Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Medicine, Health Care and Philosophy
Published in: Medicine, Health Care and Philosophy 3/2013

01-08-2013 | Scientific Contribution

Dis-appearance and dys-appearance anew: living with excess skin and intestinal changes following weight loss surgery

Authors: Karen Synne Groven, Målfrid Råheim, Gunn Engelsrud

Published in: Medicine, Health Care and Philosophy | Issue 3/2013

Login to get access

Abstract

The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of bodily change. In doing so, we were able to identify two main themes: The felt “inner” body versus the visible “surface” body and the “old” body versus the “new” body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more “normal” and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not “shrink” like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery.
Footnotes
1
(Social and Health Department of Norway 2007).
 
2
Similar messages can easily be found in Norwegian websites. In 2010, for example, a newly established private clinic used the picture of a naked woman to communicate to potential patients the “positive” outcomes of weight loss surgery. By undergoing surgery, women can, as explicitly stated in the text beneath the picture, lose weight on a permanent basis and thereby regain their “self-confidence” (http://​www.​volvat.​no/​Global/​Pdf/​Volvat_​kampanje_​overvektskirurgi​.​pdf, 13.01.10).
 
3
This is not to say that men’s experiences of bodily change following surgery are not equally significant. However, our aim with this article is to compare and contrast women’s experiences of bodily change.
 
4
Weiss distinguishes between distorted and nondistorted body images in her discussion of abjection. However, her discussion of various body images is beyond the aim and scope of our article.
 
5
If this meta-perspective “fails”, as is the situation for persons suffering from body dysmorphic disorder, shame risks becoming “pathological”. For these individuals shame is likely to gain a pervasive, unbalanced power, according to Fuchs (2002).
 
