Teaching on body ideals in physical education: a lesson study in Swedish upper secondary school

ABSTRACT

‘Characteristics and consequences of different body ideals’ are a mandatory curriculum content in Swedish physical education (PE). Didactic strategies for teaching on body ideals are, however, scarce. In this paper, we introduce a classroom-based teaching unit on body ideals and present didactic possibilities and challenges of the unit. We used a lesson study approach, drawing on Nutbeam’s concept of health literacy. Our methodology involved focus group interviews with students and teachers, lesson observations and minutes of meetings which we analysed thematically. We found teaching on body ideals to be highly meaningful to students but their engagement differed based on personal backgrounds, school context and didactic design. The gendered nature of body ideals and a lack of embodied didactics constituted challenges, while the use of storied cases emerged as a potent didactic strategy. We conclude with practical recommendations for teaching on body ideals in PE.

KEYWORDS:

• Body ideal
• didactics
• health
• physical education
• teacher
• youth

Introduction

Cultural messages on ‘ideal’ bodies are pervasive. Young people are particularly receptive to preferred but often unrealistic ideals regarding body shape, weight, and size (Lodewyk & Sullivan, 2016). From a sociocultural perspective, body ideals constitute powerful social agents which influence individuals’ experiences of as well as attitudes and behaviours towards, their own bodies (i.e. body-self relationship¹). Although this relationship is moderated by other aspects (e.g. age, dispositions, gender norms), body ideals significantly impact adolescents’ body acceptance (Grosick, Talbert-Johnson, Myers, & Angelo, 2013; Holmqvist Gattario, Frisén, & Anderson-Fye, 2014; Walseth & Tidslevold, 2019). Young people who evaluate their bodies as deficient in relation to body ideals that they encounter in media, peer groups or family risk developing negative thoughts and feelings of dissatisfaction towards their own bodies (Grogan, 2017) The impact of body ideals on youth is reflected in international surveys, such as the Health Behaviour in School-aged Children (HBSC) study, which found body-dissatisfaction to be high. In Sweden, around 53% of 15-year-old girls and 43% of the same aged boys reported being discontent with their body size (Folkhälsomyndigheten, 2018, p. 110). While boys often report higher levels of body satisfaction than girls, concerns related to a muscular male body ideal are frequent (Grogan & Richard, 2002; Grosick et al., 2013). The HBSC study confirms the influence of gendered body norms on young people. For example, wished 25% of the participating 15-year-old boys to increase their weight, while a similar percentage of girls (24%) in this age wished to lose weight (Folkhälsomyndigheten, 2018, p. 111). Taken together, body dissatisfaction in young people is concerning, given that a negative body-self relationship has long-term well-being effects and encourages health-compromising behaviours such as disordered eating and lower levels of physical activity (Beltrán-Carrillo, Devís-Devís, & Peiró-Velert, 2018; Holmqvist Gattario et al., 2014).

Acknowledging the impact of body ideals on people’s health and wellbeing, the Swedish curriculum for PE identifies body ideals in training activities, outdoor life, and society as an educational focus in upper secondary school. In the curriculum, body ideals – alongside topics such as nutrition and drugs and doping – are core content (Skolverket, 2011). This content was given weight when health was added to the title of the school subject and it became ‘physical education and health’ (Idrott och hälsa) in 1994. While physical education in Sweden has a mandate to educate students both on the representations and health consequences of body ideals, research has found this topic to be challenging for teachers because of its personal and normative nature (Walseth & Tidslevold, 2019). PE teaching on body ideals may – intended or not – confirm sociocultural or religious ideals and result in stigmatisation of certain bodies (Azzarito, 2009). Further, few pedagogical concepts on how to best teach on body ideals exist (Azzarito, Simon, & Marttinen, 2016; Oliver & Kirk, 2016). Addressing this discrepancy between curriculum requirement and didactic practice in PE in Sweden, the aim of this article is twofold: First, to introduce a teaching unit on body ideals designed collaboratively with PE teachers and second, to discuss didactic possibilities and challenges PE teachers encountered in enacting the designed unit. In what follows, we first review previous research before we detail the body ideal unit and the lesson study methodology that we used. Building on the design description, we then discuss four central didactic challenges and possibilities of the body ideal unit. We close with reflections and recommendations for teaching body ideal content in PE.

Reviewing research on body ideals in PE

A review of scholarship concerning teaching on body ideals reveals only a handful of investigations of how PE teachers can deal with body ideals (Azzarito et al., 2016; Cox, Ullrich-French, Howe, & Cole, 2017). Oliver and Lalik (2004) for example examined the development and implementation of a curricular module focusing on girls’ bodies with the aim of helping adolescent girls identify the discourses that shape their lives and regulate their bodies. They suggested that supportive teacher-student relationships and having high task expectations are, amongst other factors, important when bodies and body ideals are the focus of pedagogical practice. Oliver’s later work with Kirk (2015, 2016) on an activist approach to physical education also provides useful strategies for challenging body norms. Notwithstanding these examples, there are few practically-oriented, research-based accounts of how to work with body ideals in PE. Indeed, in some of the literature, the challenges of teaching around body ideals appear more prominent than potential pedagogical strategies (e.g. Clark, 2018). In the following, we thus summarise the literature on body ideals in physical education by presenting four main aspects that can complicate PE teachers’ work with this content.

