BMJ Open (Feb 2020)

Patients’ experiences of life after bariatric surgery and follow-up care: a qualitative study

  • Amanda Owen-Smith,
  • Jane M Blazeby,
  • Jenny L Donovan,
  • Karen D Coulman,
  • Fiona MacKichan

DOI
https://doi.org/10.1136/bmjopen-2019-035013
Journal volume & issue
Vol. 10, no. 2

Abstract

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ObjectivesBariatric surgery is the most clinically effective treatment for people with severe and complex obesity, however, the psychosocial outcomes are less clear. Follow-up care after bariatric surgery is known to be important, but limited guidance exists on what this should entail, particularly related to psychological and social well-being. Patients’ perspectives are valuable to inform the design of follow-up care. This study investigated patients’ experiences of life after bariatric surgery including important aspects of follow-up care, in the long term.DesignA qualitative study using semistructured individual interviews. A constant comparative approach was used to code data and identify themes and overarching concepts.SettingBariatric surgery units of two publicly funded hospitals in the South of England.ParticipantsSeventeen adults (10 women) who underwent a primary operation for obesity (mean time since surgery 3.11 years, range 4 months to 9 years), including Roux-en-Y gastric bypass, adjustable gastric band and sleeve gastrectomy, agreed to participate in the interviews.ResultsExperiences of adapting to life following surgery were characterised by the concepts of ‘normality’ and ‘ambivalence’, while experiences of ‘abandonment’ and ‘isolation’ dominated participants’ experiences of follow-up care. Patients highlighted the need for more flexible, longer-term follow-up care that addresses social and psychological difficulties postsurgery and integrates peer support.ConclusionsThis research highlights unmet patient need for more accessible and holistic follow-up care that addresses the long-term multidimensional impact of bariatric surgery. Future research should investigate effective and acceptable follow-up care packages for patients undergoing bariatric surgery.