Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)

In a recent attempt to update the 1948 World Health Organization definition of health as a state of complete well-being and absence of disease, it has now been proposed to change its emphasis to the ability to adapt and self manage in the face of social, physical and emotional challenges. The question how we should conceptualize such self-management, however, is rarely raised and its theoretical foundations remain largely unexplained. Still, to an increasing extent, scholars, health professionals, researchers, caretakers and policy (...) makers emphasize the great potential of self-management strategies in somatic as well as mental healthcare. Patients, so the argument runs, should not be treated... (shrink)

In recent years, there has been a rapidly increasing interest in self-management strategies in psychiatry and psychosomatic medicine. Among the conditions in which self-management is currently investigated in these contexts are bipolar disorder, depression, post-traumatic stress disorder, schizophrenia, attention deficit hyperactivity disorder, irritable bowel syndrome, chronic fatigue syndrome (Meng, Friedberg, &...