Some are easier to use as they are culturally dominant and may gain the status of truth if they obtain institutional support (Edley, 2001; Locke & Budds, 2020; Potter & Wetherell, 1987).

Interpretative repertoires and subject positions are the core analytic concepts of CDP. Interpretative repertoires refer to discursive resources related to a particular topic that people can employ in everyday social interactions (Edley, 2001; Locke & Budds, 2020; Potter & Wetherell, 1987; Wetherell, 1998). Repertoires are exemplified as relatively coherent ways of talking. They provide the building blocks for a community’s shared understandings, i.e., they form the basis for cultural “common sense” concerning a subject (Edley, 2001). In their everyday interactions, people fluently draw upon various available repertoires to make sense of a particular phenomenon. Subject positions are also discursively produced “ways of being” (Davies & Harré, 1990; Edley, 2001; Locke & Budds, 2020; Potter & Wetherell, 1987; Wetherell, 1998). In conversations, people place themselves and others in particular positions that are linked to certain rights and responsibilities, and thereby construct identities for themselves and others through specific ways of speaking. However, people are not free to locate themselves as they wish; their cultural history defines the subject positions they assume to be available (Edley, 2001; Locke & Budds, 2020; Potter & Wetherell, 1987). In addition, individuals seem to produce identities by negotiating with the subject positions that are on offer – therefore their identities are not fixed or unitary but multiple and constantly in flux.

2.2. Participants and study design

The study was reviewed by the Ethical Review Board of the Humanities and Social and Behavioral Sciences at the University of Helsinki and the ethics committee of Helsinki University Hospital. Our analysis was based on interviews of two groups of participants: Group 1 consisted of LMs who had managed to retain the recommended weight for their height, referred to as “normal weight” in the medical terminology used in clinical practice, (BMI, between 18.5 and 24.9) throughout their lives (Joki et al., 2017, 2020). To obtain comparable data on the WMs, we selected the older age group (for details on age, see Table 1) of 20 participants from all the 39 LMs interviewed. We gathered the LMs’ data in 2012. In the recruitment process, we utilized a purposeful sampling method, which is a useful technique for identifying and selecting individuals who are particularly knowledgeable about the phenomenon of interest (Hammarberg et al., 2016; Moser & Korstjens, 2018). We began by recruiting LMs from two large organizations: the Public Works Department of the City of Helsinki and the parish union of Helsinki, which both represent typical Finnish public-sector employers (Joki et al., 2017, 2020). The principal investigator emailed the invitation letter containing the participation criteria to their contact persons and asked them to forward it to potential participants. Then the appropriate and interested candidates were contacted, and interviews were arranged. After collecting information in the interviews, the participants were invited to suggest other individuals experienced in successful weight management from among their acquaintances. Therefore, the study used the snowball sampling method, which is useful when participants are members of specific subgroups (Moser & Korstjens, 2018). This method is ideal for identifying potential future participants. The participants were men and women who had maintained the medically determined “normal weight” throughout their lives.

Table 1. Characteristics of study participants.

	Weight-loss maintainers (WMs) (frequency)	Lifelong weight maintainers (LMs) (frequency)
Gender:
Men / women	7 / 13	10 / 10
Age:
Mean age (range)	64 y (51-74 y)	62 y (56-68 y)
Education:
0–9 y	2	3
10–12 y	4	5
13 y or more	14	12
Smoking/ use of snuff:
Yes	2	1
BMI (kg/m^2)
Mean BMI (range)	28.6 (22.8—41.1)	22.9 (20.5—24.7)
Leisure-time moderate-to-vigorous physical activity:
4–7 times/week	8	8
2–3 times/week	7	9
Once a week or less frequently	5	3

Group 2 consisted of WMs who had been at least overweight, had lost weight and had maintained their weight loss for three years (Raben et al., 2021). The data were based on 20 thematic interviews conducted in Finland in 2017–2018. We recruited the WMs from among the participants of the PREVIEW intervention study, the aim of which was to determine an effective lifestyle for preventing type 2 diabetes (Fogelholm et al., 2017). The selected participants had lost at least 8% of their initial weight over two months using a very-low energy diet, and had successfully maintained the required weight criteria for three years, which were:

1. A gain of less than 5% of the weight after weight loss

2. Weight at least 5% below the initial (baseline) weight

We recruited the appropriate candidates from PREVIEW’s end-of-study assessments. The successful maintainers received an information letter describing the study and a consent form. If they agreed to participate, they signed the informed consent form, allowing the principal researcher (AJ) to contact them. Thirty-one individuals met the criteria, 20 of whom agreed to participate. We excluded one person who had cancer, eight who were unwilling to contribute, and two applicable candidates, as we had enough participants.

In conclusion, the present study examined men and women with different weight maintenance histories. Table 1 presents the participants’ characteristics.

