Obese Adults’ Perceptions of News Reporting on Obesity

News reporting, in channels such as broadcast and print media, on obesity as an issue has increased dramatically in the last decade. A qualitative study, in which we used in-depth interviews and thematic analysis, was undertaken to explore 142 obese individuals’ perceptions of, and responses to, news reporting about obesity. Participants believed that news reporting on obesity focused on personal responsibility and blame, and portrayed obese people as “freaks.” They described being portrayed as “enemies” of society who were rarely given a voice or identity in such news coverage unless they were seen to be succeeding at weight loss. They were also critical of the simplistic coverage of obesity, which was in contrast with their personal experiences of obesity as complex and difficult to address. Participants believed that obesity news reporting added to the discrimination they experienced. We consider how this news reporting may act as a form of “synoptical” social control, working in tandem with wider public health panoptical surveillance of obesity.


Introduction
The news media plays an important role in the transfer of culture and social norms and values throughout society (Robertson, 1987;Schiffman, Bednall, O'Cass, Paladino, & Kanuk, 2005) and can be influential in setting the wider social agenda around an issue (McCombs, 2004). The news media encompasses the sources and presentation of news and information, and includes television, radio, newspapers, magazines, and online news sources. The news media can highlight certain aspects of an issue and marginalize others, defining an issue from a certain perspective with causes, solutions, and blame; and plays a role in social control (Conrad & Schneider, 1980). It can also influence how individuals and policy makers respond to an issue Chapman et al., 2009;Evans, Renaud, & Kamerow, 2006). The news media investigate issues and are chroniclers of daily life. . In reporting on technological, scientific and health and medical issues, they disseminate knowledge and information to the general public. They also inform, entertain, and shape cultural tastes and trends and opinions (Campbell, Martin, & Fabos, 2010).
Body weight preferences differ across cultures and throughout the history, with perceptions of one's own body shape and others' body shapes influenced by social and cultural factors (Furnham & Alibhai, 1983;Furnham & Baguma, 1994;Lake, Staiger, & Glowinski, 2000). The media, with its role in the transfer of culture and social norms, influences these preferences. While overweight and obesity are commonly presented in the media as health issues, this focus on body weight "is as much to do with a social and cultural response to particular kinds of bodies as it has to do with health" (Gard & Wright, 2005, p. 177).
Obesity is commonly portrayed as an epidemic or disaster or "looming global health catastrophe" (Gard & Wright, 2005, p. 17). The common metaphors of "ticking timebomb," a "tsunami," and "epidemic" suggest that the personal irresponsibility of some creates social and economic threats for nations (Boero, 2007;Holland et al., 2011;Saguy & Riley, 2005). The presentation of obesity in this manner may be reflecting a broader discourse of "moral panic" 1 associated with obesity (Campos et al., 2006). Furthermore, these media presentations of obesity as an "epidemic" may closely accord with what many people believe to be the truth (Gard & Wright, 2005).
Researchers suggest that the news stories focus more on personal responsibility and self-control, rather than on the broader social and environmental determinants of weight gain (Ata & Thompson, 2010;Hawkins & Linvill, 2010;Kim & Willis, 2007;Saguy & Gruys, 2010). Some researchers have noted increasing frequency of frames 2 such as mixed frames and environmental frames (De Brún et al., 2012) and emergent frames such as fatalism (Shugart, 2011) and culture (Shugart, 2013). Coverage of obesity research has been found to focus on "bad news," such as the magnitude of the problem and the impact on children, and also displays the news values of novelty, sensationalism, and controversy (Roy, Faulkner, Simone, & Finlay, 2011). The media has also been found to report on obesity research in an alarmist and uncritical manner . Sandberg (2007) suggested that the media promotes unrealistic and unsustainable weight loss solutions, along with weight loss stories adding to weight stigma.
Researchers have shown that stereotypical and negative content about obese individuals is commonplace in the media (Ata & Thompson, 2010;Puhl & Heuer, 2009), and that these stereotypes can be latent and manifest (Sandberg, 2007). For example, Saguy and Gruys (2010) found that many media reports blamed obese individuals for their body weight and commonly used "stereotypes of fat people as gluttonous, slothful, and ignorant . . . " (p. 244). Negative stereotyping and stigma of obesity are likely reinforced by the regular use of exaggerated metaphors in news reports which are applied to population-based obesity statistics (Boero, 2007).
To date, researchers have used differing approaches to attempt to analyze obesity news media through content and textual analyses and to "map" the obesity news media discourse. However, there is a notable gap in understanding the reception and impact of obesity news reporting on different audiences (Atanasova, Koteyko, & Gunter, 2012;Boyce, 2007). Different audiences may have differing interpretations, or may ignore or even resist this news presentation of overweight and obesity. In particular, obese people are an important audience to consider as "the qualitative interviewing of fat people themselves might do more to understand the lived impact of media portrayals than ever more examinations of text" (Boero, 2013, p. 7). In this study, we have investigated how obese adults, that is, adults who have a body mass index (BMI) of ≥30 (World Health Organization, 2011), perceive obesity news reporting and how they respond to this reporting.

