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Background High rates of alcohol consumption by midlife women, despite the documented risks associated with breast cancer, varies according to social class. However, we know little about how to develop equitable messaging regarding breast cancer prevention that takes into consideration class differences in the receipt and use of such information. Objective To explore the heuristics used by women with different (inequitable) life chances to determine the trustworthiness of information regarding alcohol as a modifiable risk factor for breast cancer risk. Methods and materials Interviews were conducted with 50 midlife (aged 45–64) women living in South Australia, diversified by self-reported alcohol consumption and social class. Women were asked to describe where they sought health information, how they accessed information specific to breast cancer risk as it relates to alcohol, and how they determined whether (or not) such information was trustworthy. De-identified transcripts were analysed following a three-step progressive method with the aim of identifying how women of varying life chances determine the trustworthiness of alcohol and breast cancer risk information. Three heuristics were used by women: (1) consideration of whose interests are being served; (2) engagement with ‘common sense’; and (3) evaluating the credibility of the message and messenger. Embedded within each heuristic are notable class-based distinctions. Conclusions More equitable provision of cancer prevention messaging might consider how social class shapes the reception and acceptance of risk information. Class should be considered in the development and tailoring of messages as the trustworthiness of organizations behind public health messaging cannot be assumed.

Background: Urgent action is required to identify socially acceptable alcohol reduction options for heavy-drinking midlife Australian women. This study represents innovation in public health research to explore how current trends in popular wellness culture toward ‘sober curiosity’ (i.e., an interest in what reducing alcohol consumption would or could be like) and normalising non-drinking could increase women’s preparedness to reduce alcohol consumption. Methods: Qualitative interviews were undertaken with 27 midlife Australian women (aged 45–64) living in Adelaide, Melbourne and Sydney in different social class groups (working, middle and affluent-class) to explore their perceptions of sober curiosity. Results: Women were unequally distributed across social-classes and accordingly the social-class analysis considered proportionally the volume of data at particular codes. Regardless, social-class patterns in women’s preparedness to reduce alcohol consumption were generated through data analysis. Affluent women’s preparedness to reduce alcohol consumption stemmed from a desire for self-regulation and to retain control; middle-class women’s preparedness to reduce alcohol was part of performing civility and respectability and working-class women’s preparedness to reduce alcohol was highly challenging. Options are provided for alcohol reduction targeting the social contexts of consumption (the things that lead midlife women to feel prepared to reduce drinking) according to levels of disadvantage. Conclusion: Our findings reinstate the importance of recognising social class in public health disease prevention; validating that socially determined factors which shape daily living also shape health outcomes and this results in inequities for women in the lowest class positions to reduce alcohol and related risks.

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem’s concepts of “the normal and the pathological” as a theoretical frame, we examine the gendered assumptions that shape medical understandings of “healthy” and “dysfunctional” exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

Issue addressed Australian policymakers have acknowledged that implementing obesity prevention regulations is likely to be facilitated or hindered by public opinion. Accordingly, we investigated public views about possible regulations. Methods Cross-sectional survey of 2732 persons, designed to be representative of South Australians aged 15 years and over. Questions examined views about four obesity prevention regulations (mandatory front-of-pack nutrition labelling for packaged foods; zoning restrictions to prohibit fast food outlets near schools; taxes on unhealthy high fat foods; and taxes on sugar-sweetened beverages). Levels of support (Likert scale) for each intervention and reasons for support/opposition were ascertained. Results Views about the regulations were mixed: support was highest for mandatory nutrition labelling (90%) and lowest for taxes (40%-42%). High levels of support for labelling were generally underpinned by a belief that this regulation would educate "Other" people about nutrition. Lower levels of support for zoning restrictions and taxes were associated with concerns about government overreach and the questionable effectiveness of these regulations in changing behaviours. Levels of support for each regulation, and reasons for support or opposition, differed by gender and socio-economic status. Conclusion Socio-demographic differences in support appeared to reflect gendered responsibilities for food provision and concerns about the material constraints of socio-economic deprivation. Engagement with target populations may offer insights to optimise the acceptability of regulations and minimise unintended social consequences. SO WHAT?: Resistance to regulations amongst socio-economically disadvantaged target populations warrants attention from public health advocates. Failure to accommodate concerns identified may further marginalise these groups.