Before starting the interviews, the ethical issues were discussed: participants were informed of the study’s aim, confidentiality, and anonymity, and were assured that they could withdraw from the study at any time. The data were gathered through semi-structured theme interviews. The structure of these flexible interviews can be adjusted to suit each interviewee (Bernard & Ryan, 2010). To develop the interview themes and the semi-structured interview guide, we used the results of weight-loss and weight management studies (Elfhag & Rossner, 2005; Hill et al., 2005). Our previous article provides detailed information on the pilot interviews and actual theme interviews (Joki et al., 2017). First, we asked the interviewees about their relationship with food and eating as well as their perceptions of the connections between weight management and health behavior. The interview discussion topics also covered the participants’ definitions of weight and eating management, and the factors associated with their weight.

The first author (AJ) interviewed all 40 participants using the interview guide (additional file). The list of questions was the same in all the interviews, which helped address the research themes. However, the interviews were not identical: each topic could be discussed flexibly, and the participants were encouraged to express all their thoughts on the interview themes. The interviews lasted from 45 minutes to two hours. According to the participants’ preferences, all the WMs’ interviews were conducted at the University of Helsinki (20). The LMs were interviewed in various settings: their homes (10), workplaces (8), or the University of Helsinki (2). All interviews were recorded and transcribed verbatim. They totaled 454 pages. The interviews, transcriptions and analyses were conducted in Finnish, and only the quotations used in the current article were translated into English.

2.3. Analysis

This study identified the interpretative repertoires and subject positions inherent to weight management and linked them to wider ideologies and societal discourses in order to examine how the available, normative discourses inform individuals’ sense-making and how they negotiate with them. After familiarization with the data, the first step of the CDP-based analysis was to identify the different ways in which the discursive object –successful weight management– was constructed in the text (Locke & Budds, 2020). For systematic data analysis, the lead author used Atlas.ti software in line-by-line coding (Seale, 2005). Then, we performed a more fine-grained analysis of individually coded extracts and traced the functions of the talk by examining each strip of talk in its discursive context to see what it enabled the speaker to accomplish (Locke & Budds, 2020). The next step involved producing the interpretative repertoires that were used for explaining successful and unsuccessful weight management. The researchers discussed and evaluated the adequacy of the repertoires. Specifically, the extracts that highlighted “control”, “self-discipline” and “means for eating and exercise” were grouped and identified as the “following instructions” interpretative repertoire. Further, we created the “everyday challenge” repertoire by combining the “influence of social contacts/life situation/living environment” categories. Finally, discussions on “lifestyle”, “flexibility”, “being conscious” and “habits” were grouped as the “lifestyle and personalized routines” repertoire. Next, we looked at the positionings: We listed the subject positions that each repertoire enabled and noted the rights and responsibilities that were connected to the different subject positions. A more detailed description of this process is shown in the results section, which also presents the positionings. In the final stage, we paid special attention to the relationship between repertoire and practice: the roles the repertoires played in reproducing and subverting institutions (Locke & Budds, 2020), i.e. what societal or institutional practices the identified constructions gave support to and gained support from.

3. Results

The analysis produced three interpretative repertoires (“everyday challenges”, “following instructions” and “lifestyle and personalized routines”) that the participants used to make sense of weight management. The WMs deployed the “following instructions” repertoire the most when talking about maintaining their current weight, and the “everyday challenges” repertoire when accounting for weight gains. The LMs specifically utilized the “lifestyle and personalized routines” repertoire in their explanations. The following sections present the interpretative repertoires in more detail and show the positionings enabled by each construction.

4. Everyday challenges

This repertoire was mostly used by the participants to account for unsuccessful weight management in the past. The WMs, who deployed this repertoire more than the LMs (74 times, compared to 30 times, throughout the interviews), described how social connections, life situations and their environment had imposed challenges for their weight management and had significantly contributed to their weight gain. Typical reasons that they mentioned were challenges at work (stress, time pressure for lunch), parenting, bereavement, and emotional eating. Women also presented pregnancy as a reason, portraying it as an obvious and typical explanation for weight gain:

“It’s the typical story, pregnancy and then kids. When the kids were small, I didn’t really have time to focus on managing my weight…it was a tough time of life…the kids got all my attention, I had three kids in a short time and it changed my daily life, I kind of forgot myself and what I ate” (WM, woman, aged 51).

Another example of the use of this repertoire links weight gain with the influence of the participants’ spouses on their eating: “The usual. I gained weight because my husband cooked such delicious food. And I wasn’t used to it and he served my portions, they were far too massive and this was over seven years…then I realized, hey, I can’t fit into my clothes” (WM, woman, aged 59).

