Lived Experience Research Articles

Identifying Service, Research and Policy priorities for preventing the impacts of family adversity on children’s mental health: An Australian national resource allocation study with professional and lived experience experts

ObjectivesThe objective of this study was to develop Service, Research and Policy priorities to prevent the impact of family adversity on child mental health and determine comparative priorities of diverse stakeholders to those with lived experience of adversity. MethodsValue-weighting approach conducted in a staged process: (i) professionals and experts with lived experience from health, education, justice and social care sectors attended a national symposium to identify priorities for family adversity and mental health and (ii) a subsequent resource allocation survey gathered views from participants and external experts on symposium priorities. ResultsConsensus was reached on priorities. Service priorities included establishing intersectoral hubs for children and families and early childhood nurse home-visiting programs. Research priorities included scaling up evidence-based interventions and evaluating cross-sector, flexible funding models for services addressing childhood adversity. Policy priorities included developing evidence-based policies with evaluation and implementation plans and flexible funding models to support integrated care. ConclusionsOur results provide detailed and actionable clarity on next steps to address family adversities. Implications for Public HealthThe priorities call for a focus on cross-sectoral approaches to preventing or mitigating the effects of family adversity. The current Australian policy environment provides a timely opportunity to action the proposed interventions.

Improving mechanisms of involvement of people with lived experience in decision-making processes.

Improving mechanisms of involvement of people with lived experience in decision-making processes.

Assessing the inclusion of women of color in lichen sclerosus treatment studies: a scoping review.

Vulvar lichen sclerosus (VLS) is an underrecognized chronic inflammatory skin condition with significant clinical features and potential for malignant transformation. To date, there are no studies comparing the course of this disease in women of color to other racial groups. The objective of this study was to provide a scoping review examining racial demographic data in VLS treatment studies and specifically assessing for the inclusion of women of color. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a primary literature search was conducted using 4 databases: Ovid Medline(R), Scopus, Cochrane, and Web of Science from all years to December 2022. We included published studies with adult women diagnosed with VLS and containing a treatment arm using topical corticosteroids. Single case reports, literature reviews, systemic reviews, meta-analyses, and reports not available in English were excluded. Overall, 1340 nonduplicate studies were assessed for eligibility criteria. In total, 65 publications were included. Only 6 included racial demographic data. Black women made up at most 3.8% of the sample population and Latinx women made up at most 5.7%. Our review focused on a specific intervention (ie, the use of topical corticosteroids for the treatment of VLS), which may restrict the generalizability of our findings to other interventions. No risk of bias assessment was done due to the scoping nature of the review. Women of color are underrepresented in studies of topical corticosteroid use in adult women with VLS. Intentional diversity in recruitment will enable the collection of data that is both more accurate and reflective of a broader spectrum of perspectives and life experiences.

Building Relationships, Forming Collaborations: Lessons Learned From an Unconference Seeking to Cultivate Solutions in Healthcare.

Calls for a 'major rethinking' of the delivery of healthcare services are echoed across Canada as the healthcare crisis continues. Proposed strategies to address the challenges of this crisis include: a transdisciplinary approach that is patient-focused and community-based; a representative team composed of patients, caregivers, healthcare providers, decision makers and policymakers; and authentic collaboration among stakeholder groups throughout the research cycle. This study aimed to enable community members to take on a leading role in building capacity and to provide a space for discourse among diverse groups while respecting community wisdom, values and priorities. The Collaborative Health Research Institute of Southern Alberta (CHRISA) organized a participant-oriented Unconference event to address the factors contributing to the healthcare crisis in Alberta, Canada. An Unconference is a participant-oriented meeting where the attendees nominate the topics, agree on the agenda and lead the sessions. This article describes the Unconference programme and presents the findings from a thematic analysis of the discussion notes from breakout sessions, feedback from participants (i.e., lessons learned) and pragmatic recommendations for future Unconference events. Findings from sessions included the following: (1) identifying the 'wicked' problems, (2) the factors/causes contributing to each problem (i.e., contributors) and (3) potential multifaceted solutions or ideas to remedy the problem. Lessons learned from the postevent evaluation resulted in six recommendations for organizing future Unconferences. The CHRISA Unconference achieved its goals by providing a venue for attendees to connect, engage and network on topics of interest, explore new ways of addressing challenges in healthcare and serve as a foundation for future initiatives and collaborations in healthcare research and practice. The Unconference was attended by community members who identify as patients, frontline workers, programme administrators and representatives of public organizations and agencies. Participants contributed to breakout session discussions, provided feedback on the Unconference and offered recommendations for future events. The co-authors are service users, people with lived experience or those work in the healthcare setting; they have been involved in data collection, analysis and interpretation, and contributed to this report.

