Janet Followell


Obesity has reached epidemic proportion in the United States. Results of diet, exercise regimens, and/or medications are discouraging for most individuals; therefore, bariatric surgery is on the rise. Patients undergoing bariatric surgery are overwhelmingly female. There is a plethora of research regarding improvement of co-morbidities, but little focus has been placed on the impact of bariatric surgery on positive as well as negative psychosocial outcomes. The purposes of this study were to explore experiences of women who have undergone bariatric surgery and to gain an understanding of the decision to have surgery. No qualitative research was found regarding individuals' life experiences after bariatric surgery. This study used a qualitative research design, guided by a phenomenological approach, to investigate and describe the meaning of experiences of women before and after bariatric surgery. Initially, a focus group of six members of a bariatric support group was conducted to confirm data from individual interviews. Semi-structured in-depth interviews were then conducted on a sample of ten women who had undergone bariatric surgery and were two to four years postoperative. Eight main themes emerged from the data: (a) relationship with food, (b) interpersonal relationships, (c) relationship with self, (d) living with excess skin, (e) food intolerance, (f) treatment from society, (g) concern with aging, and (h) support systems. After further analysis, three subthemes then emerged from relationship with food: food and family, emotional response to food, and coping with temptations. Interpersonal relationships developed into two subthemes: limited activity with family and relationship with others. As analysis continued, three subthemes of concern with aging emerged: fear of not growing old, fear of the unknown, and fear of gaining weight. Themes that emerged from the women's experiences all revolved around the need to be better prepared for surgery and the need for continued support after surgery. Family was interconnected to most of the themes. In order to be successful, close family members should understand the requirements of lifelong medical monitoring and the necessary changes in diet and lifestyle. Results revealed limited psychological counseling as well as long-term nutritional counseling occurred. The majority did not attend support groups, although the need for support was expressed. Support groups conducted by health professionals benefit those who are considering surgery and those who have undergone bariatric surgery. Recommendations for health education include addition of bariatric surgery into curriculums. Knowledge of bariatric surgery would assist health educators in planning programs for this population.

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