The Panopticon and Synopticon-A Theoretical Framework
The use of theory can provide insightful explanations and extend understandings of issues (National Cancer Institute, 2005). In this article, we draw upon two theoretical concepts, the panopticon and synopticon, to understand obese people's perceptions and responses to obesity news reporting. Foucault's (1979) theoretical concept of the panopticon as an important form of social control is familiar and well established in public health. Using Jeremy Bentham's prison design, the panopticon, as a metaphor Foucault (1979) developed the notion of the "panopticon" to explain modern forms of surveillance. In the panopticon-designed prison, a single guard could observe all inmates, without these inmates being aware if they were being watched at any given time. Applied conceptually, the panopticon metaphor demonstrates that in modern societies surveillance, whereby a "few" can watch "many," is the main form of social control (Foucault, 1979) having replaced the spectacle of sovereign power of previous times. Social institutions, and the people who work for them (the few), undertake surveillance on populations (the many). The "methods of fixing, dividing, recording" undertaken by these institutions have led to an "immense activity of examination that has objectified human behaviour" which has spread throughout society (p. 305). Health and medical institutions contribute to this surveillance through assessment, classification, and diagnosis. The collection of epidemiological data is a form of surveillance familiar to those in public health (Petersen, 2007). The collection of large populationbased data sets has allowed for the establishment of what is perceived as "normative" or healthy and what is perceived as "deviant" or unhealthy. In relation to obesity, the collection of population data on individuals' height and weight is used for calculating BMI and the associated health risks for different weight categories, and is an example of the "many" (the population) being surveilled by the "few" (researchers, doctors, and public health professionals). This population information is then in turn used to direct public health interventions and responses. That is, this panoptical, epidemiological surveillance leads to regulatory, evaluative, and policy responses (Petersen & Lupton, 1996) as forms of population-based social control. Panoptic surveillance also promotes and extends self-discipline, encouraging people to fit within defined body weight norms and become themselves the main locus of social control: "Persons themselves and their bodies are turned into 'objects,' self-surveillance emerges as a practice of control" (Eckermann, 1997, p. 157). This promotion of the entrepreneurial self and personal responsibility are key neoliberal methods of self-government (Crawshaw, 2012).
Panoptic surveillance and the promotion of personal responsibility are examples of how social control and the government of citizens can be undertaken in varied ways by multiple authorities which govern different sites, in different ways, and in relation to different objectives (Rose, O'Malley, & Valverde, 2006). These different agents and forms of socialization contribute to modern forms of governmentality-the "techniques and procedures for directing human behaviour" (Foucault, 1997).
In response to Foucault's work on surveillance and governmentality, Mathiesen (1997) argued that Foucault ignored a significant development which occurred in parallel with expanding panoptic surveillance: the rise of the modern mass media (Mathiesen, 1997(Mathiesen, , 2004. This occurred over the past 150 to 220 years, with the mass press developing, then film, radio, television, and the Internet. Mathiesen developed the "synopticon" concept particularly in relation to crime in the media, but it is also pertinent for considering media portrayals of health issues. He contended that the mass media acts as a complementary and synergistic form of social control, which works in tandem with the panopticon; he called this the synopticon (Mathiesen, 1997). In contrast with the panopticon where the "few" watch the "many," modern society is a "viewer" society where the synopticon allows the "many to see and contemplate the few" (p. 219). For example, media audiences (the many) see and contemplate individuals or specific social groups (the few) that are profiled in the media, such as celebrities, criminals, and other persons of interest. Mathiesen (1997) described the synopticon as "the development of the total system of the modern mass media" and that the panopticon and synopticon "together . . . serve decisive control functions in modern society" (p. 219) and "reciprocally feed on each other" (p. 231). While Foucault suggested that we had moved away from spectacle toward surveillance as a form of social control, Mathiesen (1997) suggested that spectacle continues to exist, albeit in a novel format. The media now provides the venue or site for such displays, as opposed to the Colosseum or public hangings in earlier times, and that as such spectacle still acts as a key mechanism of social control. Spectacle often focuses on deviance, and the media provides an essential channel for the presentation of such (Winnick, 1978). In this way, the media uses spectacle and deviance to define what is acceptable and what is unacceptable (Cohen, 2011;Cromer, 1978), as such acting as a tool for social control.
Yet, with the rise of online forms of mass media (such as online newspapers) and social media, such as blogs, microblogs, forums, and social network sites, the dyadic relationship between the panopticon and synopticon has become more nuanced because of the potential participatory nature of these online media (Couch, Han, Robinson, & Komesaroff, 2015). Social media interacts with mass media, including public health media-based social marketing campaigns. In some instances, this might offer opportunities for resistance, but it may also be extending the social control function of the panopticon/synopticon dyad (Couch et al., 2015).
In this article, we suggest that the panopticon and synopticon are useful concepts for understanding how obesity is portrayed in the media and the impacts this can have on obese people. We consider how news media representations of obesity may act as a modality of social control in tandem with other social control mechanisms. We discuss possible resistance to this social control. We consider how newer forms of media and social media interact with obesity news reporting, offering opportunities for resistance, and potentially adding another component to synoptical social control.
The interplay between the panopticon (Foucault, 1979), the synopticon (Mathiesen, 1997), and the extension of this to newer forms of media (Couch et al., 2015) provides a new theoretical perspective for examining obesity news reporting and other public health issues.

