No abstract

This paper shifts focus from an individualised and anthropocentric perspective on obesity, and uses a new materialist analysis to explore the assemblages of materialities producing fat and slim bodies. We report data from a study of adults' accounts of food decision-making and practices, investigating circulations of matter and desires that affect the production, distribution, accumulation and dispersal of fat, and disclose a micropolitics of obesity, which affects bodies in both 'becoming-fat' and 'becoming-slim' assemblages. These assemblages comprise bodies, food, fat, physical environments, food producers and processing industries, supermarkets and other food retailers and outlets, diet regimens and weight-loss clubs, and wider social, cultural and economic formations, along with the thoughts, feelings, ideas and human desires concerning food consumption and obesity. The analysis reveals the significance of the marketisation of food, and discusses whether public health responses to obesity should incorporate a food sovereignty component.

Objectives: This study explores the relationships to food and hunger in women living with anorexic type eating difficulties and asks how imagery-based elaborations of food and eating thoughts are involved in their eating restraint, and recovery. Design: The qualitative idiographic approach of Interpretative Phenomenological Analysis (IPA) was used. Four in-depth semi-structured interviews were conducted with women self-selected as having experienced anorexia or anorexic like behaviour. Methods: The data was analysed using IPA and an audit of the analysis was conducted to ensure that the process followed had been systematic and rigorous and appropriately considered reflexivity. Results: Hunger was perceived positively by participants as confirmation that they were achieving their goal of losing weight, or avoiding weight gain. Hunger conferred a sense of being in control for the participants. Intrusive thoughts about food were reported as being quickly followed by elaborative mental imagery of the positive aspects of weight loss, and the negative consequences of eating. Imagery appeared to serve to maintain anorexic behaviours rather than to motivate food seeking. However, negative imagery of the consequences of anorexia were also described as supporting recovery. Conclusions: The finding that physiological sensations of hunger were experienced as positive confirmation of maintaining control has potentially important clinical and theoretical implications. It suggests further attention needs to be focused upon how changes in cognitive elaboration, involving mental imagery, are components of the psychological changes in the development of, maintenance of, and recovery from, anorexia.

Purpose – The purpose of this paper is to describe the development of an eating disorder care pathway for adults with eating disorders, in a northern borough town. It arose out of a need to reduce and address inconsistent access to services and treatment pathways. Design/methodology/approach – The development involved a mapping exercise of current service delivery, a review of the literature on eating disorder care pathways, consultation workshops, the engagement of service users and carers, and the development of draft pathways for patients and carers. Findings – Significant emphasis was on raising awareness, prevention, identification and assessment, treatment and recovery. Two pathways were proposed, one for service users focusing on awareness raising/prevention, identification and assessment, treatment, stabilisation and relapse prevention and one for carers/families focusing on carers being identifiable in their own right to receive support for caring for someone with an eating disorder. Research limitations/implications – A limitation of the care pathway under development was the difficulty obtaining an accurate figure of the true number of cases of eating disorders in the local area. This, together with the lack of any form of systematic review or meta-analysis of care pathways made identifying the number of people suffering from eating disorders and developing an effective model difficult. Originality/value – The proposed pathway places significant emphasis on increasing knowledge, incorporating the patient perspective, and enhancing the recognition and understanding of eating disorders in the community. A model was created that could be implemented successfully and identify patients suffering from eating disorders, when the true incidence of eating disorders remains hidden.