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Fat Studies and Health at Every Size

Seminar 2: Fat in the Clinic and Health at Every Size

13th - 14th May, 2010. Warwick University

Short Report on Seminar 2: Fat in the clinic / HAES

Introduction

The second of the four seminars for this series took place on 13th - 14th May, 2010 at Warwick University. The seminar was focussed on Health at Every Size and other non-discriminatory approaches to fatness within clinical spaces (including weight-loss surgery, dietetics, exercise interventions, etc). The seminar aimed to:

  • explore experiences of fatness in clinical spaces and other spaces of health intervention
  • explore the advantages and challenges of Health at Every Size and other non-discriminatory approaches to fatness as alternatives to dominant medical models for engagement with fat bodies within health care contexts

Speakers

The event aimed to present different perspectives and accounts of fat in the clinic and HAES, including academic presentations, personal and professional reflective accounts and informal discussion with those involved in HAES (practitioners and patients). The academic papers were structured into two sessions with a total of 7 excellent papers (see below for details), each of which explored encounters with fatness within clinical spaces in different ways.

An excellent and insightful key note address was given by Lucy Aphramor which included a detailed critique of the ‘science’ of obesity, along with stories about the successes and challenges which she has faced in trying to practice HAES principles within the NHS. Lucy also brought along HAES artwork which was displayed throughout the final session of the first day.

The second day concluded with a session on HAES in the community. This included a deeply personal and insightful account by Sharon Curtis of key moments in her life which led her to question dominant medical approaches to fatness and discover the possibilities which a HAES approach offers. This was followed by a discussion by Shauna Clarke of her experiences as a dietetics student and an informal discussion led by Lucy Aphramor with other HAES practitioners and members of the ‘Well Now’ patient group which Lucy runs in Coventry.

Where possible, audio recodings, narrated slides and / or powerpoint are provided below. Apologies for the low quality of some of the audio recordings, particularly for the group discussion - this is due to the size of the seminar room and background noise.

Key Note: Lucy Aphramor ‘Never mind the ethics, feel the resistance: the challenges of HAES in the UK’

[ Narrated Slides | Powerpoint Presentation (.ppt) ]

Unfortunately the sound recording failed after 20 mins of Lucy's keynote. We have provided narrated slides for the first 20 mins. The powerpoint presentation covers the whole keynote, we appologise for the lack of narration for the second half of the talk.

Session One: Fat in the clinic

  • Karen Throsby - ‘I’d kill anyone who tried to take my band away’: obesity surgery, patient demand and health at every size
    [ Audio Recording (.wma) ]
  • Shirlene Badger - The possibility of difference: narratives of symptoms in genetics of obesity research
    [ Audio Recording (.wma) ]
  • Helena Webb - Moral issues in interactions between doctors and patients during consultations about obesity
    [ Narrated Slides | Powerpoint Presentation (.ppt) ]
  • Helen Malson - ‘I don’t think that’s normal’: exploring the anorexification of ‘healthy’ weight management
    [ Narrated Slides | Powerpoint Presentation (.ppt) ]

Session Two: Young people, activity and bodies

Participation

Approximately 45 people attended the seminar, representing a range of academic disciplines, activists, health practitioners, local health authority policy actors and interested individuals. Time was left at the end of each presentation and as part of the community discussion for questions and debate from those who attended the seminar with the aim to provide an inclusive atmosphere and broaden the perspectives offered.

Feedback

Feedback (both formal and informal) was positive, with delegates praising the “interesting and thought provoking” range of topics covered. The opportunity to discuss and debate approaches in a space which wasn’t dominated by medical accounts of fatness was particularly seen as important and the involvement of practitioners and policy actors who have had limited engagement with HAES in the past also helped to introduce people to this approach and identify problems and challenges for HAES. For example, a delegate who works in public health commented that “The perspectives invited by the HAES approach have really re-affirmed my commitment to the importance of working from a person-centred approach and has helped me to question the broad medical-model driven teachings of traditional healthcare and public health practice.”

As with the first seminar, the accessibility of the event was also praised in terms of physical space, bursaries, lack of registration fee, and inclusion of non-academic delegates. The financial support from the ESRC was vital here in enabling the event to be free of charge for attendees and the provision of bursaries ensured participation was possible for those not able to get support from their employers. Also praised was the community discussion forum on the second day “as this added a practical dimension to the issues being discussed”. Further opportunities for such discussions and small group work was suggested as important for the final two seminars.

Reflection and Conclusion

This seminar offered a different context than the first, being more explicitly focussed on clinical and medical spaces and on health interventions. Perhaps unsurprisingly then, more tensions, challenges and disagreements were evident in this seminar than the first – although the seminar remained a supportive space and these disagreements opened up debate rather than closed down discussion. The debates and discussions which revealed these tensions made important progress in addressing the overall aims of the series concerning the intersections between Fat Studies and HAES and the ethical, practical and conceptual challenges involved in each of these approaches and in bringing these approaches together.

In particular, three questions emerged from these debates concerning:

  1. the types of ‘authority’ called upon when people speak about fatness and the different ways in which HAES, Fat Studies and Fat Activism challenge or perhaps reinforce these forms of authority;
  2. the extent to which HAES, Fat Studies and Fat Activism can address the experiences of those who may chose to lose weight or otherwise engage with health interventions without objectifying or vilifying those people;
  3. the ways in which the body size of the practitioner, researcher, activist, etc who speaks about or practices Fat Studies and HAES is important and has implications for the ethics and legitimacy of their engagements with, and accounts of, fat bodies.

These questions provide points for discussion to be explored further in the subsequent two seminars.

Also see Charlotte Cooper’s reflection on the seminar on her blog:

http://obesitytimebomb.blogspot.com/2010/05/reporting-back-on-second-esrc-fat.html