Method
In this article, we aim to provide a detailed understanding of how obese adults perceive and respond to news reporting on obesity. The data analyzed for this article are from a larger qualitative study, Obesity: Have Your Say, which examined the everyday life experiences of obese people (e.g., Lewis, Thomas, Blood, et al., 2011;Lewis et al., 2010;. In this study, we used a semi-structured interview schedule which included questions in six thematic areas, to investigate the experiences and attitudes of obese adults in Australia. These themes were physical and mental health and well-being; early experiences with weight, weight gain, and weight loss; current experiences with weight, weight gain, and weight loss; body image and societal perception; media; and public health policy and approaches.
The media thematic area included a specific focus on news reporting of obesity, along with some other questions about the Internet as a source of news and information, and about the television program The Biggest Loser.
The first cluster of questions in the interviews was a structured survey, which asked about individuals' demographic details and health-related behaviors (e.g., smoking, physical activity, alcohol consumption). For the remaining questions in the different thematic areas, we were flexible in what questions were asked, how questions were worded, and the order of questioning. Some questions were relevant to some individuals and groups, and not others. For example questions related to experiences of weight loss methods were not asked of people who had never tried to lose weight. Furthermore, the discussions were not limited to the questions within the interview schedule. This allowed for new themes and lines of enquiry to be introduced during the interview by both the interviewer and the interviewee.
Within the media thematic area, we asked four specific questions to stimulate discussion about obesity news reporting. These four questions focused on the personal impact of obesity news stories, perceptions of how the news frames obesity and overweight, likes and dislikes about obesity news reporting and how such news reporting might be improved to better reflect the experiences of obese people. These questions were supplemented by prompts and broader discussion between the researcher and participant. The responses to these questions and other broader discussion about obesity news form the basis of the data discussed in this article.
Participants were recruited using theory-informed, purposive, and strategic sampling methods to represent a range of attitudes about, and experiences of, obesity (Denzin & Lincoln, 2000). We sought to attract individuals who had differing attitudes and experiences of obesity, and from different demographic groups. To do this, we recruited via a diverse range of channels, and we were informed by stigma theory and literature about self-reporting of weight. We used a study website and advertisements in university, hospital and workplace newsletters. We also sampled through newspaper articles (including local community newspapers and an article in the highest read tabloid newspaper in Australia) and snowball techniques (participants passing on the details of the study to their relevant contacts).
We wanted to ensure that our sample included people who wanted to be thinner but did not know how, people who said they were happy with their size, and people who were actively trying to lose weight. To do this, we recruited through advertising within gyms, recreational facilities, weight loss centers, plus size clothing stores, online weight loss support groups, and online fat-acceptance groups.
Based on the literature that people often underreport their weight and BMI (Gorber, Tremblay, Moher, & Gorber, 2007), we revised the wording of our advertisement to ask for people who are overweight to attract those who may have been obese but did not identify as obese.
Stigma coping and management theories also informed the sampling. Potential stigma management strategies include passing (i.e., attempts to hide the stigmatized trait), disclosure (i.e., admission of the stigmatized trait in hope of acceptance), disavowal (rejection of the stigmatized trait; O'Brien, 2011). In people with obesity specifically, responses to stigma can include attempts at social activism, communal coping, and attempts at weight loss (Puhl & Brownell, 2003).
Our sampling through weight-loss-related channels includes attempts to recruit people who were disclosing their stigma and making attempts to address it; our sampling of people from the fat-acceptance movement addresses those disavowing the stigma and attempting to address it through social activism (Dickins, Thomas, King, Lewis, & Holland, 2011). Our sampling of weight loss groups addressed those who might have been responding to the stigma through communal coping. Participants from online support groups might also be seen to be attempting to "pass" in that their participation in an online environment may have allowed them to physically hide their body weight, and it may also have been seen as a form of communal coping. These multiple sampling methods aimed to select cases that would provide a wide variation in experiences of living with obesity to aid in the development of a well-developed understanding of these experiences (Liamputtong, 2009). Participants were offered a AU$10 voucher as reimbursement for participating in the study.
Recruitment was ceased when we reached saturation for the majority of questions; that is, when interviews ceased to provide "new" information (Strauss & Corbin, 1998). In practice, this meant that three members of the research team met on a regular basis (weekly/fortnightly) to discuss preliminary coding and the emerging themes and to review the transcripts together. It was through this process that a point was reached where it appeared that there was nothing new emerging from the interviews. At this point, consultation was undertaken with other members of the research team to draw upon specific disciplinary expertise to determine if they also agreed that the core thematic areas had reached saturation. When this agreement was achieved among the broader research team, interviewing was ceased.
Digitally audio-taped, telephone interviews lasting 60 to 90 min were conducted between April 2008 and March 2009 by the second and third authors or a research assistant. All interviews were transcribed by a professional transcription agency within 7 days of the interview. An extensive pilot study (Thomas, Hyde, Karunaratne, Herbert, & Komesaroff, 2008) suggested that telephone interviews would be an appropriate, accessible, and emotionally safe way for obese adults to take part in this study. Telephone interviews encouraged participation from individuals living outside the metropolitan area where the research team was based; and individuals whose size, comorbidities, or economic circumstances prevented them from traveling for the interview. We were also concerned about how participants' responses might have been influenced by the weights of the interviewers-who were younger women in the "normal" BMI weight range (Wilson, Roe, & Wright, 1998). Finally, telephone interviews can provide more open responses to questions of a sensitive nature because of the relative anonymity they give participants when compared to face-to-face interviews (de Vaus, 2002).
Ethics approval was obtained from the Monash University Ethics Committee. Participants were informed that participation in the research was voluntary, that personal identifying information would be kept confidential, and that they did not have to answer questions that they felt were uncomfortable. They were able to stop the interview at any time, and they were informed that they could withdraw from the study until the publication of the data.
We used thematic analysis to analyze the data. This form of analysis allows for inductive interpretation of the data, while also considering preexisting theory (Liamputtong-Rice & Ezzy, 1999). To do this, we initially noted preliminary ideas and thoughts, and then read and reread the transcripts and coded and organized the coded data (Braun & Clarke, 2006). We undertook further review and analysis until the codes were reduced to a number of core themes (Strauss & Corbin, 1998). This analysis involved our initial inductive interpretation of the interview data, which was then reviewed in relation to existing theoretical constructions (Liamputtong, 2009), thereby incorporating sequentially both "inductive" and "theoretical" thematic analyses (Braun & Clarke, 2006). The inductive data analysis was conducted by the first, second, and fifth authors, and all authors had input into the theoretical thematic analysis. As the first author did not conduct the interviews, the first author held frequent and repeated discussions with the second, third, and fifth authors during the inductive data analysis to ensure the integrity of the interpretation. Further discussion was undertaken with all authors in the theoretical analysis, identification of the theoretical framework, and subsequent development of this article.
To aid in the explanation of the data, the frequency of themes is provided. The term "most" is used to indicate more than 75% of responses, "many" for 50% to 75%, "some" for 25% to 50%, and "few" for less than 25% of responses.

