Patient experiences of weight loss and eating after bariatric surgery: A systematic review and qualitative synthesis.

BACKGROUND

An estimated 26% of men and 29% of women in the UK are living with obesity according to recent statistics. Bariatric surgery can induce significant weight loss and improve comorbidity status. However, previous studies highlight challenges in maintaining dietary changes and weight loss. This systematic review aimed to investigate patient experiences of weight loss and eating in the first 2 years following surgery, as well as provide clinical recommendations to support this group.

METHODS

Ethical approval was granted by the University. A systematic search was conducted in four databases. Studies were selected according to the predefined eligibility criteria and methodological quality, assessed via the Critical Appraisal Skills Program (CASP) tool. Data were extracted and analysed using a thematic synthesis method. Rigour was enhanced via use of a data extraction tool, a validated method for data synthesis, peer review and transparent reporting.

RESULTS

In total, 507 records were screened; nine studies met the inclusion criteria. The thematic synthesis yielded four, interlinked analytical themes based on the experiences of 154 patients: relationship with food, relationship with oneself, relationship with others and unfinished journey. Positive experiences were reported including development of healthy eating behaviours and significant weight loss, improving physical and psychosocial wellbeing. On the other hand, challenges in adjusting to life after surgery were also reported.

CONCLUSIONS

The present study highlights the need for personalised dietary advice, addressing the psychological aspects of eating. Support should be extended to the family. Ongoing psychological support must be incorporated in the postsurgery care pathway to help patients deal with the negative outcomes of surgery such as excess skin.

© 2022 British Dietetic Association.