title: Mandatory weight loss during the wait for bariatric surgery.
abstract: Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies.
authors.affiliation: University of Montreal, Montreal, Quebec, Canada nglenn@ualberta.ca.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Glenn
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kim D
authors.initials: KD
authors.lastname: Raine
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: John C
authors.initials: JC
authors.lastname: Spence
mesh_terms: D050110:Bariatric Surgery / Q000379:methods* / Q000523:psychology*; D006801:Humans; D009765:Obesity / Q000601:surgery; D009767:Obesity, Morbid / Q000601:surgery*; D036301:Qualitative Research; D014850:Waiting Lists; D015431:Weight Loss
keywords: ethics / moral perspectives; evidence-based practice; experiential methods; health care; lived experience; obesity / overweight; phenomenology; van Manen