Results
We provide a summary of the demographic characteristics and weight of the sample, and then present the findings according to the main themes which emerged from the analysis as follows: simplistic and inaccurate reporting that blames and shames; weight loss success stories; freaks and enemies; the absence of obese voices; the absence of identity; and limited news consumption.

Characteristics of the Sample
Enquiries to participate in the study were received from 172 people. Of these, 142 participated in the study. Twenty-two individuals were excluded because they resided outside Australia or because they were not classified as obese according to the World Health Organization's (2011) International classification of adult obesity (i.e., BMI ≥ 30). An additional eight individuals chose not to participate in the interview, due to the length of the interview or because they thought the study was trying to test a weight loss product. Most of them who participated in this study were female (n = 106). Participants were aged 19 to 75 (M = 44.8), and many were married or in a de facto relationship (n = 92). Eighty-nine participants had completed a university degree, 33 participants had completed secondary school, and 20 had not completed secondary school. Most participants were born in Australia (n = 103). Participants' BMI was calculated from their self-reported height and weight and ranged between 30.0 and 71.7 (M = 39.3). Key participant details are provided in Table 1.

Simplistic and Inaccurate Reporting That Blames and Shames
Most participants were concerned that news coverage was superficial, unrealistic, inaccurate, unfair, or unhelpful (n = 122). For example, one participant stated, I think they could cover more behind obesity other than what you shove in your mouth . . . there would be a huge difference in attitudes and maybe the way larger people look at themselves if they didn't feel like they were being attacked everywhere they look. (Female, aged 28) Participants described in detail the pervasive culture of blame and shame that they believed was directed at obese individuals in news reporting using words such as "ridicule," "mocking," "unfair," "discriminatory," "alienating," "derogatory," "spectacle," "exploiting," "offensive," "vile," "disgusting," "humiliating," "belittled," "cruel," "sensationalism," "dehumanizing," and "taunting." Many described how the discrimination evident within news reporting went almost exclusively unchallenged: I think it's one of the last prejudices. You can't use the word "nigger" or "boong" [sic] and rightly so, you shouldn't be able to. But you can use the word "fatty" on the front page of The Age. (Female,aged 32) Participants discussed the focus on personal responsibility in obesity news reporting (n = 36). These participants described how they perceived obese adults were blamed for their condition, and that they could lose weight if they tried hard enough. One participant explained, "[the news] can be very much point the finger and like it's their fault they're the way they are" (female, aged 37). Participants felt that the often basic and limited coverage of obesity added to this focus on personal responsibility as it did not allow issues to be covered in depth or to address the complexities around body weight, weight management, and what it is like to live as an obese person. They were critical of this one-dimensional approach, which removed obesity from any social context and focused on the message that to lose weight all obese people need to do is exercise and improve their eating: " . . . it's just the simplistic eat better, do more and you'll be perfect like us" (female, aged 40).
Participants stated their beliefs that the presentation of obesity within news reports had led to an increase in the amount of negative commentary that was directed at them. Participants described how the news presentation of obesity as an issue that could be controlled through healthy eating and increased exercise had created a "culture of stigma" where it was acceptable to publicly abuse and ridicule people because of their weight. One participant described how she believed media reporting provided implicit justification for individuals to stigmatize her: The idiots who yell out comments to me when I'm trying to do something positive, like ride my bike home . . . It [the news] almost feeds those people and allows them to be more abusive because they look in the paper, and the paper is on a slightly subtler level, doing the same thing. (Female, aged 32-same participant as above)

Weight Loss Success Stories
Participants described how an increase in news reporting about the obesity "epidemic" has been paralleled by an increase in weight loss success and miracle cure stories. Participants' perceptions and responses to weight loss success stories elicited differing responses. One participant commented on how those who lost weight were portrayed as "winners" and those who remained obese as "losers": "[The media] will talk to you when you've lost the weight, when you're a champion, but they don't want to talk to you beforehand" (female, aged 33). Another participant described the way in which obese individuals are automatically expected to be able to apply these successes to themselves, and the public reactions when they were unable to achieve the same levels of weight loss success: . . . a lot of stories . . . I think are probably unrealistic and that people can feel as if they're second class citizens because they can't do what someone else has done. (Female,aged 54) Despite this, many participants (n = 75) also commented that they felt very positively about weight loss stories, finding them positive, inspirational, and motivating: "I remember the Courier Mail had a . . . girl who'd lost 84 kilos. That was pretty cool. An awesome story" (male, aged 21). One participant stated that this was her chance to share a sense of common identity with another fat individual: You can actually see the journeys and the struggles people have. You know it's not just you, and I guess you can identify with that and maybe try to draw something from it. (Female,aged 28) Weight loss stories provided the few opportunities our obese participants had to identify with people in the news in a somewhat positive way, rather than in the more common negative portrayals of obesity and obese people.

