'A war of a different kind': local municipalities' experiences in managing the COVID-19 pandemic in Israel-a qualitative study.

OBJECTIVES: In Israel, in 2020, 57/257 local municipalities were part of the Healthy Cities Network (HCN). HCN municipalities have a strong political commitment to health promotion and reducing health inequalities. This research aimed to (1) explore local municipalities' management of the pandemic and (2) assess whether belonging to the HCN impacted this management. DESIGN, SETTING AND PARTICIPANTS: Fourteen municipalities were chosen-seven HCN municipalities, matched to seven non-HCN municipalities. In each municipality, semistructured telephone interviews were conducted with three to four officials. Interviews were recorded, transcribed and analysed using inductive thematic coding, both in general and specifically to compare HCN and non-HCN municipalities. RESULTS: Forty-two interviews were conducted, with five main themes: (1) relationship with the government; with the transference of information to the local municipalities found to be challenging and a strong need for more independence at the local level; (2) contact with residents which was divided into several actions, such as mapping the city population, supporting vulnerable populations and managing volunteers; (3) relationships within the municipality which included a sense of collaboration and community but also a feeling of wear out; (4) difference between the first lockdown compared with following lockdowns; within these themes, no significant differences were found between HCN municipalities and non-HCN municipalities and (5) the role of the Healthy City (HC) coordinator which was critical in several municipalities. They served as brokers, had a pre-existing intersectoral network and held a broader vision of health. CONCLUSIONS: Local municipalities in Israel played an important role in the pandemic response. Municipalities requested a central information source and more independence at the local level. Challenges and responses were similar across municipalities and residents, regardless of their HCN status. However, in some municipalities, the role of the HC coordinator was crucial for the pandemic response due to pre-existing interprofessional and intersectoral networks.

The Ethical Work of Weight Loss Surgery: Creating Reflexive, Effortless, and Assertive Moral Subjects.

While higher-weight bodies have been radically medicalized in modern Western discourse, they are also culturally conceived as a moral project. In clinical settings aimed at transforming the body, the consultation sessions between bariatric professionals and patients reveal nuanced moral deliberations. I suggest that bariatric surgery becomes a site of a "moral breakdown," where professionals direct patients to morally recuperate not only through technologies of the self, such as intensive bodywork and diets, but through "moral laboratories," which invite moments of experimentation in everyday life. Drawing on ethnographic inquiry in a bariatric clinic, I argue that this moral project is understood through new relationships within various registers of patients' subjectivity. First, patients are instructed to "listen to their bodies" and to reconnect to their embodied sensations. They are further guided to cognitively imitate an effortless "thin state of mind." And finally, they are instructed to "put themselves first" by reorganize their interactions with significant others. Professional guidance encourages dialog and reflexivity within the patient that are consonant with neoliberal understandings of the self-disciplined subject, yet they expand, and at times undermine these neoliberal notions by attending to other body ethics and contesting elements of fat stigma.

'We Don't Want You to Diet': Bariatric professionals' boundary work and negotiation of pleasure and control.

Although patients who undergo weight-loss surgery (WLS/bariatric surgery) must follow severe eating restrictions in a manner similar to that of dieting, professionals strive to demarcate distinctions between the approaches and methods of WLS and diet. Drawing from ethnographic research, this study focuses on the content and interpretative dimensions of professionals' boundary work as well as its meaning and implications for patients. The post-surgical body is revealed as a site of dispute. Professionals portray the logic of diet as one that assumes individuals ought to discipline themselves - and not 'give in' to pleasure - in order to achieve an ideal body. In contrast, WLS is depicted as a more advanced and balanced method that negotiates pleasure and control. Professionals construct boundaries by shifting the causes for obesity from the individual to the context, by expanding the meaning of success and by portraying food as healing. These findings join recent critical literature that shows that the lived experiences of care practices contest the prevailing framing of obesity care as solely about exerting disciplinary power and control. WLS professionals negotiate fat stigma and question dominant discourses regarding body size, thin ideals and responsibility.