Social Science & Medicine 219 (2018) 61–69

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Social Science & Medicine

journal homepage: www.elsevier.com/locate/socscimed

Distribution and disavowal: Managing the parental stigma of Children's T

weight and weight loss
Jenny L. Davisa,∗, Carla Goarb, Bianca Managoc, Bobbi Reidingerb
a
The Australia National University, School of Sociology, Australia
b
Kent State University, Department of Sociology, Australia
c
Vanderbilt University, Department of Sociology, Australia

ARTICLE INFO ABSTRACT

Keywords: Parents who seek weight loss treatment for their children find themselves pulled between double moral burdens.
United States Blamed and shamed for the weight itself while culpable for the psychological effects of encouraging weight loss,
Stigma parental stigma comes from multiple directions. Through interviews with parents who send their children to
Fat stigma weight loss camps (N = 47), we ask: how do parents maintain a moral sense of self? We show that parents
Weight
distribute moral blame for their children's weight and disavow moral blame for encouraging weight loss. We
Family
Morality
further interrogate how parents' own weight status informs moral management strategies. We find parents'
Moral stigma bodies and biographies affect the ways distribution and disavowal take form. Parents with self-identified weight
Morality work problems internalize significant self-blame for children's weight gain, while parents without personal weight
problems more freely allocate blame to outside actors and factors. However, when disavowing the effects of
encouraging weight loss, parents with current or past weight issues rely on a shared experience that is un-
available to their slender counterparts. Our findings elucidate the moral tensions of parents who embark on
weight loss intervention for their children while highlighting the interplay between primary and associative
moral stigma in a family context.

Parents of children with high body weight face significant stigma-
tization. With heightened concern about the “childhood obesity epi-
demic” in the developed West, children's large bodies have become
visible markers of parental irresponsibility. Yet, encouraging weight
loss introduces new possibilities for enacting psychological harm and
sparking pathological food-body behaviors. Parents who seek weight
loss treatment for their children thus find themselves in moral tension.
Described as a pull between “two best goods” (Andreassen et al., 2013),
parents who seek weight loss treatment for their children are driven to
address the physical, psychological, and social effects of high body
weight while mitigating negative consequences of weight loss inter-
vention (Andreassen et al., 2013; Buchanan, 2000; Jackson et al.,
2005).
Existing literature documents two clear patterns: parents of children
with high body weight experience significant stigmatization (Callahan,
2013; Friedman, 2015; Jackson et al., 2005) and when parents focus on
weight, children have increased rates of disordered eating and lowered
self-esteem (Berge et al., 2013; Brewis, 2014; Davison and Birch, 2001;
Wansink et al., 2017). While these lines of research have advanced
independently, few studies address their intersection. We add to the
family health literature by training our focus on parents' moral tension
as they manage and maintain a moral sense of self while managing and
maintaining their children's bodies through weight loss intervention.
We do so through interviews with 47 parents and guardians who send
their children to weight loss camps. These data are part of a larger
project about stigma in a family context that also includes the stigma-
tization of race and disability. We broached the topic of weight for its
distinct moral quality. Unlike parents of children of color or parents of
children with disabilities, parents of overweight children are often held
responsible for their children's high body weight. The weight-based
element of the project, presented here, is driven by the broad question:
how do families manage moral stigmas of the body?
Anchored by theories of stigma and morality, we show that parents
distribute blame for their children's high body weight, while disavowing
blame for the potential psychological harms of encouraging weight loss.
Distribution refers to parents' intrinsic and extrinsic allocations of
blame. Disavowal refers to blame repudiation. Although we show dis-
tribution and disavowal throughout the sample, parents' own weight

∗
Corresponding author. School of Sociology, Research School of Social Sciences, Building 22, Haydon Allen Building, The Australian National University,
Canberra, ACT 2601, Australia.
E-mail address: jennifer.davis@anu.edu.au (J.L. Davis).

https://doi.org/10.1016/j.socscimed.2018.10.015
Received 3 May 2018; Received in revised form 13 October 2018; Accepted 18 October 2018
Available online 19 October 2018
0277-9536/ © 2018 Elsevier Ltd. All rights reserved.
J.L. Davis et al.
status informs how stigma management strategies take shape. Parents
with a history of personal weight troubles attribute more self-blame for
children's weight than their thin counterparts. At the same time, parents
use personal struggles with weight as a critical tool when disavowing
the effects of weight loss intervention. Parents' bodies—both thin and
large—thus emerge in various circumstances as both assets and li-
abilities for moral stigma management.
These findings are both empirically and theoretically significant.
Empirically, we follow Andreassen et al. (2013) by focusing on the
fraught intersection of fatness and weight loss for parents of children
with high body weight. Our analysis demonstrates that multiple moral
burdens, though operating together, impinge on parents in distinct
ways. Theoretically, we give conceptual clarity to the ways parents
contend with entangled moral burdens through robust and complex
strategies of stigma response. By investigating the relationship between
parents' stigma management practices and their own weight status, we
demonstrate how bodies, biographies, and social relations inform
stigma management practices in the family context.
1. Managing associative moral stigma
Stigma refers to a mark that is discrediting (Goffman, 1963) re-
sulting in status loss and social devaluation (Link and Phelan, 2001).
Stigma shifts with cultural and social contexts (Pescosolido and Martin,
2015), and can refer to bodily abnormality, status1 (e.g., race, religion,
gender), and blemishes of character (Goffman, 1963). Because char-
acter is ostensibly under a person's own control, blemishes of character
have a distinct moral quality. Weight, with its cultural ties to con-
sumption and self-control, maintains a strong moral element. While all
forms of stigma bear social consequences (Hatzenbuehler et al., 2013)
the costs of moral stigma are particularly sharp for both life chance
outcomes and emotional wellbeing (Corrigan, 2000; Goffman, 1963;
Jones et al., 1984; Thoits, 2011).
Stigma not only affects those directly afflicted (i.e., primary stigma)
but also affects those with whom the stigmatized associates (Goffman,
1963). Associative stigma is the process by which stigma spreads.
Connection to a stigmatized person can result in status loss, social re-
jection, and a range of socio-emotional consequences (Corrigan et al.,
2006; Gray, 2002; Green, 2003; Khamis, 2007; Östman and Kjellin,
2002; Phelan et al., 1998; Thomas, 2006; Turner et al., 2007).