Freaks and Enemies
Participants identified and described a number of ways in which news reports reinforced the undesirability of fatness. Many participants commented on the extreme examples of news stories where obese individuals were characterized as "freaks." Some participants (n = 63) described the "freak show" portrayals of interventions for severely obese individuals. Examples of stories recalled by participants were as follows: Forklifts needed to lift obese dead people in funeral homes; obese people needing specialized facilities and equipment to weigh them on which would normally be used for machinery or animals; walls knocked down to get an obese person out of their house; cranes used to lift obese people; hospital beds not big enough; and women who were so fat they were not able to go to hospital to have their babies: . . . people who've been bed ridden for like years upon years upon years and they can't fit through the door you know, they've got to get either a crane to lift them out. (Male,aged 35) Participants who were classified as morbidly obese described how these news stories made them feel humiliated and ashamed and reinforced feelings of deviance. Most participants described how it was their perception that obese individuals were almost exclusively portrayed in a negative way by the news media. Participants stated that they felt that news reporting emphasized that obese individuals were a threat not only to themselves but also to the broader community. For example, one participant discussed the use of war metaphors: I've noticed an incredible increase in the amount of time that the media spend reporting on the obesity epidemic or the war on obesity. I just think it is appalling that it is being called a war. I feel like an enemy. I feel like an enemy of society. (Female,aged 39) A few participants (n = 14) described how news media coverage emphasized the economic burden of obese individuals on the community, such as costs to the health care system, costs to modify public facilities to accommodate obese people, the cost to schools to make wider facilities, and that obese people are a liability and a burden on society in general: " . . . oh my god fat people are causing so much strain on the health system" (female, aged 36).

The Absence of Obese Voices
Some participants (n = 47) raised concerns about the lack of voice given to obese people in news stories. Participants commented that obese individuals were only given a voice when they were embarking on a weight loss journey or had lost a significant amount of weight. Participants described the importance of including the experiences and opinions of obese individuals within non-weight loss obesity news reporting. Participants explained that obese people's experiences would help increase the public understanding of the pathways to obesity and to dispel the moral assumptions about obese individuals: The news hasn't taken the time to sit down and speak to someone obese. Not one person has come up to me in the media and said, "Tell us your story? How did this happen and why did this happen and what is it that made it happen?" Questions like that are important questions. (Female,aged 41) Participants also discussed their desires to see obese people present in the media more generally, included in diverse stories and other topics not just about obesity. Participants described that an "us" versus "them" presentation of obese individuals in newspapers made them feel that newspaper editors completely ignored that an obese individual might be reading the article: They talk about fat people like they're not there or that they're not one of their readers. There are all these fat people out there, be careful you might run into one. (Female, aged 36)

The Absence of Identity
In addition to the lack of "voice" for obese people in news reporting, our participants raised concerns about the use of "headless fatty" images. Participants specifically referred to their perceptions of how images of "headless fatties" stereotyped and dehumanized obese individuals (n = 27), such as one participant commenting, "Where the heads are blurred out and you've just got this huge one and a half meter wide bum in a tracksuit wobbling down the street" (female, aged 39) and another participant explaining, "They show the shots from the neck down, that it suggests to me that all people are the same. Any generic fat person will do . . . it doesn't matter about anything else about them" (female, aged 39), and although their face might not be visible "every time you'll notice they're scoffing into food" (female, aged 48). Participants felt that these stereotypical images debased them, and that they did not deserve to have a valued identity within their communities: "[They] don't deserve to have their head there anymore, they only deserve to have the obese part of them or the fat part of them" (female, aged 47). Participants also noted more generally how obese people were presented in the media as unattractive. This lack of identity and portrayals of unattractiveness, coupled with lack of voice, made our participants feel excluded and ostracized from broader society because of their obesity.

Limited News Consumption
Despite being able to identify aspects of obesity news reporting that they liked and disliked, some of our participants (n = 56) noted that they had limited news consumption. Within this group, some noted that they did not read the newspaper much or see news in other formats because they were too busy. A few of the participants discussed how they were very selective in their news consumption and avoided newspapers and other mainstream news outlets, and that they preferred to access their news online and through non-commercial sources, such as government news outlets.
Some of these participants discussed how they specifically avoided obesity news reporting as they felt that most of the reporting repeated a common theme that they had seen before, and was in a format in which obese people were portrayed negatively. One participant highlighted how she actively ignored negative imagery of obese people: "I think it's the same image we see all the time and I'm just kind of over seeing it. I think maybe, I just kind of went 'oh' and turned away" (female, aged 28). Participants' discussions of how they limited or resisted obesity news reporting also demonstrated one of the methods they used for managing the personal impacts of obesity news reporting: " . . . I tune off, tune out. It depresses you so you don't want to know" (female, aged 54). Limiting their consumption of news reporting of obesity may have allowed our participants to avoid what they perceived to be almost constantly negative and stigmatizing coverage.

Discussion
Much of the literature to date on obesity news reporting has used textual and content analysis and has concentrated on the stigma and personal responsibility. A key outcome of this study is that it gives voice to obese people's experiences of obesity new reporting and the "lived impact" of such reporting (Boero, 2013, p. 7).

