‘What’s the point in extending your life if this is your life’: A qualitative exploration of pre-surgery, short-term and long-term responses to bariatric surgery

ABSTRACT

This study examined experiences of weight, physical activity, diet, and quality of life of individuals prior to and following bariatric surgery. Twenty-seven people participated who represented three periods related to bariatric surgery: pre-surgery; short-term post-surgery (i.e., 1–2 years) and long-term post-surgery (i.e., 3–7 years). A qualitative descriptive design was adopted, with data collected through interviews and analysed using thematic analysis. Themes in the pre-surgery period were identified as follows: a) Growing up: Variation by family and ability, b) Weight gain: Transitions, traumas, and triggers; c) Perceptions of self: Hate, loathing, and worthlessness; d) Spiralling weight: Lack of control over vicious cycles of dieting and weight gain, and; e) Surgery: A final and essential lifeline. Short-term post-surgery themes were: a) Physical changes: Rapid weight loss and enhanced health versus hesitation and disappointment; b) Physical activity: Changes in engagement and perceptions despite ongoing barriers; c) Finding oneself: Increased emotional wellbeing, self-concept and confidence, and; d) Quality of life: Renewed physical capabilities and capacity but some continuing challenges. In the long-term following surgery, themes of: a) Weight plateau/regain: Disappointment and feelings of failure, and; b) Excess fat: Frustration and feelings of vulnerability emerged from the data. It is evident that participants go on an extended journey in the years before and after bariatric surgery and experience a range of both positive and negative outcomes. Overall, the findings highlight the importance of practitioners understanding individual’s overall journeys when seeking to help them lose weight and improve psychological health.

KEYWORDS:

• Bariatric surgery
• weight loss
• physical activity
• diet
• quality of life

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. UK supermarket chain.

2. UK plus size clothing brand.

3. UK clothing brand.

Additional information

Notes on contributors

Stephanie. J. Hanley

Stephanie. J. Hanley completed this research as part of her MSc by Research degree at Swansea University. Her areas of interest and research are in understanding the exercise and dietary patterns and behaviours of overweight and obese populations, with a current interest in maternal obesity. She is currently studying for her PhD at Nottingham Trent University (2017-present). She has presented papers on her MSc topic at conferences around the UK, as well as other research she has assisted in regarding the glycaemic responses to resistance exercise in individuals with type 1 diabetes.

Camilla. J. Knight

Camilla. J. Knight obtained her BSc in Sport and Exercise Science and MSc in Sport and Exercise Psychology at Loughborough University before moving to Canada, where she completed her PhD examining parental involvement in sport at the University of Alberta. Camilla subsequently took up a lectureship at Swansea University where she is now an Associate Professor. Camilla’s research interests are concerned with understanding and enhancing the experiences of children in sport, with a particular focus upon the influence, and experiences, of parents. Camilla draws on a range of qualitative research methodologies to address her questions and also enjoys applying these methods within interdisciplinary teams examining diverse topics ranging from mental health and wellbeing, to perceptions of science, and the application of engineering principles in sport.

Nicole. M. Glenn

Nicole. M. Glenn recently began working with Dr. Candace Nykiforuk and the Centre for Healthy Communities in the School of Public Health, University of Alberta. Prior to this role, Nicole completed a post-doctoral fellowship in the Public Health Research Institute at the Université de Montréal in Montréal, Canada (2014–2018). Nicole was supported by a fellowship from the Canadian Institutes of Health Research (2015–2018) and worked under the direction of Dr. Katherine Frohlich and within the Department of Social and Preventive Medicine as part of the Interdisciplinary Study of Inequalities in Smoking team. In her post-doctoral work Nicole explored experiences of smoking to better understand how place of residence intersects with and potentially impacts social inequalities in smoking. Nicole received her PhD in 2014 from the Faculty of Physical Education and Recreation at the University of Alberta under the supervision of Drs. John C. Spence and Kim Raine. Her dissertation examined the experience of waiting to have bariatric surgery.

Jeffery. W. Stephens

Jeffery. W. Stephens qualified in Medicine from St. Mary’s Hospital Medical School (Imperical College), London in 1994. He undertook specialist training in Diabetes, Endocrinology and General Internal Medicine throughout Central London. Between 2001–2004 he undertook a PhD in Genetics based at the Centre for Cardiovascular Genetics within the School of Medicine at University College London. He returned to Wales in 2005 to take up the post of Senior Clinical Lecturer and subsequently Reader in the College of Medicine at Swansea University. He is currently a full Professor of Medicine (Diabetes & Metabolism) based at the Institute of Life Sciences at Swansea University and a Consultant Physician in Diabetes, Endocrinology and General Internal Medicine at Morriston Hospital, Swansea.

Richard. M. Bracken

Richard. M. Bracken is an Associate Professor of Exercise Physiology and Biochemistry at Swansea University, Wales, UK. He is also the Vice-Chair for the Exercise and Physical Activity study group (ExPAS) of the European Association for the Study of Diabetes. Dr. Bracken’s research aim is to explore the interaction of exercise, nutrition and medication in the energy metabolism and functional outcomes of people with type 1 diabetes. He is also interested in a better understanding of the impact of exercise stress on factors beyond glycaemic control in people with Type 1 diabetes who wish to exercise safely.