Corrigan et al. (2006) distinguish three manifestations of associative
stigma: blame, shame, and contamination. While contamination results
in social distancing, blame and shame mark the stigma associate with a
moral failing and entail the amplified penalties of moral stigmatization
(Corrigan and Miller, 2004; Jones et al., 1984). Parents of children with
high body weight offer a clear case of associative moral stigma. Chil-
dren's body size is perceptibly linked to parents' feeding practices and
the lifestyle parents cultivate in the home (Andreassen et al., 2013;
Copelton, 2007; Jackson et al., 2005; Stewart et al., 2008). Indeed,
parent-blame narratives hold strong purchase in a cultural moment that
frames obesity as an epidemic and locates children as key subjects of
concern (Andreassen et al., 2013; Buchanan, 2000; Copelton, 2007;
Jackson et al., 2005; Jarvie, 2016; Maher et al., 2010). At the same
time, parents who encourage weight loss may be blamed and shamed
for fostering poor body image and instigating disordered eating beha-
viors (Andreassen et al., 2013; Buchanan, 2000). Thus, parents who
encourage weight loss find themselves in moral tension and face moral
threats to the self.
Certainly, the effects of stigma can be extensive and far reaching.
However, these effects are not immutable. Stigmatized subjects can
actively challenge cultural meanings and contest their own stigmatized
1
Goffman originally used the term “tribal” for what we call “status” stigma.
Our use of “status” follows Pescosolido and Martin (2015) who use status as a
correction to Goffman's racially charged terminology.
62
Social Science & Medicine 219 (2018) 61–69
status (Thoits, 2011). For those marked with a moral stigma, managing
its effects entails mitigating moral meanings, rejecting moral devalua-
tion, and recasting moral vulnerabilities as moral strengths. These
processes of moral stigma management constitute strategies of morality
work (Davis, 2014; Davis and Love, 2017).
Rooted in deviant accounts studies (Scott and Lyman, 1968; Sykes
and Matza, 1957) morality work is the process by which morally stig-
matized persons reclaim a moral sense of self (Davis, 2014; Davis and
Love, 2017; Davis and Manago, 2016). We thus investigate parents'
narratives to understand how they engage in morality work amidst
multiple and competing moral burdens. Our data set, which includes
parents both with and without self-identified weight issues, allows us to
parse the ways that parents' weight status affects the morality work
process. That is, how does shared stigma serve and constrain morality
work for parental stigma associates? We show that parents' own bodies
and biographies are entangled with the moral meanings placed upon
them, and the strategies available to them, as they manage children's
weight and weight loss.
2. Methods
Data come from interviews with parents who enrolled their children
in two separate weight loss camps in the United States during the
summers of 2014 and 2015 (N = 47). One camp is a small non-profit
owned and run by the founder. Although campers come from all across
the country, there is a concentration of regional clientele. The camp
director is a former nurse and started the camp after noticing adult
diseases, such as type-2 diabetes, emerging in her adolescent patients.
She used personal assets to start the camp and lives on-site year-round.
The amenities are clean and sufficient but relatively rustic and
minimalist. The camp relies on a small hired staff as well as volunteers
with backgrounds in nursing and nutrition. The second camp is a larger
for-profit outfit with broader national reach. This camp has a main
campus and has franchised out to additional locales over the past five
years. The camp has updated amenities, a large staff, and an extensive
range of activities available to campers.
Despite different business models and facilities, the camps are si-
milarly structured and comparably priced. Both camps offer sessions
ranging in length between 4 and 8-weeks, with shorter “refresher”
sessions available. Campers live on-site for the duration of their ses-
sions. Prices range from $2,000 for the shortest sessions, and up to
$10,000 for the longest. Scholarships and grants were available, and
many parents took advantage of these. In addition, it was common for
parents to report that they informally arranged discounts and payment
plans with camp directors to accommodate financial needs. Although
both camps offer family programming such as “Mom's Camp” and fa-
mily weekends, we drew our sample from parents who sent their chil-
dren to the kids-only camps, which serve campers under 18-years-old.
Both camps tout health as the primary objective and define them-
selves in their published literature as “not a fat camp.” This messaging
proliferated in opening-day presentations by camp staff. Camps were
thus explicit in their political orientation towards health as a primary
goal and weight as a secondary concern. However, the camps also place
significant time and attention on caloric intake and expenditure and
centralize before-and-after images in which weight change is the pro-
minent signifier of success.
The final sample (N = 47) includes 45 parents, 1 older sibling, and 1
great-grandparent, all of whom identify as the campers' primary care-
givers. For clarity of presentation, we refer to this entire group as
“parents” throughout the paper. Although two participants are techni-
cally guardians, these participants occupy a parental role. We did not
specify a preference for mothers or fathers in our recruitment efforts
however, the sample is disproportionately made up of women (85%
women, 15% men). This resonates with existing parental research in
which mothers, tasked with primary child care responsibilities, are
more likely speak with researchers about children's issues (Davis and
J.L. Davis et al. Social Science & Medicine 219 (2018) 61–69

Table 1 as possible during drop-off day so that some rapport would already be
Family demographics.a established by the time phone interviews commenced.
Respondent (N = 47) Campers (N = 52)b Interviews lasted between 30 min and 90 min. We asked partici-
pants about their demographic information, their children's weight
μ/% range μ/% range history, their own weight history, family dynamics, and about the
general experience of raising a child with weight issues. In addition, we
Sex Sex
Male 14.89% Male 44.23% asked how parents talk about weight with their kids, including how
Female 85.11% Female 55.77% parents broached the topic of weight loss camp. Finally, we asked
Age 48.2 27–68 Age 13.3 9–20 parents for their general views on weight as a physical, psychological,
Race Racec social, and cultural issue. All interviews were transcribed and coded.
White 87.50% White 77.07%
We analyzed the data using an abductive approach (Tavory and
Person of Color 12.50% Person of Color 22.73%
Weight Identification First time campers 38.46% Timmermans, 2014; Timmermans and Tavory, 2012). An abductive
Thin 40.43% approach combines inductive and deductive strategies, such that re-
Overweight 59.57% searchers begin with a firm base in existing theory and literature and
Marital Status
then closely analyze empirical data using grounded, interpretive
Married 77.78%
Divorced 20.45% methods. The abductive approach situates findings within ongoing in-
Widowed 2.22% tellectual discussions while leaving room for the particularities of a
given data set to diverge from theoretical expectations.
