Hasler V1,2
1HESAV – HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland, 2University of Lausanne, Institute of the Humanities in Medicine, Lausanne, Switzerland
Background: Obesity is now considered a chronic systemic disease. Many studies not only link obesity and poor health, but also show a continuous increase in its prevalence in all countries of the world. This has reached the point where we commonly refer to it as the "obesity epidemic". However, obesity has not always been a public health problem, even though the "too big" has always existed. Several scholars have shown how the threshold that separates obese people from others has decreased over time, as have the ways of defining obesity, diagnosing it and probably treating it. In this specific area, therapeutic programs led by multidisciplinary teams mainly focus on diet and physical activity. Physiotherapists are involved in this second area.
Purpose: This historical research investigates ways of seeing, thinking and treating obesity from the moment physiotherapists integrate it into their field of expertise. The aim is to better understand how medical and physiotherapeutic objects are constructed, what this reveals about the evolution of the profession for itself and in its relationship with related professions (including medicine).
Methods: The analysis is based on a wide range of archives, which allow the question to be explored from various angles - clinical, political, identity, as well as from the point of view of social expectations - for the Swiss context.
Results: Obesity is a very early concern for practitioners active in the field of physical therapies. However, there are several shifts in the way it is approached. At the beginning of the 20th century, obesity, which is often associated with moral weakness and ugliness, led to the creation of services with hygienic or aesthetic orientation. Physiotherapists then offer “medical” physical culture, massages, as well as all kinds of devices designed to induce sweating in their patients. After the war, while medicine developed surgical interventions to treat obesity, physiotherapists were forced to reposition themselves. Although very active in the field of rehabilitation, they continue to invest this interfield between health and beauty, by offering weight loss cures or cellulite treatments. Two fields of intervention that they will later leave to other professionals.
Conclusion(s): While therapeutic exercise has always been one of the physiotherapists´ responses to obesity, it has not been the only one. In addition, the care of obese people has encouraged physiotherapists to develop part of their activity on the borderline between the fields of health and beauty, by claiming both proximity and autonomy towards medicine.
Implications: Historical research might help the profession to reflect on the present. The case of obesity is particularly interesting because it is the subject of alarming speeches while remaining difficult to diagnose (due to a controversial definition).
Keywords: Obesity, physiotherapy, history
Funding acknowledgements: This project did not request or received funding.
Purpose: This historical research investigates ways of seeing, thinking and treating obesity from the moment physiotherapists integrate it into their field of expertise. The aim is to better understand how medical and physiotherapeutic objects are constructed, what this reveals about the evolution of the profession for itself and in its relationship with related professions (including medicine).
Methods: The analysis is based on a wide range of archives, which allow the question to be explored from various angles - clinical, political, identity, as well as from the point of view of social expectations - for the Swiss context.
Results: Obesity is a very early concern for practitioners active in the field of physical therapies. However, there are several shifts in the way it is approached. At the beginning of the 20th century, obesity, which is often associated with moral weakness and ugliness, led to the creation of services with hygienic or aesthetic orientation. Physiotherapists then offer “medical” physical culture, massages, as well as all kinds of devices designed to induce sweating in their patients. After the war, while medicine developed surgical interventions to treat obesity, physiotherapists were forced to reposition themselves. Although very active in the field of rehabilitation, they continue to invest this interfield between health and beauty, by offering weight loss cures or cellulite treatments. Two fields of intervention that they will later leave to other professionals.
Conclusion(s): While therapeutic exercise has always been one of the physiotherapists´ responses to obesity, it has not been the only one. In addition, the care of obese people has encouraged physiotherapists to develop part of their activity on the borderline between the fields of health and beauty, by claiming both proximity and autonomy towards medicine.
Implications: Historical research might help the profession to reflect on the present. The case of obesity is particularly interesting because it is the subject of alarming speeches while remaining difficult to diagnose (due to a controversial definition).
Keywords: Obesity, physiotherapy, history
Funding acknowledgements: This project did not request or received funding.
Topic: Non-communicable diseases (NCDs) & risk factors; Non-communicable diseases (NCDs) & risk factors
Ethics approval required: No
Institution: Université de Lausanne
Ethics committee: --
Reason not required: Project has respected the Swiss legal framework and the code of ethics of the Swiss Historical Society (SSH).
All authors, affiliations and abstracts have been published as submitted.
