'What's the point in extending your life if this is your life': A qualitative exploration of pre-surgery, short-term and long-term responses to bariatric surgery

This study examined experiences of weight, physical activity, diet, and quality of life of individuals prior to and following bariatric surgery. Twenty-seven people participated who represented three periods related to bariatric surgery: pre-surgery; short-term post-surgery (i.e., 1-2 years) and long-term post-surgery (i.e., 3-7 years). A qualitative descriptive design was adopted, with data collected through interviews and analysed using thematic analysis. Themes in the pre-surgery period were identified as follows: a) Growing up: Variation by family and ability, b) Weight gain: Transitions, traumas, and triggers; c) Perceptions of self: Hate, loathing, and worthlessness; d) Spiralling weight: Lack of control over vicious cycles of dieting and weight gain, and; e) Surgery: A final and essential lifeline. Short-term post-surgery themes were: a) Physical changes: Rapid weight loss and enhanced health versus hesitation and disappointment; b) Physical activity: Changes in engagement and perceptions despite ongoing barriers; c) Finding oneself: Increased emotional wellbeing, self-concept and confidence, and; d) Quality of life: Renewed physical capabilities and capacity but some continuing challenges. In the long-term following surgery, themes of: a) Weight plateau/regain: Disappointment and feelings of failure, and; b) Excess fat: Frustration and feelings of vulnerability emerged from the data. It is evident that participants go on an extended journey in the years before and after bariatric surgery and experience a range of both positive and negative outcomes. Overall, the findings highlight the importance of practitioners understanding individual's overall journeys when seeking to help them lose weight and improve psychological health.