Post-surgical cliff after weight loss surgery: Accounts of patients and their health care professionals

Abstract

Background: Little is known about the psychological effects on life after weight loss surgery. Results from the systematic review above showed some persisting disordered psychosocial quality of life and wellbeing in longer term follow up periods in participants after the procedure when compared to control groups. This highlighted potential need for psychological intervention post-surgery and further research to provide more data on long term psychosocial impact of weight loss surgery. Even clearer was the lack of patient perspective on their experience and needs after having the surgery. Generating qualitative post-surgery data is vital as it gives health professionals detailed information on whether patients feel psychological care is needed after surgical obesity treatment and, if so, specifically what kind of care. Therefore, the study aims were; 1) to explore patients’ experiences of life after weight loss surgery, discussing perceived benefits and limitations of the procedure, and realisation of patients’ expectations AND 2) compare patients’ experiences with the views of health professionals involved in surgery and ongoing care to examine concordance between the cohorts. Methods: Ten individuals who had had weight loss surgery between 2 to 6 years ago and eight health professionals were recruited within an NHS bariatric surgery service through purposeful sampling and individually interviewed by the researcher. The semi-structured interviews were transcribed and analysed using thematic analysis. Findings: Patients reported drastic weight loss and improvements in a range of co-morbidities in the first year that coincided with better psychological and social function. However, long term experiential narratives revealed postsurgical cliffs in patient care, highlighting a need for psychological aftercare to support patients through physical and psychological changes. Specifically, issues of excess skin, acceptance of non-obese self and perceived prejudice following drastic weight loss were highlighted. Discussion: Overall, it would seem that weight loss surgery is a great catalyst for weight loss in those suffering from severe obesity. However, this tool needs to go hand in hand with psychological support post-surgery to aid long term optimal results. In relation to health psychology, suggestions for theoretical application and health interventions to facilitate patients through postoperative adjustments after surgery are outlined as well as recommendations for better service provision