JMIR Publications

ABSTRACT

Background:

Bariatric surgery is an effective procedure for the treatment of obesity. Despite this, worldwide only 0.1%-2% of eligible individuals undergo surgery. The stigma surrounding surgery might be a reason for this. Thus far, no research exists that has systematically studied the nature and implications of bariatric surgery stigma. The limited studies on bariatric surgery stigma are often conducted from the perspective of the public or healthcare professions and either use small and non-representative samples or fail to capture the full essence and implications of stigma altogether, including attitudes towards patients and perpetuators of stigma. Additionally, studies from patient perspectives are limited and tend to address bariatric surgery stigma superficially or implicitly. Finally, the extent to which cultural factors shape and facilitate this stigma and the experiences of patients has not yet been researched.

Objective:

Therefore, this study aims to explore the perceptions, experiences, and consequences of bariatric surgery stigma from the perspective of the general public, healthcare professionals, and pre- and post-bariatric surgery patients. Furthermore, although the concept of stigma is universal, every society has specific cultural norms and values that define acceptable attributes and behavior for its members. Therefore, this study also aims at exploring to what extent cultural factors influence bariatric surgery stigma by comparing the Netherlands, France, and the United Kingdom.

Methods:

This paper describes the protocol for a multiphase mixed methods research design. In the first part, we will conduct a literature review to determine the current knowledge on bariatric surgery stigma and identify knowledge gaps. In the second part, semi-structured interviews among pre- and post-bariatric patients will be conducted to explore their experiences and consequences with bariatric surgery stigma. In the third part, surveys will be carried out among both the general public and healthcare professionals to determine the prevalence, nature, and impact of bariatric surgery stigma. Surveys and interviews will be conducted in the Netherlands, France, and the United Kingdom. In the final part, data integration will occur at the interpretation and reporting level.

Results:

The research study started in September 2020 and will continue through September 2025. With the results of the scoping review, we will create an overview of the current knowledge regarding bariatric surgery stigma from patients’ perspective. Qualitative data will provide insights into patients' experiences with bariatric surgery stigma. Quantitative data will provide information related to the prevalence and nature of bariatric surgery stigma from the perspective of the general public and healthcare professionals. Both qualitative and quantitative data will be compared between each country.

Conclusions:

The findings from this study will lead to new insights which can be used to develop strategies to reduce bariatric surgery stigma and to improve access, utilization, and outcomes of bariatric surgery.