Notes We coded each transcript, treating full statements as the unit of ana-
a
Demographics are based on self-report. Not all respondents gave their race/ lysis. We first identified instances of blame and shame. We then de-
ethnicity or age. Percentages are calculated relative to others who provided
termined if participants were addressing blame and shame for children's
their demographic information. 85% of respondents provided all demographic
weight or blame and shame around weight loss intervention. We then
information
b discerned how parents treated each instance of blame and shame, identi-
There were 5 sets of siblings, accounting for the difference between the
number of parents and children. fying categories of distribution and disavowal. For instances of distribution,
c
Race (along with all other demographic information about children) was we determined self vs. other, and then parsed which other(s) emerged as
reported by parents. blameworthy. For disavowal, we examined how parents disavowed blame
and shame. We then analyzed how patterns of distribution and disavowal
Manago, 2016; Goar et al., 2017; Green, 2003; Landsman, 2008; took shape in accordance with parents' weight status. Analyzing at the
Manago et al., 2017). On average, respondents were 48.2 years in age statement level allowed us to identify multiple (and competing) moral
and most were married (80%). About 60% of parents reported they management strategies within each transcript, thus capturing parents'
were currently overweight or obese or had been at some point in their multifaceted stigma experiences. Comparing transcripts illuminated key
lives, which closely mirrors the U.S. population in which 2 in 3 adults patterns and enabled us to map theoretically relevant dynamics.
are considered overweight or obese (Flegal et al., 2016). Five parents Our analysis yielded associative moral stigma as a key theme. This
had more than one child at camp, bringing the total number of campers theme coincides with existing literature about parents of stigmatized
to 52. Campers were relatively evenly gender distributed, with 56% children in general, and parents of children with high body weight, in
girls and 44% boys, and their average age was 13.3 years. Both re- particular (Jarvie, 2016; Maher et al., 2010). In addition, our data re-
spondents and campers were majority White, as identified by the par- vealed the active ways that parents, as moral stigma associates, navigate
ents (87.5% White parents, 74.1% White campers). Nearly 62% of their own moral sense of self. To analyze this thread, we identified in-
campers were returning, with the average number of years at camp stances of parent blame and shame (both self-inflicted and extrinsic),
around 2 (see Table 1).2 noting the subject matter of that blame and shame (Corrigan et al.,
After receiving ethics approval from all authors' respective institu- 2006). We then traced the ways that parents manage their moral vul-
tions, recruitment took place in two stages. First, we sent an email to nerabilities: rejecting, embracing, and negotiating moral meanings at-
parents via camp directors. The email introduced the study and gave tached to the self while adhering to, acknowledging, and pushing against
parents an opportunity to contact us directly. In addition, we attended a cultural norms of health, beauty, and the body ideal. Parsing the data by
drop-off day at the beginning of the summer. Drop-off day is highly parents' self-reported weight status allowed us to map the effects of
structured and includes camp tours and presentations by camp staff. We shared stigma upon morality work processes. The authors first coded the
set up a table at registration where we could speak with parents one-on- data independently, and then collaboratively. Instances of disagreement
one and provide parents with a 1-page handout about the study. We were resolved through discussion, debate, and revisiting the literature.
also made a short announcement during the opening information ses-
sion. Parents who were interested in participating gave us their contact 3. Findings
details and we followed up to arrange interviews.
Camp directors at both sites keep drop-off day activities highly re- As moral stigma associates, parents in our sample widely reported
gimented and remove parents from camp premises as efficiently as experiencing blame and shame. Parents shared cases of explicit moral
possible so that kids can quickly immerse themselves in the camp set- accusations leveraged against them, anticipated moral rejection, and an
ting with minimal emotional distraction. For this reason, we could not internalized sense of guilt. Stemming from perceived parental respon-
conduct interviews on-site. Instead, we conducted interviews over the sibility for children's physical and psychological wellbeing, parents'
phone and skype, as per participants' preference. Although face-to-face associative moral stigma was characterized by concerns over high body
interviews are ideal for fostering rapport and observing body language weight as well as the consequences of weight loss intervention.
and non-verbal cues, the structure of drop-off day combined with the Notably, participants used the term “stigma” as a prominent de-
fact that camps draw from all over the country, made remote interviews scriptor in their narratives about both weight and weight loss, thus
the most practical and feasible method. We made ourselves as available demonstrating a tight fit between our theoretical orientation and par-
ents' lived experiences. Reflecting a widespread theme among partici-
pants, Anne3 expressed concern that others view her children's body
2
Throughout the text and in all figures and tables we use the language
“weight issues”, “overweight”, “normal weight” and “thin” because these were
3
the self-descriptive terms parents used to self-identify. All names are pseudonyms.

63
J.L. Davis et al.
size as a moral failing of parenthood.
I mean it's just very stigmatized. I do see parents looking at me and
my husband as failures. I feel like a failure, and I feel as though other
people look at me and think…You know, ‘clearly, she must be a
horrible mother. It must be like a stressful family. Things must be
horrible’.
At the same time, parents face the blame and shame of associative
moral stigma when encouraging weight loss. Kristin, the mother of a
13-year-old camper recounts:
I have a girlfriend who's close to me whose mom has struggled with
anorexia my girlfriend's whole life. My girlfriend's daughter and my
daughter are best friends. I almost feel like they've been not sup-
portive at all [of my efforts at weight loss intervention] because I
think she completely thinks that [my daughter] should just do
whatever she wants.
Pulled between “two best goods” (Andreassen et al., 2013), parents
seeking weight loss treatment for their children experience associative
moral stigma for both weight itself, and for the possible effects of
weight loss intervention. We turn now to the ways parents maintain a
moral sense of self in the face of these double moral burdens. We first
recount the ways parents distribute moral blame for high body weight
and then show how parents disavow moral blame for encouraging
weight loss.
3.1. High body weight: distributing moral blame
With little exception, parents in our sample owned a degree of re-
sponsibility for their children's weight. The presence of self-blame
across the sample comports with documented stigma processes, in
which cultural norms and values are internalized by stigmatized sub-
jects (Link and Phelan, 2001). However, parents do not bear the moral
burden all on their own. Rather, parents distribute blame across various
actors and factors, many of which are out of the parents' control.