Literature
Aasheim, T.E., T. Mala, T.T. Søvik, J. Kristinsson, and T. Bøhmer. 2007. Kirurgisk behandling av sykelig fedme [Surgical treatment of morbid obesity]. Tidsskrift for den norsk Lægeforening 127: 38–42.
Ahmed, S. 2004. The cultural politics of emotion. Edinburgh: Edinburgh University Press.
Balsamo, A. 1999. Technologies of the gendered body: Reading cyborg women. Durham, London: Duke University Press.
Bordo, S. 1993. Unbearable weight. Feminism, western culture and the body. Los Angeles: University of California Press.
Bordo, S. 1997. Twilight zones: The hidden life of cultural images from Plato to O. J. Berkley: University of California Press. Cited in Dolezal, L. 2010. The (In)visible body: Feminism, phenomenology, and the case of cosmetic surgery. Hypatia 25(2).
Buchwald, H., Y. Avodor, E. Braunwald, M. Jensen, P. Walter, K. Fahrbacj, and K. Schoelles. 2004. Brariatric surgery: A systematic review and meta-analysis. Journal of the American Medical Association 292(14): 1724–1728.
Burgmer, R., K. Grigutsch, S. Zipfel, and S. Herpertz. 2005. The influence of eating behavior and eating pathology on weight loss after gastric bypass operations. Obesity Surgery 15: 684–691.PubMedCrossRef
Dahlberg H. 2011. The weight of the body. The question of flesh and human being in Maurice Merleau-Ponty’s Le visible et l’invisible. [Vikten av kropp. Frågan om kött och människa i Maurice Merleau-Pontys Le visible et l’invisible.] PhD dissertation, Gothenburg University, Sweden, Department of Literature, History of ideas and Religion, Gothenburg.
De Beauvoir, S. 2000. Det annet kjønn [The second sex]. Oslo: Pax Forlag, A/S.
De Zwann, M., K.L. Lancaster, and J.E. Mitchell. 2002. Health related quality of life in morbidly obese patients: Effect of gastric bypass surgery. Obesity Surgery 12: 773–780.CrossRef
Dolezal, L. 2010. The (in)visible Body: Feminism, phenomenology, and the case of cosmetic surgery. Hypatia 25(2): 357–375.CrossRef
Fisher, B., and P. Schauer. 2002. Medical and surgical options in the treatment of severe obesity. American Journal of Surgery 184(6B): 9S–16S.PubMedCrossRef
Fuchs, T. 2002. The phenomenology of shame, guilt and the body in body dysmorphic disorder and depression. Journal of Phenomenological Psychology 33(2): 223–243.CrossRef
Gimlin, D. 2000. Cosmetic surgery: Beauty as commodity. Qualitative Sociology 23(1): 77–99.CrossRef
Groven, K.S., M. Råheim, and G. Engelsrud. 2010. My quality of life is worse compared to my earlier life. Living with chronic problems after weight loss surgery. International Journal of Qualitative Studies on Health and Well-being 5(4). doi:10.​3402/​qhw.​v5i4.​5553.
Guenther, L. 2011. Shame and the temporality of social life. Continental Philosophy Review 44: 23–39.CrossRef
Haavind H. 2000. Kjønn og fortolkende metode: Metodiske muligheter i kvalitativ forskning [Gender and interpretive methods: Methodological possibilities in qualitative research]. Oslo: Gyldendal Norsk Forlag.
Harjunen, H. 2009. Women & fat. Approaches to the social study of fatness. Phd-dissertation, University of Jyväskylä, Finland.
Hofsø, D., E.T. Aasheim, G.S. Jakobsen, R. Sandbu, A.T. Aas, J. Kristinsson, and J. Hjelmesæth. 2011. Oppfølging etter fedmekirurgi. [Follow-up after weight loss surgery]. The Journal of the Norwegian Medical Association 19(131): 1887–1891.
Jakobsen, G.S., J. Hofsbø, J. Røislien, R. Sandbu, and J. Hjelmesæth. 2010. Who undergoes bariatric surgery? Obesity Surgery 20(8): 1142–1148.PubMedCrossRef
Karlsson, J.C., A. Taft, A. Ryden, L. Sjostrom, and M. Sullivan. 2007. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: The SOS intervention study. International Journal of Obesity 31: 1248–1261.PubMedCrossRef
Kristeva, J. 1982. The powers of horror: an essay on abjection. New York: Columbia University Press.
Kristeva J. and E. Engebretsen (ed). 2010. Annerledeshet: Sårbarhetens språk og politikk [Being different—the language and politics of vulnerability]. Oslo: Gyldendal Akademisk.
Kvale, S., and S. Brinkman. 2009. Interviews: Learning the craft of qualitative research interviewing. Los Angeles, CA: SAGE.
Kvigne, K., and M. Kirkevold. 2003. Living with bodily strangeness: Women`s experiences of their changing and unpredictable body following a stroke. Qualitative Health Research 13(9): 1291–1310.PubMedCrossRef
Leder, D. 1990a. The absent body. Chicago and London: The University of Chicago Press.
Leder, D. 1990b. Flesh and blood: A proposed supplement to Merleau Ponty. Human Studies 13(3): 209–219.CrossRef
Lindwall, L., and L. Bergbom. 2009. The altered body after breast cancer surgery. International Journal of Qualitative Studies on Health and Well-being 4: 280–287.CrossRef
Maggard, M.A., L.R. Shugarman, M. Suttorp, M. Maglione, H.J. Sugarman, and E.E. Livingston. 2005. Meta-analysis: Surgical treatment for obesity. Annals of Internal Medicine 142: 547–599.PubMedCrossRef
Martin, M., A. Beekly, R. Kjorstad, and J. Sebesta. 2010. Socioeconomic disparities in eligibility and access to bariatric surgery: A national population-based analysis. Surgery for Obesity and Related Diseases 6: 8–15.
Merleau-Ponty, M. 2002. Phenomenology of perception. London and New York: Routledge.
Mitchell, J.E., R.D. Crosby, T.W. Ertelt, J.M. Marino, D.B. Sarwer, J.K. Thompson, K.L. Lancaster, H. Simonisch, and L.M. Howell. 2008. The desire for body contouring surgery after bariatric surgery. Obesity Surgery. 18: 1308–1312.