The expressions used at the beginning of the sentences in both extracts above, “the usual” or “it’s the typical story”, construct a representation of weight gain as “common sense” with which the interviewer is assumed to be familiar (Edley, 2001). The participants also explained their lack of success in weight management using everyday life circumstances such as “lousy weather that prevented exercise” (WM, man, aged 68) or “living next to restaurants and a market hall” (WM, man, aged 61), which they associated with decreased physical activity or increased eating in their accounts. As the bulk of the participants’ accounts almost identically relied on this repertoire, it appeared to be a widely available sense-making resource for specifically explaining weight gain among the WMs. In terms of its links with broader discourses, the repertoire is closely related to and hence gains support from the cultural discourse of “obesogenic environment”, which emphasizes the role of larger social forces in weight gain (Townshend & Lake, 2017).

However, the WMs’ urge to voluntarily (without being asked) account for their weight gain may also be linked with the dominant discourses of weight, which frame it as a cause for social stigma (Puhl & Heuer, 2010; Wiggins, 2009). The use of this repertoire is thus linked with the participants’ identity work in relation to potentially stigmatizing notions of personal responsibility for weight management. Positioning oneself at the mercy of factors beyond one’s control functions as a discursive tool that potentially enables warding off negative self-evaluation, because the self is construed as a victim of forces over which one has no individual control or responsibility:

“My husband, he has no weight problems, he’s a punctual eater, I mean he learned to eat properly in childhood. He supports really controlled eating, good eating habits. Then when I’m alone and he’s away somewhere, I’m like, whatever, and I can’t stay strong in my eating…”(WM, woman, aged 65).

In the extract above, by suggesting an inability to control her eating without her husband’s presence, the interviewee positions food as having power over her, thus making it impossible for her to control her eating. The subject position of “uncontrolled eater” is produced by this description: she presents her as an onlooker of her behavior rather than an agent. She consolidates her self-positioning as a “victim” by implying that her husband possesses the required characteristics for success in weight management because he has learned healthy eating habits in childhood. She, in turn, lacks these. And as children are not seen as responsible for themselves and their eating habits, making this distinction enables her to negotiate with the discourses that place the moral responsibility for weight maintenance onto individuals. By positioning herself as someone who has never been given environmental support for weight management in her life, she deflects the potential accusations of moral lacking and laziness, and instead works toward presenting herself as a victim of forces beyond her control.

Similar constructions were common among the WMs as they framed the responsibility for influencing their actions and opportunities for action as being beyond their control. However, we observed that factors beyond one’s control were not only portrayed as complicating weight management, but in some narratives, as also supporting it. In addition to the beneficial influence of spouses’ eating patterns described in the extract above, factors such as favorable life situations, a weight loss group’s support, and shared goals were occasionally also portrayed as enabling successful weight management.

In sum, the WMs used this interpretative repertoire specifically in the context of accounting for lack of success in weight management in ways that allowed them to negotiate blame for it. In contrast, in their narratives, the LMs frequently used it in ways that emphasized an individual’s success in overcoming any challenges, despite acknowledging that social connections, environment, and life situations had caused difficulties in their weight management:

”The worst threat to my weight…I was in London as an aupair and gained almost 10 kilos over that year, it was awful. Although it wasn’t that typical to talk about losing weight then, I lost it by eating soups and going to visit my brother every evening; he lived near me, and never offered me anything to eat, I just stayed away every evening and I managed to normalize my weight” (LM, woman, aged 61).

As the extract above illustrates, the repertoire of external challenges typically plays quite a different role in the LMs’ narratives to that in the WMs’ narratives. Instead of positioning themselves as victims, the former group tended to position themselves as survivors, who made the necessary changes to lose the extra kilos and stop weight gain, even when social or other circumstances posed challenges. By doing so, their identity work aligned with the normative discourses that stress the significance of an individual’s activity in constantly monitoring their weight. As we will further discuss below, this identity work was frequently associated in the LMs’ narratives with explaining weight management success by employing the “lifestyle and personalized routines” repertoire.

5. Following instructions

This interpretative repertoire was deployed to explain weight management success as dependent on self-control or practices and was the most common repertoire used by the WMs (133 times throughout the interviews). The participants understood weight management as a way of controlling eating and exercising to maintain equal energy balance. Regular monitoring and self-discipline were mentioned as critical for success. Several duplicate accounts such as “To obey given instructions” indicated that weight management was considered something that came from the outside, as an object of control guided by external rules. The WMs associated weight management with regimented eating, such as avoiding their favorite foods and denying themselves foods categorized “bad” for maintaining weight loss.

Interviewee: I struggle with certain foods such as cheeses and chocolate, if I open the package and take a bit, I can’t resist it…so, I avoid them, I don’t buy them anymore as I can’t keep them without eating them.

Interviewer: Do you feel that you need to restrict your eating then?

Interviewee: For my weight, yes, I need to restrict my eating but I think in a good way, I don’t complain about it because it’s unnecessary and not that healthy either. Also, the evenings are challenging, when I’m watching TV, I’d like to eat something nice, that’s what I’m trying to learn to stop…you try to battle against your desires and try to make changes…if you want to eat something, you take a lighter version of it…and luckily I like carrots (WM, woman, aged 70).