Aripiprazole/Sertraline Combination: Clinical and Cost-Effectiveness in Comparison With Quetiapine for the Treatment of Bipolar Depression (ASCEnD Trial)-Protocol for a Nested Qualitative Study.

Bipolar disorder is a recurrent mental health disorder with a prevalence rate of 1.4%. On average, there can be a delay of 9.5 years from the initial presentation of symptoms to a confirmed diagnosis. Individuals living with bipolar disorder have a reduced life expectancy. There is limited evidence regarding the effectiveness of antidepressants in treating bipolar disorder. The ASCEnD clinical trial will test the clinical and cost-effectiveness of the aripiprazole/sertraline combination in comparison with quetiapine for the treatment of bipolar depression (individuals who suffer from depressive episodes in bipolar disorder) and will include a nested qualitative study. The qualitative study will use semi-structured interviews to explore pilot trial participants' and clinicians' perspectives on recruitment procedures, the acceptability of the intervention, the management of bipolar disorder and attitudes to medication combinations. Findings will inform recruitment strategies and optimise training for the participating sites in the ASCEnD full trial. They will also help to illuminate the lived experience of people with bipolar disorder and the clinicians who work with people with bipolar disorder. The discussion will explore perspectives on the delay in diagnosis, having a diagnosis, the impact of living with bipolar disorder and attitudes to treatment, including drug combinations. A Lived Experience Advisory Panel (LEAP) has been convened with the support of the McPin Foundation, which will contribute to the ASCEnD trial and its nested qualitative study to provide input on the design and delivery of the trial and qualitative study, analysis of qualitative data and dissemination of findings.

"It's Almost Like Playing 'The Price is Right'": Factors Considered by Online Male Sex Workers When Setting the Price for Their Services.

Some men who have sex with men (MSM) engage in the exchange of sexual services for money, drugs, shelter or something else of value. There has been limited research examining the factors that influence how male sex workers (MSWs) determine their fees for their services. To learn more about this, qualitative interview data were analyzed from 180 MSM from 8 US cities who had recently engaged in exchange sex with clients they had primarily met through dating/hookup websites and apps. The primary factor that affected participants' fees was the type of services provided, with a higher price generally charged for anal sex than for oral sex, mutual masturbation or massage. Condomless anal sex, in particular, commanded a higher fee. Additionally, participants required more money for special kinks or fetishes or any services that they considered to be risky, demanding or physically or emotionally uncomfortable. Other factors that affected how much participants charged for a given encounter included the duration of the meeting, the level of client appeal, the perceived wealth of the client, and the participant's current financial situation. Participants varied in their approaches to fee setting, in terms of both their degree of flexibility when negotiating a price and whether they preferred to suggest a fee or have the client first state an amount they were willing to pay. Information about MSWs' approaches to fee setting provides greater understanding of their lived experiences and the risks they may accept for higher fees.

Investigating the relationship between personality types and resilience in pregnant women. A cross-sectional study

BackgroundChildbirth is considered a critical experience in a woman's life when she needs mental adaptation and reorganization of relationships. Factors such as personality and self-perception can help facing and solving crises. This study aimed to investigate the relationship between personality types and stress resilience among pregnant women. MethodsThis was a cross-sectional study on 210 multiparous and nulliparous pregnant women who were 32–37 weeks pregnant and referred to Shiraz medical hospitals for delivery selected via convenience sampling. Data collection tools were personal and midwifery information questionnaires and the Goldberg personality and visual pain assessment scale that were completed through interviews. Data analysis was performed by SPSS software using descriptive tests to describe the data and the Pearson correlation test to analyze the data. ResultsThe highest personality type was conscientiousness (48.1%) and the lowest was extraversion (2.4%). Maternal resilience had a significant positive relationship with extraversion (p=.001) and conscientiousness (p=.001). There was no significant relationship between the 2 variables of neuroticism and maternal resilience (p=.12). There was a significant positive relationship between the 2 variables of openness to experience and maternal resilience (p=.005). ConclusionWomen's healthcare providers can help to mitigate the negative effects of psychological distress, and psychologically empower this vulnerable group by considering the resilience and personality type of pregnant women during prenatal care.

