A complexidade da obesidade e o processo de viver após a cirurgia bariátrica: uma questão de saúde coletiva

Abstract

O conhecimento dos altos índices de pessoas obesas submetidas à cirurgia bariátrica como tratamento da obesidade, gerou a necessidade de realizar um estudo com o objetivo de conhecer as repercussões desse tratamento na saúde de um grupo de indivíduos a ele submetidos. Os dados foram coletados por entrevista em profundidade, com foco na identificação da história da situação de obesidade que gerou a decisão pela cirurgia e o processo de viver o cotidiano após esse tratamento. A análise mostrou que as constantes dificuldades e frustrações no combate da obesidade e a expectativa da cura definitiva geraram, naquele grupo, a decisão de se submeter à cirurgia. Entretanto, a vida após esse tratamento, ainda se caracterizava como um processo contínuo de enfrentamentos, com mais desafios para reaprender a viver o cotidiano e resgatar a saúde integral. Esse contexto implica, também, desafios para a equipe de saúde; envolve maior investimento na saúde coletiva, aperfeiçoamento nas estratégias de prevenção e controle de obesidade da população e também ações de cuidado integral àqueles indivíduos. Tal complexidade exige atuação interdisciplinar com olhar sincronizado com as questões afetivas e socioculturais dessa população.

The decision of an obese woman to have bariatric surgery: the social phenomenology

“…The limitations of a physical and social nature arising from obesity lead the person to incapacitating reactions, which include withdrawal from work, and restrictions on physical activities and leisure, as well as the emotional burden resulting from bodily appearance (21) This burden becomes even more significant when it takes place in the feminine public, at whom society directs an even greater level of demand for achievement of a thin body. Under western culture, being thin contributes to the perception of being a woman.…”

“…The majority of obese people seek to lose weight through conventional treatments such as diets, physical activity and medication.However, when these attempts do not provide a response, they decide in favor of bariatric surgery (21,24) . When assessing her experience of living with obesity, the woman considers that it is worth running the imminent risk of a surgical procedure, transcending the fear and deciding in favor of the gastroplasty.…”

“…This expectation was held by women in a study held in the town of Juiz de Fora, in the state of Minas Gerais, who were able to get jobs after losing weight through surgical treatment (24) . Added to the resumption of living in society, joining the job market has a positive effect on the quality of life of the person who has undergone the operation and of those who participate in his or her social circles (21) .…”

A necessidade da avaliação fonoaudiológica no protocolo de pacientes candidatos à cirurgia bariátrica

“…This occurs because of the early satiety feeling, by inadequate absorption of nutrients, the rapid transit of the food to the small distal intestine and contribute to the reduction of orexigenic hormones such as ghrelin and increased PYY and GLP-1 19,20 . The evaluation of the individual of the changes after surgery is essential, since it is essential that the patient fully understands the possible risks of the surgery, the post-surgical discomfort, and the need for a multidisciplinary approach in the pre and long term post-operative 5,9,21 .…”

“…However, there is a considerable number of cases in which these traditional treatments and/or clinical trials are ineffective in losing or maintaining weight, intensifying the feeling of guilt, discomfort and prejudice, further compromising the quality of life of obese. In this scenario the option for bariatric surgery becomes plausible 5,6,8,9 . Whatever the choice of antiobesity treatment is, the patient has to be monitored by a multidisciplinary and interdisciplinary team.…”