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Abstract Background For decades, dominant weight discourses have led to physical, mental, and social health consequences for young women in larger bodies. While ample literature has documented why these discourses are problematic, knowledge is lacking regarding how they are socially organized within institutions, like fashion and media, that young women encounter across their lifespan. Such knowledge is critical for those in public health trying to shift societal thinking about body weight. Therefore, we aimed to investigate how young women’s weight work is socially organized by discourses enacted in fashion and media, interpreting work generously as any activity requiring thought or intention. Methods Using institutional ethnography, we learned from 14 informants, young women aged 15–21, in Edmonton, Canada about the everyday work of growing up in larger bodies. We conducted 14 individual interviews and five repeated group interviews with a subset (n = 5) of our informants. A collaborative investigation of weight-related YouTube videos (n = 45) elicited further conversations with two informant-researchers about the work of navigating media. Data were integrated and analyzed holistically. Results Noticing the perpetual lack of larger women’s bodies in fashion and media, informants learned from an early age that thinness was required for being seen and heard. Informants responded by performing three types of work: hiding their weight, trying to lose weight, and resisting dominant weight discourses. Resistance work was aided by social media, which offered informants a sense of community and opportunities to learn about alternative ways of knowing weight. However, social media alleging body acceptance or positivity content often still focused on weight loss. While informants recognized the potential harm of engagement with commercial weight loss industries like diet and exercise, they felt compelled to do whatever it might take to achieve a “normal woman body”. Conclusions Despite some positive discursive change regarding body weight acceptance in fashion and media, this progress has had little impact on the weight work socially expected of young women. Findings highlight the need to broaden public health thinking around how weight discourses are (re)produced, calling for intersectoral collaboration to mobilize weight stigma evidence beyond predominantly academic circles into our everyday practices.

Inspired by consciousness-raising practices of North American second-wave feminism, Dorothy Smith developed institutional ethnography (IE) as an alternative to established sociology, which she argued objectified people and their experiences. Instead, IE begins from an embodied standpoint to examine how local phenomena are coordinated to happen by ruling relations from afar. In this article, we present methodological insights from our experiences of applying IE, informed by principles of participatory research, in Alberta, Canada to examine the challenges young women (aged 15–21) in larger bodies face while navigating their everyday lives. We begin by exploring current discussions in the burgeoning field of IE, including how IE’s social ontology aligns with participatory approaches to research. Contextualized by our public health backgrounds, we then describe how we used IE to study how the work of growing up in a larger body is socially organized, interpreting work generously as any task requiring thought and intention. Between March-December 2019, we conducted 14 individual interviews and facilitated 5 working group meetings with a subset of interview participants. Discussions during the working group meetings were structured by an adapted critical analysis framework to prompt participants in questioning taken-for-granted assumptions around weight and health. As part of this working group, we developed knowledge mobilization materials (infographics and an open letter) for parents, educators, and healthcare providers about how to navigate weight-related issues with young people, grounded in participants’ experiential knowledge. We specifically reflect on how IE was a valuable tool for addressing four principles of participatory research central to this study: go beyond “do no harm”; provide opportunities for giving feedback; create space for critical engagement; and bring knowledge mobilization to the fore. Overall, our experiences suggest value in IE as a pragmatic, flexible approach to public health research, offering unique methodological tools which keep research participants in view.