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ASU researchers take novel approach to studying obesity

ASU-Mayo partnership brings social science into the study of obesity.
"Wholesale shift toward understanding, empathy" needed to solve obesity issue.
October 27, 2016

Obesity Solutions group acknowledging the stigma and public health concerns, as well as social reactions to bariatric surgery

A newly implemented policy requiring passengers to weigh in before boarding flights on Hawaiian Airlines has triggered a national conversation over obesity and whether people of larger body sizes face discrimination.  

ASU researcherBrewis is a President's Professor in the School of Human Evolution and Social Change, an academic unit of the College of Liberal Arts and Sciences. Alexandra Brewis has heard about the controversy and says that although the issues are nothing new, she and her colleagues at ASU’s Obesity Solutions are coming up with novel ways to approach them.  

“There’s plenty of research on obesity. The point is not that we need to study it more, but that we need to study it better,” Brewis said. “There is no country, despite 20 years of public health effort, that has reversed rising obesity rates. That means the types and scale of solutions we’re implementing are not working.”

Obesity has been linked to heart disease, high blood pressure and even some cancer. There are many causes, and larger people say they face stigma and discrimination, the basis for criticism of the Hawaiian Airlines policy. Hawaiian Airlines representatives, however, have said they only want to ensure safety and fuel efficiency. Federal officials ruled recently that the policy wasn’t obviously discriminatory.    

As for ASU, researchers want to tackle both the public health concerns and stigmas.

ASU co-director of Obesity Solutions Alex Brewis headshot

Co-director of ASU Obesity Solutions Alexandra Brewis

One of the goals of Obesity Solutions, a partnership between ASU and the Mayo Clinic, is to get away from assumptions and conventional wisdom, and instead focus on habits and motivations to develop lasting solutions.

The Post-Bariatric Lives Project has been employing just such an anthropological approach to help people who have lost considerable weight through surgery.

It “was conceived of as way to bring social science into alignment with medical models of treating obesity,” Brewis said. “Our partnership with Mayo Clinic, allowing us access to work closely with patients struggling with weight issues, has allowed us to do that.”

The project, which began in 2012, is in the final stages of wrapping up field work and disseminating findings, though several publications have already come out of the study — research that has been highlighted in the media, including a New York Times report with the headline “The Shame of Fat Shaming.”

“Because we have such an interdisciplinary team working on this study, people with different strengths and skill sets, it’s easier to talk to a wider audience,” said Sarah Trainer, a post-doctoral fellow with Obesity Solutions who is working on a book that will share the findings in a way that allows health professionals to consider weight loss from the patient’s perspective.

“We have this incredibly rich data set that allows us to use different lenses very strategically to look at different issues,” she added.

The project also draws on the design aspirations of the New American University to act locally but think globally, and to think in innovative ways to design solutions to complicated problems.

As a medical anthropologist, Trainer joined the project in 2014 with the objective of building relationships with bariatric patients and health care providers at the Mayo Clinic in Phoenix, seeking ways to improve patient experiences. She started out by attending pre-surgery behavioral classes and support group meetings.

“To the untrained eye, it looked like I was just lurking,” Trainer said. But as she got to know the patients better, she was able to conduct one-on-one interviews. “Then I was able to get a really in-depth look at how they’re coping with this life-altering event.”

Trainer followed each patient for about 18 months, from pre- to post-op, observing changes in their relationship with food, how they dealt with health issues and how they interacted with people. 

One surprising finding was that patients who had undergone the surgery and lost significant amounts of weight often did not divulge to new acquaintances that they used to be heavier. That’s because bariatric surgery is sometimes seen as “cheating.”

ASU Obesity Solutions post-doctoral researcher Sarah Trainer

“From a medical perspective, surgery is the single most successful strategy of dealing with extreme obesity. We assumed as people dropped weight they would find release from stigma,” Brewis said. “That’s not what happened. Having a past of extreme weight turned out to be hard for people to escape from, because of this idea that they didn’t put in the hard work.”

Part of the stigma, researchers say, is linked to the proliferation of gyms, gadgets and restaurants that offer healthier options. “There is a definite tide flow to the casual stigmatizing of larger bodies,” Trainer said. The people who choose to undergo bariatric surgery have spent a lifetime dealing with that.

“We need a wholesale shift toward understanding and empathy for our fellow human beings, recognizing that blaming people for their weight does more harm than good,” Brewis said.

“And that’s not an easy ask. But we’ve seen public attitudes toward things like same-sex marriage change. So we know there is the capacity for society to do it.”



