Abstract

Bariatric surgery is becoming an increasingly common intervention for the management of adult obesity. Bariatric surgery is usually recommended after a person with obesity has unsuccessfully attempted to lose weight through other methods such as diet and exercise. Surgery offers rapid and sustained weight loss, improves obesity-related illnesses and makes significant changes to a person’s appearance and eating habits. As a result, bariatric surgery has a significant impact on a person’s life, especially everyday social situations, which require a period of adjustment. The aim of this thesis was to explore how people adjust their lives in the first two years following bariatric surgery.

Constructivist grounded theory was used to establish mutual reciprocity between participants and myself to illuminate their experiences, whilst acknowledging my position as researcher at all times. Symbolic interactionism allowed an in-depth exploration of the meanings and actions of the participants. Semi-structured interviews were conducted with participants who had undergone bariatric surgery at City Hospitals Sunderland NHS Foundation Trust within two years of the time of interview. Eighteen participants were interviewed between January 2014 and April 2015.

The findings showed that participants conceptualised the adjustment process as underpinned by risk. Many of these risks were centred on social situations and encounters and participants’ attitudes towards risk and the meaning of risk underpinned their subsequent actions. The risk attitudes were underpinned by the meanings and actions of how participants handled social interactions as a result of learning to live with new ways of eating, a changed physical appearance and social interactions. Three risk attitude profiles were constructed from the data: Risk Accepters, Risk Contenders and Risk Challengers.

The act of choosing whether to disclose having bariatric surgery was particularly meaningful to the participants and highlighted a theme of feeling judged by others, which many participants sought to avoid. The findings also showed that participants felt that the social aspects of life after bariatric surgery were not widely understood by the public and healthcare professionals. This theory is a co-construction between the participants and me.

As rates of bariatric surgery increase, understanding patients’ experiences of adjusting to life after bariatric surgery will assist patients to prepare for post-surgical life and healthcare practitioners to further support patients during this time.