Active on his own terms? A discourse analysis of professional guidelines

Purpose: To investigate how language and meaning production express and explain overweight, within official guidelines for prevention and treatment of overweight and obesity among children and adolescents. Design: Discourse analysis. Material: National guidelines for primary care. Method: Question based reading. Results: Through discursive measures within the language in use, the guidelines produce both an ordinary family with a hectic daily life, a vulnerable family and a deviant one with challenges. The guidelines use stigmatizing discourses, producing people with overweight as lacking control and knowledge. A discursive order that gives precedence to the medical perspective on overweight and obesity, risk to medicalize overweight children based on bodyweight alone. Health care personnel are provided a paternalistic position within lifestyle treatment, despite weak evidence for the treatment offered and despite explicit ethical considerations and user involvement. Conclusion: The Norwegian Directorate of Health tend to use stigmatizing discourses to construct children with overweight and their families. The discourses risk to disguise the possibility of understanding these families as people with resources. For physiotherapists to contribute in valid ways within lifestyle treatment, they must reflect upon their own position within the stigmatizing discourses.