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The way to a man’s stomach

There are more overweight or obese men in Australia than women, yet most weight-reduction surgeries are performed on women. A team of researchers hopes to help change that.

As the number of bariatric surgeries increases, the numbers of men receiving the procedure remain relatively low. The Australian Institute of Health and Welfare reported four in five admissions for bariatric surgery were for women. This figure is alarming, as Australian National Survey figures from 2007–08 indicate 68 per cent of men were overweight or obese whilst the figure for women is less, at 55 per cent. With a continued increase in obesity the demand for surgery for weight reduction will continue to rise.

And whilst there is much data related to bariatric surgery and body image issues for females, there is little to none for males. The impact of bariatric care on men, obesity and their mental health is, therefore, worthy of further exploration to inform practice.

My team and I are leading one such study at St Vincent’s Private Hospital Melbourne, in collaboration with Australian Catholic University.

The study aims to explore body image and adaptation to life post-surgery in male bariatric patients. Included was a question related to how the men looked for information about bariatric care and barriers they perceived to accessing it. Discovering how men seek such data can help healthcare providers navigate barriers and increase men’s awareness.

Morbid obesity can lead to psychosocial problems, including depression, anxiety, poor self-esteem, stigma and poor quality of life. Physically, individuals have an increased risk of morbidity and, in the worst-case scenario, death.

These physical and psychosocial problems are often increased if an individual does not respond to a surgical procedure as anticipated.

The most important gains from bariatric surgery include weight reduction and associated decline in the negative physical and psychosocial effects. However, not all patients respond significantly to surgery and a noteworthy proportion of post-operative patients met the criteria for mental disorders [about 40 per cent].

Whilst evidence supports the claim that the majority of people undergoing bariatric surgery experience significant improvements in quality of life and body image, including sexual function, a few recent studies have indicated some problems can arise in adapting to new lifestyle patterns and learning new boundaries and perception of control and body image.

Despite these issues, limited data exists related to the psychological impacts and perceptions individuals have regarding their personal expectations for outcomes of the surgery, including their body image, which is often affected by issues related to redundant skin – a condition that affects about 96 per cent of all patients post-bariatric surgery.

The study’s preliminary results reveal the internet is a main source of information for men after post-bariatric surgery. They indicated real-life stories of other people who have had the surgery were important to them. Receiving the data in this way allows men to make their own decisions whilst remaining anonymous when they are contemplating their options for weight loss.

Healthcare professionals, including doctors, nurses and allied health, need to extend their scope of practice beyond the physical and dietary management of these patients post-surgery. Of note, health information targeting men in this demographic needs to advance with gusto in a bid to help overweight and obese men become informed of their medical options.

Karen-leigh Edward is an associate professor of nursing research in the Faculty of Health Sciences at Australian Catholic University and director St Vincent’s Private Hospital Melbourne nursing research unit.

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