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The purpose of this paper is to evaluate Feel WonderFull Fitness (FWF), a program adhering to the Health At Every SizeTM (HAES) paradigm, on larger women's physical activity and psychosocial health. FWF was tailored to overcome barriers based on weight bias.

The study compared “overweight” and “obese” women in FWF to those not currently enrolled in formal exercise programs. Controls were divided into low physical activity (LPA) and moderate physical activity (MPA) conditions based on pretest exercise level. Outcome measures were collected at pretest and three months later at posttest.

FWF participants had the greatest gains in physical activity and demonstrated significantly greater improvements in depression than the LPA group. FWF and the MPA group showed more improved scores on perceived body attractiveness than the LPA group. Scores on an eating disorders measure improved for all groups, but somewhat more so for the FWF group. Improvements occurred in the absence of weight loss or decreases in body mass index and body fat percentage.

The study was based on a small, homogenous sample using a quasi-experimental design.

The study illustrates HAES strategies that practitioners might incorporate into various health and fitness settings.

The study highlights weight bias as a social justice issue and as a barrier to physical activity participation for larger women.

The study adds to a growing body of literature evaluating HAES approaches, with HAES representing a novel alternative to weight-loss interventions for improving psychosocial health among larger women. It also contributes to the literature on weight bias that has been understudied relative to bias based on other areas of difference.

Purpose: To understand how lesbian, bisexual, transgender, queer, and asexual (LBTQA+) young women interpret the social construction of “lesbian obesity” in the context of their lived experiences and membership in the LGBTQ+ community.

Methodology: Individual, in-depth interviews were conducted with a convenience sample of 25 LBTQA+ women, ages 18–24, to explore how participants perceive and experience dominant discourses about gender, sexuality, and weight. Interviews were analyzed using a combination of deductive and inductive coding approaches.

Findings: Participants resisted public health discourse that frames obesity as a disease and the implication that their sexual identities put their health at risk. Many participants viewed their sexual identities and membership in the LGBTQ+ community as protective factors for their health statuses in general and their body image in particular.

Implications: Our findings suggest a need to reconsider the utility of the concept of “lesbian obesity” to characterize the significance of elevated rates of overweight and obesity in this population. Public health and clinical interventions guided by body positive approaches may be of greater relevance for sexual minority women.

Originality: This study centers the perceptions and experiences of LBTQA+ young women in order to examine how the intersections of sexual minority identity, dominant cultural ideals about weight, and obesity discourse inform their health.

Doctors need to consider all kinds of traits and risk factors about a person in a treatment situation, while antidiscrimination law puts significant restrictions on what an employer can consider about a person in hiring. These two contexts – health care and the antidiscrimination-governed workplace – seem to adopt entirely incompatible conceptions of how to regard the person, and hence, what rights she is considered to deserve. Therefore, how can we make sense of the claim by fat acceptance advocates that doctors discriminate against them based on their weight? Even when little or no formal rights exist for fat citizens in either sphere, there are nonetheless transformative discourses available that cross-pollinate each context. Revisiting rights by bringing these two discordant contexts together helps illuminate problems of injustice that must be confronted in the future as we move toward a more universal and equitable health care system in which conceptions of rights must have some place.

There is a growing need for school-based nutritional educational programs that promote healthy eating attitudes without increasing an unhealthy focus on restrictive eating or promoting a poor body image. Research suggests that intuitive eating (IE) approaches, which encourage individuals to focus on internal body signals as a guide for eating, have had a positive impact on eating-related psychological outcomes in adults. The purpose of this paper is to investigate the effects an IE education program on the eating attitudes of high school students.

In a quasi-experimental study, 48 high school students (30 females) in a Midwest town in the USA received instruction on IE or a comparison program over seven days during health classes. Repeated measures analyses of covariance were conducted to examine changes in eating attitudes in sexes across conditions.

Students who received the IE program made significantly greater gains in overall positive eating attitudes on the Intuitive Eating Scale than students in the comparison program (p=0.045), as well as on the Unconditional Permission to Eat subscale (p=0.02). There were no significant effects of sex on any of the analyses.

Because of the relatively small sample size and short duration of the program, the results should be generalized with caution.

The results suggest that IE instruction may encourage the development of healthy eating attitudes in high school students, and health teachers may wish to consider including IE instruction in the health curriculum.

This is the first study to examine the effectiveness of an IE program in a K-12 population, with instruction provided in the context of the school. The results are promising and suggest that this may be a fruitful area for future research in nutrition education.

This paper contributes to emerging discourse about social movements in social marketing by examining how tensions, issues and challenges may arise in areas of social change that have attracted social movements and the ways actors can come together to drive inclusive social change agendas.

Through the lens of new social movement theory, a case study of the interactions and dynamics between fat activists and obesity prevention public health actors is examined. This is undertaken through a multi-method qualitative analysis of interview and archival blog data of fat activists located in Australia, which was compared with the campaign materials and formative and evaluative research related to two high profile Australian Government funded anti-obesity campaigns.

The case analysis highlights the disconnect between public health actors and the marginalized voices of those they are meant to be representing. Whilst public health actors characterise obesity as a social issue of individual responsibility, disease and rational-decision making; fat activists frame a competing collective identity of well-being, support and self-acceptance that characterise their social change efforts.

