Journal of the Academy of Nutrition and Dietetics 2018-03-16

“Take Me through the History of Your Weight”: Using Qualitative Interviews to Create Personalized Weight Trajectories to Understand the Development of Obesity in Patients Preparing for Bariatric Surgery

Amanda I. Lynch, Elizabeth McGowan, Kerstyn C. Zalesin

文献索引：10.1016/j.jand.2017.12.008

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摘要

Background Obesity can develop during any life stage. Understanding the contexts within which obesity develops can inform our understanding of the disease and help tailor interventions specific to life stages. Objective Using life-course theory as a guiding framework, this study aimed to explain the development of obesity in bariatric surgery patients by creating personalized weight trajectories. Design Qualitative methods using semistructured interviews were used to uncover participants’ experiences with and explanations for the development of obesity. A grounded theory approach using the constant comparative method was used to analyze transcripts for categories and themes. Participants/setting Thirty pre-bariatric surgery patients (24 women, 6 men) were recruited from a bariatric surgery center; 25 participants were available for follow-up. Participants were interviewed before surgery and at 6 and 12 months postsurgery. Results Four weight history groups were created based on patterns of weight changes from adolescence through adulthood: Always Heavy, Late Peak, Steady Progression, and Weight Cycling. Participants’ explanations for weight changes centered around themes of transitions and life-course events or stressors. Differences in the weight history groups could be explained by the timing of transitions, life events, and responses to stress. Conclusions The development of obesity does not follow the same pattern for all individuals. Weight gain patterns can be explained by the timing of life-course events, stressors, and the type and effects of environmental transitions. Weight management counseling should include strategies tailored to an individual’s current life-stage and circumstance, but also acknowledge previous responses to transitions and stressors.