Contrasting Views of the Post-bariatric Surgery Experience between Patients and their Practitioners: a Qualitative Study.

ABSTRACT

BACKGROUND: The superiority of obesity surgery for improving medical and weight outcomes in severely obese patients when compared to other weight loss interventions remains undisputed. However, knowledge about the psychological impact of the procedure on patients' lives is limited. Systematic reviews indicate persisting psychological distress after surgery compared to control groups especially longer term, suggesting the need for postoperative psychological support and assessment. Research literature also infers limited knowledge regarding the postoperative patient experience of obesity surgery. This may form a barrier in health practitioners' understanding of these patients' ongoing needs. METHODS: Ten patients who had obesity surgery two or more years ago and eight obesity surgery practitioners were recruited within hospital settings and individually interviewed by the researcher to capture their accounts of the postoperative experience. Concordance between the two groups was explored to gauge awareness of patients' subsequent health needs. RESULTS: Thematic analysis of transcribed interviews elicited a key finding around 'post-surgical cliffs in patient care' within a heavily structured service. Participants reported some unmet needs, namely, psychological aftercare to facilitate adjustment following drastic weight loss and excess skin, acceptance of their non-obese self and perceived stigma. The impact of contrasting views of success between patients and practitioners on postoperative care within the service context was highlighted. CONCLUSIONS: Obesity surgery is a great weight loss catalyst for severe obesity. However, lack of psychological aftercare may threaten early gains in health outcomes over the longer term. More qualitative and quantitative studies are needed to validate current study results.