Abstract
BackgroundBariatric surgery leads to changes in mental health, quality of life and social functioning, yet these outcomes differ among individuals. In this study, we explore patients’ psychosocial experiences following bariatric surgery and elucidate the individual-level factors that may drive variation in psychosocial outcomes.MethodsEleven semi-structured focus groups with Michigan Bariatric Surgery Collaborative (MBSC) patients (n = 77). Interviews were audio recorded, transcribed verbatim, and analyzed using a grounded theory approach. Data on participant demographic characteristics were abstracted from the MBSC clinical registry.ResultsMost focus group participants were female (89%), white (64%), and married (65%). We identified three major themes: (1) change in self-perception; (2) change in perception by others; and (3) change in relationships. Each theme includes 3 sub-themes, demonstrating a range of positive and negative psychosocial experiences. For example, weight loss led to increased self-confidence among many participants while others described a loss of self-identity. Some noted improved relationships with family or friends while others experienced worsening or even loss of relationships due to perceived jealousy.ConclusionWeight loss following bariatric surgery leads to complex changes in self-perception and inter-personal relationships, which may be proximal mediators of commonly assessed mental health outcomes such as depression. Individuals considering bariatric surgery may benefit from anticipatory guidance about these diverse experiences, and post-surgical longitudinal monitoring should include evaluation for adverse psychosocial events.
Highlights
Bariatric surgery leads to changes in mental health, quality of life and social functioning, yet these outcomes differ among individuals
A growing number of individuals live with morbid or severe obesity, which leads to serious health consequences and contributes significantly to obesity-related health care spending [6]
In contrast to the predictable physical health benefits of major weight loss, psychosocial outcomes differ among patients and little is known about the individual-level experiences that may contribute to these variations
Summary
Bariatric surgery leads to changes in mental health, quality of life and social functioning, yet these outcomes differ among individuals. We explore patients’ psychosocial experiences following bariatric surgery and elucidate the individual-level factors that may drive variation in psychosocial outcomes. In addition to poor physical health, individuals with obesity are more likely to experience poor mental health [12,13,14] and social dysfunction secondary to factors such as weight-related stigmatization, discrimination, and poor body image [15,16,17]. Psychosocial changes occur following major weight loss after bariatric surgery [18]. In contrast to the predictable physical health benefits of major weight loss, psychosocial outcomes differ among patients and little is known about the individual-level experiences that may contribute to these variations.
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