A Qualitative Exploration of Obese Individuals' Motivation for Seeking Obesity Surgery.

Objectives: To explore the processes involved in deciding to seek obesity surgery. Method: In-depth, semi-structured interviews were conducted with nine participants attending a specialist outpatient obesity clinic. The interviews were audio-taped, transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Results: The results provide insights into the decision making process and highlight the role of defence mechanisms, a defining moment and the importance of hope. In particular, participants described in detail the negative experience of being an obese person and how they utilised defence mechanisms to cope with such negative experiences. This ultimately resulted in the maintenance of status-quo, leading to an inability to lose weight in the long-term. Participants also described the process of attempts at weight-loss and how although they are unsuccessful in losing and maintaining their weight-loss, these failed attempts lay the foundations for arriving at the decision to seek obesity surgery. The final decision to have surgery however does not seem to emerge solely from these failed attempts, but requires a defining moment which offers hope of an alternative life trajectory. Such defining moments included meeting someone else who had lost weight or seeing an x-ray of their thinner self inside their fatter body and generated hope which allowed participants’ defences to be dropped, enabling them to safely contemplate their own mortality and consider surgery as their last chance and an opportunity to break the vicious cycle of weight gain. Conclusions: This study’s findings contribute to current theoretical perspectives on the processes involved in decision-making and behaviour change. It is suggested that the decision to seek surgery results from a combination of both a gradual process of accumulation of the need to change, which lay the foundations and prepare an individual for change, and an immediate trigger or “defining moment” which offers hope of an alternative life trajectory. The findings highlight the need for health professionals to encourage obese individuals to lose weight through the injection of hope, rather than emphasising the negative consequences of not changing.&#xa0