Representações sociais da obesidade e do processo de emagrecimento em pessoas que realizaram cirurgia bariátrica

Abstract

Obesity has been increasing globalization, and is a condition that may reflect negatively on the physical and mental health of individuals. Social prejudice, such as physical and emotional limitations in weight loss attempts, are the other reasons, the factors that lead to bariatric surgery as a form of obesity treatment are important. Thus, this study was seen to be social representatives and the obesity and process of weight loss in people who performed bariatric surgery. The present dissertation is made by two studies. The study 1 is an integrative review of the literature and has as answer the following guiding question, elaborated by the PICO strategy: What are the orientations in psychology (I)? Scopus, PubMED, PsycINFO and SciELO databases were consulted and withdrawals were published between January and 2012 and June 2017. Twenty-six articles were found, and the results pointed out the predominance of behavioral and / or cognitive behavioral information and some gaps in knowledge, such as the scarcity of national studies on the subject and the predominance of the female sample in the studies. Study 2, which deals with an exploratory, cross - sectional study supported by the qualitative methodology, had as objective to know the forms of obesity and the weight loss process in people who underwent bariatric surgery. They were included in the study of the clinical follow-up of the Ambulatory of Digestive System Surgery of HC-UFTM. For the sample size, the exhaustion criterion was used, in which all participants were submitted to the inclusion and exclusion criteria. Data were collected through a semi-structured interview. To analyze the data, an analysis of the data was used and it was done by the Social Representations of Serge Moscovici and with the support of the literature of the area. Sixteen participants, all women, were interviewed. What is a bariatric surgery is the question of everyday experiences, which face prejudices, stigma and difficulties with the fat body that they have; and different from this body, a lean and socially accepted body, is the object of desire and pursuit. The quest for weight loss appears in two ways: at first as a form of health reestablished, and there is no other way of reintegrating into society with the body within the pattern of beauty.

A cirurgia bariátrica é a principal forma de tratamento para a obesidade, mas não garante, per si, melhor qualidade de vida, demonstrando que a obesidade está intimamente relacionada às questões psicológicas, além das biológicas. Esta revisão integrativa da literatura seguiu a estratégia PICO para identificar as abordagens em psicologia realizadas com indivíduos antes e após a cirurgia bariátrica. Foram consultadas as bases Scopus, PubMED, PsycINFO e SciELO, e incluídos artigos publicados entre janeiro de 2012 e junho de 2017. Foram analisados 26 artigos, e os resultados mostraram que a maior parte dos estudos fazem uso da abordagem comportamental e/ou cognitivo comportamental, que tem como princípio que o processo de mudança corporal e mental associados a mudança de comportamentos.

Bariatric surgery is the main form of treatment for obesity, but it does not guarantee better quality of life per se, demonstrating that obesity is closely related to psychological as well as biological issues. This integrative review of the literature followed the PICO strategy to identify the approaches in psychology performed with individuals before and after bariatric surgery. Scopus, PubMED, PsycINFO and SciELO databases were included, and articles published between January 2012 and June 2017 were consulted. Twenty-six articles were analyzed, and the results showed that most of the studies use the behavioral and / or cognitive behavioral approach , which has as principle that the process of physical and mental change associated with behavior change.

A obesidade vem aumentando de maneira globalizada, e é uma condição que pode refletir de forma negativa na saúde mental dos indivíduos. O preconceito social, as limitações físicas e os insucessos nas tentativas de emagrecimento, dentre outros motivos são importantes fatores que levam a decisão pela cirurgia bariátrica como forma de tratamento da obesidade. Este estudo teve como objetivo conhecer quais as representações sociais da obesidade e do processo de emagrecimento em pessoas que realizaram a cirurgia bariátrica. Foram convidados a participar do estudo indivíduos atendidos no Ambulatório de Cirurgia do Aparelho Digestivo do HC-UFTM, selecionados de acordo com os critérios de inclusão e exclusão estabelecidos. Um roteiro de entrevista semiestruturada foi aplicado face a face com cada participante, individualmente. Este roteiro foi elaborado a partir dos objetivos deste estudo, contemplando perguntas sobre a vivência da obesidade, bem como suas repercussões nos diferentes âmbitos da vida, a escolha pela cirurgia bariátrica, o processo de preparação para a cirurgia e o processo de emagrecimento após a cirurgia. Para a análise dos dados foi utilizada a Análise de Conteúdo e a interpretação dos dados deu-se por meio das Representações Sociais de Serge Moscovici e com apoio da literatura da área. Foram entrevistados todos os pacientes operados entre janeiro de 2017 à novembro de 2017, compreendendo 16 participantes, todas mulheres. Observou-se que a obesidade é uma condição que cursa com repercussões negativas na vida dos indivíduos, e que a decisão pela cirurgia bariátrica se pauta nas vivencias cotidianas destes, que enfrentam preconceitos, estigmas e dificuldades com o corpo gordo que possuem. Nesse sentido, diferente deste corpo, um outro corpo- magro e socialmente aceito, é o objeto de desejo e busca pelas mulheres. A busca pelo emagrecimento aparece principalmente sob duas óticas: num primeiro momento como forma de ter a saúde reestabelecida, e no outro como forma de se reinserir na sociedade com o corpo mais próximo dos padrões de beleza estabelecidos. A elevada procura pela cirurgia bariátrica por parte das mulheres reflete as profundas questões culturais envolvidas na hipervalorizarão do corpo magro, e a coerção social sob o corpo da mulher, que ao adquirirem o corpo magro parecem serem reinseridas socialmente, modificando vários aspectos de suas vidas.

Obesity has been increasing globalization, and is a disease that may reflect negatively on the mental health of individuals. Social prejudice, such as physical and physical abilities in attempts to lose weight, among others, are important factors that lead to bariatric surgery as a form of treatment of obesity. This study aimed to know the issues of obesity and the weight loss process in people who underwent bariatric surgery. They were included in the Outpatient Surgery of the HC-UFTM, selected according to the criteria of inclusion and exclusion of data. A semi-structured interview script was applied face-to-face with each participant individually. This script was elaborated with the objective of this study, contemplating questions about the experience of obesity, as well as its repercussions in the different exercises of life, the choice for bariatric surgery, the process of preparation for surgery and the process of weight loss after surgery. To analyze the data, an analysis of the data was used and it was done by the Social Representations of Serge Moscovici and with the support of the literature of the area. All patients operated between January 2017 and November 2017 were interviewed, comprising 16 participants, all of them women. Obesity is a condition that can negatively affect the lives of individuals, and is a bariatric disease that can cause daily living, which face preconceptions, stigma and difficulties with the fat body that exist. This sense, different from this body, the third and the socially accepted body, is the object of search and search for women. The search for weight loss had as main events two women: a first moment as a form of health reestablished, and another way of reintegration into society with the body closest to established beauty standards. A search for bariatric surgery on the part of women reflects how the main cultural factors are found in the world, and a social coercion on the body of women, which is an attractive for social and social growth, modifying various functions of their lives.