Slim choices: young people’s experiences of individual responsibility for childhood obesity

ABSTRACT

When trying to understand childhood obesity, policymakers and healthcare professionals most often make use of behavioural sciences and biomedical perspectives. This approach assumes that fatness is unhealthy and caused by people making ‘bad choices’ about their diet and physical activity. Increasingly not only parents, but also children, are considered to be individually responsible for their weight, their health, and through that, for the ‘obesity epidemic’. Drawing on critical obesity/weight studies and practice theory, this paper challenges the individualistic and weight-based view of health, and the heuristic of ‘individual food choice’, and through that such a framing of childhood obesity. It does so by focusing on the experiences of young people medically identified as overweight, who are trying to lose weight. Looking at two domains of children’s lives, their family and peers, the paper demonstrates how young people experience and negotiate the individualized health advice, and what sort of consequences this has for their daily lives, and their mental and physical wellbeing. The article is based on observations of interactions between families and healthcare professionals, conversations with children and parents, as well as participant observation at youth summer weight loss camps, which were part of a larger ethnographic research project conducted in 2018–2019 in Poland. The paper concludes by proposing to reframe how we think about childhood obesity, and consider young people’s knowledge and lived experiences when re-designing policy interventions and wellbeing promotion programmes, that is, to work with, and not on, children.

KEYWORDS:

• Childhood obesity
• weight loss
• individual responsibility
• children
• health

Acknowledgements

I would like to thank everyone who helped to facilitate my research, including the organizers of programs I studied, and of course research participants. I would also like to thank Stanley Ulijaszek, Celia Plender and Marcin Serafin, as well as two anonymous reviewers, for taking the time to carefully read and comment on this article.

There is no financial interest or benefit that has arisen from the direct applications of this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. I do not use the term pejoratively here, but as a descriptive adjective.

2. The numbers provided are based on International Obesity Task Force calculations. According to WHO measurements, the number of 8-year-olds with overweight and obesity would be 30.7% (Fijałkowska et al., 2017), and 11-, 13- and 15-year-olds 21.3% (Mazur & Małkowska-Szkutnik, 2018). The calculations are based on different BMI percentile cut offs, demonstrating how deeply problematic calculating ‘childhood obesity’ in fact is.

3. Research was funded by the National Science Centre in Poland (2016/20/S/HS3/00310).

4. Public health system is of course not a unity, and although most initiatives focus on prevention, the programmes I studied were an exception. I should point out that their organizers, and many healthcare professionals I met, devoted a lot of their time, attention and energy to helping children, and often to fighting the rather hostile and obsolete public health system.

5. I do not know the origin of that particular picture that was used few times. Dietitians and food/health educators who used it told me that they found it online.

6. There is a difference between how psychologists and social scientists understand the concept of habits. For psychologists it is a matter of individual behaviour and a will and motivation to change it. While for social scientists it is more about its relationality and embeddedness in the social surroundings (see Lahire, 2011, p. 72).

Additional information

Funding

This work was supported by Narodowe Centrum Nauki [DEC-2016/20/S/H53/00310].