Obesity News Reporting: The Panopticon and Synopticon at Work?
Our study suggests that the news media focus on spectacle, deviance, personal responsibility, and exclusion acts effectively as forms of social sanction and control, and contributes to the wider social regime of control and management of obese bodies. These effects are realized as a result of simplistic coverage to blame and shame obese people, through weight loss stories, through the "othering" of obese people, and through portrayals of them as "freaks" lacking either or both voice or identity. Participants in our study who limited their news consumption may have been demonstrating resistance to these social control mechanisms and their personal effects.
The findings from our study demonstrate the pertinence and potency of the dyad of the panopticon and synopticon. Panoptic surveillance, where the "few" watch the "many," leads to regulatory, evaluative, and policy responses (Petersen & Lupton, 1996) and promotes self-discipline and personal responsibility, which encourages individuals themselves to become the main locus of social control (Eckermann, 1997). The synopticon, where the "many" see and contemplate the "few" (Mathiesen, 1997) works alongside, and synergistically with, the panopticon. It uses spectacle (with associated stigma and ridicule) to demonstrate what is unacceptablewhat happens to those people who do not internalize and act upon panoptic surveillance. Our participants' discussions of news reporting of obese people as "freaks" who needed specialist equipment and public emergency services to help them from their homes were examples of the role of spectacle. Obese people are presented in such news stories as so "abnormal" that they cannot exit their homes in a normal mannerthey need to be "rescued" by emergency services personnel, highlighting the deviance of obese bodies and making spectacles of them. Their deviance is examined in the public domain by the "many" (the news media audience).
These "freak" stories, along with our participants' wider discussions around the role of simplistic and inaccurate news reporting, demonstrate their perceptions of the role of this news reporting in creating blame and shame. Blame is an act of attributing censure and responsibility, and has an intrinsically important role in social control (Innes, 2003). Shame, a negative feeling which arises when people evaluate themselves and consider their actions, behaviors, or way of being as wrong (Pattison, 2000), has been used throughout history as a form of social control (Bechtel, 1991). Our participants' perceptions of the blame and shame caused by obesity news reporting indicate that they felt censured and held to account for their obesity and any associated outcomes from obesity. They were experiencing the social control function of the synopticon.
Information about obesity from the panopticon (e.g., from epidemiological studies) becomes important news and contributes to alarmist concerns Saguy & Almeling, 2008), commonly presenting obesity as an epidemic (Boero, 2007;Campos et al., 2006;Holmes, 2009;Oliver, 2006). These stories are presented in the same system of news media messages as the individual "freak" stories. In such "freak" stories, information is stripped of context, so that only a small aspect of the person becomes the whole person, "whereupon the material is hurled back into open society as stereotypes and panic-like, terrifying stories about individual cases" (Mathiesen, 1997, p. 231). Our participants were cognizant of this lack of context when they raised concerns that the news media rarely presented information that reflected the complexity of their own weight experiences and what it is like to live as an obese person.
Participants' discussions and concerns about the use of "headless fatties" are an additional example of how obese people are portrayed as spectacle and as "other" and deviant, demonstrating the personal impacts of obesity news reporting. These images provide spectacle through imagery such as a "huge . . . wide bum . . . wobbling . . . " and of people gorging themselves on junk food. Such images portray obese people as objects of cultural fear, and it has been argued that the images are headless to deny obese people identity as punishment for their social transgression (Cooper, 2007). These images are stigmatizing and may act as reinforcement for societal weight-based stigma (Puhl, Peterson, DePierre, & Luedicke, 2013). Our participants felt stereotyped and devalued by the use of such negative images. Their perceptions of, and responses to, this negative imagery are supported by research. A study found that 72% of images used on five major American news websites portrayed overweight or obese people in a negative and stigmatizing manner (Heuer, McClure, & Puhl, 2011). Furthermore, people who view such negative images of obese people have been found to hold more negative attitudes toward obese people (McClure et al., 2010).
These findings demonstrate how portrayals of deviance and spectacle contribute to the synoptical role of obesity news reporting, where the "many" are watching and judging the "few." "Headless fatty" images, with their focus on the individual, albeit unidentified, deviant body, may also contribute to the focus on personal responsibility, whereby obesity is seen as a personal issue faced by individual people  and so is deserving of personal blame (Puhl et al., 2013).
Personal responsibility for health is widely considered an essential component of good citizenship in modern Western societies, and people judge themselves and others according to "how well they succeed or fail in adopting healthy practices" (Crawford, 2006, p. 402). To demonstrate personal responsibility for their health, people are expected to acquire health and medical knowledge, and then apply this in their daily lives (Wetherell, Taylor, & Yates, 2001). Our participants felt that obesity news reporting focused strongly on personal responsibility. This is consistent with previous research findings, which have suggested that the overwhelming focus in the media is on obesity as an issue of personal responsibility (Boero, 2007;Caulfield, Alfonso, & Shelley, 2009;Inthorn & Boyce, 2010;Lupton, 2004;Malterud & Ulriksen, 2010). Our findings support these conclusions, with our participants perceiving that they were subjected to increased numbers of stigmatizing comments and public ridicule as a result of the way obesity is presented in the news media. This is an important finding, as it validates what has predominantly only been investigated via textual and content analysis previously.
Weight loss success stories in the media, as discussed by our participants, are another way in which the media focuses on personal responsibility for health. Achieving and maintaining one's weight within the BMI normal range is an important way of demonstrating this personal responsibility and good citizenship (Halse, 2009). Overweight and obese people are expected to acquire knowledge for weight loss through these success stories (and other sources), and then apply to their own lives to successfully lose weight. These weight loss stories are part of the highly moralistic virtue discourse which promotes normative BMI, and that is promulgated through the (synopticon) media and other (panoptic) sources, such as medical and scientific research and health services (Halse, 2009). Our participants' responses to these weight loss stories, both critical and positive, demonstrated that they understood that achieving weight loss would make them good citizens, whereas if they could not achieve weight loss they were "second class citizens" or "losers," and that others judged them negatively for this failure. They recognized that achieving an acceptable BMI through weight loss is "aligned with self-discipline and restraint and a high BMI (overweight or obesity) is . . . the physical manifestation of self-indulgence and a lack of self-discipline and moral fortitude" (Halse, 2009, p. 48). Participants who enjoyed these weight loss stories and found them inspirational and motivating may be demonstrating their internalization of the message about personal responsibility for health, along with body weight norms. These responses to weight loss stories are suggestive of the synopticon exerting its influence, yet the differing responses to weight loss stories also demonstrate how people can interpret similar stories in varied ways, which can demonstrate resistance, as well as alignment with dominant ideas and norms (Seale, 2003).
Our participants' perception that the media highlighted the cost of obesity to society, with obese people portrayed as liabilities, is another example of the synopticon at work. Such news stories are suggestive, that in comparison with "good" conformist citizens, obese people are costly, as their deviant bodies require specialized equipment and responses, which use public monies that could be better spent elsewhere. In this way, the obligation to be personally responsible for one's weight is important for the economic well-being of the community and the nation (Halse, 2009).
In response to these overwhelmingly negative portrayals of obese people and obesity, our participants also expressed the need for more positive portrayals of obese people. Given that research suggests that the use of positive imagery in obesity news reporting might reduce stigma and weight bias (McClure et al., 2010) and encourage people to act more positively toward obese people (Pearl, Puhl, & Brownell, 2012), this desire for improved imagery seems well founded.
The synopticon "directs and controls or disciplines our consciousness" (Mathiesen, 1997, p. 230) through a whole system of messages, produced by many different media stories, rather than isolated single ones. News stories which highlight the importance of personal responsibility are an integral part in this system of messages, alongside stories which highlight deviance. This synoptical system of messages encultures the audience by creating a general understanding of the world; it produces and reproduces norms. The range of obesity news reporting stories that our participants discussed-from being blamed and shamed, portrayed as "freaks" and "headless fatties," to the wonders of weight loss success, to the positioning of obesity as an epidemic of social concern-demonstrates the different types of messages in a system of messages about what is normal and abnormal body weight. The absence of obese voices and identities, as discussed by our participants, are different, yet relevant, forms of messages in the system of messages, as exclusion is also an important facet in social control (Fischer & Poland, 1998). Considered together, these various story formats suggest that obese people should be ostracized, excluded, and ridiculed but may be welcomed back when they lose weight and achieve a socially acceptable body size in a society that celebrates thinness through the heavy promotion of the thin ideal. In addition, while not discussed in the data presented in this article, other media messages form part of this system of messages and social control, which defines what normal, acceptable body weight is and is not. The valorization of the thin ideal throughout the media (Harrison, 2000) is an important component of the system of media messages about body weight. Obesity prevention and management social marketing campaigns present various media messages about weight, health, and weight management, and promote personal surveillance whereby individuals are encouraged to measure and monitor themselves. Advertisements for weight loss products and services, along with weight loss reality television programs, are another part of this system of messages focused on personal responsibility for, and self-control of, body weight. These diverse stories in the synoptical system demonstrate that the body is "the ultimate site of political and ideological control, surveillance and regulation" (Lupton, 2003, p. 25). Our participants' experiences of stigma and public ridicule, which they perceived was influenced and supported by how the news reported on obesity and presented obese people, demonstrate how this system of messages coheres into a form of social control whereby, as discussed by our participants, non-obese people are able to socially sanction obese people by publically voicing their dislike and contempt.
The panopticon and synopticon have developed as a dyad through intimate interaction, and the synoptical role of news may allow for the further allocation of resources to panoptical surveillance (Mathiesen, 1997). Research has found that when reporting obesity as a crisis, the news takes its cue from scientific studies, while also magnifying the extent of the crisis by using metaphors and evocative language (Saguy & Almeling, 2008). The regular news coverage of obesity as an issue of concern, through the highlighting of "freaks" and "deviants," the quoting of population data and scientific findings, and presenting the issue as an epidemic may be seen to magnify the issue and add credence to calls for more funding to tackle the obesity "issue" and for further surveillance. In the same way, there has been found to be a two-way, concurrent relationship between breast cancer media coverage and funding (Corbett & Mori, 1999). Thus, the synoptical role of news reporting of health issues is complementing and working in tandem with the panoptical role of public health surveillance and epidemiological research. The panopticon and synopticon expose the relationship between knowledge and power, and demonstrate how power is diffuse and "comes from everywhere" (Foucault, 1998, p. 63).