One challenge to effective teaching concerning body ideals is the personal and simultaneously cultural nature of ideals (Lodewyk & Sullivan, 2016; Walseth & Tidslevold, 2019). Research suggests that all young people are affected by cultural ideals, but that they are affected in different ways (Grosick et al., 2013). Not all young men will feel pressure to gain weight, for example, just as not all young women will feel pressure to lose it (Folkhälsomyndigheten, 2018). Further, despite concern that young people are exposed to potentially harmful body ideals in the media (Gray, MacIsaac, & Harvey, 2018), several scholars suggest that young people should not be seen simply as passive receivers of cultural ideals (Clark, 2018; Frisén & Holmqvist, 2010). Young people negotiate, resist, and shape ideals (Wiltshire, Lee, & Evans, 2017). Any education aimed at increasing young people’s abilities to deal with body ideals must account for personal and cultural dimensions, and acknowledge young people’s capacities to affect and be affected by body ideals.

Second and related, the intersection of body ideals with other discourses such as gender, race, social class and ethnicity (Rich, De Pian, & Francombe-Webb, 2015; Walseth & Tidslevold, 2019) make developing effective pedagogies challenging. Azzarito (2009) for example, has suggested that the kinds of female bodies that are constructed as healthy in American PE are not only slim but overwhelmingly ‘white’. Intersectionality means that challenging body discourses necessarily means re-thinking how we understand gender, ethnicity, and other broad issues that affect students’ lives. Given the increasingly heterogeneous nature of schools worldwide (Barker, 2019), PE teachers need to have a sensitivity for these issues, navigate intersecting discourses concerning body ideals, and be mindful of the potential consequences that changes could have for students.

Research has also suggested that a narrow scope of health definitions typically used within physical education has the potential to hinder teachers as they work with body ideals. When PE teachers adopt a ‘healthist’ perspective (Clark, 2018; Welch & Wright, 2011) and equate health with fitness, they tend to reinforce pathogenic views of bodies (Harris, Cale, Duncombe, & Musson, 2018; Quennerstedt, 2008; Skolinspektionen, 2010). Consequently, students risk learning implicitly that lean, fit bodies are healthy, good bodies (Walseth & Tidslevold, 2019; Wrench & Garrett, 2014). Cliff and Wright (2010) provide an illustrative case study, demonstrating how one PE teacher and her students at an all-girls school continued to focus on getting healthy as avoiding becoming overweight, despite eating disorders presenting a greater risk in that particular context. If teachers are to create conditions for students to negotiate body ideals, they need to adopt reflective and critical approaches to health (Harris et al., 2018).

Finally, some research has shown that teachers are aware of the risks of ‘getting it wrong’ (Johnson, Gray, & Horrell, 2013). Long lasting body dissatisfaction, disorders, such as anorexia nervosa, and dropping out of physical activity can result from unreflective didactic approaches (Beltrán-Carrillo et al., 2018; Cliff & Wright, 2010). In this sense, it is unsurprising that some PE teachers avoid teaching on body ideals. The irony is that students learn about bodies in PE lessons without teachers explicitly addressing the topic (Johnson et al., 2013; Oliver & Lalik, 2004). To counter this problem, some scholars suggest that PE teachers need content-specific didactic strategies (Azzarito et al., 2016; Leahy, Burrows, McCuaig, Wright, & Penney, 2016).

In sum, the body ideal curriculum is important for student health and wellbeing but is complex for teachers to manage. Indeed there are a variety of personal and cultural factors that affect teachers’ work and these factors tend to be dynamic and shifting. Consequently, well-grounded didactic innovation is needed for this PE content.

Methodology

We address our first research aim by detailing how the author team in collaboration with in-service PE teachers designed and realised a teaching unit on body ideals in two upper secondary schools. To guide this process, we applied a lesson study (LS) approach. LS originated in Japan as a form of teacher professional development. Today, it is an established bottom-up curriculum development strategy that allows teachers to progressively improve teaching and address didactic problems (Dudley, 2014). In practice, LS typically involves a group of teachers who first define specific learning goals for the lesson(s) they aim to improve and consult literature for recommendations or involve researchers for additional perspectives (Hiebert, Gallimore, & Stigler, 2002). In a next step, the lessons(s) will be designed and then enacted by a teacher of the group while others observe. Based on a joint evaluation, the LS group will refine the design before another teacher will test it in a next cycle which is again evaluated and refined. This process continues until the group deems the lesson(s) ready for usage (Hiebert et al., 2002).

