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Dimitrov Ulian M, Fernandez Unsain R, Rocha Franco R, Aurélio Santo M, Brewis A, Trainer S, SturtzSreetharan C, Wutich A, Gualano B, Baeza Scagliusi F. Weight stigma after bariatric surgery: A qualitative study with Brazilian women. PLoS One 2023; 18:e0287822. [PMID: 37498887 PMCID: PMC10374044 DOI: 10.1371/journal.pone.0287822] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 06/13/2023] [Indexed: 07/29/2023] Open
Abstract
Prior studies suggest that one anticipated benefit of bariatric surgery is the achievement of a thinner body, one that is less subject to perceived negative judgment and condemnation by others. However, additional analyses also indicate that stigma may persist even with significant post-surgery weight loss. To investigate the stigma-related perceptions and experiences of women who have undergone bariatric surgery and the resulting body transformations, we conducted individual, semi-structured interviews with thirty Brazilian women (15 aged 33-59 and 15 aged 63-72). The resulting text was then analyzed using thematic analysis. We found that some form of weight stigma persisted for our participants, regardless of weight loss. Ongoing experiences of stigma were also evidenced by the constant internal and external vigilance reported by the women, as well as their articulated efforts to distance themselves from their previous bodies. Additionally, participants reported being judged for choosing an "easy way out" to lose weight. Those in the older group reported that weight stigma was entangled with ageism: older participants received mixed messages underscoring the ways that weight and age may interact in doubly stigmatizing ways. Family and close peers were especially powerful sources of stigma experiences. Collectively, these results show that weight stigma persists even when people undergo a procedure to lose substantive weight and that the degree and types of stigma experiences are influenced by gender and age. Our study suggest future research should explore whether a targeted approach might be more effective, for example, an approach that would emphasize the importance of developing coping strategies with respect to experiences of stigma and discrimination after surgery.
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Affiliation(s)
- Mariana Dimitrov Ulian
- Departamento de Nutrição, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Ramiro Fernandez Unsain
- Departamento de Nutrição, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Ruth Rocha Franco
- Unidade de Endocrinologia Pediátrica do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Marco Aurélio Santo
- Divisão de Cirurgia do Aparelho Digestivo, Unidade de Cirurgia Bariátrica e Metabólica, São Paulo, SP, Brasil
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States of America
| | - Sarah Trainer
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States of America
| | - Cindi SturtzSreetharan
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States of America
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States of America
| | - Bruno Gualano
- Grupo de Pesquisa em Fisiologia Aplicada e Nutrição, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Fernanda Baeza Scagliusi
- Departamento de Nutrição, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP, Brasil
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Moscoso MG, Villarreal-Zegarra D, Del Castillo D, Zavaleta E, Miranda JJ. Personality profiles and engagement with the augmented reality game Pokémon GO: a cross-sectional study. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18397.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Since its release in 2016, Pokémon GO™ has achieved not only extensive popularity but has also accrued evidence that it helps to increase physical activity and sense of belonging. Personality traits may explain a differential engagement and fidelity with the game, hence potentially allowing for prediction of different patterns of game engagement as well as its health benefits. Our objective was to compare personality traits between Pokémon GO game players and non-players. Methods: We conducted a cross-sectional study in participants aged 18+ years through an online survey. The following categories of game engagement were defined: active players, occasional players, former players, and never players. Personality was measured with the NEO-FFI inventory that evaluates personality across five domains: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. ANOVA and MANOVA models were performed to test differences in personality traits’ scores. Multivariate regression models were also used to describe specific differences across groups of game engagement. Results: Data from 654 participants, average 28.6 years of age, 75% male, were included in the study. In the ANOVA analysis, we observed differences between the three players' subgroups in openness (p=0.015) and conscientiousness (p=0.032). In MANOVA and multivariate regression analyses, we found that active players presented higher scores in openness and agreeableness, but lower scores in conscientiousness compared to former or non-players. Conclusions: We found evidence that people that actively play Pokémon GO are more likely to be friendlier and more open to new experiences, but also scored less on conscientiousness which is related to discipline. This gives us better insight on how personality may help identification of people and their involvement with activities that demand fulfillment of tasks. These findings could help inform the engagement with health-related behaviors, including physical activity and medication adherence.
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