Exploring patients’ lived experiences with bariatric surgery stigma

Background: For people with severe obesity, bariatric surgery is considered the only effective treatment to lose and maintain weight loss. Despite this, worldwide, only 0.1%–2% of eligible individuals undergo surgery. The underuse of bariatric surgery can be attributed to the stigma surrounding surgery. Bariatric surgery is viewed as a last resort and an easy way-out method to lose weight. Moreover, people with obesity who choose to or undergo bariatric surgery are perceived by others as lazy, less competent, and lacking in self-discipline compared to people with obesity who lose weight through diet and exercise. Current research into bariatric surgery stigma is mostly conducted from the perspective of the general public or healthcare professionals. Patients’ perspective and thus our knowledge regarding patients’ experiences with bariatric surgery stigma remains limited. Also, to date no studies looking into bariatric surgery patients’ experiences with stigma have been conducted in the Netherlands.

Objective: Therefore, the objective of our study was to explore the experiences and consequences of bariatric surgery stigma from the perspective of Dutch bariatric surgery patients.

Methods: This study is ongoing. So far, we have conducted 17 interviews among pre- and post-bariatric surgery patient exploring (1) patients’ perception of bariatric surgery (2) the extent to which patients experience bariatric surgery stigma, (3) and the consequences of this stigma for patient’s everyday life, (4) including the implications of stigma in the decision-making process regarding surgery. The data from the interview transcripts were analyzed using both deductive and inductive thematic analysis.

Results: The initial findings from the interviews will be presented. Findings from the first interviews show that patients experience different forms of bariatric surgery stigma, including public, perceived, anticipated, and internalized stigma. Patients become aware of the negative stereotypes attached to surgery through first hand experiences, conversation with other bariatric surgery patients, patient forums, and the media. Actual experiences of bariatric surgery stigma include negative attitudes, disapproval, and discriminations from family members, friends, acquaintances, and healthcare professionals. Patients who experienced or anticipated stigma reported hiding the status of their surgery, feeling compelled to defend their choice for having surgery, or tended to avoid people who they anticipated would disapprove of surgery. Although some patients claimed not to be affected by stigma their narrative suggested otherwise.

Conclusion: The results of these interviews provide a small glimpse into the experiences and consequences of bariatric surgery stigma as told from patients’ perspective and demonstrate that the stigma surrounding bariatric surgery impacts patients live both pre- and post-surgery. To more fully understand the nature and extent to which bariatric surgery stigma impacts patients’ health and well-being more studies from patient perspectives are needed.