Traditional View of Obesity Expert
Having been overweight for 22 of my 34 years of life, I deeply understand the cultural norms and values associated with being overweight and attempting weight loss. My experimentation has included formal and personal education nearly sufficient to earn a degree; numerous weight loss regimes; thousands of weight conversations with professionals and other overweight women; and volumes ofjournal pages filled with the insights, anguishes, and celebrations I have experienced in my effort to achieve right body size. This wealth of experience makes me an expert: I am an expert in my knowledge of what is true and unique to my relationship with my body. Through thousands of trials and tests I have developed a large set of facts about how my body and psyche react to a variety of food, behavior, exercise, medical, and emotional strategies. The preceding statement of self-knowledge may appear obvious and self-evident to some, yet it represents the results of a hard-fought battle for me and a significant turning point in my life. I am sharing this story here to support my assumption that there is huge gap in the identification of “expert” in traditional research – that is, the gap between the research/health care experts and the expert knowledge of the women in treatment for weight loss. This study is designed to help bridge this gap.
Orbach (1988) asks us to question the notion that medicine is healer and science is truth. Her warning is imperative and addresses the casual and not-so-casual assumptions we make about science and experts’ knowledge. According to Lopez (1995):
A professional intervention framework often assumes that the professional is in possession of all relevant information and that the client is empty of any useful knowledge pertaining to the chief complaint. This may possibly be the reason that women’s personal experiences with weight treatment have not been systematically explored as relevant sources of data for designing treatment models, (p. 106)
The power given to “expert opinion” is typically not noticed or addressed in the field of obesity research. It is important, however, to remember that the casual use of language can give undue weight to the judgments of professionals and minimize the value of the subjects’ perspective.
An example of such misuse of language comes from Yale University where researchers Schwartz and Brownell (1995) surveyed 25 obesity “experts” to assess the feasibility of matching individuals to weight loss treatments. The experts were defined as those involved in the research and treatment of obesity from the disciplines of psychology, psychiatry, nutrition, internal medicine, surgery, and endocrinology. Participants were asked to classify 170 client characteristics as matching factors for 11 common approaches to weight loss.
I question two key aspects of this study: a) the use of the term “expert”; and b) the researchers’ subjectively chosen sample. “Expert” connotes a person with a particular type of power – knowledge-power. However, knowledge-power has been misused with respect to women and particularly those with disordered eating. Feminist researchers remind us to be conscious ofthe power associated with the authoritative roles, particularly that of expert: “An examination of history has demonstrated that women have often been taught to rely on the advice of experts and to deny the validity of their own feelings and perceptions” (Lopez, 1995, p. 7).
The readers of this article must trust the researchers to distinguish an obesity expert from an obesity novice, since the reader is excluded from the selection process. The published study provides no specific criteria for the selection process of the expert sample; nothing is revealed about the length of time in the field, education, success of their clients, or personal experience with the issue. All that is disclosed is that these 25 people have been identified as experts by the researchers (who are assumed to be knowledgeable themselves).
The fact that this article was published despite the authors’ oversight is another important point in this discussion. It reveals the shared though unacknowledged assumption among journal editors and researchers that those who identify themselves as weight loss experts (or are so identified by well-regarded researchers, as is the case with these authors), are indeed experts.
More significant than their findings is this statement by one of the “experts” who didn’t complete the survey: “Unfortunately, I sincerely believe that we don’t know enough right now to make recommendations about assignment of different kinds of patients to different kinds of treatments” (Schwartz & Brownell, 1995, p. 152). It is my contention that researchers will continue to lack the knowledge necessary to offer successful treatment approaches until they integrate the knowledge of the true experts – the subjects themselves.