In weaving together action and research, LS can feature as ‘a highly specified form of classroom action research’ (Dudley, 2014, p. 2) that aims to enhance pedagogical practice, in-service teachers’ professional knowledge, and students’ learning (Dudley, 2015; Soto Gómez, Serván Núñez, Trapero, & Pérez Gómez, 2019). For our aim, the LS approach was well suited and we used its cyclical and iterative inquiry principles that include documentation (data collection) and evaluation (analysis) to structure our research (Dudley, 2015). However, we also move beyond classic LS, as we not only consulted but worked alongside teachers in planning, enacting, evaluating and refining the lesson design. In so doing, the researchers served as ‘more knowledgeable others’ (Vygotsky, 1978), who facilitated deeper understanding of the body ideal content, stimulated reflection on teaching and learning, and assured that data collection and usage was systematically weaved into the study.

The context and participants

Over the course of one year, the authors collaborated closely with four in-service PE teachers from two upper-secondary schools located in the south-west of Sweden and one pre-service teacher. While the schools became involved primarily because of their PE teachers’ interest in developing teaching on body ideals, the schools also represented cases of contrasting student populations and educational environment. Public school A offered pre-vocational educational schemes and Swedish integration classes for newly arrived students. This school had around 400 students, class sizes varied between 15 and 30 students and the average admission score for the school was 166 of 340 possible points. The PE teachers involved were a female PE-teacher education student of non-Swedish ethnic background doing her internship training at school A, and a certified female PE-teacher of Swedish ethnic background with eight years of teaching experience. The eight girls and seven boys in the participating class in school A were 16- to 17-years of age and they followed the educational scheme in preparation for working in the restaurant and hospitality industry. Of the 15 students, four girls and two boys had non-Swedish ethnic backgrounds. Private school B in contrast had a strong academic profile and offered prestigious natural science, economics and social science programs. The average admission score for the school was 312 of 340 possible points. The school had over 500 students enrolled, the regular class size being 30 students. The three classes involved in the LS, were an economy class with 21 girls; a natural science class with 17 boys; and an economy class with 18 girls. Students in these classes were also between 16- and 17-years of age, and had mainly Swedish background (one class had 2 students with non-Swedish ethnic background, one class 3, and one none). The three PE-teachers involved in the LS at school B were all certified and had at least seven years of teaching experience. They all had Swedish ethnic background.

The lesson study on body ideals

Upon establishing the collaboration, the LS team of teachers and researchers iteratively moved from the conception of learning goals for a unit on body ideals, to jointly planning learning aims and teaching activities for four lessons. In a first cycle, the unit was enacted and evaluated with the two PE teachers at school A. Following evaluation, we planned a second cycle with the three PE teachers from school B. To better fit their teaching plan, the teachers condensed the unit to three lessons which each of them enacted in their respective classes. During this process, we used a mix of qualitative methods to investigate teaching and learning on body ideals. Figure 1 provides an overview of the cyclical processing of the LS at the two schools. We attend to key elements of unit design, enactment and evaluation in the following.

Figure 1. Overview of the lesson study on body ideals.

Designing a teaching unit on body ideals

For the actual design of the unit, we drew on Nutbeam’s (2008) conception of health literacy, largely because of its focus on education. Nutbeam (2008) proposed an asset model whereby education can be used to develop individuals’ capacity to understand, critically reflect and act upon health-related knowledge. Considering health literacy as an ‘asset’ reflects a social view of health, which incorporates education, learning and critical decision making as ways of increasing health status (Smith, Dixon, Trevena, Nutbeam, & McCaffery, 2009). This view aligns with salutogenic conceptualisations of health and wellbeing that reflect the Swedish PE curriculum (Skolverket, 2011) and which have gained prominence in health and physical education contexts in the last decade (McCuaig, Quennerstedt, & Macdonald, 2013).

Nutbeam (2000) conceptualised three different types of health literacy, organising the types into a three-level, system (Nutbeam, 2008). The first level is ‘functional’ health literacy, which is the ability to function in everyday situations using basic skills in reading and writing. This is considered to be the conventional, narrow characterisation of health literacy (Nutbeam, 2000). The second level is ‘interactive’ health literacy, which focuses on more advanced cognitive and social skills (Nutbeam, 2000). At this level, communication skills are used to extract and derive information to act independently on that knowledge. The third level of Nutbeam’s (2000) model is ‘critical’ health literacy, which is orientated toward ‘supporting effective social and political action, as well as individual action’ (p. 265). Here, individuals and communities acquire the ability to critically analyse health related information in order to exert control over life events (Sykes & Wills, 2018). Based on Nutbeam’s (2008) ternary conception of health literacy, the LS team developed the teaching unit to address the PE curriculum content of ‘consequences of different body ideals’ (Skolverket, 2011). The learning aims and teaching activities of each lesson were designed to create conditions for students to progress from functional towards interactive and critical body ideal literacy. In addition, we created a short survey to evaluate students’ pre- and post-unit understanding of key concepts in the area of body ideals (functional literacy test). The following Table 1 gives an overview of the unit.

Table 1. Overview of the teaching unit on body ideals.

