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Working toward eradicating weight stigma by combating pathologization: A qualitative pilot study using direct contact and narrative medicine
Journal of Applied Social Psychology ( IF 2.2 ) Pub Date : 2021-03-18 , DOI: 10.1111/jasp.12717
Rachel Fox 1 , Kelly Park 2 , Rowan Hildebrand‐Chupp 3 , Anne T. Vo 4
Affiliation  

Stigma against fat people permeates every level of healthcare, yet most attempts to reduce weight stigma among healthcare providers have shown only marginal results. Fat studies, a field that rigorously interrogates negative assumptions about fatness, can help social psychologists understand weight stigma by centering the pathologization of fatness as a major contributor to weight stigma at the structural and interpersonal level. A fat studies approach also reorients the normative goal of weight stigma interventions from reducing stigma to eradicating stigma and calls for methods that reject weight stigma’s roots in medicine and medical discourse. Even nuanced and sympathetic models of “obesity” cannot combat stigma that is structurally based in medical authority. We applied these principles to develop a new method of weight stigma intervention: direct contact structured through narrative medicine. In a qualitative pilot study, four medical students and two fat activist community members met for five 2-hours narrative medicine workshops over 5 weeks. All participants completed focus group interviews about the experience. Interview transcript analysis revealed that these workshops provided a space for depathologizing, humanizing, empathy-inducing, and power-leveling interactions between medical students and fat people, where members of both groups reported benefiting from the experience. We conclude that non-pathologizing approaches to eradicating weight stigma are not only feasible, but both ethically and methodologically necessary.

中文翻译:

通过对抗病理化来消除体重歧视:一项使用直接接触和叙述医学的定性试点研究

对肥胖者的污名化渗透到医疗保健的各个层面,但大多数减少医疗保健提供者对体重的污名化的尝试都只取得了微不足道的效果。脂肪研究是一个严格质疑关于肥胖的负面假设的领域,它可以帮助社会心理学家通过将肥胖的病理化作为结构和人际层面上体重耻辱的主要贡献者的中心来理解体重耻辱。脂肪研究方法还将体重耻辱干预的规范目标从减少耻辱重新定位为根除耻辱,并呼吁采用拒绝体重耻辱根源于医学和医学话语的方法。即使是“肥胖”的细微差别和同情模型也无法消除结构上基于医学权威的耻辱感。我们应用这些原则开发了一种新的体重歧视干预方法:通过叙事医学构建的直接接触。在一项定性试点研究中,四名医学生和两名肥胖活动家社区成员在 5 周内举行了五场 2 小时的叙事医学研讨会。所有参与者都完成了关于体验的焦点小组访谈。访谈记录分析显示,这些研讨会为医学生和胖人之间的去病态化、人性化、共情诱导和权力平衡互动提供了一个空间,两组成员都报告说从这些经历中受益。我们的结论是,以非病态化的方式消除体重耻辱感不仅可行,而且在伦理和方法论上都是必要的。四名医学生和两名肥胖活动家社区成员在 5 周内举行了五次 2 小时的叙事医学研讨会。所有参与者都完成了关于体验的焦点小组访谈。访谈记录分析显示,这些研讨会为医学生和胖人之间的去病态化、人性化、共情诱导和权力平衡互动提供了一个空间,两组成员都报告说从这些经历中受益。我们的结论是,以非病态化的方式消除体重耻辱感不仅可行,而且在伦理和方法论上都是必要的。四名医学生和两名肥胖活动家社区成员在 5 周内举行了五次 2 小时的叙事医学研讨会。所有参与者都完成了关于体验的焦点小组访谈。访谈记录分析显示,这些研讨会为医学生和胖人之间的去病态化、人性化、共情诱导和权力平衡互动提供了一个空间,两组成员都报告说从这些经历中受益。我们的结论是,以非病态化的方式消除体重耻辱感不仅可行,而且在伦理和方法论上都是必要的。医学生和胖子之间的共情诱导和权力平衡互动,两组成员都报告说从这次经历中受益。我们的结论是,以非病态化的方式消除体重耻辱感不仅可行,而且在伦理和方法论上都是必要的。医学生和胖子之间的移情诱导和权力平衡互动,两组成员都报告说从这次经历中受益。我们的结论是,以非病态化的方式消除体重耻辱感不仅可行,而且在伦理和方法论上都是必要的。
更新日期:2021-03-18
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