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Learning to manage : a substantive grounded theory of large bodied women's interactions with medical professionals


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Williams, DM 2012 , 'Learning to manage : a substantive grounded theory of large bodied women's interactions with medical professionals', PhD thesis, University of Tasmania.

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A qualitative research approach using constructivist grounded theory methodology was
used to further understanding and generate dialogue about the experiences of overweight
and obese female healthcare consumers. Participants included 22 women, all of whom
identified as large bodied. Data was collected from two major sources: semi structured
interviews with participants and current literature. The value of this study lies in the
documentation of a substantive theory which elucidates the issues facing overweight and
obese female healthcare consumers, and the strategies they employ to manage these issues.
The substantive grounded theory of ‘Learning to Manage’ details what large bodied
women viewed as the salient concerns that face them as healthcare consumers, and how
they resolve these issues. They identified their interactions with medical practitioners,
specifically with general practitioners (GPs) as the most challenging. The women in this
study felt extremely vulnerable when they became healthcare consumers. They believed
they were negatively branded by their body size which worked to create a one dimensional
identity – that of an overweight or obese patient. Once they were labelled their weight
became the central focus of the consultation, often obscuring the reason they had sought
help. Consequently, the shared social problem of women was identified as ‘being defined’.
Feeling like ‘just a fat body’ (as described by participants) was common to all participants,
and left women battling feelings of invisibility, shame, guilt, responsibility and fear. For
large bodied female patients, being defined by their size was something which had
significant ramifications both on the women themselves and on the clinical interaction.
Being defined was comprised of three categories – ‘feeling invisible’, ‘expecting the
worst’ and ‘feeling judged’.
In order to manage or counteract the issues and feelings associated with ‘being defined’
participants developed a range of strategies which have been conceptualised as the basic
social psychological process ‘Learning to Manage’. Women believed that the weight
commentary from medical professionals was usually inappropriate and frequently hurtful;
however they felt they had limited recourse because of the power held by medical
professionals. Subsequently they learnt to manage their interactions with medical
professionals in ways which blocked out or minimised the consequences of embodying the identity of an obese patient without having to overtly challenge their doctor. They believed
that if they openly challenged their doctor they risked further sullying their already marked
identity. Logically women knew that they could not be refused what they needed, however
they felt that it was easier to manage from an emotional perspective if they engaged in
strategies which pretended compliance or apology for their fat bodies.
This research adds to the limited body of health science literature which has investigated
weight through a framework which is cognisant of the multilayered meanings attached to
fat female bodies. It also adds to the ever increasing research which recognises the impact
of stigma in addressing public health crises such as obesity.

Item Type: Thesis - PhD
Authors/Creators:Williams, DM
Keywords: large bodied women, stigma, general practitioners, qualitative research, grounded theory, health sociology
Copyright Information:

Copyright 2012 the Author

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