Psychosocial factors influencing the consideration of bariatric surgery as a treatment for obesity

Hamlet, Claire

Abstract

Bariatric surgery (BS) is invasive, associated with risks and side-effects, and has a long-term impact on an individual’s lifestyle. Furthermore, research evidence suggests it is not the panacea it was once thought to be for weight loss. Despite this, increasing numbers of individuals living with obesity in the United Kingdom (UK) are undergoing BS, yet the psychosocial factors that influence this are unknown. This exploratory cross-sectional study examined the influence of internalised weight stigma (fear of enacted stigma and self-devaluation), weight locus of control, eating-self efficacy, body dissatisfaction and health related quality of life, on the consideration of BS as a method of weight loss amongst a community sample of 432 women in the UK with a BMI ≥ 35. An embedded qualitative element sought to validate quantitative findings, as well as identify any additional factors influencing the consideration of BS.
In total 28.5% of participants agreed they would consider BS. Univariate ordinal logistic regressions examined the hypotheses that higher internalised weight stigma, higher external weight locus of control, reduced eating-self efficacy, higher body dissatisfaction and reduced health related quality of life would be associated with an increased likelihood of considering BS. All hypotheses were supported, but when all variables were entered in the final model only a fear of being stigmatised, weight locus of control and poor health related quality of life contributed to the final model, accounting for 15.5% of the variance in the consideration of BS. However, a fear of being stigmatised due to weight explained the majority of the variance. Mediation analyses revealed that a fear of being stigmatised mediated previous significant relationships between BMI, eating self-efficacy, body dissatisfaction, self-devaluation and the consideration of BS. Additionally self-devaluation mediated the relationship between eating self-efficacy and the consideration of BS. Content analysis on qualitative data generally supported quantitative findings, as most variables were reflected in participants’ reasons for undergoing BS. Additionally, it highlighted that perceived risks and learning of others’ negative BS experiences were barriers to considering BS. Furthermore, individuals who felt that weight was psychological in origin did not feel BS was an appropriate solution.
Findings from this study indicate that weight stigma, in particular a fear of being stigmatised, is a significant influence on considering BS amongst those living with obesity. Furthermore, individuals understand that psychological factors contribute to their obesity, and therefore do not always consider BS an appropriate intervention. The implications of these findings for health psychology, NHS weight management services and future research are discussed.

• Thesis Type: Thesis
• Deposit Date: Apr 8, 2019
• Publicly Available Date: Apr 8, 2019
• Public URL: https://uwe-repository.worktribe.com/output/848967
• Contract Date: Apr 8, 2019