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'Feathers and Teeth' dressed for success

Seven-show run debuts Friday at 7:30 p.m. at the Nelson Fine Arts Center.
Director Ricky Araiza says he's always a "ball of nerves" before a show starts.
October 27, 2016

Rehearsal goes well ahead of ASU student's horror-comedy play, set to debut Friday in Tempe after weeks of preparation

Editor's note: This is the fourth installment of a semester-long series following the production of "Feathers and Teeth" from casting call to wrap party. Look for the next story soon.

Director Ricky Araiza knows he’ll wake up Friday morning the same way he always does when a show is ready to open: petrified and in full panic.

“I’m terrified,” said Araiza, an ASU graduate student who will unveil his biting new horror-comedy “Feathers and Teeth” Friday evening in Tempe.

“I’m already a ball of nerves, and that’s just how it is,” he said. “The week before opening night where all of the elements come together is the most stressful time for me.”

The seven-performance run will debut Friday at 7:30 p.m. at the Nelson Fine Arts Center and conclude on Nov. 6. Two of the performances are almost sold out. General admission tickets are $10 and $5 for students. For more information, go here.

Araiza, a third-year master of fine arts student in Arizona State University’s School of Film, Dance and TheatreThe School of Film, Dance and Theatre is a unit of the Herberger Institute for Design and the Arts., says these emotions have become ritual for him and that they come with being a director. Whether he knows it or not, he’s a perfectionist. This play is not only the equivalent of his master’s thesis, but it’s his baby, his ball of wax — and he feels the weight.

The young director felt the full force Wednesday night when the first dress rehearsal for “Feathers and Teeth” took place, almost eight weeks after the first audition.

The rafters of Nelson Center Fine Arts Center, Studio 133, were filled approximately with 50 crew members who collectively cover design and construction, sound and lighting, special effects, props, makeup, wardrobe, choreography and publicity. The mixture of stage veterans and rookies were all gathered to see how the play's elements blended together with the actors’ performance.

Feathers and Teeth

Actors Maria Harris and Evan Carson are reflected in the back of monitor of media operator Maya Christian during the technical rehearsal of "Feathers and Teeth" on Wednesday evening at the Nelson Fine Arts Center on the Tempe campus. Photo by Charlie Leight/ASU Now

Araiza, as the old saying goes, expected the worst and hoped for the best.

“This will probably be a terrible run-through, and that’s good,” he said. “I like and encourage failing. When we mess up, we get it out of our system and understand what we did wrong and how we can do it better.”

Actually, it wasn’t bad. The first run-through exposed a lighting cue and wardrobe snag, which are considered easy fixes. In the dark, Araiza could be seen furiously scribbling notes, writing down mistakes only his eyes could spot.

“Tonight was typical for a dress rehearsal, and Ricky’s doing a great job,” said Tom Aberger, a clinical assistant professor and stage manager in the School of Film, Dance and Theatre in the Herberger Institute for Design and the Arts. “He’s always finding little tweaks to make things better.”

While Araiza is making adjustments with the technical crew, the cast has to make new acting choices brought on by the new wardrobe.

Tess Galiboti, a 20-year-old acting major, said she has been preparing for this night for weeks by walking around in 3-inch heels. Her character, Carol, has been described by playwright Charise Castro Smith as “Carol Brady on speedballs." Carol is flashy, flamboyant and fond of turquoise eye shadow and Pepto Bismol-colored pantsuits. 

“Costumes force your body to move differently,” Galiboti said. “Then add in sounds, lighting, props, all these different elements. Every show becomes a work in progress, even after opening night.”

“Feathers and Teeth" is about Chris, a 13-year-old girl who suspects foul play when her father hooks up with an attractive home-care nurse after the death of her mother, Ellie. Set in a Rust Belt factory town in 1978, the play combines the supernatural with classic rock, family dysfunction and gremlin-like creatures that roam the house’s crawl space.

The ending even has a dark 1970s-style amorphous conclusion, which tickles actor Fargo Tbahki pink, or, in this case, blood red.

“It has a very horror ending where you thought something was done but really wasn't done,” Tbahki said. “Like in 'Carrie' where the hand pops back out of the grave.”

Read more

Part 1: Anything goes at 'Feathers and Teeth' casting call.

Part 2: Building chemistry among a new cast.

Part 3: Crew members sink ‘Teeth’ into new Herberger production.

Top photo: Fargo Tbakhi (who plays Hugo) gets a little touch-up from makeup artist Macaley Fields as Evan Carson checks his phone before the technical rehearsal of "Feathers and Teeth" at the Nelson Fine Arts Center on Wednesday evening. The play, directed by Ricky Araiza and written by Charise Castro Smith, is scheduled to run from seven shows beginning Oct. 28 and concluding with a matinee on Nov. 6. Photo by Charlie Leight/ASU Now