The lived experience of laparoscopic adjustable gastric banding (LAGB) surgery : a narrative exploration.

Abstract

Objectives: In the United Kingdom (UK), laparoscopic adjustable gastric banding (LAGB) surgery is available to obese individuals who meet the National Institute for Clinical Excellence criteria (NICE, 2014). The literature suggests that LAGB surgery can provide an effective route to weight-loss and other health benefits for some but not all individuals, and these benefits are not always maintained in the longer term. There is a current gap in the literature exploring the longer-term (>5 years) impact of LAGB surgery on individuals in a UK sample. The present study used narrative analysis to explore the lived-experience of obesity, and the role of LAGB in managing weight loss and diabetes, 5-years post-surgery for seven female patients with type-2 diabetes to better understand these mixed findings. Design: Secondary analysis of a primary qualitative dataset was used, applying a retrospective narrative approach. Results: Participants provided rich accounts of their lived-experience of obesity (pre-surgery) and their five-year journey thereafter. Individual case analysis revealed participant’s core narratives, including the ‘episodes’, characters and emotional tone. The process of cross-analysis identified four main themes (and 20 subthemes): 1. My Weight Is Beyond My Control, 2. The Band is Not a Miracle Cure, 3. Everything’s Changed but Not Me, 4. Change Occurs Within a System. Conclusions: Findings suggest that participants experienced their weight as beyond their control and they were seeking the LAGB to provide an external source of control. While the band satisfies this need to some extent it also presents challenges and does not address the fundamental psychological problems that underlie obesity. To support and maintain effective weight loss, services might consider psychological support to address the psychological and behavioural mechanisms underlying obesity. Further research is now needed to develop a theoretical model, which addresses all aspects of the bio-psychosocial nature of obesity in relation to LAGB surgery, which can be used clinically to inform weight-management services