Moi, T. 1998. Sex, gender and the body: The student edition of “What is a woman”. Oxford: Oxford University Press.
Munoz, D.J., M. Lal, E.Y. Chen, M. Mansour, S. Fischer, M. Roehring, L. Sanchez-Johnsen, M. Dymek-Valenitine, J. Alverdy, and D. Grange. 2007. Why patients seek bariatric surgery: A qualitative and quantitative analysis of patient motivation. Obesity Surgery 17: 1487–1491.
Murray, S. 2005. Unbecoming out? Rethinking fat politics. Social Semiotics 15(2): 153–163.CrossRef
Ogden, J., C. Clementi, and S. Aylwin. 2006. The impact of obesity surgery and the paradox of control. Psychology and Health 21(2): 273–293.PubMedCrossRef
Ogden, J.C., C. Clementi, S. Aylwin, and A. Patel. 2005. Exploring the impact of obesity surgery on patients’ health status: A quantitative and qualitative study. Obesity Surgery 15: 266–272.
Padwal, R.S., and A.M. Sharma. 2009. Treating severe obesity: Morbid weights and morbid waits. Canadian Medical Association Journal 181(11): 777–778.PubMedCrossRef
Rugseth, G. 2011. Overvekt som livserfaring. Et empirisk-teoretisk kunnskapsbidrag. [Obesity as lived experiences. An empirical –theoretical contribution]. Phd-dissertation. Oslo: University of Oslo, Faculty of Medicine.
Salant, T., and H.P. Santry. 2006. Internet marketing of bariatric surgery: Contemporary trends in the medicalization of obesity. Social Science & Medicine 62: 2445–2457.CrossRef
Sjöström, L.K., and C.D. Nabro. 2007. Effects of bariatric surgery on mortality in Swedish obese subjects. New England Journal of Medicine 357: 741–752.PubMedCrossRef
Skårderud, F. 2001. Tapte ansikter. Introduksjon til skampsykology 1. Beskrivelser [Lost faces. Introduction to shame psychology 1. Descriptions] In Skam, perspektiver på skam, ære og skamløshet i det moderne [Shame, perspectives on shame, honesty and shamelessness in modernity], ed. Wyller, T. 37–53. Oslo: Fagbokforlaget.
Skårderud, F. 2006. Flukten til kroppen—senmoderne skamfortellinger [The body escape—stories of shame] In Skam i det medisinske rom [Shame in the medical room] ed. Gulbrandsen, P., Fugelli P., Stang Hovind G.G, and B. Wilmar (red), 45–64. Oslo: Gyldendal akademisk.
Sobal, J. 2009. Sociological analysis of the stigmatization of obesity. In Germov, J. and L. Williams. Oxford: A Sociology of Food & Nutrition.
Social and Health Department of Norway. 2007. Utredning og behandling av sykelig overvekt i spesialisthelsetjenesten. [Treatment of morbid obesity in the health service].
Sveneus, F. 2009. The phenomenology of Falling ill: An explication, critique and improvement of Sartre’s theory of embodyment and alientation. Human Studies 32(1): 53–66.CrossRef
Throsby, K. 2008. Happy re-birthday: Weight loss surgery and the ‘new me’. Body & Society 14(1): 117–133.CrossRef
Throsby, K. 2009. The war on obesity as a moral project: Weight loss drugs, obesity surgery and negotiating Failure. Science as Culture 18(2): 201–216.
Throsby, K. 2011. Obesity surgery and the management of excess: exploring the body multiple. Sociology of Health and Illness 34(1): 1–15.PubMedCrossRef
Van Manen, M. 1997. Researching lived experience: Human science for an action sensitive pedagogy. 2nd ed. Ontario: Hignell Book Printing.
Wahl, A.K., E. Gjengedal, and B.R. Hanestad. 2002. The bodily suffering of living with severe psoriasis: In-depth interviews with 22 hospitalized patients with psoriasis. Qualitative Health Research 12: 250–261.PubMedCrossRef
Weiss, G. 1999. Body images: Embodiment as intercorporeality. London: Routledge.
Zeiler, K. 2009. Ethics and organ transfer: A merleau-pontean perspective. Health Care Analysis 17(2): 110–122.PubMedCrossRef
Zeiler, K. 2010. A phenomenological analysis of bodily self-awareness in the experience of pain and pleasure: on dys-appearance and eu-appearance. Medicine Healthcare and Philosophy 13(4): 333–342.CrossRef
Zeiler, K., and E. Malmquist. 2010. Cultural norms, the phenomenology of incorporation and the experience of having a child born with ambiguous sex. Journal of Social Work Theory and Practice 36(1): 157–164.
Zeiler, K., and A. Wickström. 2009. Why do ‘we’ perform surgery on newborn intersexed children? Feminist Theory 10(3): 359–377.CrossRef
Metadata
Title
Dis-appearance and dys-appearance anew: living with excess skin and intestinal changes following weight loss surgery
Authors
Karen Synne Groven
Målfrid Råheim
Gunn Engelsrud
Publication date
01-08-2013
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 3/2013
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-012-9397-5

Other articles of this Issue 3/2013

Medicine, Health Care and Philosophy 3/2013 Go to the issue

Scientific Contribution

The philosophies of psychiatry: empirical perspectives

Scientific Contribution

One or two types of death? Attitudes of health professionals towards brain death and donation after circulatory death in three countries

Scientific Contribution

Organ transplantation and meaning of life: the quest for self fulfilment

Scientific Contribution

Models of occupational medicine practice: an approach to understanding moral conflict in “dual obligation” doctors

Scientific Contribution

Practicing physiotherapy in Danish private practice: an ethical perspective

Short Literature Notices

Short literature notices