Society for Medical Anthropology
Volunteered - Oral Presentation Session
Themes of surveillance and control are well established in studies of diets and bariatric surgeries, and are regularly contrasted with joy and pleasure. Studies often use Foucauldian concepts of bio-power, governmentality and bio-pedagogy and focus on the disciplined subject. Nonetheless, researchers have recently challenged this dichotomy and showed how some clinicians use more empathic, enjoyable methods of weight loss.
In this paper I suggest that bariatric dietitians work to demarcate intra- professional boundaries between WLS and diets, presenting the former as new, advanced and more patient-centered approach. These boundaries are constructed and maintained by negotiating the dichotomy between pleasure and control: by shifting the focus from the individual’s self- control to the overall context; by changing diet language; redefining success and more. While some patients challenge these differences between WLS and diets, many patients take pride in this new attitude, which distances them from the two extremes of food behavior: they are no longer the out-of-control eaters they considered themselves to be prior to the surgery, yet they also avoid being seen as the over-controlling dieters who exercise unhealthy weight loss methods. I argue that this agenda opens up new meanings for perceiving the self and the body.
This paper is based on interviews with 5 bariatric dietitians and on participant observation in a weight loss clinic: I observed 55 dietitian-patient consultations; 100 psychologist-patient sessions and 20 meetings of a bariatric support group, guided by a dietitian and a psychotherapist.