Stigmatizing attitudes and beliefs about obesity among dental team members.

Weight stigma is prevalent within healthcare settings and is an aspect of the lived experience of people living with obesity. There is international evidence of weight stigma in the dental setting, where currently there is also evidence indicating limited training amongst dental professionals regarding obesity or obesity-related stigma. There has been Australian research and none have included dental support staff. This cross-sectional survey aimed to assess stigmatizing attitudes and beliefs of dental professionals (registered general dentists, oral health therapists) and support staff (dental assistants, dental receptionists) working in private and public regional practices in New South Wales and specialists in Special Needs Dentistry across Australia toward people living with obesity. An anonymous electronic validated survey was administered through REDCap™ to assess stigmatizing attitudes and beliefs held amongst respondents in relation to people living with obesity. Fifty-three participants completed the survey (n=33 clinicians, n=20 support staff). The majority 47/53 (88.7%) held positive attitudes toward people living with obesity. Of the clinicians, 15/33 (45.5%) reported 1hour or less and 14/33 (42.4%) reported two to 5hours of obesity-related education. 14/20 (70%) of the support staff reported no prior education or training about obesity. Of responses reflecting weight stigma, only three clinicians reported negative reactions toward the appearance, or discomfort during examination, of a patient with obesity, or a perception of laziness, compared with normal weight individuals. A higher proportion 4/20 (20%) of support staff reported responses indicating negative attitudes for people with obesity compared with normal weight individuals. Survey responses reflected evidence of weight stigma in both dental professionals and support staff. Professional development targeting weight stigma reduction in the dental setting is needed for both clinicians and support staff.

Clinical benefit of a physical activity rehabilitation pathway and the lived experience of patients with obesity

Clinical benefit of a physical activity rehabilitation pathway and the lived experience of patients with obesity

A Novel Content and Usability Analysis of UK Professional Regulator Information About Raising a Concern by Members of the Public.

Health and social care regulators ensure that professionals have the correct qualifications and experience to practice in their profession. Globally, there are over 130 regulators of nursing alone and 13 health and social care statutory regulators in the United Kingdom. The public are the largest source of concerns to regulators about the registrants' fitness to practise (FtP). This study aimed to examine the amount, type and content of the information available from UK regulators and evaluate the usability of the process for members of the public considering raising a concern with a regulator about a registrant's fitness to practise (FtP) and the experience of those who had recently raised a concern. The websites of the UK's 13 statutory health and social care regulators were searched between November 2021 and February 2022 for information about the process of raising a concern. Webpages and public-facing documentation were downloaded, and qualitative content analysis was conducted. The usability of regulator websites and the concerns referral form were assessed by 11 people using an adapted 'system usability scale'. Seven interviews, a focus group (n = 5) and a survey (n = 62) of people who had raised a concern were used to explore their experiences to validate our findings and recommendations. Themes were identified related to format and layout, the process and support to raise a concern, with wide variation found between regulators. Focus groups, interviews and surveys validated these findings. Information and the ease of finding this information are fundamental in promoting public confidence and trust in regulator purpose and process. When raising a concern, it is important that information is honest, clear and accurate and available in a range of different formats so that it suits the diverse needs of members of the public. Improvements in these processes could support regulators to better achieve their primary purpose of protecting the public. The public were consulted on our findings using two focus groups, seven interviews and 62 survey respondents. Our project advisory group of people with lived experience of involvement in FtP discussed the findings and contributed to the recommendations. N/A.

Shuttle Time for Seniors: The Impact of 8-Week Structured Badminton Training on Markers of Healthy Aging and Evaluation of Lived Experiences-A Quasi-Experimental Study.