Extending the Synopticon and Panopticon
Critiquing and building on the concept of the synopticon, Doyle (2011) suggested that while the synopticon is useful for understanding how the mass media and surveillance interact narrowly, it is limited because it does not consider the possibility of resistance to the media. Resistance to the media may come either at the media production stage or at the reception stage (Doyle, 2011). Our participants may have been demonstrating resistance to news reporting of obesity during the reception stage when they chose not to consume news media generally, when they chose to explicitly avoid obesity news reporting, or when they chose non-commercial and non-tabloid media channels for their news.
Our participants expressed a desire to see obese people given voice in the media to tell their stories, along with obese people appearing more generally in the media in a positive manner. This demonstrates their desire for change at the production stage of news reporting as channel of resistance (Doyle, 2011); yet, this is something they are commonly excluded from in the traditional news media.
The rise of the Internet has been criticized for providing further opportunities for surveillance, but it has also given rise to additional opportunities for resistance and activism (Doyle, 2011). It can provide opportunities for resistance because it can allow and nurture a considerably different set of social relations compared with the predominantly unidirectional communication of more traditional media forms. The Internet has allowed for resistance to flourish at this production stage with huge amounts of fat activism occurring in the form of blogs and on social networking sites (Cooper, 2008). The rise of this activism and of the "fatosphere" (an online fat-acceptance community) is an example of obese people resisting at the production stage and providing alternative messages about body weight and obesity. Participation in the fatosphere has been found to provide feelings of empowerment and allow people to resist fat stigma (Dickins et al., 2011). Yet, even fat-acceptance blogs enact strong moderation policies to ensure that "any commenting that goes against fat acceptance will be removed and the commenters blocked" (Fat Heffalump, 2014). The Internet has also been found to offer opportunities of resistance and empowerment to people facing different weight issues, such as anorexia (Dias, 2003). Or it may be that rather than simply using the Internet for resistance, mass media coverage of obesity initiates a process of reflection which allows some people to respond by developing their own deeper, more nuanced understanding of this issue through immersion in online discursive networks and discussions, and that the Internet allows them to move beyond the traditional media in their consideration of their obesity and responses to it.
In contrast with these opportunities for resistance, empowerment, and discursive explorations, the Internet and newer forms of media may also extend the synopticon, such as through online reader comments reinforcing or magnifying online news article content (Couch et al., 2015). For example, a study which examined a large online forum found that obesity was highly stigmatized in forum discussions, that overweight and obese people were considered to be of diminished status, and the forum users tried to distance themselves from being labeled obese (De Brún, McCarthy, McKenzie, & McGloin, 2014).
In this article, we have demonstrated how the application of the theoretical concepts of the panopticon and synopticon working together allows for a thorough, systematic and socially contextual understanding of obesity news reporting and obese people's perceptions of, and responses to, this reporting. We have also considered how the Internet and newer forms of online media may provide opportunities for resistance (Doyle, 2011), along with potentially extending and enhancing the social control functions of the traditional mass media.