Participants produced weight management constructions through health-promoting nutritional discourse, orienting the responsibility to the individual level (Dodds & Chamberlain, 2017). For maintaining weight loss, one is expected to have enough control and self-discipline to eat foods categorized good/healthy and to avoid foods considered bad/unhealthy, which is a common construction of food in Western societies (Churruca et al., 2017; Dodds & Chamberlain, 2017; Madden & Chamberlain, 2010). This construction allowed the participants to rationalize their regimented eating habits. The public health discourse encouraging food restrictions to keep a healthy weight also echoed through the participants’ accounts and justified their behavior. This finding is in line with the common notion that healthy eating is the opposite of pleasure, and individuals with a high level of self-control manage to resist temptations and only make healthy choices (Dodds & Chamberlain, 2017).

Another recurring pattern constituting this repertoire was claiming that the practices related to eating and exercise, food, and monitoring, were essential for weight management success. The participants described the concrete means that they utilized to keep a stable weight in everyday life:

”You just try and eat healthily, as people should. It’s probably eating habits that play an important role, I’ve been trying to eat in a way that prevents weight gain, like eating more vegetables and eating regularly. Yeah, that’s what happened, and I make sure that I keep eating enough veggies. And physical activity, it’s essential in many ways – it makes you feel good and also affects weight…I’ve noticed its benefits myself; if you carry on eating in the usual way and exercise less, it results in slow weight gain”(WM, man, aged 68)

The participants constructed an essential link between weight management practices and successful weight management on both the general and personal level. They specified foods that prevented weight gain and connected healthy eating with human nature (as shown at the beginning of the account above), portraying it as a general, normal way of keeping weight stable. Moreover, they described weight management and diet as a common and active discussion topic in everyday life. They typically offered a more personal level by describing how they had managed to succeed and shared their weight management experiences. Using these constructions, the interviewees justified their weight management practices as a normative way for weight management.

In their narratives, the participants deployed two dimensions of the repertoire –emphasis on control and emphasis on practices– in different ways. The WMs mostly emphasized the significance of practices when they explained the changes they had made after the weight-loss intervention and which they believed to be essential for success. However, when describing their current successful weight management, they tended to emphasize control, and portrayed self-control as a tool for maintaining these changed practices. The LMs exploited the repertoire less than WMs (91 times, compared to 133, throughout the interviews) and mostly in hypothetical situations when they were asked to imagine a sudden weight gain and their reaction to it or to give weight management tips. In doing so, they relied on familiar versions of weight success loss, widely used in the health promotion messages of clinical practice guidelines and weight-loss interventions (Couch et al., 2014; Dodds & Chamberlain, 2017; Riley et al., 2008). Based on this observation, we claim that culturally dominant weight management discourses are readily utilized for describing situations with no personal experience.

The “following instructions” repertoire relied on the medical approach of the body and attributed the responsibility for weight to individuals (Blackburn & Stathi, 2019; Gotovac et al., 2020; Wiggins, 2009). This logic positions individuals as accountable for monitoring their behavior and adapting it when necessary to prevent weight gain. Several accounts stressed the duty to eat healthily and thereby shape one’s body through weight management habits. The repertoire characterized the body as a “mechanistic device” that burns calories and positioned the individuals in a key role in controlling their consumed calories and expended energy:

”Exercising makes weight management easier, it’s the most important thing for me. I don’t know what I would eat, I guess I wouldn’t eat hardly anything, at least not chocolate or ice cream…exercise is crucial. There are two factors: consumed calories and burned calories, it’s obvious that if you consume more calories than you burn, you gain weight and vice versa.” (LM, man, aged 61).

As the extract above illustrates, the mechanistic view of the body was associated with the culturally common construction of food as a reward, with the idea that one needs to compensate for or earn “bad foods” through exercise (Benford & Gough, 2006; Churruca et al., 2017; Rich & Evans, 2005).

This repertoire enables the subject position of a “self-controller”. This is characterized by strong agency, exemplified by an emphasis on how hard the participants had worked to achieve their success. By doing so, they were justifying their disciplined behavior and distinguishing themselves from people who, according to them, take stable weight for granted.“Of course it takes disciplined behavior, I think it’s obvious. It just needs systematic lifestyle changes and a strong nature; slimming is not easy. But I’m free to choose what I want, and I don’t feel I’m forced into it. As I control myself and my weight and I’m a good citizen, I can do what I want” (WM, man, aged 74). The repertoire allowed the reiteration of the moral discourse of weight that supported the interviewees’ constructions of the self-controller as a dutiful citizen who wants to take care of him/herself rather than burden society’s health services (Dodds & Chamberlain, 2017; Fullagar, 2002; Tischner, 2013). In this sense, control practices were presented as central to body management; as a normative approach to health. In the data, emphasizing these practices was accompanied by highlighting one’s freedom to choose whether one wants to control one’s weight. This emphasis on “choice” aligns with common discourses of health and lifestyle change that individualize disease risk, and thereby position the governing of healthy lifestyle practices as the moral responsibility of each individual (Blackburn & Stathi, 2019; Rich & Evans, 2005; Tischner, 2013).