Keeping in mind that culpability is the hallmark of moral stigma
(Goffman, 1963), blame distribution is a move that partially neutralizes
moral devaluation and improves parents' position on the moral stigma
continuum (Davis, 2014; Stets and Carter, 2011, 2012).
In the process of giving their children's weight history and
throughout the interviews, parents frequently explored the causes of
their kids' high body weight. Of all attribution statements, 36.9% are
self-attributions, and 63.1% reference some external force. Of the 47
parents we interviewed, 46 expressed self-blame at least once and all 47
pointed to external causes. That is, parents did not either blame them-
selves or blame others, but blamed both themselves and also others.
Parents in our sample thus internalized stigmatization while actively
pushing against it. One mother, Jane, was an exceptional case and
placed all blame in extrinsic factors. Her personal history, which in-
cludes both of her own parents dying prematurely from weight related
complications, led her to engage in vigilant monitoring of food and
nutrition in the home. Jane's exceptionalism among the sample, cou-
pled with an extraordinary history, acts as a reminder that individual
cases may diverge from the standard and should be evaluated on their
own terms. At the same time, the notable exception of Jane's experience
bolsters self-and-other blame distribution as the general rule.
Although nearly all parents expressed a combination of self-blame
and other-blame, the pattern of distribution varied by parents' weight.
Parents with current or past weight issues named themselves as
blameworthy actors in 45% of attributions, while parents who reported
“normal” weight placed about 25% of blame attributions upon them-
selves (see Fig. 1). Said otherwise, in each interview, parents with
current or past weight issues distributed blame to others an average of
2.6 times, and to themselves an average of 2.14 times. In contrast,
parents who considered themselves to be “normal” or “thin” distributed
blame to others 3.05 times and to themselves 1.11 times, on average.
64
Social Science & Medicine 219 (2018) 61–69
Parents with weight issues blamed themselves twice as often as parents
who reported being of normal weight (2.14 vs. 1.11, diff = 1.03.) In
this way, parents' bodies and biographies enabled and constrained their
strategies of moral stigma management.
3.1.1. Intrinsic blame
Parents across the sample expressed self-blame for their family
feeding practices. These articulations of unease and perceived failure
among participants—especially from mothers—reflect long standing
traditions of nourishment as integral to children's cultivation (Lareau,
2011) and the maintenance of healthy family life (DeVault, 1994). In
this vein, Janet expressed regret for not cooking more healthful meals
in the home:
I should've been different…, I should've always been providing
healthier meals. I was once told that it's up to me, you know, what
my kids eat. What my husband eats…I could definitely be better
about the food that gets brought into the house. I wish I knew how
to cook. I wish I cooked better. I wish I cooked food that my kids will
eat…
Similarly, Stella, claimed responsibility for family food provisions
and expressed a sense of guilt for creating too much temptation with
“unhealthy” food items:
I'm…totally responsible for what I provide. Okay? She doesn't do the
shopping. I do…I mean, you know, we have two different kinds of
cookies, and five different kinds of cereal, and you know, three kinds
of chips in there right now…That's where I have to start being alert
to what's going on.
In addition to providing the “wrong” foods, parents worried about
modeling unhealthy behaviors and failing to foster the active lifestyle
that would keep their children within the desired weight range. This
theme was especially prominent among parents, like Claire, who
identified weight problems in themselves.
So for myself I don't adopt the healthiest practice. And I know from
the research that I've done, that children are born to mimic what
their parents are doing. So she's nine. So when she gets older she's
not going to look at the fact that I'm getting up early and making all
these healthy breakfasts and lunches for her. She's going to look at
how I withhold eating and I eat right before I go to bed. I know
there's some behavior changes that I've been resetting with myself.
3.1.2. Extrinsic blame: actors and factors
Although parents certainly interrogated their own role in children's
high body weight, they did not absorb all of the blame themselves.
Rather, they spread the moral burden across myriad actors and factors.
While thin parents spread the blame more liberally, all parents out-
sourced at least some of the moral burden. Parents named their children
and other family members as blameworthy actors, along with biological
factors and larger cultural trends contributing to children's weight gain.
Although parents' weight status affected the degree to which they dis-
tributed blame externally, the actors and factors they named appear
similar.
3.1.2.1. Extrinsic actors. Parents across the sample named children as
key blameworthy actors. Patricia, like many other parents, described
how her own efforts are thwarted by her son:
We stopped soda and we stopped junk food but he still put on eleven
pounds this year… He would eat double portions. He would eat two
or three turkey sandwiches at a time. He would sneak food. If you
got up and left the table he'd steal your food.
Parents often shared incidents of unearthing food and wrappers in
their children's rooms, discovering their children had been purchasing
extra food at school, and coming home to find empty boxes of granola
J.L. Davis et al.
Fig. 1. Weight blame distribution by parent weight.
bars, [one]hundred-calorie packs, and other food items meant to be
eaten in single servings. Parents at times laughed about these in-
subordinations, but other times expressed exasperation and dismay,
feeling pained that their children would behave in ways that seemed
self-destructive.
Along with blaming children, parents distributed blame to other
family members, both inside and outside the home. Jim lamented the
negative influence of his ex-wife upon their 13-year-old daughter, while
Rebecca expressed frustration about her husband's use of food to bond
with their son.
Jim: [H]er mother is sedentary. She does no exercise, she doesn't
even really have any concern about her weight, which is troubling.
But, I mean, she follows her mother. She loves her mother, and they
spend a lot of time together. So, I think that, you know, birds of a
feather. You hang with people that have that mentality, that's what,
largely, what you're going to be.
Rebecca: My son, until recently, didn't even drink soda, and he was
overweight. My husband would buy soda and that bothered me
tremendously…he'd take him to McDonalds and have a soda and
don't tell mommy, like that kind of thing. It was a bonding thing I
guess. But that would piss me off.
3.1.2.2. Extrinsic factors. In addition to blaming other actors, parents
also distributed blame across a range of factors including children's
physiology and sociocultural circumstances. These factors are
ostensibly outside of any individual's control, thus weakening causal
ties between parents' behaviors and children's weight.
