Table Of ContentMiddlesex University Research Repository
An open access repository of
Middlesex University research
http://eprints.mdx.ac.uk
Westland Barber, Sandra (2017) Being large: An interpretive phenomenological enquiry into
the lived world of problematic weight. Other thesis, Middlesex University.
Final accepted version (with author’s formatting)
This version is available at: http://eprints.mdx.ac.uk/21373/
Copyright:
MiddlesexUniversityResearchRepositorymakestheUniversity’sresearchavailableelectronically.
Copyright and moral rights to this work are retained by the author and/or other copyright owners
unlessotherwisestated. Theworkissuppliedontheunderstandingthatanyuseforcommercialgain
is strictly forbidden. A copy may be downloaded for personal, non-commercial, research or study
without prior permission and without charge.
Works, including theses and research projects, may not be reproduced in any format or medium, or
extensive quotations taken from them, or their content changed in any way, without first obtaining
permissioninwritingfromthecopyrightholder(s). Theymaynotbesoldorexploitedcommerciallyin
any format or medium without the prior written permission of the copyright holder(s).
Full bibliographic details must be given when referring to, or quoting from full items including the
author’s name, the title of the work, publication details where relevant (place, publisher, date), pag-
ination, and for theses or dissertations the awarding institution, the degree type awarded, and the
date of the award.
If you believe that any material held in the repository infringes copyright law, please contact the
Repository Team at Middlesex University via the following email address:
[email protected]
The item will be removed from the repository while any claim is being investigated.
See also repository copyright: re-use policy: http://eprints.mdx.ac.uk/policies.html#copy
Being Large: An interpretive
phenomenological enquiry into the
lived world of problematic weight
Submitted to the New School of Psychotherapy and Counselling
and Middlesex University Psychology Department in partial
fulfilment of the requirements for the Degree of Doctor
of Existential Counselling and Psychotherapy.
Sandra Westland Barber
June 2016
0
Acknowledgements
I would like to thank all at the New School for making it possible to study
Existential Psychotherapy at a Doctoral Level, and Susan Ram for her stoic
support in the process of putting this project together.
To complete such a project took me great focus, dedication and heart and was
only possible and as enjoyable as it was, with others by my side to share, discuss
and encourage me along the way. Thus I would like to thank Linda Finlay, my
supervisor, for profoundly taking me on such a highly personal process of
understanding and embodying phenomenological research and my topic of being
large. Through her care, guidance and expertise this project became possible. I
apologise for all my first drafts and thank her for holding the bigger picture! I feel
privileged to have had such an experienced expert from which to learn.
Finally I would like to thank Tom Barber, my husband, whose unwavering
enthusiasm, belief, patience, support and humour over the last decade has held
me strong. I feel incredibly blessed and honoured to have him in my life and by my
side. A truly amazing human being whom I love deeply.
1
Abstract
The aim of this study is to explore how large women who are unhappy with their
weight experience their everyday lives. This qualitative phenomenological
research was conducted through semi-structured interviews with six participants
(all who defined themselves as BMI ≥ 30), whose descriptions were then analysed
using Interpretative Phenomenological Analysis. Two main themes were identified.
The first highlighted the continual experience of being a monstrously huge body
and how this impacts life. The second explored how perpetually feeling the eyes of
others created everyday challenges that needed to be managed.
This study seeks to contribute to the limited existing phenomenological UK based
research undertaken with large women from the general population. Its findings
suggest the highly ambiguous lived experience of being large. There is an
intensely all-consuming bodily managing practice of disownment and positioning
the body as an object-like form (medically, socially and impaired). There is
constant self-surveillance and social scrutiny trying to be acceptable in their
unacceptable bodies within their relational world. There is an attempt to avoid
feelings of shame and to experience themselves as more than their body even
though this is how they experience themselves. The clinical significance lies in its
attempt to increase understanding from an integrative existential psychological
perspective for weight management including; the experience of someone’s
physical, social, psychological and spiritual worlds; the understanding and impact
of general moods; embracing the ambiguity of the body and the enhancement of
agency. The study recommends that further research be undertaken into how
these areas are specifically experienced and the meaning given by large women.
2
Keywords
Interpretative Phenomenological Analysis, IPA, Existential Psychotherapy,
Obesity, Being Large, Weight loss.
3
Statement of authorship
This dissertation is written by Sandra Westland Barber and has ethical clearance
from the New School of Psychotherapy and Counselling and the Psychology
Department of Middlesex University. It is submitted in partial fulfilment of the
requirements of the New School of Psychotherapy and Counselling and the
Psychology Department of Middlesex University for the Degree of Doctor of
Existential Counselling and Psychotherapy. The author reports no conflict of
interest, and alone is responsible for the content and writing of the dissertation.