Interestingly, when drawing upon this repertoire, the participants also positioned themselves as rule-oriented characters who could easily follow given instructions:”It’s easy, you don’t think about it at all, just follow the instructions, it suits my personality”(WM, man, aged 66). They also portrayed it as their responsibility to obey authorized instructions. As opposed to the “self-controller” positioning, in which participants laid the emphasis on their own activity as controllers as being crucial for success, here they positioned themselves as “subjects of control” in the sense of an ability to follow rules imposed on them from the outside. By associating this ability with their innate/natural characteristics (i.e. with having a rule-oriented personality), they shifted accountability partly onto factors beyond their conscious control. In sum, this repertoire enabled positionings that shared the importance of following instructions. However, the identities created varied: “self-controller” positioning was used for constructing identities as individuals who worked hard and put effort into keeping their weight stable, whereas positioning as an obedient “subject of control” laid less emphasis on individual agency and more on the ability to obey rules set by others.

6. Lifestyle and personalized routines

This interpretative repertoire was deployed to explain weight management success as being dependent on habitualized self-regulation, flexibility and lifestyle. Descriptions of weight management motivation being rooted in internal needs and desires were essential for this repertoire. A further characteristic of this repertoire was the emphasis on customizing weight management practices individually. When this repertoire was employed, ideal weight played a key role as a valued goal that guided weight management behavior. Constant learning was described as a core component of weight management.

The LMs typically explained their success using this repertoire (135 times throughout the interviews) and highlighted the importance of finding a balance between eating and exercise.“Constantly monitoring how you feel…that’s also a kind of weight management, that when you notice your pants are tight, oh no, I’ve gained weight, I need to lay off the treats…of course you regulate your behavior by doing so, it’s just natural”(LM, woman, aged 56). What is stressed here is the importance of being aware of one’s routines and making necessary changes to maintain a stable weight. Success is thereby constructed as requiring a certain level of control and regulation, but these are to be exercised flexibly rather than with a rigid approach. As the extract above illustrates, the LMs considered self-regulation a typical weight management approach. This approach was rooted in internal motivations and the participants’ desires and values. They highlighted their ability to eat properly, and described how they improvised with foods and ingredients and did not completely avoid certain foods. Thus, self-regulation differed from the “following instruction” repertoire’s self-control concept that highlighted the external motivators of weight management.

The orientation based on flexibility in this repertoire worked as a counter argument for the control explanations and was often used in arguing against the utility of excessive self-control: “I disagree, of course, you need to live a kind of disciplined everyday life but it doesn’t mean that you’re not allowed to eat anything good”(WM, woman, aged 70). Throughout this repertoire, the participants expressed their aspiration to strike a balance between pleasure and control in weight management.

In addition to highlighting flexibility, another key dimension in this repertoire is the portrayal of weight management as part of a lifestyle. The LMs’ accounts that employed this repertoire, presented successful weight management as an integrated part of their daily behavior, or as internalized routines in which one does not need to force oneself to engage: “I’d say lifestyle plays the main role, but as it’s lifestyle, I don’t feel I need to cycle to work because of my weight, it’s more a mental thing, it makes me feel good, I don’t need to work on my weight” (LM, woman, aged 57). Narratives that drew upon this repertoire resisted the dominant understandings of weight management that conceptualize it as being dependent on discipline and hard work. In addition, contrary to the “following instructions” repertoire’s dichotomous approach to food and eating, moderation plays a key role in this repertoire. In short, weight management is portrayed as part of broader life management and a way of taking care of oneself and enjoying life.

The WMs also utilized this repertoire when they were constructing a “lifestyle changes” narrative (47 times throughout the interviews): “Now I’m more conscious of my eating…I’m on my way, and I can do it. That’s what I’ve learned. I’ve made the same mistake so many times…I’ve started fasting, but it just doesn’t work”(WM, woman, aged 65). They also proposed that they had learned new ways to employ weight management. The association between adopting a new lifestyle and achieving success in weight management was highlighted by contrasting their present success with weight control efforts in the past, the failure of which they attributed to not having reached the required stage of change in adopting a new lifestyle: “Yes, it requires daily choices in terms of weight management… in a way it’s subconscious, it doesn’t happen by accident but pretty much subconsciously, you don’t have to control it all the time…maybe as a lifestyle. This three-year-intervention has influenced my behavior, it’s become a habit that doesn’t control my thinking” (WM, woman, aged 65). The “lifestyle change” narratives portrayed successful weight management holistically, as a source of wellbeing that requires flexibility and long-term regulation instead of rigid control and anxiety. In these narratives, habit formation reduces the need for active thinking and self-control. This change is accompanied by an identity shift from being a dieter/active self-controller to accepting a new, healthy lifestyle.

