The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Hilla Nehushtan is an Israel Institute Teaching Exchange Fellow in the Jewish Studies program at the University of Pittsburgh. She wrote her MA master’s thesis on women exiting commercial sex work. Her Ph.D. is from the Hebrew University of Jerusalem, where she investigated the social constructs of weight loss surgeries.

What is your article “The Ethical Work of Weight Loss Surgery: Creating Reflexive, Effortless, and Assertive Moral Subjects” about?

The article discusses some moral issues surrounding higher-weight bodies and their portrayal in consultation sessions between bariatric professionals and patients. I suggest that bariatric surgery becomes a site of a “moral breakdown” (the supposed immorality of people allowing themselves to get “this big”), where professionals advise patients to recuperate through minor everyday moments of experimentation with ethics. Drawing on ethnographic inquiry in a bariatric clinic, I argue that this moral recovery is made in three ways: First, patients are advised to “listen to their bodies” and to reconnect to their embodied sensations. They are further guided to imitate a “thin state of mind.” And finally, they are instructed to “put themselves first” by reorganizing their family and work responsibilities. While these instructions consonant with the common cultural ethos of self-discipline and self-control, they expand and, at times, undermine these notions and contest elements of fat stigma.

Tell us a little bit about yourself and your research interests.

I am a medical anthropologist interested in health and illness and how these issues interact with cultural and social constructs. I also explore gender inequality, primarily body size issues and how the overweight body is perceived and experienced. Today I am an Israel institute teaching exchange fellow and enjoy developing and teaching various courses about gender, body size and health and illness at the welcoming and thought-provoking Jewish studies program at the University of Pittsburgh. I am a passionate qualitative researcher enthusiastic about unmediated encounters with interlocutors.

What drew you to this project?

When I started contemplating this topic for my research, I was fascinated and shocked by the countless stereotypes associated with larger bodies that had never even occurred to me. For instance, a former colleague told me she did not hire the service of a big-bodied Doula because she felt this woman could not have positive relations with her own body. The more I delved into this issue, the more I found its cultural and social constructions intriguing. Furthermore, it is a broad topic that includes numerous dimensions of daily lives: the way larger-bodied people are treated by their family and peers; the discrimination against larger-bodied people in the workplace and the fashion industry; the way people are judged while eating in public; the ways children and adolescents are socialized to dislike their bodies; the evergrowing diet industry that shames larger-bodies, and of course, the biomedical point of view and its influences all of the above. I feel like this is a topic that deserves more nuanced attention.

What was one of the most interesting findings?

The most interesting and surprising finding was how the weight loss professionals’ messages empowered patients. While often medical professionals’ statements are interpreted by critical literature as oppressive and disciplined, the fact that women were encouraged to pass some of their responsibilities and housework to other family members, and take time to eat well and care for themselves, even temporarily after surgery, was experienced by them as empowering and well deserved. Medical professionals legitimized taking a break from daily responsibilities at work and home, encouraging patients to care for their bodies and selves. This was particularly meaningful for women, who are often responsible for house work and child care.

Furthermore, I found that prodessionals frame the reason for larger bodies as derived from constantly putting others first,and not taking care of themselves in terms of healthy eating and bodywork. This, I argue, subverts fat stigma. It diverges the blame for obesity from lack of control or gluttony.

What are you reading, listening to, and/or watching right now?

I recently read (or listened to, more precisely) the book “Hunger: A Memoir of (My) Body “by Roxane Gay. This book is a disturbing and fascinating documentation of her life story, which is often sad and painful. In the book, she emphasizes life with a body size that is considered much larger than average. She describes her physical and health difficulties, but mostly the social challenges of living with a larger body. The book evokes a lot of empathy and enables a deep understanding of her life as a successful award-winning author on the one hand and a person with many daily struggles on the other. I highly recommend it.

If there was one takeaway or action point you hope people will get from your work, what would it be?

A more nuanced listening to interlocutors’ experiences, whether patients or medical professionals, even within critical literature, can benefit our understanding of patients and professionals. Such listening can open new possibilities for a deeper insight into people’s motives and interpretations of these procedures and allow a better understanding of medical professionals who also sometimes struggle to negotiate and rationalize these procedures for themselves.   

---