A decisão pela cirurgia bariátrica como projeto de superação do adoecimento vivido: uma abordagem interpretativa

Abstract

This research investigates how individuals construct the decision-making process for bariatric surgery. Bariatric surgery (gastroplasty) is a surgical procedure aimed at drastically reducing a patient’s stomach to accelerate weight loss, focusing on the regression of comorbidities. The approach proposed herein to understand the decision for gastroplasty is based on participants’ narratives of their bariatric surgery experiences, adopting an interpretative stance toward the elements involved in this decision. This approach deviates from the direct debate on the medicalization of fat and sets aside the category of “obesity”. This distancing was necessary to enable an analysis that could encompass the complexity of the elements involved in the collected narratives. By setting aside the category of obesity, a specific categorization was established to understand how fatness is experienced throughout the individuals’ biographies: “weight” (body mass) and “body fat” (aesthetic and spatial dimension) are conceptualized as categories whose constituent elements can be experienced independently by individuals. Thirteen narratives were analyzed, collected from semi-structured interviews conducted online via voice or video calls. Given the insufficiency of dominant approaches in the Brazilian Social Sciences to interpret the collected data, this study adopted a theoretical framework grounded in authors from phenomenological-based Social Sciences. This theoretical framework, in conjunction with the methodology proposed herein, allowed for conclusions that reject the decision for bariatric surgery as being determined by the social effects of the medicalization of fat (e.g., stigmatization and pressure for aesthetic conformity). This thesis argues, therefore, that no specific element determines this decision. Rather, it is constructed from experiences of fatness established throughout the individuals’ biographies and emerges as a possible therapy within a “project” aimed at overcoming a lived “illness experience” (experiência de adoecimento). This illness is understood as any lived situation signified by the individual as a “limit-situation” that impedes the normal unfolding of their biographical flow and, ultimately, threatens their biographical continuity (potentially leading to extreme physical or psychological suffering, or death).