Trainer Sarah, Benjamin Tonya
The ASU-MC Obesity Solutions Initiative, Arizona State University, Tempe, Arizona, USA.
MC Arizona, Scottsdale, Arizona, USA.
J Adv Nurs. 2017 Apr;73(4):894-904. doi: 10.1111/jan.13193. Epub 2016 Nov 23.
The aim of this study was to explicate the processes by which a patient's choice to undergo bariatric surgery is made to feel like a medical necessity, to explore the ways widespread societal stigmatization of weight and bariatric surgery shapes patient and provider discourse about surgery and to discuss patient rationalizations of the choice to have surgery.
Severe obesity is currently highly stigmatized. Bariatric surgery has become an increasingly used option for individuals seeking to lose drastic amounts of weight. The surgery itself, however, remains stigmatized across many diverse settings.
This research design is centred on an ethnographic study of bariatric surgery patients who undergo surgery at a particular bariatric clinic in the American Southwest.
Data collection included repeated ethnographic interviews with 35 individuals enrolled in the bariatric programme over the past 5 years. The interviews were supplemented by extensive participant observation, starting in 2014 to date. Thematic analysis of fieldnotes and transcribed interviews followed.
People who have bariatric surgery for weight-loss may trade one type of stigma for another. Thus, individuals who qualify for bariatric surgery based on weight alone may be reluctant to explore the surgery as a viable option. This research also shows that younger women are more likely to face the effects of weight-related stigma, which has an impact on their motivations for undergoing bariatric surgery.
Stigma - both weight-related and surgery-related - needs to be addressed at a larger level, in terms of policy and in clinical bariatric programmes.
本研究旨在阐明使患者选择接受减肥手术的过程如何被视为一种医疗必需，探讨社会对体重和减肥手术的普遍污名化如何塑造患者和医疗服务提供者关于手术的话语，并讨论患者对选择手术的合理化解释。
严重肥胖目前受到高度污名化。减肥手术已成为寻求大幅减重的个人越来越常用的选择。然而，手术本身在许多不同环境中仍然受到污名化。
本研究设计以对美国西南部一家特定减肥诊所接受手术的减肥手术患者的人种志研究为中心。
数据收集包括对过去5年参加减肥项目的35个人进行多次人种志访谈。从2014年至今，通过广泛的参与观察对访谈进行补充。随后对实地记录和转录访谈进行主题分析。
因减肥而接受减肥手术的人可能会用一种污名换取另一种污名。因此，仅基于体重符合减肥手术条件的个人可能不愿将手术作为可行选择进行探索。本研究还表明，年轻女性更有可能面临与体重相关的污名的影响，这对她们接受减肥手术的动机有影响。
与体重相关和与手术相关的污名都需要在政策层面和临床减肥项目中在更大范围内加以解决。