Engagement in sport offers the potential for improved physical and psychological well-being and has been shown to be beneficial for promoting healthy aging. Opportunities for older adults to (re)engage with sport are limited by a paucity of age-appropriate introductory sports intervention programs. As such, the study evaluated the efficacy of a newly designed 8-week badminton training program (Shuttle Time for Seniors) on markers of healthy aging and the lived experiences of participation. Forty-three older adults assigned to a control (N = 20) or intervention group (N = 23) completed pre-post assessment of physical and cognitive function, self-efficacy for exercise, and well-being. Focus groups were conducted for program evaluation and to understand barriers and enablers to sustained participation. Those in the intervention group increased upper body strength, aerobic fitness, coincidence anticipation time, and self-efficacy for exercise. Objectively improved physical and cognitive functions were corroborated by perceived benefits indicated in thematic analysis. Shuttle Time for Seniors was perceived as appropriate for the population, where the age-appropriate opportunity to participate with likeminded people of similar ability was a primary motivator to engagement. Despite willingness to continue playing, lack of badminton infrastructure was a primary barrier to continued engagement. Shuttle Time for Seniors offered an important opportunity for older adults to (re)engage with badminton, where the physical and psychosocial benefits of group-based badminton improved facets important to healthy aging. Significance/Implications: Age-appropriate introductory intervention programs provide opportunity for older adults to (re)engage with sport. However, important barriers to long-term engagement need to be addressed from a whole systems perspective.

Was Oleksandr Dovzhenko a Judophobe (According to the materials of the Soviet special services)

The submitted article is aimed at the revealing and representing previously unknown archival documents from the funds of the Soviet special services, concerning the non-conformist attitudes of Oleksandr Dovzhenko, his resentment towards the Jews in particular. The author’s task is directed at stimulating further studies and discussions in order to find means of depicting a realistic image of Dovzhenko. Methodological principles are based on the fundamentals of historicism and critical analysis of sources with a complex combination of the entire multiplicity of newly discovered historical facts and events in accordance with specific historical circumstances. The scientific novelty consists in the comprehension of the documents of the communist special services as a source component of unprejudiced research strategies of modern Dovzhenko Studies. Conclusions. Newly discovered archival documents prove that Dovzhenko’s critical attitude towards Jews is the result of complex and situationally determined attitudes and life experiences. This is why these cannot be simplistic and straightforward narratives. Communist special services have monitored closely Dovzhenko’s anti-Soviet sentiments, suspected him of «counter-revolutionary activities», and also recorded his statements directed at Jewish cinematographers. However, they haven’t given unequivocal assessments to such statements. Dovzhenko has collaborated and made friends creatively with many Jewish artists, and his critical attitudes have never turned into denunciation and other practical forms of revenge.

Addiction recovery stories: Dylan Suttie in conversation with Lisa Ogilvie

Purpose The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process. Design/methodology/approach The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery. It has been used in this series, as well as in the design of interventions that improve well-being and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model. Findings This paper shows that addiction recovery is a remarkable process that can be effectively explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented. Originality/value Each account of recovery in this series is unique, and as yet, untold.

Sensibility in the world of science and gendered society: the ethics and aesthetics of skin in The Skin I Live In

ABSTRACT This paper focuses on the aesthetical and ethical representations of skin in Pedro Almodóvar’s The Skin I Live In (2011). By emphasising the interconnectedness of the skin as an expressive interface mediating between the inner self and the material world, this paper examines how the image of skin extends beyond the visual aesthetics to engage viewers in a haptic sense. I argue that the haptic experience, when actively engaged, can transcend bodily suffering from unjust treatment, charging moving images with ethical consideration and envisioning alternative human bonds in a posthuman condition. By engaging with phenomenological concepts of flesh, intersubjectivity, and interobjectivity, this paper criticises the mistreatment of beings in the scientific field and the objectification of human bodies to sustain a gendered and patriarchal structure. Instead of solely attributing abusive and controlling masculinity and the oppression of women to the patriarchy, it is essential to go beyond traditional categories of male/female and masculinity/femininity and examine the modern systems that excessively alienate human beings. The paper proposes that an individual’s existence precedes social and political identification and advocates for a dynamic way to recognise and describe the process of becoming-body as it continuously undergoes qualitative changes through lived experiences.