Lesson	Learning aim	Teaching activity	Material
Lesson 1	Create connections to the topic in relation to students’ prior knowledge on body ideals	Functional literacy test Focus group discussion on key concepts	Tests Word cards with explanations Question guide
Lesson 2	Identify and describe stereotypical body ideals and consequences	Film clip and guided discussion Group work with cases Film clip with guided reflection Writing of own case (homework)	Film Cases Word cards Working guide Homework instructions
Lesson 3	Develop strategies to create positive body attitude	Pair discussion of key concepts Film clip with guided reflection Group presentations and discussion of strategies Writing of own case (homework)	Film Cases Word cards Working guide Homework instructions
Lesson 4	Identify conditions for positive body attitudes	Functional literacy test Focus group discussion	Tests Question guide

Enacting the teaching unit

As outlined, the unit was first enacted in a class at school A.

Lesson one. In the first lesson, teachers divided the students in focus groups of three to four. All groups obtained eight cards, each with a word on the front side and its explanation on the rear.² The words included concepts which the Swedish PE curriculum highlights as key for the content (Skolverket, 2011), namely body ideals, stereotype female/male, as well as concepts researchers and teachers identified as meaningful for critical health literacy in students, namely to have or to be a body, weight stigmatisation, healthism, fat phobia. The cards served as guides and students were asked to first discuss if they had heard the word, then to look at the definition, and finally to discuss different contexts in which the word could be used. In school A these discussions were led by a teacher or researcher and voice recorded.

Lesson two. The aim of the second lesson was to identify and describe stereotypical body ideals and their consequences. After jointly summing up the previous lesson and the meaning of the word stereotype, a short film clip³ exemplified how social media affects development of body ideals in youth. We then used short storied cases which we had created using fictive writing to portray various experiences young people can make with body ideals. To create these cases, we drew on LS team members’ personal experiences or experiences with students. The cases aimed to facilitate discussion and reflection on how different ideals arise and how they affect thoughts and behaviour. To increase interpretive leeway and stimulate discussion on the gendered dimension of body ideals, we intentionally used the Swedish gender neutral pronoun ‘hen’ [they] and names that could suit both girls and boys (e.g. Billie). To introduce the students to the task, one exemplary case was discussed with the whole class. In groups of three to four, the students thereafter discussed different cases and were asked to note their thoughts. In addition to the word cards from the first lesson, we supported the group discussions with guided questions such as: How do you think the person experiences their situation? What role do you think the media, teachers, peers, parents, culture, have for the person’s situation? At the end of the lesson, students started writing a real or a fictive case on the topic of body ideals which was to be completed as homework. Students’ one-page-long cases needed to contain a stereotypical body ideal, use key concepts introduced during the lessons and contain ideas how the person in the case could counteract the stereotypical notion. We closed the lesson with watching and reflecting with the class on a film clip³ of an interview with the child and youth psychologist Jenny Klefbom.

Lesson three. To recap earlier content, we started this lesson with students discussing in pairs the key concepts that were introduced in the previous lesson. Next, we used another film section entitled ‘Is my body not good enough?’ to introduce the development of strategies to create healthy body-self relationship as a learning aim for this lesson. Then, students were split in newly composed groups and were asked to present the cases discussed in the previous lesson. Supportive questions were: (1) What body ideal is guiding the main character in your case? (2) How do the ideals affect the main character? (3) Does gender make any difference? The groups were then to develop strategies to create positive body-self relationship. Questions to support the learning activity were, for example: (1) How could the main character handle their situation? (2) How can parents, peers, school, media and so forth, contribute to the person’s healthy and positive body attitudes? (3) How would the main character feel if the body ideal would look different? As a closing activity the groups were asked to reflect on how realistic the ideals are for young people and what they think it takes for youth to create healthy and positive body-self relationships. At the end of the lesson, students were given time to continue the creation of their own cases, a homework for the fourth and final lesson.

Lesson four. The last lesson aimed at advancing students’ capacity for a positive body-self relationship and to evaluate their learning on body ideals. A central activity during this lesson were discussions in focus groups with 5–6 students guided by LS team members. These group discussions aimed to further strengthen students’ interactive and critical literacy in identifying conditions for positive body attitudes. We used an interview guide to ensure that the following four themes were covered in the different groups: (1) Dominant body ideals, including questions such as: ‘Which body ideal do you think influences you as a person; how do you think these ideals affect your view of your body?’ (2) The influence of contexts, covering questions such as: ‘In which contexts do you feel most at home in your body (e.g. at home, among friends, in the training room, at school); Is there any context where you experience negative body attitude; Can you give examples of strategies to avoid/react to such contexts?’ (3) The impact of physical education, including questions such as: ‘What role does physical education play in relation to body stereotypes and how does it affect your feeling of joy in your body? Can you give examples of situations?’ Lastly, the theme (4) New strategies included questions like: ‘What new strategies do you want to try out to develop, or strengthen a positive body vision? What can help you to realize these strategies and are there any obstacles to it?’. We ended the lesson with a whole class evaluation of the teaching unit in which we asked the students to share their experiences of the unit.

Upon completion of the unit at school A, we reflected in the LS team on teachers’ enactment and needs for adjustment in design. Based on the teachers’ feedback, we introduced two more key concepts in lesson 1, namely body positivism and self-esteem. The inclusion of these words aimed at broadening students’ functional literacy and strengthening salutogenic dimensions. The unit was condensed to three lessons to better meet teaching realities at school B. This involved for example that students watched the introductory video clip on body ideals as homework prior to the unit. Otherwise, the key activities were maintained (see Tab. 1). A final adjustment was that at school B, the three PE teachers conducted the unit on body ideals without involvement of the author team which meant that the focus groups were replaced by student discussions. The second cycle closed as the first with a joint evaluation in the LS team.

