Obesidade, Educação e Mudança: mobilização do pensar na saúde

Abstract

Accumulated evidence suggests different definitions for obesity, characterized by the complex integration and interdependence of different dimensions, and should maintain a close dialogue with socioanthropological approaches and body diversity. Paradoxically, curricula, public policies, and care practices are still inspired by the biomedical paradigm, resulting in challenges for those who care and those who live in this condition. Because of this context, the present thesis sought to analyze the limits and possibilities of the course "Qualification of Care for Overweight and Obese People" in the mobilization of thinking about the obesity phenomenon. This qualitative study has as theoretical and methodological orientation the scoping review, which mapped the initiatives of Continuing Education in Health in the care of people with obesity, and the case study, outlined from an educational initiative in health, which analyzed the meanings of obesity for the participants and the possible changes of meanings mobilized by the initiative. The research participants were health professionals from Primary Care in the state of Bahia enrolled in the course. The information was produced through documentary analysis, non-participant observation, and an online questionnaire and examined employing content analysis and prototypical and descriptive statistics. A triangulation of methods produced three categories of analysis - Concept of obesity, Etiological approaches to obesity, and Health Education. Como principais resultados, é possível destacar o número reduzido de pesquisas na área e um desenho geral das iniciativas bem distantes do que propõe a Educação Permanente em Saúde, com abordagem biomédica da obesidade, metodologias tradicionais de ensino alentes à centralidade no cotidiano de trabalho e ao foco na noção de redes de atenção, linha do cuidado, integralidade e culturas alimentares e corporais. Accordingly, when analyzing the meanings of obesity in professionals, the case study revealed the predominance of the pathological and individualized perspective of obesity, despite the expansion of modern scientific knowledge and institutional guidelines on obesity. On the other hand, after the end of the course, significant inflections in the way of thinking about the obesity phenomenon were observed in dialogue with the ecological, syndemic, and multifactorial approaches, anthropological perspectives, and body diversity. As limits of the initiative studied are circumscribed to the previous training of the trainees, the descending design of the initiative, the scope and awareness of the learners, and the difficulty of releasing workload in the service. As possibilities, we highlight the use of participatory methodologies, problematizing and involvement with the reality of learners, the approach of "obesity under different views and multiple expressions," the act of reflecting a proposal aligned by entities of education - management - social control and the advantages of the teaching modality. It emerged as urgent that health curricula be revisited, presenting the multifactoriality and complexity in an interdisciplinary and multiprofessional movement to influence how training processes and care practices are structured.