However, even these narratives pointed toward the powerful position of the opposite discourses highlighting control in weight management. This became evident in the participants’ efforts to pre-emptively counter the potential criticism that their alternative construction may provoke due to departing from dominant understandings (Billig, 1987; Frederick et al., 2016). For example, one participant began their turn in an interview by stating: “This is not what you want to hear, but I don’t have to control my eating or weight, not at all” (LM, man, aged 58). The beginning of the sentence marks the following utterance as an untypical response to the interviewer’s question about their weight management practices, and thereby expresses recognition of an opposing account of weight management –the kind that emphasizes continuous hard work– as the typical one. The interviewee continued by offering a detailed description:

”Now we’re talking about a weight controller, a person who really needs to control their weight and carefully consider their choices and refuse some foods that they would like to eat. But that’s not my life, I don’t have to control my weight. My life is normal, I eat what’s offered and I don’t actively think about it. I won’t eat, if I feel like not eating. It’s just a lifestyle that has emerged without thinking”

The above extract invokes the common weight maintainer’s stereotype and simultaneously positions the participant as having departed from it. Through this repertoire, several identical accounts enabled an “effortless weight maintainer” position that could be read as subverting the dominant constructions of weight management. It is noteworthy that in the extract above, the interviewee portrays their style of weight management not as burdened by a need to actively control their weight, but as enabling a “normal” life, therefore insinuating its superiority as an orientation. By doing so, the interviewee constructs an identity that is distanced from that of a “weight-watcher”, and instead is based on the freedom to eat without constantly thinking. This identity construction aligns with the “ideal subject” constituted in weight management studies that emphasize the importance of internalized routines and habit formation for achieving success (Joki et al., 2017; Kwasnicka et al., 2019; Pedersen et al., 2018).

However, this repertoire was also mobilized in unison with a slightly different positioning, that of “subjects of active self-regulation”. With this positioning, the responsibility for weight remained with the individual, whose duty was to find suitable ways to succeed in weight management. This was accompanied by monitoring their behavior and actively making choices and decisions to keep their weight stable: “I find it important that everything you eat needs to be something that you want to eat and you need to be aware that it is healthy” (LM, man, aged 64). The “subject of active self-regulation” position gains support from the cultural view of weight as an indicator of health (Blackburn & Stathi, 2019; Gotovac et al., 2020). In this positioning, the participants constructed their role as vital for success and distinguished themselves from people who explained their weight gain through external factors such as constant time pressure and no time for exercise and healthy eating. In doing so, they drew upon and reiterated the moral discourse of obesity, in which individuals have a moral obligation to take care of their weight and health (Blackburn & Stathi, 2019; Bombak et al., 2016).

7. Discussion

We identified patterned ways of thinking and talking about weight management among people with different weight maintenance histories. They employed three main interpretative repertoires when making sense of weight management. The “everyday challenges” repertoire functioned as an explanation for not succeeding. It allowed the participants to negotiate with blame by framing the responsibility for influencing their behavior as being beyond their control. Wiggins (2009) found that the patients in the weight management treatment groups used a similar strategy for managing weight blame. They located the blame outside their own control and deflected their failure onto factors such as medical conditions or individual characteristics (Wiggins, 2009). Similarly, Salemonsen et al. (2018) noticed that individuals with overweight or obesity felt that they needed to justify their weight challenges and link them to external reasons to avoid being judged as lacking personal responsibility. This corresponds to our findings.

The “following instructions" repertoire’s narratives emphasized the importance of following weight control advice given by health promotion institutions. A study that explored men’s weight loss stories also highlighted modified eating practices, tracking physical activity, and weight monitoring practices to keep weight stable (Couch et al., 2014). Similarly, in a study of diet talk, older men with obesity constructed their diet by describing it as something that needs to be obeyed and that they had to “do what the book says” (Seymour-Smith et al., 2020). Furthermore, the repertoire’s accounts underscored the significance of regular monitoring and self-discipline. This finding is in line with a Finnish discursive study that explored lifestyle changes and highlighted self-control for maintaining weight loss (Jallinoja et al., 2008). Similarly, the Healthy Life Centre’s service users mentioned “willpower and discipline” as necessary for maintaining the changes made to diet and activity habits (Salemonsen et al., 2020).

Finally, in the “lifestyle and personalized routines” repertoire, the participants explained success as being dependent on tailored needs and formed habits. This repertoire resembles the diet talk identified in, for instance, the discursive analyses of men’s talk about how they adapted diets to suit their own needs (Seymour-Smith et al., 2020). Salemonsen et al. (2020) also saw that lifestyle change was more likely to be accomplished if it was based on individual needs and values. In line with this, our participants emphasized the significance of being aware of one’s routines and regulating them flexibly. Jallinoja et al. (2008) noted a similar strategy for maintaining weight loss. Our findings also correspond with those of a study that examined long-term and short-term weight maintainers (Pedersen et al., 2018) and found that long-term maintainers had more self-regulatory strategies (planning, coping, recovering) than short-term maintainers. Lastly, the desire to balance pleasure and control and to portray weight management as a part of lifestyle were key dimensions of this repertoire. Similarly, previous inquiries into the normative discourses on health have considered excessive obsession with exercise and healthy eating harmful, unnatural, and even health threatening (Crossley, 2003; Gill, 2008; Pajari et al., 2006).

