Visual Expressions of Patient's Perceptions of Obesity-Related Stigma Through Drawing

Obesity is a heterogeneous health issue associated with stigma, depression, low self-esteem, body dissatisfaction, mood disorders, and anxiety impacting physical health, and quality healthcare. The aim of this pilot study was to explore the feasibility of using drawing, together with focus group discussions and an illness perception questionnaire, as a methodology to establish dialogue with patients living with obesity.

A two-hour workshop was conducted with people living with obesity. Patients completed the Brief Illness Perception Questionnaire (BIPQ) and demographic information, followed by a drawing activity. Quantitative and qualitative data were analyzed using IBM SPSS, Version 27.0. and the MAXQDA software, respectively.  RESULTS: Twelve participants (82% women, mean age 56.6 ± 10.26 years) were included. 45% reported low perceived threat of the disease. Analysis of drawing discussions revealed concepts that were organized into nine categories and four meta-categories. The most frequent were impact and support (64%) and change (22%). Prevalent themes emerging from drawings included experiences of stigma, expressions of positive feelings, sadness, and avoidance behaviors. We observed potential frictions between drawings and linguistic concepts.  CONCLUSIONS: This pilot study suggests that drawing is a feasible and acceptable methodology for exploring the experiences and perceptions of people living with obesity, while also showing potential as a positive intervention that may influence how individuals perceive themselves. The drawings and subsequent discussions provided insights into stigma, emotional responses, and coping strategies that may not surface in conventional clinical encounters. 1. Group discussions helped understand patient's emotional and social experiences. 2. Group setting revealed varied perspectives, highlighting each patient's journey. 3. Drawings uncovered emotions and challenges not captured by traditional methods, like face-to-face interviews. 4. Emotional, social, and psychological factors influencing obesity evolve over time.