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

Nehushtan, Hilla

doi:10.1007/s11013-021-09756-z

Cited by 3 publications

(3 citation statements)

References 65 publications

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“…Other research has shown profound shifts in people's lived experiences in the years after bariatric surgery, mirroring their bodily transformations [30][31][32][33]. Negative judgments of postbariatric bodies are commonly reported in the literature, often centering on the persistence of side effects from the surgeries [34][35][36][37][38] and/or difficulties with managing the rigid personal habits the surgeries necessitate [32][33][34][35][36][37][38].…”

Section: Plos Onementioning

confidence: 99%

Weight stigma after bariatric surgery: A qualitative study with Brazilian women

Unsain¹,

Franco²,

Santo³

et al. 2023

PLoS ONE

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Prior studies suggest that one anticipated benefit of bariatric surgery is the achievement of a thinner body, one that is less subject to perceived negative judgment and condemnation by others. However, additional analyses also indicate that stigma may persist even with significant post-surgery weight loss. To investigate the stigma-related perceptions and experiences of women who have undergone bariatric surgery and the resulting body transformations, we conducted individual, semi-structured interviews with thirty Brazilian women (15 aged 33–59 and 15 aged 63–72). The resulting text was then analyzed using thematic analysis. We found that some form of weight stigma persisted for our participants, regardless of weight loss. Ongoing experiences of stigma were also evidenced by the constant internal and external vigilance reported by the women, as well as their articulated efforts to distance themselves from their previous bodies. Additionally, participants reported being judged for choosing an “easy way out” to lose weight. Those in the older group reported that weight stigma was entangled with ageism: older participants received mixed messages underscoring the ways that weight and age may interact in doubly stigmatizing ways. Family and close peers were especially powerful sources of stigma experiences. Collectively, these results show that weight stigma persists even when people undergo a procedure to lose substantive weight and that the degree and types of stigma experiences are influenced by gender and age. Our study suggest future research should explore whether a targeted approach might be more effective, for example, an approach that would emphasize the importance of developing coping strategies with respect to experiences of stigma and discrimination after surgery.

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Section: Plos Onementioning

confidence: 99%

Weight stigma after bariatric surgery: A qualitative study with Brazilian women

Unsain¹,

Franco²,

Santo³

et al. 2023

PLoS ONE

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show abstract

“…Qualitative studies allow us to understand the meanings of this procedure to the candidates [7][8][9][10][11] , to comprehend how these meanings affect the surgery outcomes [12] , and to clarify the expectations, perceptions, and beliefs about obesity surgery among would-be bariatric patients [7,11] . It is important to highlight that "obesity" designates fatness as pathological.…”

Section: Introductionmentioning

confidence: 99%

“…Otherwise, words such as "high body weight" and "large body" were used [13] . Most bariatric programs-and the research that flows from them-still attempt to understand the lived experiences of bariatric surgery and its attendant weight loss through a focus on the moral individual: Individuals classified with obesity "fail" to make effective lifestyle changes before and even after the surgery, reinforcing the sociocultural view of people with higher body weight as "undisciplined", "without willpower" and responsible for their condition [7][8][9][10][11] . Less is understood about how weight loss and surgery are placed by patients in the context of their specific life trajectories; that is, how they come to understand the broader processes in which their own weight was and remains embedded.…”

Section: Introductionmentioning

confidence: 99%

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

Dimitrov Ulian,

Fernandez Unsain,

Rocha Franco

et al. 2023

j. of psychol. res.

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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.

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Paradoxical bodies: negotiating biomedical fix, responsibility, and care in a weight-loss surgery clinic

Nehushtan,

Goodman

2024

BioSocieties

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This ethnographic project explores how inherent discursive and social tensions are expressed and worked out within obesity care at a weight-loss surgical (WLS) clinic. First, complicated doctor and patient encounters occur because WLS follows a medical logic of intervention and is presented as a “biomagical” procedure that miraculously alters the body. Surgeons, however, explain that the surgery’s success depends on patients’ long and hard work. Second, the clinic’s interdisciplinary approach adds more complexity. While expanding the scope of treatment, it blurs the division of labor among professionals and the distinction between body and mind. It also diffuses the responsibility for patients’ lifestyles and recovery among professionals. Third, alongside notions about patients’ autonomy and free choice, their wishes and bodies are constantly channeled, problematized, and negotiated with various family and peer support. While crucial for the surgery’s success, such interconnectedness raises questions about how decision making and social pressures affect the patients’ journey. Thus, WLS is refracted among webs of multiple actors and contradictory perspectives. This complexity invites a reflection on how such tensions and paradoxes destabilize medical power in modifying the body, challenge personal responsibility assumptions, and impact the quality of care.

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

Cited by 3 publications

References 65 publications

Weight stigma after bariatric surgery: A qualitative study with Brazilian women

Weight stigma after bariatric surgery: A qualitative study with Brazilian women

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

Paradoxical bodies: negotiating biomedical fix, responsibility, and care in a weight-loss surgery clinic

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