“Eu me sinto muito bem...”: os efeitos produzidos pelas Práticas Integrativas e Complementares em pessoas com obesidade no contexto da Rede de Atenção à Saúde

Abstract

New therapeutic approaches emerge aiming not only at obesity management, but also, and fundamentally, at the expansion of integral care to people with obesity, such as Integrative and Complementary Health Practices (IPCPs). This dissertation aimed to understand the effects, senses and meanings produced by Integrative and Complementary Practices in people with obesity in the context of the Health Care Network.. This study used a qualitative exploratory-descriptive methodology and was developed in the PICS Outpatient Clinic of a State Reference Unit of SUS. The empirical universe of the research was made up of males and females, aged between 18 and 60 years, with a medical diagnosis of obesity, referred to the practices offered at the unit: Podal Reflexology, Reiki, Chromotherapy, Auriculotherapy and Meditation. The research, carried out from January to August 2020, used semi-structured interviews and participant observation as data production techniques, and field diary writing as a data recording technique. Comprehensive analysis was used as the mechanism for data analysis and interpretation. The design process of this study resulted in the construction of two articles. The first article sought to understand the effects produced by the use of Integrative and Complementary Practices in the care of people with obesity treated at a state referral center of the Brazilian Unified Health System, from the users' narrative. As a result of the results of the first article, the second article referred to an integrative review, which aimed to assess the state of the art on the possible associations between anxiety symptoms and obesity in adults, from the literature relevant to the topic. Through the analysis of the interviews it was possible to understand that “feeling well” appears as an articulating element of a reorganization of the subject's life, of caring for oneself and for the other. It was possible to observe that the organic presence of the PICS assumes a hybrid and dynamic place in the flow of care, although a perspective that still links the PICS to obesity through the control of anxiety, the body, and food stood out. With the integrative review, it was possible to observe

that, in general, the evidence for the association between anxiety symptoms and obesity in adults is not conclusive, although the justifications for the findings and the discussions presented direct towards a confirmation of the association between obesity and anxiety symptoms, understanding that the latter is mitigated when there is a reduction in body weight. In this sense, it is essential that further studies be developed aiming not only to understand the possible associations between anxiety symptoms and obesity, as well as in other health conditions, but especially to understand the processes involved when there is coexistence of these. Given the above, it is important to develop new research with theoretical and methodological contributions similar to those used in this study, so they can contribute to strengthening health systems that consider not only the various dimensions related to the phenomenon of obesity, but also the therapeutic strategies to be used in the process of self-care and health. It is hoped, then, that the design and reading of this study, and of the bibliographic productions arising from it, may broaden the debate about obesity, considering the complex, plural and multidimensional perspective of this phenomenon.