It was common for parents to note that their children had been large
since infancy, referencing weight and height charts that showed their
children in the highest percentiles. In this vein, parents discussed slow
metabolisms and bulky builds, along with genetic lines that predispose
their children to high body weight. Betsy pointed out several “morbidly
obese” relatives on both sides of the family, while Tamara described her
daughter as “big boned…a bit like her dad”. Christine, quoted below,
talked about metabolic variations that disadvantage her family:
[S]ome people are sort of predisposed to easily kind of gaining
weight whereas some people it seems like they just have a fast
metabolism and they can sort of eat more and not gain as easily.
That's not our situation. We really have to be careful about diet and
activity level and you know, that's about it.
65
Social Science & Medicine 219 (2018) 61–69
Beyond individual factors, parents were acutely aware of the social
and cultural factors that contribute to weight gain. Claire's complaint
about school lunches rang true for many parents in the sample:
I honestly think the problem was the school lunch. I didn't realize
the type of stuff that they were eating. They had access to ice cream
every day. They took sodas with sugars out of school. They're still
eating pancakes or sausage and with syrup. I had no idea.
Technology emerged as another key sociocultural factor, fostering a
sedentary lifestyle different from the lifestyle that parents experienced
during their youth. As Janet explained:
When I was a kid we had three TV channels. You either watched to
see something on the three or four TV channels, or you read a book,
or you went outside and played. Ninety percent of the time I'm
outside playing. So that's probably why I was never a chubby child.
But nowadays they have stuff streaming on their phones, they have
computers, they have iPads…
Parents felt that lifestyles “nowadays” are rushed, and the available
food is often of poor nutritional quality. Sandra's statements summarize
this point:
Everybody is sitting around. We drive everywhere. Our public
transportation a lot of the places aren't that wonderful. Food is
cheaper. Junk food is cheaper. When you go to any office buildings,
you don't see fresh fruit or fresh vegetables in a bowl. You see candy
in a bowl.
In sum, parents owned a degree of blame, but did not bear the entire
moral burden. Instead, parents distributed blame across myriad actors
and factors, keeping some for themselves while allocating blame to
children, family members, and sociocultural conditions. Blame dis-
tribution operated not as an either/or, but as a both/and. Parents va-
cillated between self-blame and other-blame, partially alleviating ne-
gative moral meanings without unburdening themselves entirely. In
this way, parents worked to manage a moral sense of self. Parents' own
bodies and biographies played a significant role here. While nearly all
parents enacted a combination of self-blame and other-blame, those
with current or past weight issues carried a disproportionately high
moral burden, blaming themselves in nearly half of their attribution
statements. In contrast, slender parents self-blamed in just a quarter of
blame attributions, mobilizing their own thin bodies for moral relief.
J.L. Davis et al.
3.2. Psychological effects of weight loss intervention: disavowing moral
blame
Research shows that parents just talking about weight can have
negative effects on children's relationship to self, food, and body (Berge
et al., 2013; Davison and Birch, 2001; Wansink et al., 2017). Directly
encouraging weight loss thus leads parents down a fragile and possibly
troublesome path. Parents seeking weight loss intervention for their
children must make an active decision to do so. In the case of camp
enrollment, this entails researching options, paying a substantial fee,
talking with children about camp, and arranging for children to get to
camp, often driving children to camp themselves. That is, while parents
can claim a (partially) passive role in children's weight gain, they are
distinctly active in the decision to encourage weight loss. Thus, the
moral burden of weight loss intervention sticks to parents tightly.
Disavowal emerged as a key strategy for managing moral meanings
as parents encouraged weight loss. Disavowal refers to rebuffing some
claim, and in this case, it is distancing the self as a cause of psycholo-
gical harm. Although all parents in the sample expressed disavowal, we
saw clear patterns based on parents' own weight status. Namely, thin
parents expressed disavowal more actively than parents with a history
of weight issues, while parents with a history of weight issues utilized
their shared stigma to soften the blow of weight loss intervention.
On average, each parent gave 2.76 disavowal statements in the
course of a standard interview. However, compared to self-identified
overweight parents, thin parents made 0.75 more disavowal statements
per interview. That is, thin parents disavowed the negative effects of
weight loss intervention about 27% more often than overweight parents
(see Fig. 2). This pattern indicates heightened concern among slender
parents of enacting psychological harm, likely born of an implicit and
visible contrast between parents' own bodies and those of their chil-
dren. This pattern gains context when examining how parents dis-
avowed blame, as those with current or past weight issues actively
highlighted their own histories and constructed weight loss as a shared
journey, a narrative unavailable to parents who benefit from thin pri-
vilege. In disavowal, we see that shared stigma presents a unique asset
for moral stigma management.
Parents across the sample were sharply aware of the psychological
consequences to which they expose their children by encouraging
weight loss. Disavowal is the process by which they actively refute these
consequences as a source of blame. Parents disavowed blame in two
interrelated ways: (1) framing weight loss intervention as a risky moral
necessity, and (2) highlighting direct efforts to minimize psychological
harm.
Fig. 2. Mean number of disavowal statements per interview, by parent weight.
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Social Science & Medicine 219 (2018) 61–69
3.2.1. Weight loss intervention as a necessary risk
By and large, parents in our sample expressed regret that their
children were in a position that required weight loss intervention, but
treated it as a risky moral necessity due to what they perceived as the
far greater consequences of high body weight. As Matthew put it:
It's one of the worst subjects to talk about…I don't want to talk to
him [13-year-old son] about it. I just want him to be happy. As a
loving parent, all you want is for your children to be happy. You
don't want to broach subjects that will make them miserable. It has
to be done at times, but you never want to do it.
Parents expressed concerns about health, social rejection, and psy-
chological strife tied to high body weight. The risk of weight loss in-
tervention was thus set up as less risky than allowing continued weight
gain. Focusing on social concerns, Emma observed:
When he was thinner he had more of a social life and he was more
involved with other kids and now he's not. …I feel like, yeah, he'll
forever face those issues… I just don't feel like he'll be invited to
many parties or be as popular as some of the other kids. Who
knows? He might not even be able to get a girlfriend at like sixteen,
seventeen years old like most of the kids do. Not at the rate he's
going.
