Caught between conduct and free choice--a field study of an empowering programme in lifestyle change for obese patients.

The aim of this study was to investigate understandings and strategies of empowerment in Learning and Mastery Centres, in a course in lifestyle change for morbidly obese patients. A field study was conducted with nonparticipant observation, and data analysis was inspired by foucauldian discourse analysis. The analysis revealed powerful discourses underlying the course, and the analysis showed how different discourses were set at play within the teaching strategies in the course. The course leaders balanced powerful aspects that involved directing the participants towards strategies promoting their autonomy. The analysis revealed how strategies to reduce the impression of direction and conduct are powerful actions. From a foucauldian perspective of power, this analysis demonstrates how power is everywhere as a productive force. When creating programmes to empower patients to help them deal with their health, it seems vital that health professionals examine power. By accepting the presence of power, professionals can examine the truth motivation underlying an empowerment programme.