Abstract B096: Patient, Provider, and Advocate Perspectives on Factors that Impact Participation of Black Women in Breast Cancer Clinical Trials

Abstract Background: Black women are more likely to present with advanced stage disease and to die following a breast cancer (BC) diagnosis compared with women from other racial and ethnic groups. This persistent health inequity is in part driven by underrepresentation in clinical trials (CTs), as well as structural and social drivers of health. Multi-level factors impact patients’ decision to enroll on a cancer CT. Objective: The goal of the FOR ME (Fostering Opportunities in Research through Messaging and Education) study is to develop, optimize, and test a narrative web-based video intervention for Black women diagnosed with BC to promote shared decision making and CT participation. Here, we report findings from the development phase, wherein we engaged Black women with BC, oncologists and CT office staff, and cancer advocates. Our objective was to identify cross-cutting and unique themes concerning barriers and motivating factors to CT participation, intervention priorities, and to understand lived experiences to enhance authenticity and to inform video content. Methods: Guided by community engaged research approaches, we used multiple qualitative methods, including story circles and 1:1 interviews. We used thematic analysis and inductive and deductive coding approaches. Data analysis for each group followed the same approach: we annotated a subset of transcripts, compiled the annotations into a preliminary codebook, and conducted inter-coder reliability to improve quality and refine the codebook. Finally, we used Dedoose to analyze quotations and code co-occurrences, application frequencies, and relationships. We examined cross-cutting and unique themes during data collection and analysis. Results: In total, 38 Black women with BC participated in interviews and story circles, ranging in age from 27-75 years (M=59, SD =12); about 27% were currently receiving BC treatment and 27% had prior CT participation. Oncologists (n=16) and CT office staff (n=4) reported having on average 11.6 and 9.5 years of CT experience, respectively). Finally, 15 cancer advocates completed interviews, of whom 73% identified as Black women; 87% reported that the organization they were involved with connected patients to or provided education about CTs. Several cross-cutting themes were identified, including: 1) Acknowledgement of time, financial, and logistical burdens of CT participation; 2) The impact that current and historical racism, discrimination and mistreatment has had on CT enrollment for Black BC patients; 3) A lack of accessible CT information poses significant challenges for health literacy; and 4) Positive provider relationships and communication are important facilitators to CT participation. Conclusion: To promote health equity and participation in CTs among Black women with BC, interventions should consider multiple perspectives and prioritize addressing culturally sensitive patient-provider communication, shared decision-making, and patient empowerment. The information we learned will inform the development of a culturally tailored decision aid video. Citation Format: Leslie R. Carnahan, Eliza B. Cohn, Tigist Mersha, Neha Hippalgaonkar, Ryan Nguyen, Kauthar Salum, Ana Williams Waite, Christen Sandoval, Lolita Coleman, Beulah Brent, Paris Thomas, Paramjeet Khosla, Kent F. Hoskins, Vida Henderson. Patient, Provider, and Advocate Perspectives on Factors that Impact Participation of Black Women in Breast Cancer Clinical Trials [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B096.

How dignity matters for life and lifelong learning: insights from participatory story-telling by university students in South Africa

ABSTRACT The claim made is that dignity matters in both legal and recognitional aspects for flourishing and lifelong learning opportunities for young adults. Dignity is understood here as a foundational capability and functioning to be and to do in ways which matter to a person, requiring the material and non-material conditions which enable and secure equal dignity for each person. The claim is first explored drawing on both the capability approach and conceptualisations of dignity, especially the inflorescent form. Then, to empirically animate the claim, the article draws on a participatory story-telling project undertaken in a South African university in 2020 with graduate students, in which they were co-creators of knowledge. Participants were supported pedagogically in producing their own individual and collective digital stories, focusing on their lived experiences of social justice and specifically of human dignity. The project shows that dignity is an especially important capability for young people’s present and future wellbeing and their aspirations. Dignity is formed in and sustained relationally in collective spaces. Further, dignity enables repair of the injustices of the colonial and apartheid past. If dignity is not fostered in and through education in adult and higher education spaces, education will always fall short of social justice aspirations and lifelong learning conditions.

