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Monday, November 2, 2009: 3:50 PM
Learning Objective 1: understand why perons who choose to undergo bariatric surgery withhold, or restrict who they inform, regarding their decision.
Learning Objective 2: ground this secrecy within the lived experiences of prior weight loss and diet failure.
The incidence of obesity is increasing world-wide and the growing popularity of bariatric surgery to reduce body weight is growing exponentially. Persons who chose to undergo a surgical weight loss intervention (SWLI) require adaptation to physiologic and psycho-social change and these findings provide the foundation for nursing practice initiatives to promote health for these individuals. This paper describes the phenomenon of ‘secrecy’, or the ‘failure to disclose’ a personal decision to undergo a SWLI. Using a qualitative approach, we explored the experience of women who underwent Roux-en-Y gastric bypass. Snowball sampling was used to identify 14 college educated females, who ranged in age from 28 to 63 years. The highest reported weight prior to surgery was 412 pounds, and the lowest was 247 pounds. Post surgery weight lost ranged from 167 pounds to 72 pounds. The decision to not disclose or the phenomenon of ‘secrecy’ was a consistent experience heard across the interviews. Three themes illuminated the common attribute of ‘secrecy’ surrounding the participants’ decisions to pursue bariatric surgery: “the lonely decision” “looking for approval” and “not telling.” The findings of this research, that participants perceived negative responses from others and felt a need to hide their choice of bariatric surgery, are consistent with the findings of stigmatization and discrimination found by Rogge, Greenwald and Golden (2004). From a social construction perspective, obesity is a problem about losing weight, yet when these participants chose a surgical intervention to lose weight their choice was still perceived as socially unacceptable. The evidence from this study provides the foundation for developing initiatives and guidelines for advance practice nurses to enhance client outcomes.