Focusing on health, Anne confessed fear of an early death for her
now 16-year old son if he does not lose weight, noting that “the human
body wasn't meant to carry that extra weight around”. Similarly,
Courtney cited a family history of health problems as the impetus for
encouraging weight loss for her 15-year-old daughter:
[W]e have a lot of health issues on both sides of our family. My dad
battled cancer twice, my mom has Rheumatoid arthritis, also colitis.
We've had diabetes on both sides, a lot of autoimmune. My uncle
passed away from that... So that's my concern for her, I want her to
be healthy and to live a long life and not have to deal with anything
like diabetes or anything else if we can avoid it.
Although parents focused to different degrees on health versus so-
cial/psychological issues, all parents cited multiple reasons that talking
about weight, though difficult, is a duty of responsible parenting.
Exemplifying the way parents entwined their range of concerns, Jim
listed all of the reasons he makes weight loss a priority for his 13-year-
old daughter:
I'm concerned that she wouldn't be as healthy down the road. That
she might develop nutritional deficiencies… And, you know… I
want her to be attractive. I want her to be a pretty girl, that she is,
J.L. Davis et al.
she's a beautiful girl. And I think that the prejudice exists in society
in all that those people that are obese, they could be wonderful
people and beautiful people, but that layer that they are on the
outside is going to dictate an awful lot about what job they get, who
they hang around with, how favored they are, all kinds of things.
3.2.2. Harm reduction
A second way that parents disavowed the potential negative effects
of weight loss intervention was by actively engaging in harm reduction
strategies. That is, parents were keen to share the ways they approached
weight loss thoughtfully, remaining sensitive to issues of self-esteem
and body image. Overall, parents reported mitigating harm by focusing
on health (rather than weight), involving the entire family in diet and
exercise, actively contextualizing weight as just one small part of who
the child is, and highlighting the child's strengths while encouraging
healthy habits.
Parents reported emphasizing positivity and avoiding punitive
measures as a key strategy to mitigate harm. Sasha stated this tactic
simply:
Small goals and lots of encouragement. Make it about your kid's
achievements and your kid's ambition and not about setbacks.
Highlighting health and actively avoiding words like “fat” and
“weight” was another way that parents addressed the issue without
overemphasizing body image ideals. This tactic aligns with both camps'
political orientations of health-rather-than-weight. For example:
Dawn: I'm trying to put the emphasis rather than on being fat or
whatever try to put the emphasis on his health. And eating healthy.
That type of thing rather than trying to make him feel bad about
himself.
Minnie: It's just a really, really hard balance. It's hard to figure out
what is the right thing to say. I know that she's at such a vulnerable
age. So…I try not to talk about weight. We talk about health, and we
certainly set a good example in our family. That's what we try to
focus on.
3.2.3. Shared stigma and disavowal
Although parents across the sample disavowed blame by framing
weight loss as a moral necessity and by actively engaging in harm re-
duction, these morality work strategies took shape in distinct ways for
parents with and without personal weight issues. Parents who had
personally dealt with high body weight deployed their own bodies and
biographies as sources of compassion and shared struggle, bolstering
claims about weight loss as a moral endeavor and describing lifestyle
changes as collectively beneficial joint ventures within the family. In
contrast, slender parents engaged in family health campaigns despite
rather than because of, their personal weight status.
Framing intervention as a risky moral necessity and carefully en-
acting weight loss measures means entrenching intervention efforts
within a larger narrative of love and care. Here, parents with current or
past weight issues evoked their own experiences as a way to express
commiseration—rather than judgment—as they put their children on a
weight loss path. For example, Erika reported centralizing her own
story when talking to her daughter about weight.
I was overweight myself, so…when I'm talking to her, I would try to
tell her that I want the best for her and I don't want her to go
through the pain that I went through trying to lose weight and trying
to work towards it every day. I want her to be happy with herself
and prom is coming. And so many good things are coming for her.
Similarly, Brooke recalled her own struggles to find clothing that fits
and recounted feeling self-conscious in public and among friends.
“Because of my weight issue I'm more sensitive to the fact that I don't
want them to live like I've been living”, she said.
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Social Science & Medicine 219 (2018) 61–69
When implementing dietary and exercise changes, parents with self-
identified weight issues often embarked on a joint weight loss venture
that would benefit the whole family. For instance, Nancy attended a
“Mom's” health program while her daughters were away at camp, and
Aaron goes to a personal trainer with his son where they both learn
about food and fitness. “You can only lead by example” he explained.
“You have to get in there with them”.
In contrast, parents with no weight issues faced an additional hurdle
in weight loss intervention as their own slender stature became a salient
point of comparison. “I don't know what to do”, said Vicky. “I'm skinny
and she's not. I never ever brought up that issue because I never wanted
her to feel self-conscience about it. I didn't want her self-esteem to
suffer because of that. But, unfortunately it was obvious.”
Parents own bodies and biographies were clear factors in disavowal.
While thin parents could point to other family members who have
struggled with weight, parents with a personal history of high body
weight could present themselves as a trustworthy source with first-hand
knowledge of what children are going through and may face in the
future. In this way, a shared stigma experience eased the process of
disavowal. Parents' large bodies were an asset here, rather than a lia-
bility, as they justified the decision to encourage weight loss for their
children and cushioned the moral blow of weight loss intervention.
4. Conclusions
Parents who seek weight loss treatment for their children are subject
to associative moral stigma from multiple directions. Blamed and
shamed for the weight itself, and culpable for negative effects of en-
couraging weight loss, parents who send their children to weight loss
camps walk a moral tightrope between the two best goods of physical
and psychological wellbeing. Guided by theories of morality work and
associative moral stigma, we showed how parents who send their
children to weight loss camps navigate a morally precarious position.
Our finding that parents experience stigmatization from multiple
directions resonates with and offers further support for research by
Andreassen et al. (2013) about the moral tension parents face when
broaching weight loss intervention for their children. We build on ex-
isting findings by documenting distribution and disavowal as strategies
that address distinct components of the stigma experience. This con-
tribution shows that parents are not morally trapped, but rather, adept
at navigating a delicate moral terrain. While Andreassen et al. (2013)
highlight parents' moral precariousness, we identify the active strate-
gies by which parents address stigmatization in its multiple and com-
peting forms. By attending to stigma's multiple and competing forms,
our findings begin to bridge parallel literatures about parental stigma
around children's weight on the one hand (Callahan, 2013; Jackson
et al., 2005), and potential psychological harms of weight loss inter-
vention, on the other (Berge et al., 2013; Wansink et al., 2017).
