The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of (...) bodily change. In doing so, we were able to identify two main themes: The felt “inner” body versus the visible “surface” body and the “old” body versus the “new” body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more “normal” and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not “shrink” like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery. (shrink)

In this study we explore how a selection of Norwegian women account for their decision to undergo weight loss surgery. We argue that women’s descriptions of their experiences leading up to this choice of action illuminate issues regarding social norms of bodily appearance and personal responsibility. The starting point is women’s own experiences within a cultural context in which opting for WLS often attracts moral scrutiny. Inspired by Merleau-Ponty’s notion of consciousness as embodied and de Beauvoir’s ideas concerning women’s situation, (...) we argue that bodily as well as socio-cultural aspects intertwine with women’s choice of surgery as a means of losing weight. Although society’s stigmatization of women with obesity has been well challenged by scholars in the field of critical fat studies, women with obesity still experience the bodily hindrances associated with being overweight in an intense and subjective way. The findings suggest that women confronting the option of WLS do so in a context of pain, dysfunction and social stigma, a combination which illuminates the intricate ambiguity of the obese body as both subject and object. (shrink)

Surgeons who perform sex reassignment surgeries define their goals and evaluate their outcomes in terms of two kinds of results: aesthetic and functional. Since the neogenitals fashioned through sex reassignment surgeries do not enable reproductive function, surgeons must determine what the function of the genitals is or ought to be. A review of surgical literature demonstrates that questions of what constitute genital form and function, while putatively answered in the operating room, are not answerable in the discourses of clinical evaluation (...) used to define them. When the genitals—the word itself derived from the Latin genitas meaning to beget—are not reproductive, the question of their function shifts away from the biological and into other registers: pleasure, intimacy, sociality. As condensed sites of meaning and meaning-making around which selves, affects, resources, anxieties and futures are organized, the genitals signify in excess of the categories of “aesthetic” and “function” that surgeons use to assess them. Not reducible to either aesthetics or function, but constitutive of them both, this excess appears in surgical texts in the form of imagined futures of social and sexual engagement and demonstrates a powerful means by which properly sexed bodies are created. (shrink)

Background and Objectives: The unconventional body management among Iranian women has led to the emergence of various individual and social consequences, highlighting the necessity of investigating this phenomenon from different dimensions. This study aimed to examine the moderating role of religion in the relationship between identity and body management. Methods: This descriptive-analytical study was conducted on all women aged 15-65 years old in the city of Tehran, Iran, selected using the multi-stage cluster sampling method. The research instruments consisted of three (...) questionnaires, namely a researcher-made questionnaire on body management, the Dimensions of Religiosity Scale, and the Extended Objective Measure of Ego Identity Status-2. The validity of the researcher-made questionnaire was confirmed by experts and its reliability was evaluated as appropriate using Cronbachchrs alpha coefficient method. Results: The results of the correlation test showed that at the 99% confidence level, there was a statistically significant correlation between tendency to body management and identity. Moreover, based on the results of regression analysis, religiosity had a moderating role in the relationship between identity and tendency to body management and strengthens the negative correlation between dependent and independent variables. It was also revealed that the beliefs and consequences dimensions of religiosity had respectively the highest and least moderating effect in the relationship between tendency to body management and identity. Conclusion: The results showed that religiosity could play a role in the tendency to body management, meaning that a higher level of religiosity led to a lower tendency to body management by affecting identity. (shrink)