Data collection and analysis

In line with the LS approach (Dudley, 2015), data collection and analysis was an integrated part of the collaborative curriculum inquiry on body ideals. We used a combination of qualitative procedures to observe practice as it happened in situ and to reflect on teaching. For the purpose of this article, we used: (a) in-lesson focus group discussions with students (n = 6), (b) lesson observations (n = 2), and (c) post-unit teacher interviews (n = 2) to document the enactment of the unit and teachers’ and students’ experiences with it. In addition, we kept minutes of our meetings in the LS group (n = 11).

To inform PE teachers and students about implications of their involvement in the collaboration and ethical safeguarding, we held information meetings initially with teachers and then with the classes with which the teachers’ chose to enact the unit. At these meetings, we distributed a written information form and consent form. The information form outlined the purpose of developing and researching teaching on body ideals, the duration and content of the unit, as well as the voluntary nature of participation and the procedures that we would take to safely store and anonymize data. In the consent form, students were able to indicate if they did not want their data/learning material to be used for research. In addition to general consent, participating teachers and students were asked at the outset of interview occasions if they agreed to being recorded.

Data collection

We used focus group interviewing (Krueger & Casey, 2014) to create a supportive environment that could help students to voice their thoughts on a sensitive topic and to balance age and power differences between researchers and participants. The focus group interviews were integrated into teaching activities and the key word cards and cases (see Tab. 1) served as cues to promote discussion. These materials were an integrated part of the interview guide that we used to assure the same themes were covered in the different groups. The focus groups consisted of 4–5 students and one or two LS study team members who guided the discussion. In total, we conducted six focus group interviews at school A, three in lesson one and three in lesson four. The interviews were recorded and lasted between 30 and 35 min.

Lesson observation is a common data collection mode in classroom research as it allows to capture both what is said and done and to document how practice unfolds in real-life contexts (Öhman & Quennerstedt, 2012). To document the enactment of the unit, we took field notes during lesson two and three at school A by assigning to one of us the role of participant observer. Field notes were afterwards extended into lesson summaries documenting lesson structure, and teachers’ and students’ interaction with the unit.

Post-unit semi-structured interviews with the involved teachers was a method we used to gain insight into teachers’ experiences with the unit and their reflections on challenges and needs for adjustment. We used an interview guide that explored the following themes through open-ended questions and probing: teachers’ experiences of the developed body ideal curriculum, didactic challenges encountered and adaptations made, students’ interaction with the curriculum, and suggestions for revision. Given the existing collaboration, we attempted to maintain a non-hierarchical relationship with the teachers and to create space for their reflections and additional themes that they voiced. In total, we conducted two post-unit interviews, one with the in-service teacher at school A lasting 30 min and one with the three in-service teachers at school B, lasting 90 min. Both interviews were transcribed. In addition, we kept minutes of the meetings we held in the LS group (n = 11) to document the development of the LS and our reflections on the didactic questions.

Data analysis

To identify pedagogical challenges and possibilities teachers encountered, we used inductive and deductive procedures (Sparkes & Smith, 2014). In meetings before, during, and after enactment of the unit and data collection, we reflected on the didactic challenges and possibilities of the body ideal curriculum. Through this process, four themes emerged: (a) differences in students’ engagement, (b) gendered nature of body ideals, (c) practice theory divide, and (d) translation of body ideals in cases of generalised others. In a deductive step, Astrid and Heléne analysed the data using these four themes. Both worked first individually through the data, extracting relevant quotes from the material into each theme and writing their interpretations next to the quote. To align this process, we used the same table template in Word, in which we compiled quotes and interpretation under each of the four themes. During this process, Astrid and Heléne met repeatedly to discuss quotes and interpretations, as well as possible needs for adjustment in the initial themes. The continuous dialog helped us to identify key quotes for didactic issues and to critically question our interpretations. Next, we composed our findings in writing which we then sent back and forth in the author team for further discussion and critical questioning. The result of this process are presented below.

Discussion of didactic possibilities and challenges

Differences in students’ engagement with the unit

Students’ engagement varied greatly at both schools. Some stated that the topic was close to their heart and passionately discussed body ideals and their impact. Other students however remained relatively silent. We found a combination of reasons for differences in engagement, including students’ personal backgrounds and levels of Swedish language, their health situation, the school culture, as well as the design of the teaching and learning activities.

In school A, a considerable number of students had Swedish as their second language. Possibly due to the largely text- and language-based nature of the teaching activities, students with limited Swedish-language skills tended to remain silent or used strategies of avoidance, such as passing on the task to take notes for the group to other students, and avoiding eye-contact with the teacher/researcher who posed questions to the students in the focus group discussions. In school B in contrast, students’ drive to perform and achieve high grades was strong, which raised questions for teachers about students’ motives for engagement. A teacher commented in the post-unit interview:

It was sometimes difficult to know if students were just saying what they believed I as teacher wanted to hear or if they were really sharing their own opinion. This is also because they are so grade focused.

