The War on Obesity as a Moral Project: Weight Loss Drugs, Obesity Surgery and Negotiating Failure

Abstract

Anti-obesity interventions are configured within British biomedicine as a hierarchy of condoned practices, with access to those further up the hierarchy made contingent on documented failure with interventions further down. The unsuccessful use of weight loss drugs, for example, is a condition of access to surgery, which is positioned at the top of the hierarchy. This configuration of interventions, I argue, exposes surgery patients to the risk of the moral censure of others: the failure to lose weight is attributed to a lack of self-discipline rather than to the inefficacy of any particular intervention. This risk is particularly pronounced in the case of weight loss drugs and surgery, which are commonly (mis)conceptualised as attempts to ‘cheat’ at weight loss and avoid the bodily work of diet and exercise. This paper argues that those undergoing surgery have to account for their unsuccessful use of weight loss drugs in a way that resists these negative characterisations. This is achieved through the strategic mobilisation of three key discursive resources in relation to the drugs: discourses of degradation, danger and inefficacy. These discursive resources, and their strategic mobilisation, highlight the profoundly moral context of the ‘war on obesity’ within which the escalating hierarchy of anti-obesity interventions operates.