This article explores how desire operates in the daily lives of women with disordered eating. Based on qualitative findings from a South Australian study investigating why women with disordered eating are reluctant to seek help, we trace the multiple “tipping points” and triggers that are central to participants’ everyday experiences. Employing anthropological interpretations of desire, we argue that triggers are circulations of productive desire, informed by cultural values and social relations, and embodied in routine daily acts. We examine the cultural-work of desire and the ways in which gendered relationships with food, eating and bodies trigger desires, creating a constant back and forth movement propelling participants in multiple directions. In conclusion, we suggest that a socio-cultural approach to desire in disordered eating has clinical implications, as cultural configurations of desire may help to understand ambivalence towards relapse and recovery.

BACKGROUND Scholarship across the humanities and social and life sciences has documented a wide variety of historical, sociocultural and medical attitudes to large bodies, including both positive and negative associations. Obesity has never been a stable or unified category. OBJECTIVE The aim of this article is to provide an overview of the historical trajectory of obesity as a disease in a Western context. DISCUSSION Discussions about whether obesity should be classified as a disease have been ongoing. Many scholars regard the early Greeks as the first to identify obesity as a disease, and trace changing manifestations of obesity from Classical times through the Middle Ages and Age of Enlightenment to contemporary times. This trajectory of obesity as a disease is contentious, and in light of recent moves to attribute disease status to obesity in Australia, this article outlines the politics and value of classifying obesity as a disease.

The potential for regulatory measures to address escalating rates of obesity is widely acknowledged in public health circles. Many advocates support regulations for their potential to reduce health inequalities, in light of the well-documented social gradient in obesity. This paper examines how different social groups understand the role of regulations and other public health interventions in addressing obesity. Drawing upon focus group data from a metropolitan city in southern Australia, we argue that implementing obesity regulations without attention to the ways in which disadvantaged communities problematise obesity may lead to further stigmatisation of this key target population. Tuana's work on the politics of ignorance, and broader literature on classed asymmetries of power, provides a theoretical framework to demonstrate how middle class understandings of obesity align with dominant 'obesity epidemic' discourses. These position obese people as lacking knowledge; underpinning support for food labelling and mandatory nutrition education for welfare recipients as well as food taxes. In contrast, disadvantaged groups emphasised the potential for a different set of interventions to improve material circumstances that constrain their ability to act upon existing health promotion messages, while also describing priorities of everyday living that are not oriented to improving health status. Findings demonstrate how ignorance is produced as an explanation for obesity, widely replicated in political settings and mainstream public health agendas. This politics of ignorance and its logical reparation serve to reproduce power relations in which particular groups are constructed as lacking capacity to act on knowledge, whilst maintaining others in privileged positions of knowing.

This paper examines how contemporary understandings of 'health' and 'care' are engaged with and practiced by women with disordered eating. Based on findings from an Australian study investigating why people with disordered eating are reluctant to engage with treatment services (March 2012 to March 2015), we demonstrate how young women use elements of a 'health habitus' and 'care' to rationalise and justify their practices. Moving beyond Foucauldian theories of self-discipline and individual responsibility we argue that Bourdieu's concept of habitus and ethnographic concepts of care provide a deeper understanding of the ways in which people with disordered eating embody health practices as a form of care and distinction. We demonstrate how eating and bodily practices that entail 'natural', medical and ethical concerns (in particular, the new food regime known as orthorexia) are successfully incorporated into participants' eating disorder repertoires and embodied as a logic of care. Understanding how categories of health and care are tinkered with and practiced by people with disordered eating has important implications for health professionals, family members and peers engaging with and identifying people at all stages of help-seeking.