This research highlights how complexities arise but can potentially be overcome in creating inclusive social change coalitions that incorporate the voices of citizen groups whom have mobilised into social movements. Specifically, we highlight the importance of generating a common language around obesity, the significance of collaborative and supportive relations and the need to create common unity through emotional investment and returns - a departure from the highly rational approaches taken by most social change programs.

Obesity is a complex social issue marked by conflict and contestation between those who are obese and the very actors working to support them. Our research contends that creating an inclusive social change coalition between these stakeholders will require a shift towards language anchored in well-being as opposed to disease, relations defined by support as opposed to an emphasis on individual responsibility and emotional investments that work to bolster self-acceptance in place of rational appeals as to the “correct” behaviours one should chose to engage in. Such steps will ensure social change program design is collaborative and incorporates the lived experiences of the very citizens such initiatives are targeted towards.

We contribute to wider discussions in social marketing about the development of holistic and progressive, multi-stakeholder, multi-level programs by advocating that inclusive social change coalitions united through the collective identity elements of cognitions and language, relational ties and emotional investment offer an important step forward in tackling the wicked problems that social marketers work to address.

Availability and access to food is a determinant of obesity. The purpose of this paper is to examine food availability within and outside of post-primary schools in Ireland.

Data on the internal school food environment were collected from 63 post-primary schools using questionnaires. The external school food environment for these 63 schools was assessed by mapping food businesses within 1 km of schools, using a Geographic Information System (GIS). Food businesses were categorised based on type of food sold.

A total of 68.3 per cent of schools had a canteen, 52.5 per cent had a small food shop and 37.1 per cent had a vending machine. A total of 32.7 per cent of schools reported selling chips (French fries) in their canteen while 44.2 per cent of schools reported selling energy-dense nutrient-poor foods in their school shop. Of the schools surveyed, there was an average of 3.89 coffee shops and sandwich bars, 3.65 full service restaurants, 2.60 Asian and other “ethnic” restaurants, 4.03 fast food restaurants, 1.95 supermarkets, 6.71 local shops and 0.73 fruit and vegetable retailers within a 1 km radius of the post-primary schools. Findings are presented by geography (urban/rural), disadvantage (Delivering Equality of Opportunity in School (DEIS)/non DEIS), gender (girls/boys/mixed) and food policy in place at the school (yes/no).

These data will facilitate schools working on the framework for Health Promoting Schools in Ireland.

This work can contribute to current discussions on restricting accessibility to certain foods and food premises for school children.

The study explores the internal and external school food environment. GIS have been used to link the external food environment to specific schools thus allowing a comprehensive analysis of the schools’ food environment. To the authors knowledge, this is the first time that both environments are explored simultaneously.

Since the 1980s UK government enthusiasm for market reforms has reconfigured the nature and scope of public services. Initially the marketisation of public services changed how public services were provided, increasingly market reforms and pro business policies have also modified the formation and understanding of public policy problematics and how they ought to be resolved. This is particularly noticeable when markets work imperfectly or even fail. UK governments have shown their reluctance to employ regulatory instruments to change the behaviour of companies preferring instead to make use of softer interventions, by focusing on providing advice for consumers and urging individuals to act responsibly. The dilemmas of this approach are explored by discussing the UK's former Labour government's (1997–2010) response to the increase in the incidence of obesity and related health complications.

This paper examines the views of Australian primary school parents regarding the food and nutrition education (FNE) curriculum. Associations with personal values (Universalism and Hedonism) and demographic measures were also explored.

An online survey was conducted among 787 parents in March 2021. Parents rated the importance of 17 FNE topics. They were also asked about their support for six curriculum improvements and to state their own improvement suggestions.

Parents viewed the “Effect of food on health” and “Food hygiene” as the most important topics. Three FNE components were derived: (1) food safety and preparation, (2) health and nutrition information, (3) food origins and environmental sustainability. The “Food safety and preparation” component score was associated with both universalism-nature and hedonism values but negatively associated with parental education. The “Health and nutrition information” component score was associated with universalism-nature value and main language spoken at home. Lastly, the “Food origins and environmental sustainability” component score was associated with universalism-nature value. The two personal values, universalism-nature and hedonism, were more strongly associated with parents' views of curriculum topics than parental demographic characteristics. Parents had several criticisms of current FNE, including school food environments not resonating with FNE taught in the classroom and that FNE might increase the risk of eating disorders. They also suggested that the FNE curriculum should support both parents and teachers by providing relevant resources and training.

Australian parents' views of the importance of FNE topics and how to improve FNE in primary schools have been under-examined.

In this chapter I explore how conflicting discursive claims made by the medical community are consequential for bariatric weight loss surgery patients. Bariatric surgery has become increasingly common in the United States since the 1990s, with over 177,000 Americans undergoing surgery in 2006. Despite the surgery's growing popularity, the US medical community does not wholeheartedly endorse the surgery. Rather, different members of the medical community espouse contradictory evaluations of weight loss surgery. I broadly characterize this intra-medical community controversy and, then, discuss how conflicting claims have helped shape the bariatric surgery industry's discursive conception of an “ideal patient.” Next, I analyze actual patients’ negotiations of the ideal patient archetype, and find that patients’ responses follow three paths: embracing the ideal, having a mixed response to the ideal, and strategically complying with the ideal. As patients are compelled to grapple with the ideal archetype in order to access surgery, I conclude that the ideal archetype acts as a discursive frame connecting individual patients to broad bariatric surgery discourses.