While the PE teachers who enacted the lesson reported that students generally engaged in lively discussions and especially liked the storied cases about young peoples’ experiences with body ideals, they also doubted if the teaching activities were sufficiently advanced to challenge students’ intellectually. One teacher reflected on the changes she felt necessary to involve her students:

The unit definitely would need upscaling to meet the level of the students and to challenge them more. It has to be more creative, lead to deeper discussions, and require more reflection from their side. (Post-unit interview teachers school B).

Students’ experiences with negative health consequences of body ideals also influenced their engagement. In school B, one teacher knew two girls in her class who had/were currently suffering from anorexia. The teacher asked each student prior to the unit how they felt about participation. Both stated it would be ‘too difficult’ and decided not to participate although one welcomed the topic being addressed in PE. While these examples highlight the sensitive nature of the curriculum content (Beltrán-Carrillo et al., 2018; Johnson et al., 2013), experience with eating disorders was not always a barrier to participation. For Linda, a student at school A, the unit provided a space to share parts of her own experience:

Linda:

Today, it does not affect me at all, but it used to affect me very much the whole thing about body ideals and so. But today, I don’t bother.

Interviewer:

What was it that has brought about this change?

Linda:

I went through the worst period in my life and then I learnt that body ideals play no role for me – as long as I am healthy.

Taken together, the examples highlight how young peoples’ body ideals intersect with other categories of social difference, such as non-Swedish/Swedish ethnic-backgrounds, and academic background (Walseth & Tidslevold, 2019) as well as health state, and how this intersection creates didactic challenges due to the diverse learners’ needs and backgrounds, but also possibilities for empowerment of young people.

The gendered nature of body ideals

Our data illustrate that boys and girls engaged with the content differently but differences were not clear cut, as exemplified in the post-unit teacher interview at school B:

Interviewer:

Did you see any difference in how girls and boys engaged with the unit?

Teacher 1:

No, not directly.

Teacher 2:

No, not spontaneously [pausing] But, more girls watched the film clip at home. I think the boys watched it because it was a homework and many girls watched it because they wanted to.

In the same interview, teacher 1 commented that ‘the cases worked well and led to discussions, boys and girls could identify’, which is in line with observations at school A:

I [participant observer] ask the two students who they are going to write about [in their case]. The boy says shyly, ‘maybe myself’. The girl says ‘maybe my little sister … She thinks that she is fat’.

These examples illustrate how body ideal issues resonated with boys and girls making teaching on the topic relevant for both. While teachers identified gender differences regarding engagement with the content, these were not consistent. Adopting an intersectional perspective (Azzarito, 2009), we interpret engagement with body ideals to relate to students’ identity, context, and didactic design rather than determined solely by gender.

A key learning objective of the unit was to develop young people’s critical health literacy (Nutbeam, 2008). Our data demonstrates how students deconstructed and challenged gendered body ideals, but also reaffirmed them. Tamara, for example, drew on the prior introduced concept ‘stereotype’ to uncover gendered body norms.

If you see a fat woman, then you think this woman is lazy even if she tries to train a lot. These are stereotypes. (Observation lesson 2, school A)

Another girl demonstrated interactive health literacy regarding a YouTube clip¹ we used to discuss consequences of body ideals.

Sara [teacher] stops clip and asks what do you think? One girl says that the girls on the clip are talking about body image but they are actually wearing makeup and taking care of their image. She finds that a little bit strange. (Observation lesson 3, school A)

However, students also drew on heteronormative gender discourses in discussions on body ideals. This became particularly obvious with the storied cases.

Girl: ‘OK, next question’. Boy ‘is this about a boy or a girl?’ Probably a boy because boys go in strength training more than girls. With ice skating, it is more 50/50. Then the group discusses people that they know who do these activities. (Observation lesson 3, school A)

The gender ambiguity of the cases created disruption and resistance. While the teachers at school A did not experience the gender neutral cases as problematic, teachers at school B discussed consequences on students’ focus and learning.

Teacher 1:

It does not need to be ‘hen’ [Swedish gender neutral pronoun], it can be a boy or a girl in some of the cases … Because if it is ‘hen’ then it is so obvious … then the focus is on [the gender aspect] – I think it is better to create a strong and good narrative that one can discuss.

Our findings stress the intricate connection between body ideals and gender stereotypes that on the one side make body ideals a potent teaching content for young people’s health literacy and identity development (Frisén & Holmqvist, 2010; Oliver & Kirk, 2015). On the other side, this connection complicates didactic design and makes thorough and practice-proved pedagogical strategies necessary.

Practice theory divide

The teaching on body ideals was in this LS enacted through classroom-based lessons. An important didactic element was the introduction of key concepts and their meanings in the first lesson before letting students use these concepts in the next lesson to discuss the cases (see Tab. 1). The following quote illustrates how the concepts helped students to develop interactive health literacy: ‘I feel that body ideal fits in here – they comment [in the case] on fat people, and even about hair under the arms so that has to do with body ideals.’ In another discussion a student used the concept having or being body to explain body-dissatisfaction ‘Everyone has one body but maybe wants another body’.