A key element of our findings is that patterns of distribution and
disavowal varied between participants with and without personal
weight issues. Parents who identified as overweight continued to
shoulder a majority share of the blame for their children's body size
while parents without a history of weight issues outsourced a majority
of blame to extrinsic actors and factors. At the same time, parents who
identified weight issues in themselves mobilized their bodies as tools in
disavowal. By embedding intervention within narratives of shared
struggle and commiseration, high body weight parents positioned
themselves as empathetic allies. While slender parents actively worked
to disavow harm, they had to contend with an a priori position of
presumed judgment. It is perhaps this juxtaposed embodiment that
fostered more active disavowal by thin parents vis-à-vis their heavier
counterparts.
Parents own bodies thus informed their morality work practices.
Those with thin privilege had greater freedom to cast themselves as
minimally culpable for children's high body weight, while those who
shared in the stigmatized mark could more easily claim a benevolent
J.L. Davis et al.
position of collective struggle. This finding complicates the canon of
“fat stigma” studies. In line with existing social deficit models of high
body weight, parents in our sample faced an extra burden when dis-
tributing blame for children's size. However, the shared struggle of fat
stigma provided parents of size with a clear advantage in managing
weight loss intervention, positioning high body weight as a tool parents
wield to protect their children's emotional wellbeing and mitigate their
own blame and shame. While the fat stigma literature shows clear
trends by which persons of size face social disadvantage (Giovanelli and
Ostertag, 2009; Puhl, 2011; Puhl et al., 2012), our work highlights a
case in which fat is an asset. Our work is thus distinct in its depiction of
high body weight as a social advantage in the context of particular
parent-child interactions.
In this vein, our work broaches the important topic of shared status
as a critical component of stigma dynamics. Parents with high body
weight were both hindered and served by their stigmatized status be-
cause they share this status with their children. The shared nature of the
stigmatized status amplified parents' blame and shame for causing
children's weight issues, but is also the mechanism that transformed
parents' high body weight from a social liability to an asset when dis-
avowing psychological harm. Goffman's (1963) classic work refers to
the “choir” as insiders made up of the “own” and “the wise.” While both
the “own” and the “wise” are sympathetic to the circumstances of the
primary stigmatized, the “own” are distinguished by shared experience.
Our work shows that one's position within the choir—as an “own” or a
“wise”—affects how stigma spreads and the mechanisms available for
mitigating and alleviating blame and shame upon the self while at-
tending to the needs of an intimate stigmatized other.
This study further builds on the morality work research program by
applying the morality work frame in an associative stigma context.
Previous work has addressed how individuals account for their own
moral stigmas (Davis, 2014); and how moral stigma boundaries are
debated in the public sphere (Davis and Love, 2017). Highlighting
morality work among stigma associates positions stigma as a relational
process that spreads through social networks (Davis and Manago,
2016). Our focus on parents' morality work practices in the face of
moral tension gives greater depth and precision to the morality work
research program, while the morality work framing provides structure
to parents' complex lived experiences as they deal with children's
weight issues. Future studies should continue to develop a morality
work frame within which stigma management can be examined for
multiple actors across social contexts. A greater understanding of these
processes may increase awareness of management strategies used by
stigmatized individuals and their families.
We recognize that while our data illuminate parents' lived experi-
ences and shed light on sociological questions, the data are necessarily
limited. In particular, we note that the cost of weight loss camp is
prohibitive for many families. Although a substantial number of fa-
milies obtained discounts, we are primarily working from narratives of
middle and upper-middle class parents. Moreover, weight loss camp is a
relatively extreme measure. The stigma experiences of parents in our
sample may therefore be more pronounced than in families seeking
milder forms of intervention such as family dietary changes or con-
sultation with a pediatrician. The empirical element of our argument
should be interpreted with these limitations in mind.
Noting the limitations, our theoretical contribution, with regard to
the intersection of bodies, biographies, and stigma management in a
family context, likely extends beyond the particularities of our sample
and forms a basis for future research in diverse family settings.
Furthermore, our findings may be of use to health care professionals
who should be aware of morality work processes and practices around
weight in a family context. For instance, we know that existing cam-
paigns premised on shaming parents of children with high body weight
have emerged largely ineffective (Callahan, 2013). Our research in-
dicates that parents are already keenly aware of the devalued status of
high body weight and actively manage both the weight and negative
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Social Science & Medicine 219 (2018) 61–69
effects of weight loss for children and themselves. Support and colla-
boration from medical professionals is likely more effective than efforts
to blame and shame.
Funding
Funds for this project were drawn from a Fund for the Advancement
of the Discipline (FAD) seed grant, administered through the American
Sociological Association and the National Science Foundation.
References
Andreassen, P., Grøn, L., Roessler, K.K., 2013. Hiding the plot: parents' moral dilemmas
and strategies when helping their overweight children lose weight. Qual. Health Res.
23, 1333–1343.
Berge, J.M., MacLehose, R., Loth, K.A., Eisenberg, M., Bucchianeri, M.M., Neumark-
Sztainer, D., 2013. Parent conversations about healthful eating and weight: asso-
ciations with adolescent disordered eating behaviors. JAMA pediatrics 167, 746–753.
Brewis, A.A., 2014. Stigma and the perpetuation of obesity. Soc. Sci. Med. 118, 152–158.
Buchanan, D.R., 2000. An Ethic for Health Promotion: Rethinking the Sources of Human
Well-being. Oxford University Press.
Callahan, D., 2013. Children, stigma, and obesity. JAMA pediatrics 167, 791–792.
Copelton, D.A., 2007. “You are what you eat”: nutritional norms, maternal deviance, and
neutralization of women's prenatal diets. Deviant Behav. 28, 467–494.
Corrigan, P.W., 2000. Mental health stigma as social attribution: implications for research
methods and attitude change. Clin. Psychol. Sci. Pract. 7, 48–67.
Corrigan, P.W., Miller, F.E., 2004. Shame, blame, and contamination: a review of the
impact of mental illness stigma on family members. J. Ment. Health 13, 537–548.