Further, “obesity epidemic” and “weight-centered health promotion” discourses produce a rationalizing framework for disciplined weight control practices that WMs consider a key factor of success. Public discourses have supported, justified, and to some extent normalized these practices (Tischner, 2013). Interestingly, the LMs’ sense-making differed from both the WMs’ and the culturally prevailing way of understanding weight. Even though interpretative repertoires draw broadly from shared sociocultural knowledge, various factors such as personal history, life experiences, environment, and biology can influence how and why people exploit particular interpretative repertoires (Jallinoja et al., 2008). For example, as Table 1 shows, the mean BMIs differed among these groups, and most of the WMs would be categorized at least as individuals with overweight. The LMs’ and WLs’ genetic susceptibility to gain weight may differ, which might influence the number of actions needed to keep their weight stable, further affecting their sense-making. Moreover, the duration of weight management put these groups into different positions, as previous studies have suggested that maintaining weight loss becomes more comfortable over time (Wing & Phelan, 2005). One of the reasons may be habituation, as this is thought to play a relevant role in weight management (Joki et al., 2020; Lally et al., 2011). Moreover, from childhood onwards, individuals’ living environments may vary, which affects their ways of talking and explaining their weight management.

On the other hand, people under a constant threat of weight stigma experience specific pressure to present themselves as morally acceptable people and thus as adopting practices that are visible to the social environment (Guassora et al., 2014; Pajari et al., 2006; Puhl & Heuer, 2010; Salemonsen et al., 2018; Täuber et al., 2018; Tischner, 2013; Wiggins, 2009). For instance, people prefer observable behaviors that can be implemented quickly (such as obtaining and reading brochures about dieting and healthy food) over less visible and more time-requiring strategies (such as truly adopting a healthy diet which in the long run might lead to beneficial changes in weight). Regarding weight stigma, our participants were not in an equal position, as the subject positions on offer for the WMs were not as preferable as the LMs positions. The weight of LMs has always been in the “ideal” weight range, and thus, they have supposedly not had to face social judgment. In contrast, the WMs have been, and still are, potential targets of critique due to their weight and are therefore under an immediate threat of being judged by others. Similarly, Täuber et al. (2018) noticed that the experience of weight stigma promoted more other-determined and less self-determined regulation of dieting and exercising. Our results supported this finding, and the above-mentioned differences between the WMs and LMs may explain the different use of repertoires and subject positions by these groups.

To illustrate, according to the logic of weight-centered discourses, if the WMs wanted to be seen as morally acceptable individuals, such as healthy citizens, adopting practices consistent with the population goal was their only choice to avoid being positioned as a morally undesirable person, despite how they emphasized their freedom to choose whether they wanted to control their weight. As people have cultural priority to portray themselves as having agency, power, and control (Reynolds et al., 2007), the subject position of “self-controller” as a hard-working individual guided the participants’ controlled behaviors. Similarly, Guassora et al. (2014) noticed that patients in clinical dialog about lifestyle issues presented themselves as responsible individuals who were able to control their lifestyles, thus defending themselves against shame. The “victim” position in the “external challenges” repertoire also allowed the WMs to frame themselves as morally acceptable individuals by negotiating the blame and avoiding sociocultural stigma. In contrast, as the LMs were not obligated to justify their moral acceptability, they were able to more freely make sense of their success.

Furthermore, CDP sees identities as situationally performed in encounters with other people and thus as limited to each situation. However, in addition to and intertwined with the situatedness of identity, it is also possible to see continuity in the ways in which people see and understand themselves (Wetherell, 2008). With sufficient repetition of certain practices and the identity representations aligning with them, identities can become more or less routinized and automatic. This may also contribute to the LMs’ willingness to use the dominant weight management discourses.

Further, all the discursive constructions that were drawn upon in the current study engaged in dialogue with Western societies’ general assumption that individuals can affect their weight through eating practices and physical activity, thus placing the responsibility with the individuals (Frederick et al., 2016). However, “victim” positioning in the everyday challenges repertoire resisted this individualized construction of weight and placed accountability into wider societal influences.

8. Limitations and strengths

We aimed to provide a novel insight into weight management using CDP, which would enable us to explore the sense-making of individuals with different weight maintenance histories. The key strength of this approach is its attempt to pay attention to both macro and micro levels of talk, i.e., how individuals employ culturally available, wider societal discourses and what they achieve by doing so. Thus, we managed to gain nuanced information on how people give meanings to successful weight management. Different meanings ascribed to weight management are linked with different everyday practices and identities and can therefore significantly shape people’s behaviors and experiences.

