Representações sociais de equipes de cirurgia bariátrica sobre obesidade: evidências científicas e implicações clínicas

Abstract

Obesity has a multifactorial etiology and is responsible for compromising the quality of life of millions of brazilians, especially when associated with comorbidities. In addition to the physical difficulties and associated diseases, obese people suffer psychologically due to the stigmas sustained by several social actors in their conviviality. Obese people frequently report experiences with negative meanings attributed to obesity and weight stigmatization, and they feel vulnerable in multiple environments and contexts. Social representations are knowledge production modalities that surround everyday life, such as values, ideas and meanings, and have the objective of become familiar what is not familiar. Health professionals are responsible for the care, treatment and intervention with obese patients in bariatric surgery. Social representations by health professionals about obesity can be manifested in the treatment of obese, influencing the therapeutic relationship and adherence to treatment. Considering the above, the objective of the dissertation was to investigate social representations of obesity for professionals in bariatric surgery teams. The objective of Study 1 was to perform an integrative review of the literature on the meanings attributed to obesity. Searches were carried out in the portals BVS-Psi (Lilacs and SciELO) and PsycINFO, delimiting the period from 2015 to 2021, and the Portuguese, English and Spanish languages. The corpus of the study consisted of 17 articles. It was noted that the main actors of the negative meanings attributed to obesity are young students, media (print, online and television) and professionals involved in health practices. In addition, it was found that the stigmas, meanings and negative attitudes towards obese negatively impact the self-assessment of the obese people, causing damage in the occupational context and relationships, sadness, low self-esteem, insecurity and social isolation. Study 2 aimed to investigate the social representations of obesity in the work context of bariatric surgery teams. Interviews were conducted with seven professionals. The interviews were audio-recorded and transcribed, and were submitted to the Discourse of the Collective Subject method. The data were analyzed and compared with the specific literature in the area of obesity and social representations, and notes from the researcher's diary. The main results found in the discourses of the collective subject were: the conflicting relationship of the obese person with food causes discomfort for themselves and for others; obese as a sick patient responsible for his clinical condition; obese suffers from body image distortion; work with obesity was characterized by difficulties, concerns, feelings of incapacity and anguish; in addition, negative attitudes of medical residents towards obese patients were reported. Understanding these social representations made it possible to identify potentials and difficulties that professionals face at work, this knowledge can contribute to planning interventions directed towards improving clinical management, work environment and care, which may favor the adherence of the obese to treatment.