Strengths and Limitations
The key strength of this study is that it has given voice to the experiences of obese people, as it has investigated the perceptions and responses to obesity news reporting for this key audience (Atanasova et al., 2012;Boyce, 2007), and provides understanding and insight into the lived impact (Boero, 2013) of this reporting. Another strength of this study is that it used a conceptual framework to consider the obesity news reporting within a wider system of social control of bodies. Other strengths of this study include the large sample size and the use of diverse sampling methods, along with theoryinformed sampling.
While efforts were made to sample as widely as possible, there were many more female participants (74.6%) in our study than male (25.4%), despite obesity prevalence being only slightly higher in females than in males in Australia (21.8% vs. 19.1%;National Preventative Health Taskforce, 2009). Our participants were also highly educated, with 62.7% having a university or postgraduate degree. We cannot therefore generalize our findings to other obese individuals. This study used self-reported data for BMI. Self-reported weight and BMI is often inaccurate (Gorber et al., 2007), but as these self-reports are more likely to be underestimations rather than overestimations, it is unlikely that participants in our study were not obese.
News reporting of obesity is just one component of a vast array of messages and representations of bodies and body weight in modern Western culture. The meanings our participants take from news reporting of obesity are made sense of in a broader cultural context, such as gender, social class, ethnicity, individual life stage, and broader historical context. Within the mass media itself, how all bodies, not just obese, are presented across various media formats contributes to this broader cultural milieu. The influence of these other media formats and the broader social, historical, and cultural context has not been considered in detail in this article. Future research could investigate how people interpret and respond to this system of weight-related media messages and public health panoptical surveillance.
Other research might further explore the complementary and dyadic role of panoptical public health surveillance and synoptical media coverage for other health issues in detail, such as smoking, pregnancy, immunization, cancers, gambling, and drink driving.

Conclusion
There has been limited research on how obese people interpret obesity news reporting. The research presented in this article considers obese persons' perceptions of obesity news reporting, situates these within the wider context of obesity news research, and then discusses the results in relation to an innovative theoretical perspective.
Our study has increased understandings of how obese people perceive news reporting and in particular the role it plays in reinforcing personal responsibility, deviance, stigma, and blame, along with the exclusion of obese people through denying them identity and voice. An important outcome is that our findings validate and build on much of the previous textual and content analysis research undertaken into this issue. Our findings indicate that obese people feel news reporting of obesity excludes or ridicules them because they defy social body norms. Only if they achieve a socially acceptable body size/weight are these social sanctions removed and such people allowed to appear positively in the news. In addition to this, the aspects of obesity news coverage raised by our participants demonstrate the strong personal impact of news reporting on people living with obesity, and the negative outcomes they experience in their day-to-day lives. Our findings demonstrate the synopticon at work through participants' experiences, which have highlighted the role of obesity news reporting in the social control of obesity. The media synopticon is working in tandem with public health panoptical surveillance of obesity.
The synopticon, alongside the more well-established concept of the panopticon, offers a new and critical way to expand our understandings of media presentations of obesity and the impact of these presentations on people living with obesity. The application of this theoretical concept to other public health issues may reveal new insights and encourage the development of innovative responses.

Acknowledgments
Danielle Couch is grateful to receive an Australian Postgraduate Award in support of her PhD studies. We would like to thank the people who reviewed this manuscript for their insightful comments and suggestions; and most importantly we would like to thank all those who partcipated in this study and who took the time to share their experiences.

Declaration of Conflicting Interests
The author(s) declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding
The author(s) disclose receipt of the following financial support for the research and/or authorship of this article: The authors are grateful to the Australian Research Discovery Grant Scheme for funding this study (Grant DP0878805). Notes 1. "Moral panics" have occurred throughout history, arising in response to issues associated with rapid societal change and attribute blame and personal responsibility to specific groups of individuals (Campos, Saguy, Ernsberger, Oliver, & Gaesser, 2006;Throsby, 2007). 2. Framing involves selection and salience. Frames are created by selecting some aspects of perceived reality and making these more salient in communicating text. In this way, framing can be used to promote a certain problem definition, interpretation, moral evaluation, and/or intervention or response recommendation for the issues described (Entman, 1993).