This paper examines the spatio-temporal disjuncture between ‘the future’ in public health obesity initiatives and the embodied reality of eating. Drawing upon ethnographic fieldwork in a disadvantaged community in South Australia (August 2012–July 2014), we argue that the future oriented discourses of managing risk employed in obesity prevention programs have limited relevance to the immediacy of poverty, contingencies and survival that mark people's day to day lives. Extending Bourdieu's position that temporality is a central feature of practice, we develop the concept of short horizons to offer a theoretical framework to articulate the tensions between public health imperatives of healthy eating, and local ‘tastes of necessity’. Research undertaken at the time of Australia's largest obesity prevention program (OPAL) demonstrates that pre-emptive and risk-based approaches to health can fail to resonate when the future is not within easy reach. Considering the lack of evidence for success of obesity prevention programs, over-reliance on appeals to ‘the future’ may be a major challenge to the design, operationalisation and success of interventions. Attention to local rather than future horizons reveals a range of innovative strategies around everyday food and eating practices, and these capabilities need to be understood and supported in the delivery of obesity interventions. We argue, therefore, that public health initiatives should be located in the dynamics of a living present, tailored to the particular, localised spatio-temporal perspectives and material circumstances in which people live.

Background This paper explores the differing perspectives of recovery and care of people with disordered eating. We consider the views of those who have not sought help for their disordered eating, or who have been given a diagnosis but have not engaged with health care services. Our aim is to demonstrate the importance of the cultural context of care and how this might shape people’s perspectives of recovery and openness to receiving professional care. Method This study utilised a mixed methods approach of ethnographic fieldwork and psychological evaluation with 28 women from Adelaide, South Australia. Semi-structured interviews, observations, field notes and the Eating Disorder Examination were the primary forms of data collection. Data was analysed using thematic analysis. Results & Discussion Participants in our study described how their disordered eating afforded them safety and were consistent with cultural values concerning healthy eating and gendered bodies. Disordered eating was viewed as a form of self-care, in which people protect and ‘take care’ of themselves. These subjectively experienced understandings of care underlie eating disorder behaviours and provide an obstacle in seeking any form of treatment that might lead to recovery. Conclusion A shared understanding between patients and health professionals about the function of the eating disorder may avoid conflict and provide a pathway to treatment. These results suggest the construction of care by patients should not be taken for granted in therapeutic guidelines. A discussion considering how disordered eating practices are embedded in a matrix of care, health, eating and body practices may enhance the therapeutic relationship.

Jamie Oliver is an English celebrity chef who has publicly politicised the relationships between class and food in Britain. No longer a simple chef, Oliver is presented as an evangelical saint, salvation of British school dinners, advocate for young disadvantaged kids, and now with his latest series Ministry of Food, a saviour of the British obesity epidemic. In this series, the population of Rotherham is surveilled and targeted as representative of poor eating habits and lifestyles in Britain. In need of urgent intervention, the townsfolk are urged to make themselves anew and ‘fight’ their way out of the obesity epidemic. Moving beyond a mechanistic application of Foucault, this article examines the intersections of different technologies that give rise to specific lifestyle interventions, and the forms of resistance they generate. Through a convergence of the cultural technology of reality TV and technologies of self-governance, this article argues that a novel form of obesity intervention is being re-invented in a health promoting, neoliberal environment.

Despite the intense level of attention directed towards obesity, there has been limited success in addressing the rising rates of this public health phenomenon. This paper argues that current approaches to obesity fail to consider concepts of embodiment, and in particular, that gendered and class-based experiences of embodiment are ignored in health promotion practices and policies. Drawing on Bourdieu's concept of habitus, this ethnographic study sought to locate obesity within the biographies and everyday experiences of two groups of women from differing socio-economic settings. Rather than identify with the clinical category of obesity, these women constructed identities that were refracted through a gendered and classed habitus, and in particular, through their role as mothers. Food provision and practices were central to constructs of mothering, and these relational identities were at odds with the promotion of individual behavioural changes. Moreover, these women's daily lives were shaped by different class-based aspects of habitus, such as employment. In demonstrating the ways in which obesity is enmeshed in participants' taken-for-granted, everyday practices, we problematise the universality of health-promotion messages and highlight the integral role that the critical theory of habitus has in understanding the embodiment of obesity.