As is typical in qualitative studies, the researcher and interviewees co-created the data. The maintainers’ accounts were based on thematic interviews, which were further guided by the existing knowledge on weight management, mostly gathered by quantitative studies. Some questions might have guided the discussions in specific directions (e.g., the question on weight management tips) and thus modified the explanations of success. If our orientation had been different already at the interview stage and if we had conducted narrative interviews, the accounts and identified repertoires may have been different. The researchers’ pre-understanding also influenced the interpretations of the study. However, we believe that variations in the authors’ research disciplines (public health nutrition, social psychology, sociology) enriched our analysis. Further, as with all studies that apply the discourse approach, the identified repertoires were specific to this study’s design.

Another limitation that needs to be considered concerns the influence of the PREVIEW intervention on WMs’ sense-making. The PREVIEW participants took part in group counseling visits (8–12 participants) following the procedure developed to change pre-diabetic people’s dietary behaviors and physical activity strategies (Kahlert et al., 2016). The psychological guidance that the WMs obtained during the intervention most likely shaped their understanding of weight management. For example, the intervention highlighted self-regulation and self-control skills such as monitoring behaviors or resisting temptations to maintain weight loss. It also emphasized the individuals’ role in lifestyle change. Therefore, it is not surprising that the WMs stressed these elements when they constructed successful weight management.

Finally, several studies have indicated that gendered pressures for women in maintaining a low body weight are greater than for men, and women are constructed as more size/weight-conscious and interested in health (Sloan et al., 2010, Tischner, 2013). In contrast, men are often construed as not worried about health (Sloan et al., 2010). Although gendered patterns in the construction of weight management discourses were not the main focus in this study, we noticed that men and women drew on the interpretative repertoires in similar ways and with a similar frequency to achieve the same discursive ends. However, the stigma of being a woman with obesity has been shown to be a significant burden on identity work. Women are expected to be normatively attractive, slim individuals, and there is substantially less flexibility in expectations concerning their bodily presentation compared to men (Gailey & Harjunen, 2019, Tischner, 2013). Therefore, even though we did not detect gendered differences in the participants’ talk patterns identified in this study, a more fine-grained analytical focus on gendered meaning-making might have shown how stigma and its influence on accountability for weight and weight management are linked to gender. Future work should include further investigations of these gender-related factors.

9. Conclusion and practical implications

By illuminating the impact of predominant discourses and the ways in which they inform acts of accounting for weight management, our findings provide indirect support for the idea that weight-loss interventions and health promotion campaigns should focus on general health and wellbeing instead of concentrating on morally polarized issues such as weight and body size. This reasoning is based on the notion that weight is viewed as representing an individual’s morality, and thus as reflecting their self and inner character, whereas wellbeing is seen as something one may obtain via lifestyle (Täuber et al., 2018). Consequently, the critique of weight is then perceived as more personal than the critique of lifestyle/wellbeing as, in the latter case, the criticism targets a person’s abilities, not the person’s self. On a continuum, weight stigma and moral debates influence the acceptance and appreciation of a person’s body and self (Malterud & Ulriksen, 2010; Salemonsen et al., 2018, 2020; Täuber et al., 2018). Individuals who see their bodies as a target of hatred and as less acceptable than other people’s bodies may thus perceive themselves as also morally flawed in other people’s eyes, and easily resort to solutions and behaviors (e.g., fad diets or extreme training) that present them as morally acceptable in the light of weight-centered predominant discourses (Guassora et al., 2014; Leach & Cidam, 2015; Salemonsen et al., 2018, 2020; Täuber et al., 2018). In contrast, employing non-judgmental discourses may lead to a positive and appreciative relationship with one’s body and a sense of worth, which may further motivate beneficial actions such as adopting health-promoting practices (ibid.).

Moreover, our results shed light on alternative ways of talking and thinking about weight management, which could be further utilized in developing strategies to avoid both stigma and the harmful, dominant sense-making surrounding weight and weight management. Viewing weight management as a permissive, flexible lifestyle based on one’s own desires and values instead of as a way to obtain the “ideal” body and social acceptance helps prevent shame and detrimental health behaviors. This is also supported by findings in the weight management literature that indicate that counter-moralizing dialogue and positive encouragement are associated with healthy lifestyle changes (Salemonsen et al., 2018, 2020; Täuber et al., 2018). Consequently, we suggest approaching weight management holistically through morally neutral language and with an emphasis on finding ways to help weight maintainers adopt a view on weight management that focuses on wellbeing and long-term lifestyle-oriented goals, instead of crash diets and immediate results based on rigid self-discipline.

Acknowledgments

We would like to thank all the interviewees for their participation and their contribution to this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author (AJ).

Additional information

Funding

This work was supported by the University of Helsinki Science Foundation, Juho Vainio Foundation, Raisio Research Foundation, and the Academy of Finland, grant number: 309157 & 335523.