Academic journal article Indo - Pacific Journal of Phenomenology

Practising Physical Activity Following Weight-Loss Surgery: The Significance of Joy, Satisfaction, and Well-Being

Academic journal article Indo - Pacific Journal of Phenomenology

Practising Physical Activity Following Weight-Loss Surgery: The Significance of Joy, Satisfaction, and Well-Being

Article excerpt

Now I can walk in the mountains without feeling dead by the time I reach the top. It feels wonderful.

The above comment from Linda, a Norwegian woman who underwent gastric bypass surgery more than five years before participating in our study, provides the starting point for this paper. As a result of her surgery, Linda experienced a radical change in the meaning she made of walking in the mountains when compared with her previous lived situation.

Linda's changed experience highlights how the meaning of physical activity can shift significantly following weight loss surgery (WLS). While previous research in this area has tended to focus on the quantification of measurable aspects of physical activity (for example, intensity and capacity), our research sought to explore women's lived experiences of physical activity. We believe that the insights gained from such research will be of value to health professionals providing advice on physical activity at different post-surgical stages, often to clients seriously concerned about regaining weight.

The literature on WLS places an emphasis on physical activity in ensuring successful long-term outcomes. With its biomedical perspective and quantitative research methods, this literature emphasizes levels of physical activity in which weight loss is the ultimate goal. Increased levels of physical activity are regarded as paramount in achieving sufficient weight loss, preventing weight regain, and improving functional health outcomes (Herring et al., 2016; King & Bond, 2013; Mechanick et al., 2013). However, a review of the literature reveals that the vast majority of those who undergo WLS do not make significant behavioural changes in respect of their level of physical activity (PA) (Bergh et al., 2017; King et al., 2015; Reid et al., 2015). As summarized by King and colleagues:

Results from studies with objective assessment of PA provide evidence that the vast majority of adults who undergo bariatric surgery have low levels of PA prior to surgery, and contrary to self-report, do not make substantial changes to their PA behaviour following surgery. (King et al., 2015, p. 1144)

Other researchers have identified different categories of participants according to their pre- and post-operative activity level. Bond et al. (2010), for example, reported that one third of the participants in their study had progressed from inactive to active, while 5 percent had shifted from active to inactive. However, registering changes in levels of physical activity in itself tells us little about the meaning of such activities from the perspective of those engaging in them. How individuals experience various physical activities and construct meaning around them seems central to an understanding of long-term experiences following WLS.

This paper sets out to illustrate that insights derived from qualitative research help us gain a sense of why some individuals become more physically active than others after WLS, and what kinds of physical activity they choose to engage in. More specifically, we explore the meanings of different kinds of physical activities and movement practices as experienced by women more than five years after undergoing weight loss surgery.

Theoretical Framework

An underlying theoretical premise of this study is that meaning is embodied. In line with Merleau-Ponty's ontological phenomenology, we regard experience as bodily based and subject to ongoing change. As bodily beings in the world, individuals aspire to make meaning of their experiences in various settings and situations, including those involving physical activity and movement (Merleau-Ponty, 1945/2002, p. 170). Johnson (2007) argues that it is through bodily experiences that meaning becomes possible and takes the form it does:

Meaning is embodied. It arises through embodied organism-environment interactions in which significant patterns are marked within the flow of experience. …

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