Purpose. Obesity has reached epidemic proportions in the U.S. and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the psychosocial impacts of surgery. The purpose of this study was to explore experiences of patients who have undergone bariatric surgery at least two years before to gain an understanding of the successes and challenges they have faced since surgery. Methods. This study used a phenomenological approach, to investigate the meaning and essence of bariatric patients with food after surgery. Semi-structured interviews were conducted on a sample of nine participants who had undergone surgery at least two years prior. Findings. Two main themes regarding food intake emerged from the data: (a) food after the first year post-surgery and (b) bariatric surgery is not a magic pill. Upon further analysis, food after the first year post-surgery had four subthemes emerge: diet adherence after the first year post-surgery, food intolerances, amount of food, and tendencies toward coping with food do not magically disappear. Conclusion. Findings revealed that post-operative diet and exercise adherence becomes increasingly difficult as weight loss slows. Many participants find that only after the first year after surgery the work really begins. 1. Introduction/Purpose Obesity is now a global public health issue and has nearly doubled worldwide since 1980 [1]. Global obesity estimates from 2008 reported that 35% of adults over the age of 20 were overweight and 11% were considered obese [1]. In addition, obesity rates continue to rise and remain epidemic in the United Sates, as well. More than two-thirds of American adults (68.8%) are considered overweight or obese and more than one-third (35.7%) of adults are obese, constituting more than 78 million American men and women [2]. Individuals who are considered morbidly, or clinically severely, obese (those with BMI of 35 in addition to documented health problems or those with a BMI over 40) are considered potential candidates for bariatric surgery [3]. Individuals elect to undergo bariatric surgery hoping to achieve long-term weight loss and to improve obesity-related comorbid conditions [4]. In 2008, nearly 350,000 bariatric procedures were performed globally [5], with an estimated 220,000 in the United States alone [6]. However, questions still arise on long-term success and its effect on weight loss maintenance and prevention of the return of lifestyle diseases [4, 7]. Previous research indicated that, about a year and a half to two years after
References
[1]
World Health Organization (WHO), “Overweight and obesity,” 2013, http://www.who.int/gho/ncd/risk_factors/overweight/en/index.html.
[2]
K. M. Flegal, D. Carroll, B. K. Kit, and C. L. Ogden, “Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010,” The Journal of the American Medical Association, vol. 307, no. 5, pp. 491–497, 2012.
[3]
National Institutes of Health, “Obesity,” 2012, http://www.nlm.nih.gov/medlineplus/obesity.html.
[4]
H. Buchwald, Y. Avidor, E. Braunwald et al., “Bariatric surgery: a systematic review and meta-analysis,” The Journal of the American Medical Association, vol. 292, no. 14, pp. 1724–1728, 2004.
[5]
H. Buchwald and D. M. Oien, “Metabolic/bariatric surgery worldwide 2008,” Obesity Surgery, vol. 19, no. 12, pp. 1605–1611, 2009.
[6]
American Society for Metabolic and Bariatric Surgery, “Benefits of bariatric surgery,” 2013.
[7]
R. H. Freire, M. C. Borges, J. I. Alvarez-Leite, and M. I. T. D. Correia, “Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass,” Nutrition, vol. 28, no. 1, pp. 53–58, 2012.
[8]
S. H. Niego, M. D. Kofman, J. J. Weiss, and A. Geliebter, “Binge eating in the bariatric surgery population: a review of the literature,” International Journal of Eating Disorders, vol. 40, no. 4, pp. 349–359, 2007.
[9]
D. G. Hays and A. A. Singh, Qualitative Inquiry in Clinical and Educational Settings, The Guilford Press, New York, NY, USA, 2011.
[10]
D. G. Hays and C. Wood, “Infusing qualitative traditions in counseling research designs,” Journal of Counseling and Development, vol. 89, no. 3, pp. 288–295, 2011.
[11]
G. B. Rossman and S. F. Rallis, Learning in the Field, Sage, Thousand Oaks, Calif, USA, 2003.
[12]
M. M. McMahon, M. G. Sarr, M. M. Clark et al., “Clinical management after bariatric surgery: value of a multidisciplinary approach,” Mayo Clinic Proceedings, vol. 81, no. 10, supplement, pp. S34–S45, 2006.
[13]
L. Rickers and C. McSherry, “Bariatric surgery: nutritional considerations for patients,” Nursing Standard, vol. 26, no. 49, pp. 41–48, 2012.
[14]
L. E. Bocchieri, M. Meana, and B. L. Fisher, “A review of psychosocial outcomes of surgery for morbid obesity,” Journal of Psychosomatic Research, vol. 52, no. 3, pp. 155–165, 2002.
[15]
R. J. Presutti, R. S. Gorman, and J. M. Swain, “Primary care perspective on bariatric surgery,” Mayo Clinic Proceedings, vol. 79, no. 9, pp. 1158–1166, 2004.
[16]
L. Dalcanale, C. P. M. S. Oliveira, J. Faintuch et al., “Long-term nutritional outcome after gastric bypass,” Obesity Surgery, vol. 20, no. 2, pp. 181–187, 2010.
[17]
V. G. Villagra, “A primer on bariatric surgery: treatment of last resort for morbid obesity,” Disease Management, vol. 7, supplement 1, pp. S23–S30, 2004.
[18]
J. Ogden, S. Avenell, and G. Ellis, “Negotiating control: patients' experiences of unsuccessful weight-loss surgery,” Psychology and Health, vol. 26, no. 7, pp. 949–964, 2011.
[19]
L. E. Bocchieri, M. Meana, and B. L. Fisher, “Perceived psychosocial outcomes of gastric bypass surgery: a qualitative study,” Obesity Surgery, vol. 12, no. 6, pp. 781–788, 2002.
[20]
V. S. Elliott, “Bariatric surgery patients need care for a lifetime,” 2004, http://www.ama-assn.org/amednews/2004/06/28/hlsa0628.htm.
