Exploring the impact of obesity surgery on patients' health status: a quantitative and qualitative study.
BACKGROUND
Obesity surgery has been shown to result not only in sustained weight loss, but also in improvements in psychological morbidity and quality of life. The present study aimed to explore the mechanisms behind the success of surgery and to examine how it might bring about such changes in patients' health status.


METHODS
Both quantitative and qualitative methods were used. A questionnaire was completed by patients who had undergone bariatric surgery in the past 4 years (n=22) and a matched-group of waiting list controls (n=39). In depth interviews were then carried out with 15 surgical patients.


RESULTS
The quantitative study showed that the surgical group weighed less, had more negative experiences of eating and yet reported improved subjective health status using a range of validated tools. The qualitative study provided some insights into this improved health status, with the surgical patients reporting improved energy and self-esteem. The patients also reported a fundamental shift in their relationship with food. In particular, they described changes in their eating behavior and stated that they had a new experience of fullness and a reduction in their hunger. Furthermore, they described how food now had a reduced role in their lives and that the operation had made them feel more in control of their food intake.


CONCLUSIONS
Post-surgical improvements in health status may not only be a result of the non-specific consequences of surgery brought about by weight loss, but also a result of the specific impact of the surgical procedure itself. By enforcing a reduction in the amount of food that can be eaten, restrictive surgery seems to generate changes in the individuals' relationship to food and may help to re-establish a perception of control over eating behavior.
Ogden
Jane
J
Kings College London, London, UK. J.Ogden@surrey.ac.uk
Clementi
Cecilia
C
Aylwin
Simon
S
Patel
Ameet
A
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015431:Weight Loss