The evaluation of complex systems-wide public health interventions requires evaluation research that is underpinned by theory. This article presents and discusses the trans-disciplinary evaluation research framework developed to support the evaluation of a South Australian program called OPAL (Obesity Prevention and Lifestyle). The aim is to provide insights into the research design, methods and implementation of the evaluation and contribute to the debate on how to evaluate community-based interventions with complicated and complex aspects. In an attempt to capture the complexity of childhood obesity and the intervention, the OPAL evaluation research employs post positivist, interpretive and critical epistemologies, valuing epistemological pluralism. Each component of the multi-phase mixed methods evaluation captures different yet complementary information concerning the context, process, cost effectiveness and outcomes providing a more complete understanding of the impacts of the complex program. Evaluation research is not without challenges. Some of the tensions and challenges that arose in the establishment, planning and conduct of the OPAL program and evaluation are discussed. Refereed/Peer-reviewed

When dealing with the moving worlds of migration among the Persian diaspora in Australia, memories cannot simply be removed to dusty attic boxes to be stored as an archive. Rather, this analysis takes the body and its sensory engagement with the world as a central focus, arguing that memories are crafted, tasted, smelt and touched in everyday temporalities. In the kitchens and lounges of Persian migrant women the lived past refuses to become undone from the countless revolutions of food, talk and domestic activity that are central to the patterning of memory. In this paper, we argue that these intimate practices have references beyond their domestic dimensions, for they point to a worldly movement of life writ domestically small. It is via a sensory network that the spatially and temporally disparate worlds of homeland and new homes are remembered and forgotten, and where miniature worlds call out to the movement of migration. Indo-Pacific Journal of Phenomenology, Volume 7, Edition 2 September 2007

This paper is concerned with the ways in which a group of Persian women, who have all fled Iran in the last two decades, give meaning to place and memory through the everyday practices of cooking and embroidery. While there are many different localised arts of patterning and flavour, we focus here on the recurring pattern of bota (the Cypress tree). In particular, we examine how the bota motif links both the making of domestic sweets and cloths, and is central in recalling and remaking a sense of place. The Cypress tree symbolises life: the continuation of life in place, and the continuation of place in life. In creating and consuming the bota motif, through eating, laying tablecloths, wrapping towels, sitting on cushions and drawing curtains, embodied experiences of landscape and relationships are reproduced. The embroidery items entail and occasion sensual engagement in and of themselves, and also serve as backgrounds for specific sensual engagements, including, for example, as tablecloths upon which fo...

Background It is commonly held that men delay help seeking because they are ignorant about and disinterested in their health. However, this discussion has not been informed by men's lay perspectives, which have remained almost entirely absent from scholarship relating to men's help seeking practices. Methods In this qualitative paper, we draw on semi-structured interviews with 36 South Australian men to examine their understandings of help seeking and health service use. Results & Discussion We use participants' talk about self-monitoring to challenge the assumption that men are disinterested in their health, arguing instead that the men in our study monitored their health status and made conscious decisions about when and how to seek help. Using an inductive approach during the thematic analysis we were able to identify four key factors that influenced how men monitored their health and explain how these intersect with the way men sought help and used health services. Conclusion We show that the men in our study were actively engaged in the self-monitoring of their health. We suggest that these findings offer an alternative approach for understanding how we can promote men's interaction with health services.

