Setting Experiences against Expectations in Personal Narratives on Talking about Weight in Healthcare Encounters

The study examines written accounts that patients provide of their discussions about weight with healthcare providers. The data consist of about 70 personal narratives written in Finnish and shared in closed groups on a social media platform in 2020–2023. The participants gave their informed consent for the use of the data for research purposes. The study draws on qualitative research on narratives and social interaction both offline and online: the narratives are understood as “constructive processes” (Mattingly and Garro, 2001) through which participants create meaning in and make sense of their lives based on the sociocultural context and their (interactional) histories (e.g. Bamberg, 2020; Drew, 1998; Koivisto, Vepsäläinen, and Virtanen, 2023; Luig, Keenan, and Campbell-Scherer, 2019; Stommel and Koole, 2010). The study explores how teller–patients construct their narratives in systematic ways to highlight key moments of healthcare encounters and weight talk as bearing particular relevance to them. The study focuses on two storytelling practices: 1) narrative prefaces that align with or deviate from, often negative, expectations of healthcare encounters (see, e.g. Jefferson, 1978; Labov and Waletzky, 1967; Sacks, 1974) and 2) stretches of reported speech assigned to healthcare providers, which display both patient and provider perspectives (see, e.g. Clift, 2000; Holt, 2000; Niemelä, 2005). Studying how tellerpatients recount their experiences of weight talk provides an important window into weight bias and weight-based discrimination in healthcare, including language use and behaviour that patients with obesity perceive as judgmental or blaming and misinterpretations of intent and misjudgements of the patient’s character or efforts. Furthermore, it shows how repeated negative experiences reinforce negative stereotypes about individuals with obesity, among both healthcare providers and patients, and, correspondingly, how the accounts themselves reinforce negative stereotypes about healthcare encounters (e.g. Farrell, 2021; Mold and Forbes, 2013; Ryan et al. 2023; Talumaa et al. 2022).