More than Meets the Eye: A Qualitative Investigation of the Complex Weight History Constructions of Brazilian Women Who Underwent Bariatric Surgery

Abstract

Most studies on bariatric surgery identify personal factors such as “non-compliance” to lifestyle changes as the cause of weight gain and subsequent inability to lose weight. Prior qualitative studies suggest that weight loss patients have complicated relationships with both self and weight, with significant emotional and psychological implications. But how do patients themselves understand the trajectories of their weight gain as related to intrinsic versus extrinsic factors? A qualitative analysis examined the aspects involved in the construction of higher body weight from the perspectives and life experiences of Brazilian women who underwent bariatric surgery, considering that Brazil has previously been reported as a highly anti-fat society. Individual, semi-structured interviews were conducted with thirty women (15 aged 33-59 and 15 aged 63-72). Data were analyzed identifying the regular, expressive, and meaningful significance units identified through the interviews. Although it was expected that different life events were reported as crucial to the perceived aetiology of individual weight gain stories, the participants reported that the emotional aspects had more impact. The extremely high value attached to having a particular body weight negatively influenced the participants’ concept of identity and harmed their interactions and understanding of what it meant to be fully loved and accepted. Most of the participants underscored the importance of food in women’s lived experiences and explanations of weight gain. Despite this somatic response being dysfunctionally directed to food, this mechanism seemed to be vital to keeping them alive and engaged in the world. Finally, the participants faced layered vulnerabilities, which decreased their opportunities to access resources aimed at better body weight management. Broad approaches that consider emotional and physical care strategies must be proposed to this population.