Obesity and minority—changing meanings of big bodies among young Pakistani obesity patients in Norway

Abstract

Globally, paediatric obesity causes widespread concern, and the role of ethnicity is an important focus. Investigating how culture can mediate health-related behaviour through ideas about bodies, food and physical activity, while addressing a notion that the Pakistani community in Norway is particularly conservative and slow to change, this article points to the centrality of health as a cultural concept and the state of efficacy of public health promotion in contemporary Norwegian society. A Foucauldian perspective lends itself to this approach and the concepts of bio-power, bio-pedagogy and proper citizenship inform the analysis. Specifically, this article examines the obesity and weight loss experiences of Pakistani youth undergoing treatment for paediatric obesity in Norway and the ways in which they negotiate and position themselves amongst competing discourses of weight, health and weight loss.

Keywords:

• Paediatric obesity
• Adolescent
• Treatment
• Ethnicity
• Bio-pedagogy

Notes

1. Participants discussed are second-generation Pakistani immigrants to Norway. The term ‘Pakistani’ is used throughout this paper, in resonance with common parlance and rather than terms such as Norwegian-Pakistani, Pakistani-Norwegian or Norwegian, though the term might not accurately capture or be said to represent all aspects of the diversity of self-identifications within the community and age-bracket.

2. Viz:

the typologies used in the cluster analysis of ethnic minority families reproduce numerous problematic, racist discourses, not least through the factors identified as significant in relation to obesity. These include: faith, cultural foods (with traditional cooking seen as unhealthy), parenting styles, […] and a lack of stigma associated with fatness. The result is that the cause of obesity is situated in the particular intergenerational and intercorporeal relations identified as ‘other’ to white […] families. (Evans, Colls, & Hörschelmann, 2011)

3. This was the second incidence in which a Pakistani girl aired this concern. The first was Maimuna.

4. This particular point holds true, to a lesser extent, for many participants. As explained by Sadeq, ‘Bad things about being large? Well, you can get diseases and stuff. It was not the doctor who told me, I hear it a lot!’ Neumark-Sztainer et al. (1997) concluded that ‘overweight youth were more likely to perceive their health as only fair or poor and were more likely to express weight-specific concerns […]’.

5. The association between being Pakistani and being fat seems to be long-standing and widespread. This can be intimated in the Norwegian Gangster-film Izzat, set in the Pakistani community, where the narrator makes a pertinent comment to the effect of, ‘keep taking in those kebabs and you easily end up like Nusrat’ [the beloved Qawwal—of whom Mustapha said: ‘Sit and play on stage is all he did. So he grew big …’].

6. The power of this analogy is derived from the ways in which membership in a particular ethnic identity might lend itself to the rationalization of obesity:

It's the ‘hook’ on which the patient has hung all inadequacies, all dissatisfactions, all procrastinations and all unpleasant duties of social life, and he has come to depend on it not only as a reasonable escape from competition but as a protection from social responsibility. (Goffman, 1963, p. 10)