While the key concepts allowed students to communicate their thoughts, the scientific language complicated usage for some. In an attempt to make sense of the concept fat phobia, a group of students agreed that phobia involves fear but could not remember its exact meaning: ‘Can this also mean being scared of other people who are fat?’ Further, some students had developed a feeling for the meaning of the word but struggled to explain it. One girl suggested that the case that was discussed could be about healthism in action. She set out to explain the concept but then gave up: ‘I don’t know’. No one else in the group tried to explain and the group moved on to the next question.

Students’ repeated use of the concepts in different contexts also enabled them to identify the mechanisms around body ideals. One student expressed her learning:

Since we have discussed this, I have started to think about who has a body and who is a body. I have noticed that some people have not yet arrived in their body, they exhibit uncertainty. (Focus group interview school A)

Despite these learning outcomes, the participating teacher at school A experienced that ‘the students were left to their own imagination’ with regard to concrete strategies for positive body-self relationship. A student from the same school commented that: ‘I missed positive models in the cases’. To shed more light on salutogenic dimensions in the second teaching unit at school B, body positivism and self-esteem were included as new key concepts. Teachers at school B further suggested to ‘involve students and ask which other words would be relevant for them’.

Overall, the results emphasise the advantage of basing the unit on theoretical concepts to develop students’ functional health literacy (Nutbeam, 2000). However, there is a didactic challenge to enable students to apply their theoretical knowledge in practical situations (for example, when using social media, or going to the pool or beach) which a holistic teaching approach would require (Harris et al., 2018).

Translation of body ideals in cases of generalised others

Teachers participating in the LS agreed that body ideals was a sensitive content to teach. To handle this sensitivity, the LS team developed case descriptions of young peoples’ experiences with body ideals. These third person narratives were intended to enable students to discuss different body ideals and their effects without directly focusing on the students’ own embodiment and possible (non-)conformity to sociocultural ideals.

In a group discussion on the storied case of Billie, who decided to start cross-fit as a consequence of being teased by peers for being clumsy and not well trained, students at school A analysed influencing factors and identified strategies Billie could use. The group believed that it was the rest of the class that established the ideal. One proposed strategy was to ‘find alternative options for the locker room’, another was that ‘Billie’s parents should be able to help with the diet.’ One student suggested that ‘Billie could start following fitness guys for motivation’. Another hinted that ‘it could also have negative consequences for Billie’. While the students identified several strategies, the group thought Billie wanted to be well-trained and thus focused mostly on how s/he could live up to the ideal rather than questioning it. Another group was more critical to existing ideals and their strategies involved resistance to outside norms: ‘Billie should ignore those who make comments’. On the question of who created the ideal, they named the people around the protagonist and Simon said ‘It is the strong people who draw the others into their thinking’.

Besides fostering interactive health literacy in some, the case stories also enabled students to draw connections to, and give examples from, their own life. Discussing a case that focused on body height one group spun off to describe how experiences of maturation in adolescence could differ and how this could become a problem.

Charlie:

15 to 16 is an age where this is a problem. Not all develop at the same time. For example my sister was taller and sturdier than others in her class.

Kim:

At this age, you have understood that there are norms. But you have not yet started to accept your own body. This can come later.

In another group at school A, students also shared own experiences with negative body-self relationship by listing: ‘feeling bad, start exercising, being angry on your body, vicious circle’.

Taken together, our data show that the students developed more sophisticated ways of describing the causes and consequences of different ideals, and were able to put words on previous thoughts but rarely changed their ways of describing ideals. To educate students in taking action to transform existing ideal towards healthy body self-relationship, the unit needs reworking. A teacher in school B suggested that the LS team ‘need[s] to discuss how teaching can make students take responsibility for creating a change in the class or other groups they belong to.’

Concluding thoughts

Building on a call for practice-based research on how PE teachers can deal with body ideals (Azzarito et al., 2016; Cox et al., 2017), the aims of this articles were to both introduce a collaboratively designed teaching unit on body ideals and to discuss didactic possibilities and challenges encountered in its enactment.

The lesson study approach, which involved close and extended collaboration between researchers and PE teachers proved valuable throughout the different study phases as it brought different expertise to work together (Dudley, 2014; Hiebert et al., 2002). We experienced that this diversity in knowledge enriched and strengthened the didactic design of the unit, its enactment in real life classroom, and the generation of insights on teaching of body ideals. However, teachers’ and researchers’ different professional realities also need to be acknowledged. To maintain collaboration over time, researchers needed for example, to adjust to school schedules, teachers needed trust to open their classrooms for research, and continued mutual commitment was important. LS’s iterative design enabled critical and constructive development of didactics for the specific teaching content (Soto Gómez et al., 2019). Moreover, the involvement of two different schools allowed us to enact the unit with diverse learners and to observe the design in contrasted contexts which increases trustworthiness of LS findings (Dudley, 2014). To further develop the unit, we suggest increasing student involvement in the design which may strengthen salutogenic and critical elements of the unit (Mong & Standal, 2019). Involvement could mean that prior to the unit students suggest topics and questions they wish to be addressed or that students contribute with material such as pictures, video clips, slogans, which they encounter in media.