4
Anonymisation and transcript conventions
The transcripts presented in the study were edited in order to preserve the
anonymity and confidentiality of participants.
Transcript notation
… significant pause
[ ] material omitted
[becomes tearful] additional material or my summary
Word count 58,907
5
Table of contents
Acknowledgements 1
Abstract 2
Keywords 3
Statement of authorship 4
Anonymisation and transcript conventions 5
Chapter 1 Introduction 9
1.1 Selecting the topic 9
1.2 A critical reflection on the use of language 13
1.3 Aims of the study 15
1.4 Personal rationale for the research 16
1.5 Research approach 18
Chapter 2 Literature Review 21
2.1 Introduction 21
2.2 Medical science: pathologising the large body 22
2.2.1 Obesity as a disease 23
2.2.2 Obesity as a psychiatric disorder 25
2.2.3 Critical reflection 27
2.3 Psychology: psychologising the large body 28
2.3.1 Psychoanalytic approach 29
2.3.2 Cognitive Behavioural approach 31
2.3.3 Embodied cognition 32
2.3.4 Critical reflection 33
2.4 Sociology: the body, embodiment and feminism 34
2.4.1 Fatness and obesity as social construction 34
2.4.2 Qualitative sociological research 39
2.4.3 Critical Reflections 42
2.5 Existential phenomenological perspectives 43
2.5.1 Theoretical perspectives: Merleau-Ponty, Sartre,
De Beauvoir 44
2.5.2 The lived embodied experience of large bodies:
a theoretical exploration 50
2.5.3 Empirical phenomenological studies 55
2.5.4 Critical reflections 68
2.6 Conclusions 69
2.7 Reflexive exploration 70
Chapter 3 Methodology and Design 75
3.1 Epistemological commitments 75
3.1.1 Alternative methodology 79
3.2 Phenomenology 81
3.2.1 Hermeneutic Phenomenology 83
3.3 Interpretative Phenomenological Analysis 87
3.3.1 Using IPA to study obesity 89
3.3.2 Limitations of IPA 91
3.4 Reflexivity 94
6
3.5 Validity and quality 101
3.5.1 Sensitivity to context 102
3.5.2 Commitment and rigour 102
3.5.3 Transparency and coherence 102
3.5.4 Impact and importance 103
3.6 Design and method 104
3.6.1 Ethical considerations 104
3.6.2 Participants and recruitment 107
3.6.3 Sample 109
3.6.4 Data collection 109
3.6.5 Data analysis 111
3.6.6 Description, discussion and conclusion 113
3.7 Reflexive exploration 114
Chapter 4 Findings 118
4.1 Being the participants 119
4.1.1 Being Sarah 119
4.1.2 Being Anne 120
4.1.3 Being Lynn 123
4.1.4 Being Sue 125
4.1.5 Being Alison 127
4.1.6 Being Rachel 129
4.2 Presentation of themes 131
4.3 Being a monstrously huge body 132
4.3.1 Despicable and disappointing form 132
4.3.2 Demanding and all-consuming inescapable
physical body 136
4.3.3 Disownment 140
4.3.4 Mis-fitting myself 145
4.4 Feeling the eyes of others 150
4.4.1 Shame 152
4.4.2 Invisibly present(able) 157
4.5 Summary 162
4.6 Reflexive exploration 164
Chapter 5 Discussion 167
5.1 The findings in relation to the literature 167
5.1.1 The body as despicable and disappointing form 168
5.1.2 The demanding and all-consuming inescapable
physical body 175
5.1.3 Disownment 182
5.1.4 Mis-fitting myself 187
5.1.5 Feeling the eyes of others: Shame and invisibly
present(able) 193
5.1.6 Summary 199
5.2 Methodological considerations and critical reflections 201
5.2.1 Reflections on Methodology 203
5.2.2 Strengths and weaknesses of sample 206
5.2.3 Strengths and weaknesses of interviews 207
5.2.4 Generalisability of findings 208
7
5.2.5 Validity and quality of research 209
5.3 Significance of the study and its implications for practice 210
5.3.1 Large women and their lifeworld: a new direction 211
5.4 Recommendations for future research 219
5.5 Reflexive exploration 221
Chapter 6 Conclusion 224
6.1 Some final reflections 275
References 229
Appendices 250
Appendix 1 Ethical clearance 250
Appendix 2 Risk assessment 254
Appendix 3 Participant information sheet 260
Appendix 4 Participant consent form 261
Appendix 5 Interview procedure and schedule 262
Appendix 6 Developing themes 265
Appendix 7 Individual participants themes 270
Appendix 8 Table of master themes 286
8
