Meleo-Erwin Zoë C
Department of Public Health, William Paterson University, New Jersey, USA.
Sociol Health Illn. 2019 Feb;41(2):285-302. doi: 10.1111/1467-9566.12823. Epub 2018 Nov 25.
This article traces the post-surgical relationship between weight-loss surgery (WLS) patients and their home bariatric clinics. Following surgery, there is substantive drop off in patient attendance at both follow-up appointments and support groups. While barriers to follow-up are often discussed with the bariatric literature, patients themselves are typically defined as the problem. Based upon a thematic analysis of 217 blog posts and comments in two top patient-led online forums, I demonstrate that bariatric patients tell a more complex story about their post-surgical lives. I argue that WLS patients constitute a population with highly specialised medical needs that is caught between the requirements for living with surgically altered digestive systems and a lack of sufficient post-operative follow-up care from their home bariatric clinics. Although online forums provide spaces for patients to examine these post-operative social and clinical experiences in critical terms, seek information and get support, ultimately the conversations serve to underline the value of personal responsibility for post-operative outcomes-a framing that echoes that of the bariatric profession. This framing should be understood within a larger climate of weight-based stigma and discrimination as well as neoliberal healthism.
本文追溯了减肥手术(WLS)患者与其家庭减肥诊所之间的术后关系。手术后,患者在随访预约和支持小组中的出勤率大幅下降。虽然减肥文献中经常讨论随访的障碍,但患者本身通常被定义为问题所在。基于对两个顶级患者主导的在线论坛上217篇博客文章和评论的主题分析,我证明减肥患者讲述了一个关于他们术后生活的更复杂的故事。我认为,减肥手术患者构成了一个有高度专业化医疗需求的群体,他们一方面要适应手术改变后的消化系统的生活要求,另一方面又缺乏家庭减肥诊所足够的术后随访护理。尽管在线论坛为患者提供了批判性审视这些术后社会和临床经历、寻求信息和获得支持的空间,但最终这些对话凸显了个人对术后结果负责的价值——这种框架与减肥行业的框架相呼应。这种框架应在基于体重的耻辱和歧视以及新自由主义健康主义的更大背景下理解。