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

Objectives: Bariatric 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.

Design: A qualitative study using semi-structured individual interviews. A constant comparative approach was used to code data and identify themes and overarching concepts.

Setting: Bariatric surgery units of two publicly funded hospitals in the South of England.

Participants: Seventeen adults (10 women) that underwent a primary operation for obesity (mean time since surgery 3.11 years, range 4 months-9 years), including Roux-en-Y gastric bypass, adjustable gastric band and sleeve gastrectomy, agreed to participate in the interviews.

Results: Experiences 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 post-surgery and integrates peer support.

Conclusions: This research highlights unmet patient need for more accessible and holistic follow-up care that addresses the long-term multi-dimensional impact of bariatric surgery. Future research should investigate effective and acceptable follow-up care packages for patients undergoing bariatric surgery.