In a new study from Lund and Gothenburg universities, patients have been interviewed about their experiences 10 years after undergoing obesity surgery. In summary, it can be said that the effect on eating lasts, while other problems, such as a feeling of guilt over still not being healthy enough, remain.
– This is a few follow-ups that have been done so long after an obesity operation, says My Engström, researcher in nursing at the University of Gothenburg.
18 patients were interviewed in the study. All felt that their eating and appetite were still affected after the operation: the body still said no, which meant that they could not eat such large amounts, and the reduced craving for unhealthy food persisted. Several participants also mentioned that they were still more easily affected by alcohol and that this had consequences in social life.
But at the same time as the operation had entailed many changes, several described life with the operated body as the new normal or their new everyday life.
– Several said that one reason that they managed their new life with less stomach as well as they did was that they had been warned and expected more complications than they actually received, says My Engstrom. – This was interesting to hear because just over 70 percent of those we interviewed had actually had an event that the health service classified as a complication, such as malnutrition, abdominal pain, bile surgery or intestinal upset.
Continued struggling existence
Participants said they continued to struggle to manage their lives and weight after obesity surgery. Among other things, it was about how they would support their children who were also often overweight. Some of the parents said that they felt abandoned in the face of their children’s weight problems; they tried to guide in the best way, but found it difficult.
Several also spoke of physical activity as a constant bad conscience. They were well aware that they should move, but found no good way forward. As a reason, they cited pain or the personal history of always being the worst at physical activity.
– Even if the overweight was not great for a long time or constituted a real obstacle, the old self-image remained as an obstacle in the way, says My Engström.
Common to the patients interviewed was that they expressed great gratitude for the weight loss operation and for the society that had paid for it. Some participants blamed themselves when something did not work optimally and said that they were not “good patients”.
– The follow-up of those who undergo obesity surgery is often deficient and must be improved, says Kajsa Järvholm, researcher in psychology at Lund University. Patients should be called to a health center once a year, but this rarely works. Patients were expected to remember to contact primary care themselves instead of being called. Once they came in contact with the health center, they often experienced that the knowledge about obesity surgery was poor.
In summary, the researchers believe that the long-term follow-up of obesity operations must be better in both specialist and primary care.
– Those who encounter obesity surgeons in their work need both help to create realistic expectations of what the operation can change and take into account that many patients blame themselves and therefore hesitate to raise problems with their care provider, says Kajsa Järvholm. This process is facilitated if the caregivers have a non-judgmental attitude and take the time to ask the patients how they feel in their everyday lives.
Download the scientific article:
Patients´view of long-term results of bariatric surgery for superobesity: sustained effects but continuing struggles
Featured image: What was life like after the obesity operation? Photo: Mostphotos
Provided by Lund University