_Background:_ Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients' experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge after bariatric surgery. _Objectives:_ (1) Evaluate the relationship between weight-related stigma and post-surgical dietary adherence; (2) understand if weight loss reduces weight-related stigma, thereby improving post-surgical dietary adherence; and (3) explore (...) provider and patient perspectives on adherence and stigma in healthcare settings. _Design:_ This mixed methods study contrasts survey responses from 300 postoperative bariatric patients with ethnographic data based on interviews with 35 patients and extensive multi-year participant-observation within a clinic setting. The survey measured experiences of weight-related stigma, including from healthcare professionals, on the Interpersonal Sources of Weight Stigma scale and internalized stigma based on the Weight Bias Internalization Scale. Dietary adherence measures included patient self-reports, non-disordered eating patterns reported on the Disordered Eating after Bariatric Surgery scale, and food frequencies. Regression was used to assess the relationships among post-surgical stigma, dietary adherence, and weight loss. Qualitative analyses consisted of thematic analysis. _Results:_ The quantitative data show that internalized stigma and general experiences of weight-related stigma predict worse dietary adherence, even after weight is lost. The qualitative data show patients did not generally recognize this connection, and health professionals explained it as poor patient compliance. _Conclusion:_ Reducing perceptions of weight-related stigma in healthcare settings and weight bias internalization could enhance dietary adherence, regardless of time since patient's weight-loss surgery. (shrink)

Using a densely constructed ethnographic subject, Josephine, the “ugly duckling,” I use Foucault’s complex notion of an Apparatus to examine how Josephine’s decision to have weight-loss surgery is understandable even though it permanently destroys her normally functioning digestive system. I try to illuminate how the decision is deeply embedded in extraordinarily complex neoliberal biopolitical structures and dynamics of fat hatred camouflaged by liberatory discourses that promise “empowerment,” becoming “normal,” and discovery of her “real self.” I argue that in contemporary America, (...) Fat Hatred must be understood as a powerful systemic structure of racialized gendered oppression, that one tactic to normalize weight-loss surgery involves assimilating it to “normal” cosmetic surgery, and that Josephine must be seen, simultaneously, as legitimizing dominant obesity discourses and practices, enacting genuinely liberating personal choices, demonstrating her status as a “good American bio-citizen,” and contributing to the collective physical health and mental health of the nation since “obesity” is soon to be included in the fifth edition of the canonical Diagnostic and Statistical Manual of Mental Disorders as a mental disorder. (shrink)

In this article we explore women’s experiences of “dumping” following weight loss surgery. The empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s notion of the “inner body.” Additionally, Simone de Beauvoir and Merleau-Ponty’s perspectives of the lived body occupy a prime framework for shedding light on different dimensions of bodily changes. The following three core themes were identified: Experiences of illness in conjunction with eating; (...) Learning to relate to changes in the inner body and; Feelings of losing and regaining control. In different, though interconnected ways, these themes encompass an ongoing challenge in the women’s lives after the surgery: namely their efforts to establish new eating habits while at the same time working hard to relate to their changed and changing inner body, and especially to the phenomenon of “dumping”. The results points to a dilemma: namely that the gastric bypass procedure is an operation that irreversibly alters the anatomy and physiology of a healthy stomach, whereas the individual’s eating habits cannot be situated in or reduced to a particular organ, but are endemic to the lived body and its history. This insight might be of importance in the understanding of the complexity of the changes and challenges the women go through after weight loss surgery. (shrink)

Weight loss surgery is an increasingly common treatment for medically defined class III obesity and related comorbidities. A rise in demand has resulted in progressively longer waiting times in Canada, lasting upwards of ten years. Extended surgical waits impact the lives of people pursuing the procedure, no doubt – I wonder in what way? What is the experience of waiting to have weight loss surgery? I sought to explore this question using a human science approach to phenomenology of practice. It (...) is within this broader inquiry that this particular text is situated. The multiple interviews I conducted with people who were awaiting surgery revealed the experiential import of contact, of touch, metaphorical and otherwise, to the overall waiting phenomenon. In this paper I consider this particular dimension of the wait – I question the experiences and meanings of contact that occur within the pre-weight loss surgical period. I reflect on the possible ethical and clinical significance of contact within this particular context while focusing on the relational aspect of the phenomenon, particularly between patient and clinician. Ultimately this deeper understanding of the experience as it is lived may elicit new and possibly more tactful ways of being with, of making contact – as in touch, hearing from or connecting with – within weight loss surgery-related clinical encounters. (shrink)