This paper examines how contemporary understandings of health and care are engaged with by women with disordered eating. Based on findings from an Australian Research Council grant study, we explore the ways in which people align themselves with ‘healthy eating’ principles to legitimize their practices. Rather than always seeing their practices as a problem in need of intervention, many participants actively pursued and ‘tinkered with’ (Mol et al., 2010) their disordered eating as a form of self-care. We investigate how participants use the new food regime of orthorexia, as well as food choices and intolerances, as a normalised cover for restrictive diets. We argue that orthorexic practices entailing natural, medical and ethical concerns were successfully incorporated into participants' eating disorder repertoires. Participant's commentary on orthorexia reveals the vulnerability of people with disordered eating to the panoply of health and fitness advice circulating in contemporary society in which the pursuit of health and healthy lifestyles are at the centre of moral virtue, personhood and citizenship (Crawford, 1980). We demonstrate how these eating and body practices relate to an ethics of care that promotes moral virtues of hard work, purity and deprivation – all of which can ultimately lead to dangerous restrictive practices. Understanding how categories of health and care are understood and transformed by people with disordered eating has important implications for identifying people at all stages of help seeking.

Anorexia can be characterized as a profound transformation in social relations. These transformations occur across a number of overlapping fields, and include a range of institutional and domestic spaces and myriad mundane bodily practices in each. Through an examination of household space and a conventional treatment programme this article demonstrates the ways in which people with anorexia use and transform space. While there are many treatment programmes available for those with a diagnosis of anorexia, the ethnographic focus here is on those who have undergone bed programmes in public hospitals. As a result of the particularities of time and space, these rooms are transformed into intimate spaces that represent domestic bedrooms, thus fundamentally changing the nature of shared space in institutionalized settings. These transformations, however, are not straightforward, for these bedrooms fuse a number of bodily practices (such as eating, sleeping and abluting) that are sharply demarcated in domestic architecture. In these hospital bedrooms, private and public space is conflated, reversed and made ambiguous. Moreover, this article argues that this institutional transformation of space reproduces many of the private practices associated with anorexia, a factor which has been overlooked in the recorded failure of these types of programmes.

This paper explores how young women with disordered eating rationalise their behaviour as 'healthy'. Based on preliminary findings from an Australian Research Council grant that is investigating why people with eating disorders are reluctant to engage with treatment services, we demonstrate how young women use normative discourses of body surveillance, 'healthy eating' and self-discipline to maintain and support eating disorder practices. Healthy lifestyles are supported by a range of public health initiatives that promote 'watching one's weight', taking regular exercise and eating foods that are low in fat. Such culturally sanctioned discourses are readily available for people with eating disorders to position themselves within, providing a normative space to practice body surveillance, and also a legitimate and moral claim to looking after oneself. Investigating the parameters in which people rationalise excessive dietary restriction, and over-exercising as a healthy lifestyle is important for early detection of eating disorders, and to the development of strategies that challenge the ease in which eating disorders can be hidden in everyday health practices. This abstract was presented in the Understanding and Treating Eating Pathology stream of the 2013 ANZAED Conference.

Introduction Disentangling the effects of maternal depression in toddlerhood from concurrent maternal depression on child behaviour is difficult from previous research. Childcare may modify any effects of maternal depression on subsequent child behaviour, but this has not been investigated widely. Methods We examined the influence of maternal depressive symptoms during toddlerhood on children9s behaviour at age 5½ years, and investigated if formal or informal childcare during toddlerhood modified any relationship observed. Results Data were available from 438 mothers and their children (227 girls, 211 boys) who completed questionnaires during children9s infancy, toddlerhood and at age 5½ years. Recurrent maternal depressive symptoms in toddlerhood was a significant risk factor for internalising, externalising and total behaviour problems when children were aged 5½ years. Formal childcare at age 2 years modified the effect of recurrent maternal depressive symptoms on total behaviour problems at child age 5½. Neither intermittent maternal depressive symptoms nor informal childcare in toddlerhood significantly affected child behaviour problems. Conclusion Recurrent, but not intermittent, maternal depressive symptoms when children were toddlers had a longer term effect on child behaviour problems at child age 5½ years. As little as half a day in formal childcare at age 2 years significantly modified the effect of recurrent maternal depressive symptoms on total behaviour problems. Formal childcare for toddlers of depressed mothers is a pragmatic, supportive strategy that may have positive short and longer-term benefits for affected mothers and their children.