Abstract

Compared with literature on weight loss and comorbidity improvement, there is a paucity of
information on the patient-reported experiences of adjusting to life after bariatric surgery.
Between 2011 and 2013, nearly 17,000 procedures were performed in the UK, with gastric
bypass comprising 55% of the operations. Clearly, there are an increasing number of people
living with bariatric surgical procedures, with the majority of these irreversible.
A systematic literature review was undertaken to identify post-surgical qualitative literature
from the patient perspective between 2000 – 2016. 18 studies met the inclusion criteria.
Findings showed that the majority of patients frame their post-surgical experiences within a
pre- and post-surgical life, drawing comparisons between the two. Bariatric surgery was
described as a ‘second chance’, ‘last resort’, ‘being rescued’ and a ‘rebirth’ by many
participants. Core themes of ‘transformation’ and ‘control’ were identified, largely centred
around living with bodily changes and learning to deal with new eating habits. The majority
of participants felt that although their problems around obesity were resolved, bariatric
surgery introduced new problems to be dealt with, which were negotiated through trial and
error.
The rapid change to physical appearance and different eating habits often invited attention,
which was not always welcomed. Many participants were not comfortable disclosing
surgery as their methods of weight loss, as this could lead to negative comments, with
reported accusations of ‘cheating’ and ‘taking the easy way out’ . Fear of being judged
appeared to be linked to previous stigmatisation of the previous obese state, which
reinforces the pre and post-surgical dichotomy.
Overall, participants reported bariatric surgery as a positive experience, and that problems
were expected as part of the surgically-imposed changes. Life after bariatric surgery is a
complex process, and the social aspects need to be further researched as more people
undergo weight loss surgery.