Nutbeam’s (2000, 2008) conception of health literacy allowed us to formulate progressing learning aims and to design teaching activities that specifically targeted functional, interactive, and critical health literacy. While teachers can take students’ functional literacy for granted and easily miss to include distinct learning activities to develop it, we found that the teaching activities that focused on introducing content-specific key concepts were both meaningful for students’ health literacy and positively evaluated by students at unit end. Students made also use of interactive health literacy. Critical health literacy however was difficult to realise in the presented LS. We relate this limitation to our didactic design which focused on theoretical knowledge and critical thinking and lacked in embodied activist didactics through which students can experience and reflect on bodily experience of ‘having’ or ‘being body’, a divide PE scholars have identified common in health didactics (Mong & Standal, 2019). Further, the classroom-based format of teaching complicates teaching for critical health literacy as defined by Nutbeam (2000). Our findings highlight that conceptualising health literacy in three levels can be misleading. For example, students at times demonstrated interactive health literacy but struggled with functional health literacy. When drawing on Nutbeam’s (2000) conception for didactic design, it is important to remember that learning does not necessarily progress step-wise from functional to interactive to critical health literacy.

While earlier research on body ideals in PE mainly stressed gender and ethnic identity (Azzarito, 2009; Oliver & Kirk, 2016), we would suggest that students’ health experiences and local school cultures also require attention in didactic design. The LS further suggests that body ideals are not only a sensitive, but also a complex content to teach and to adapt to todays’ diverse classrooms (Barker, 2019). Consequently, we consider key that PE teacher education provides students with content-specific pedagogical competencies, a safe space to reflect on personal body ideals and the ability to act on stereotypical discourses as they arise in life lessons. To advance PE teachers’ professional development in this and other areas of the curriculum, LS and similar forms of classroom action research (Soto Gómez et al., 2019) should be extended to PE teacher education. These approaches hold potential to transform PE teacher education by connecting research and practitioner knowledge and helping PE teachers develop professional craftsmanship (Hiebert et al., 2002)

The use of storied cases turned out being a useful didactic tool. It facilitated discussion on diverse representations of body ideals and allowed the students to expand their understandings of body ideals. The design helped, as Mong and Standal (2019) and Azzarito et al. (2016) have put forward, the students to be critical and reflective. Despite the narratives’ potential to empower students, we need to acknowledge our focus on negative cases and dilemmas rather than positive examples and stories. While we recognise connections between our problem-focused didactics and the predominantly critical research on body ideals in PE, we see a need to better balance pathogenic and salutogenic aspects in the teaching activities in order to more effectively promote health capacities amongst young people.

Recommendations

Based on the results, we propose the following general recommendations for teaching on body ideals in PE:

• Body ideals are a PE teaching content which students and teachers experience as highly meaningful. National Agencies of Education and schools should assure its integration in the planned and the enacted curriculum.

• The sensitivity of the content requires relationships of trust between teachers and students as well as among students. Teachers should pay attention to suitable group formations and scheduling in the school year.

• The intersectional nature of body ideals and the diversity of today’s classrooms necessitates flexible and embodied teaching strategies that allow for progression.

• Teachers need to actively engage with and be prepared to challenge students in order to question reproduction of normative body ideals and to create conditions for positive body-self relationships.

• Teaching of body ideals requires PE teachers to critically reflect over the ideals that underpin their own embodiment, professional identity and practice. Teaching for critical health literacy cannot be limited to a unit on body ideals, but needs a long-term whole school strategy.

Acknowledgements

We thank the teachers and students who participated in the study. A special thanks to Sara Sadik for her involvement in the lesson study at school A. We acknowledge the Department of Food, and Nutrition and Sport Science, University of Gothenburg, Sweden for supporting this work and the SCoPE research group for critical reading of an early draft of this paper. For their insightful comments, we thank the two anonymous reviewers.

Disclosure statement

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

Additional information

Notes on contributors

Astrid Schubring

Astrid Schubring is associate professor at the Department of Food and Nutrition, and Sport Science at the University of Gothenburg, Sweden. Astrid’s teaching and research revolve around sociological and educational aspects of health, embodiment and biography in sport and physical education settings.

Heléne Bergentoft

Heléne Bergentoft is senior lecturer at the Department of Food and Nutrition, and Sport Science University of Gothenburg. Her research focuses on aspects of learning in physical education and practice based research.

Dean Barker

Dean Barker is associate professor at the School of Health Sciences, Örebro University, Sweden. His research focuses on aspects of learning in physical education and the articulations of theory and practice.

Notes

1 We use the term body-self relationship to capture the sociological and phenomenological understanding of body and self as both subjective and lived as well as sociocultural and historical (Sparkes, 1996).

2 The teaching material can be made available on request.

3 Miss Successful (original ‘MissLyckad’), is a Swedish web series that was released in 2018. The series aimed at making young people feel positive about themselves and to promote this ideal via social media.