title: "That's who I am: a fat person in a thin body": weight loss, negative self-evaluation, and mitigating strategies following weight loss surgery.
abstract: OBJECTIVE
  To explore negative self-evaluation following weight loss surgery (WLS).
  
  
  METHODS
  In-depth interviews were conducted with 11 women who had WLS. Thematic analysis was conducted through an iterative process, allowing categories and themes to emerge. To ensure rigor, two coders analyzed the data. Data were collected until thematic saturation was achieved.
  
  
  RESULTS
  All participants reported health as the motivation for WLS. Overall sentiment regarding WLS was positive. However, negative self-evaluation was reported and includes the following: (a) body-image distortion; (b) body-image dissatisfaction, including excessive skin; and (c) perceived stigma. Mitigating strategies include the following: (a) utilizing markers of progress to increase assimilation of a new identity as a thinner person, and (b) reflecting on the former self as a time of decreased quality of life.
  
  
  CONCLUSIONS
  Nurse practitioners and other clinicians treat and counsel patients on obesity and obesity-related morbidity, and may need to discuss WLS with patients who are either contemplating it or have already undergone it. The findings from the present study can provide clinicians insight into the possible psychological effects of WLS-associated weight loss. Bringing possible negative self-evaluative effects into open discussion can help optimize patient care and healthcare results.
authors: Orvis School of Nursing/MS 0134, University of Nevada Reno, Reno, Nevada.
authors: Christine Aramburu
authors: CA
authors: Alegría
authors: Barbara
authors: B
authors: Larsen
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000523:psychology*; D001828:Body Image / Q000523:psychology; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D011788:Quality of Life / Q000523:psychology*; D015431:Weight Loss
keywords: Qualitative research; mental health; obesity; primary care; psychology; weight management; women's health