“… I still need to learn some things”: an interpretative phenomenological analysis of the lived experience of extended residential youth care in Denmark

“… I still need to learn some things”: an interpretative phenomenological analysis of the lived experience of extended residential youth care in Denmark

Pilgrims or project managers: premodern challenges for contemporary students

Presenting an alternative to the prevailing emphasis on what constitutes knowledge – knowledge as the fruit of scientific method, something that is objective and detached from the self – I argue for a critical retrieval of premodern approaches to knowledge that were promoted within the Eastern and Western Christian tradition, approaches that are spiritual in nature. I propose that spiritual modes of knowing should be considered alongside other forms of knowing, in service of a richer, more holistic approach to higher education, one that does justice to the multidimensional aspects of human nature, development, formation and flourishing. While not denying the necessity and value of many current forms of knowledge, I propose that students should also be offered opportunities to become familiar with complementary modes of knowing that are likely to extend the repertoire of the ways they read and respond to the world, other people and their experience of life. Such premodern Christian approaches privileged self-giving and self-control, rather than mastery over or control of what was investigated. Their epistemology viewed intellectual, moral and spiritual virtues as intimately interconnected. They considered knowledge to be something revealed and given rather than constructed or exposed by our methodology. The paper considers the educational potential for students today of learning from the premodern emphasis on knowledge as dependent on both ascetic training and affective formation, as entailing capacitation (being attuned to or fitted for external reality), and as promoting self-knowledge and transformation. I contrast premodern and contemporary approaches to knowledge through the metaphors of pilgrim and project manager.

Key stakeholders’ perspectives of illicit drug use and associated harms in the Northern Territory of Australia

BackgroundIn the Northern Territory (NT) of Australia, there are significant evidence gaps about illicit drug use and harms, despite having established monitoring and reporting systems. This paper reports on illicit drug use, associated harms, contributing factors, service needs and priorities in the NT from the perspective and experiences of key stakeholders engaged in providing services for, or advocating on behalf of, people who use illicit drugs in the NT.MethodsFace-to-face and online qualitative interviews were conducted with stakeholders across urban and remote locations in the NT. Key stakeholders were service providers, including acute and primary care clinicians, representatives of Aboriginal community controlled health organisations, lived experience advocates, peak body representatives and public health executives. Qualitative data were analysed thematically.ResultsFour researchers interviewed 21 participants across urban (62%), and remote areas (38%) of the NT. Themes identified were: (1) Illicit drug use and harms are diverse and distinct; (2) Client support needs are complex and influenced by co-morbidities, socio-demographic and cultural factors; (3) Priority population sub-groups need targeted strategies; (4) Local service strengths can be further developed and enhanced; (5) Local services need better resourcing; (6) Invest in progressive legislative and policy reforms; and (7) Improve routine monitoring and evaluation.ConclusionsKey stakeholders described illicit drug use, harms and contributing factors, which provided insights into the local challenges. Participants emphasised that clients have complex care needs, and further investment into targeted strategies are required to improve service engagement with priority groups. Service needs included greater understanding the role of dual diagnosis and its implementation and enhancing integrated and collaborative care in both primary health and acute care contexts. The voices of people with lived experience captured in this paper must inform local strategy and policy development relating to illicit drug use, in alignment with national strategy.

‘Who am I now?’ the lived experiences and identity construction of individuals following bariatric surgery

ABSTRACT Mediatised standards of beauty in contemporary western societies contribute to stigma and discrimination of individuals labelled ‘obese’ by medical professionals. Most people who undergo weight-reduction treatments, including bariatric surgery, choose it due to serious health conditions, often unable to lose weight in any other way. However, they are commonly constructed as ‘cheaters’ and blamed for lacking will and self-control. Cultural beliefs demonising fat and fat people produce the perceptions of an inferior identity, often leading to internalised fatphobia among such individuals. This study investigates the lived experiences of 11 individuals after bariatric surgery using semi-structured interviews analysed via narrative framework. The findings demonstrate paradoxical effects bariatric surgery can have on identity, through a persistent ‘obese’ view of self and body perception challenges, indicating long-lasting harmful effects of symbolic violence these individuals experience due to stigmatisation and medicalisation of fat and highlighting hegemonic discourses inscribing normative views on human bodies.