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Psychosocial impact of bariatric surgery

Psychosocial impact of weight loss following bariatric surgery

Study participants reported three major elements: self-perception; perception by others; and social relationships

Patients considering bariatric surgery may benefit from anticipatory guidance regarding possible complex changes in self-perception and inter-personal relationships following surgery, according to a study by researchers from the University of Michigan. These changes may be proximal mediators of commonly assessed mental health outcomes such as depression, therefore, post-surgical longitudinal monitoring should include evaluation for adverse psychosocial events.

The paper, ‘Understanding the psychosocial impact of weight loss following bariatric surgery: a qualitative study’, published in BMC Obesity, explored patients’ psychosocial experiences following bariatric surgery and elucidate the individual-level factors that may drive variation in psychosocial outcomes.

For the study, the researchers conducted 11 semi-structured focus groups with 77 US adults who underwent bariatric surgery four hospitals affiliated with the Michigan Bariatric Surgery Collaborative (MBSC), and they characterised the patient-level experiences that may drive differences in psychosocial outcomes after major weight loss.

Data were abstracted from the MBSC clinical registry for each focus group participant including age, gender, race, date of operation, procedure type (e.g. adjustable gastric band, sleeve gastrectomy, and Roux-en-y gastric bypass, or duodenal switch), marital status, education level, employment status, approximate annual income and estimate weight loss. Four members of the research team, including a bariatric surgeon (AG), a primary care physician (DG), a surgical resident (AI), and non-physician with a Master’s in Public Health (NF), independently reviewed a subset of transcripts.

The mean age of all participants was 48.8 years (range 26 to 72), most (n=69; 89%) were female, white (n=50; 65%), and married (n=49; 64%). Overall, study participants reported three major elements: self-perception; perception by others; and social relationships. Each element included includes positive and negative experiences that were often interrelated and experienced simultaneously by patients. The experiences described by participants could help to explain the differences observed in recent quantitative studies examining the psychosocial impact of weight loss after bariatric surgery.

“By understanding these lived experiences, providers may be better equipped to ascertain and address factors that may contribute to psychosocial dysfunction. Prior to surgery, patients and providers may engage in a more personalized discussion of potential psychosocial risks and benefits of surgery, and anticipatory guidance may be better tailored to the patient’s unique circumstances,” the authors conclude. “Post-operatively, bariatric surgery teams and primary care providers may more effectively elicit and address psychosocial struggles by discussing patients’ changes in self-perception and relationships with others. As rates of severe obesity and surgical treatment for the condition continue to rise, these steps are critical to optimise psychosocial functioning among patients who consider and undergo weight loss surgery.”

To access this paper, please click here

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