Corrigan, P.W., Watson, A.C., Miller, F.E., 2006. Blame, shame, and contamination: the
impact of mental illness and drug dependence stigma on family members. J. Fam.
Psychol. 20, 239.
Davis, J.L., 2014. Morality work among the transabled. Deviant Behav. 35, 433–455.
Davis, J.L., Love, T.P., 2017. Women who stay: a morality work perspective. Soc. Probl.
65, 251–265.
Davis, J.L., Manago, B., 2016. Motherhood and associative moral stigma: the moral
double bind. Stigma and Health 1, 72.
Davison, K.K., Birch, L.L., 2001. Weight status, parent reaction, and self-concept in five-
year-old girls. Pediatrics 107, 46–53.
DeVault, M.L., 1994. Feeding the Family: the Social Organization of Caring as Gendered
Work. University of Chicago Press.
Flegal, K.M., Kruszon-Moran, D., Carroll, M.D., Fryar, C.D., Ogden, C.L., 2016. Trends in
obesity among adults in the United States, 2005 to 2014. Jama 315, 2284–2291.
Friedman, M., 2015. Mother blame, fat shame, and moral panic:“Obesity” and child
welfare. Fat Studies 4, 14–27.
Giovanelli, D., Ostertag, S., 2009. Controlling the body: media representations, body size,
and self-discipline. The Fat Studies Reader 289–296.
Goar, C., Davis, J.L., Manago, B., 2017. Discursive entwinement: how white transracially
adoptive parents navigate race. Sociology of Race and Ethnicity 3, 338–354.
Goffman, E., 1963. Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall,
Englewood Cliffs, N.J.
Gray, D.E., 2002. ‘Everybody just freezes. Everybody is just embarrassed’: felt and enacted
stigma among parents of children with high functioning autism. Sociol. Health Illness
24, 734–749.
Green, S.E., 2003. “What do you mean ‘what's wrong with her?’”: stigma and the lives of
families of children with disabilities. Soc. Sci. Med. 57, 1361–1374.
Hatzenbuehler, M.L., Phelan, J.C., Link, B.G., 2013. Stigma as a fundamental cause of
population health inequalities. Am. J. Public Health 103, 813–821.
Jackson, D., Mannix, J., Faga, P., McDonald, G., 2005. Overweight and obese children:
mothers' strategies. J. Adv. Nurs. 52, 6–13.
Jarvie, R., 2016. ‘Obese’‘sumo’babies, Morality and Maternal Identity. Women's Studies
International Forum. Elsevier, pp. 20–28.
Jones, E.E., Farina, A., Hastorf, A.H., Markus, H., Miller, D.T., Scott, R.A., 1984. Social
Stigma. The Psychology of Marked Relationships. 1984.
Khamis, V., 2007. Psychological distress among parents of children with mental re-
tardation in the United Arab Emirates. Soc. Sci. Med. 64, 850–857.
Landsman, G., 2008. Reconstructing Motherhood and Disability in the Age of Perfect
Babies. Routledge.
Lareau, A., 2011. Unequal Childhoods: Class, Race, and Family Life. Univ of California
Press.
Link, B.G., Phelan, J.C., 2001. Conceptualizing stigma. Annu. Rev. Sociol. 27, 363–385.
Maher, J., Fraser, S., Wright, J., 2010. Framing the mother: childhood obesity, maternal
responsibility and care. J. Gend. Stud. 19, 233–247.
Manago, B., Davis, J.L., Goar, C., 2017. Discourse in Action: parents' use of medical and
social models to resist disability stigma. Soc. Sci. Med. 184, 169–177.
Östman, M., Kjellin, L., 2002. Stigma by association. Br. J. Psychiatr. 181, 494–498.
Pescosolido, B.A., Martin, J.K., 2015. The stigma complex. Annu. Rev. Sociol. 41, 87–116.
Phelan, J.C., Bromet, E.J., Link, B.G., 1998. Psychiatric illness and family stigma.
Schizophr. Bull. 24, 115–126.
Puhl, R.M., 2011. Weight stigmatization toward youth: a significant problem in need of
societal solutions. Child. Obes. 7, 359–363.
Puhl, R.M., Peterson, J.L., Luedicke, J., 2012. Weight-based victimization: bullying ex-
periences of weight loss treatment–seeking youth. Pediatrics, peds 131, e1–e9 2012-
J.L. Davis et al. Social Science & Medicine 219 (2018) 61–69

1106.
Scott, M.B., Lyman, S.M., 1968. Accounts. Am. Sociol. Rev. 46–62.
Stets, J.E., Carter, M.J., 2011. The moral self: applying identity theory. Soc. Psychol. Q.
74, 192–215.
Stets, J.E., Carter, M.J., 2012. A theory of the self for the sociology of morality. Am.
Sociol. Rev. 77, 120–140.
Stewart, L., Chapple, J., Hughes, A.R., Poustie, V., Reilly, J.J., 2008. Parents' journey
through treatment for their child's obesity: a qualitative study. Arch. Dis. Child. 93,
35–39.
Sykes, G.M., Matza, D., 1957. Techniques of neutralization: a theory of delinquency. Am.
Sociol. Rev. 22, 664–670.
Tavory, I., Timmermans, S., 2014. Abductive Analysis: Theorizing Qualitative Research.
University of Chicago Press.
Thoits, P.A., 2011. Resisting the stigma of mental illness. Soc. Psychol. Q. 74, 6–28.
Thomas, F., 2006. Stigma, fatigue and social breakdown: exploring the impacts of HIV/
AIDS on patient and carer well-being in the Caprivi Region, Namibia. Soc. Sci. Med.
63, 3174–3187.
Timmermans, S., Tavory, I., 2012. Theory construction in qualitative research: from
grounded theory to abductive analysis. Socio. Theor. 30, 167–186.
Turner, J., Biesecker, B., Leib, J., Biesecker, L., Peters, K.F., 2007. Parenting children with
Proteus syndrome: experiences with, and adaptation to, courtesy stigma. Am. J. Med.
Genet. 143, 2089–2097.
Wansink, B., Latimer, L.A., Pope, L., 2017. “Don't eat so much:” how parent comments
relate to female weight satisfaction. Eating and Weight Disorders-Studies on
Anorexia, Bulimia and Obesity 22, 475–481.

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