Acting on the Actions of Clinicians: The Canadian Obesity’s Network Invitation to Care

• In Event: 067 - Section on Science, Knowledge and Technology Roundtables (one-hour)
  In Refereed Roundtable: Table 03. Classification Work

Abstract

Fatness is often framed as a strictly behavioural phenomenon, a result of individuals making ‘bad choices’. This frame tends to blame and shame larger individuals, and when enacted in health care, can lead to stigmatizing care that neglects the needs of some patients. The Canadian Obesity Network seeks to improve care delivery to those deemed obese, and has developed and is disseminating an approach to clinical care called The 5 As of Obesity Management. In this paper, I outline how the 5 As approach disrupts the notion of obesity as the result of individual ‘choice’, and rejects the notion that all fatness is pathological. The 5 As assemblage situates obesity firmly within the framework of a chronic condition, one that is never cured. The assemblage introduces new inscription devices to classify obesity, makes obesity a multiplicity with a range of causes, and variable health effects. The workshop facilitator and the texts stress improving the health and wellbeing of individual patients. How to do so is not known in advance, but becomes evident via assessment of causes, consequences, complications, and patient resources, priorities, and goals. In doing so, the assemblage addresses many of the critiques of how obesity is currently known and treated, and provides a vision of health service provision more firmly situated in the logic of care, as per Mol’s (2008) description. This case exemplifies a liberal expression of governmentality directed at clinicians, one that invites clinicians to work with and care for individual persons living with a disease.

Author

• Patricia Thille, University of Calgary