Understanding the lived experience of obesity in Australia: A qualitative study

Abstract

Obesity is a serious and complex public health issue in Australia with many health and social consequences for individuals and communities. Government, commercial and community attempts to ‘solve’ the ‘obesity epidemic’ have often failed to respond to the complex socio-cultural causes of obesity. The voices and experiences of obese individuals have also been noticeably missing from public debates and discussions about ways to respond to these socio-cultural factors. This study sought to address a key gap in the obesity literature by: providing in-depth qualitative information about the ways in which Australian obese adults experience, perceive and respond to their obesity and obesity discourses; describing how individual characteristics and socio-cultural factors combine to influence these experiences and responses; identifying factors that obese adults think may improve their health and social experiences; and examining the complexities of the lived experience of obesity in Australian society. The study was guided by grounded theory techniques, which take an iterative approach to data interpretation and analysis. Semi-structured telephone interviews were conducted with a targeted sample of 142 Australian adults with a self-reported body mass index of 30 kg/m2 or more. Thematic analysis and a constant comparative method were used to analyse the data. This thesis is comprised of five academic papers, which each reveal one aspect of the lived experience of obesity in Australia. The first phase of research (Paper One and Paper Two) explored how distinct individual characteristics, namely male gender and BMI, influence experiences of, and responses to, obesity. While there were clear differences between the ways in which subgroups conceptualised and responded to their obesity, all believed messages about personal responsibility for obesity and weight loss but found it difficult to act upon these messages. The second phase of research (Paper Three and Paper Four) examined how obese adults interact with different types of information about obesity, weight loss and health outcomes. These papers revealed that public health messages about obesity-related health risks can have undesirable health and social outcomes for some individuals. They also showed that the information provided by the weight loss industry resonated with the experiences of participants more than information provided by governmental and non-governmental public health agencies. The final phase of research (Paper Five) explored a social phenomenon that was common to the experiences of obese adults by investigating how weight-based stigma influenced the health and social experiences of obese adults. It revealed that stigma had negative health and social outcomes for participants, and that they received, felt and experienced different types of stigma in different ways. Collectively this body of work provides a more sophisticated understanding of a complex health and social issue. This research provides important information to help to tailor responses to obesity that more appropriately reflect the experiences and needs of obese adults.