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

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          Abstract

          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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          Using thematic analysis in psychology

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            Sample sizes for saturation in qualitative research: A systematic review of empirical tests

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              Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission

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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draft
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 July 2023
                2023
                27 July 2023
                : 18
                : 7
                : e0287822
                Affiliations
                [1 ] Departamento de Nutrição, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP, Brasil
                [2 ] Unidade de Endocrinologia Pediátrica do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
                [3 ] Divisão de Cirurgia do Aparelho Digestivo, Unidade de Cirurgia Bariátrica e Metabólica, São Paulo, SP, Brasil
                [4 ] School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States of America
                [5 ] Grupo de Pesquisa em Fisiologia Aplicada e Nutrição, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
                Deakin University Faculty of Health, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                ‡ RRF and MAS also contributed equally to this work.

                Author information
                https://orcid.org/0000-0001-7861-8597
                https://orcid.org/0000-0003-3769-4205
                Article
                PONE-D-22-24534
                10.1371/journal.pone.0287822
                10374044
                37498887
                26935c0a-9b3a-43ec-a2a4-44ba0c4ec10a
                © 2023 Dimitrov Ulian et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 September 2022
                : 13 June 2023
                Page count
                Figures: 0, Tables: 1, Pages: 17
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100001807, Fundação de Amparo à Pesquisa do Estado de São Paulo;
                Award ID: 2019/00031-0
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100001807, Fundação de Amparo à Pesquisa do Estado de São Paulo;
                Award ID: 2017/17424-9
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100003593, Conselho Nacional de Desenvolvimento Científico e Tecnológico;
                Award ID: 309514/2018-5
                Award Recipient :
                This work was supported by the São Paulo Research Foundation (FAPESP), grant number 2019/00031-0, granted to Mariana Dimitrov Ulian. In addition, Fernanda Baeza Scagliusi received grant by FAPESP (grant number 2017/17424-9) and CNPq (grant number 309514/2018-5). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Digestive System Procedures
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Weight Loss
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Weight Gain
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Eating
                Biology and Life Sciences
                Nutrition
                Diet
                Food
                Medicine and Health Sciences
                Nutrition
                Diet
                Food
                People and places
                Geographical locations
                South America
                Brazil
                Custom metadata
                The data relevant to this paper are available from figshare, https://doi.org/10.6084/m9.figshare.23556324.v1.
                COVID-19

                Uncategorized
                Uncategorized

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