The end of an obese career? A sociological study of post-bariatric surgery biographical uncertainties (6-24 months) through the prism of body practices transformations – ChiBarAPS

Led by an already constituted research consortium, with completed and ongoing studies, this project aims to study the trajectories of people who have undergone bariatric surgery. The objective is to investigate the transformations of life habits post-surgery, with a focus on body practices. While individuals who are about to undergo surgery hope for a recovery from obesity and a shift back to the norm, we hypothesize that the 6- to 24-month period after surgery is characterized by a high degree of biographical uncertainty. We further postulate that the management of this uncertainty is critical to one's self-transformation and lifestyle changes.
To verify these hypotheses, three research lines will be investigated. The first line of research focuses simultaneously on patients' perception of the evolving effects of surgery and their management of these effects, as well as their commitment to take charge of their lives. The second line of research centers on post-surgery experiences of individuals within medical care structures as well as within non-medical structures. Particular emphasis will be placed on the study of the impact of these experiences on the agency of individuals who underwent surgery. The third line of research aims to analyze the changes in social participation after bariatric surgery. The objective is to assess to what extent the 18-month window under study is characterized by a reduction in disabling situation (due to a better compliance with ability-disability norms), and/or is characterized by new disabling situations and a decrease in social participation.
In this research, the grounded theory approach will be applied. Our study is based on a mixed-method approach, combining a qualitative and a quantitative survey. Research participants will be recruited within three partners hospital departments in Lyon, Montpellier and Toulouse. The qualitative survey includes interviews with 12-15 male and 12-15 female participants, who receive medical care in these three departments. Three interviews will be conducted with each participant: 6 months, 12 months and 24 months after surgery. Participants will also be given a diary in which they will record the body practices they engage in as well as their feelings and perceptions in the daily life. The quantitative survey consists of a lifestyle and body practices questionnaire. The questionnaire will be administered three times to a larger cohort of 200 individuals attending the partners’ hospital departments: 6 months, 12 months and 24 months after surgery.
The concept of career will be applied to analyze the interconnections between the three lines of enquiry. This concept allows to approach illness as a socio-historical construct, rather than as a fact per se. It thus offers an opportunity to challenge the notion of healing (related to the ending of medical treatment), and to reconsider the idea of "re-birth" commonly used to describe bariatric surgery. Based on the dialectical relationship between "doing" and "being done", the concept of career contributes to bring to light the socio-historical roots of individuals behaviors. The examination of the changing attitudes towards obesity, the agency, the creation and reduction of disabling situations, and the transformation of the life course support the analysis of the impact of bariatric surgery on the "body-related social history" of individuals who underwent surgery.
In addition to scientific findings, this project will produce practical information useful to medical institutions to improve the treatment of "obese" patients, especially those who undergo bariatric surgery. It thus aims to consider new ways to approach the biomedico-social supervision of individuals who undergo bariatric surgery.