A Qualitative Exploration of Candidates’ Expectations and Preparations for Weight Loss Surgery in the NHS

Abstract

Introduction: Weight loss surgery is the primary intervention offered by the NHS for patients with morbid obesity and associated health conditions (Welbourn, Fiennes & Kinsman, 2014). There are relatively few studies looking at candidates’ experiences of this and only one since the implementation of NHS commissioning guidance (2013) for weight loss surgery pathways. This study therefore sought to explore this. It focused specifically on candidates’ experiences of pre-surgical assessment, their hopes for life after surgery and how they have prepared for this. Method: The study followed a qualitative design using a mixed inductive and deductive thematic analysis (Braun & Clark, 2006 & Boyatzis, 1998). Participants (N=11) were adults aged 18 or over, who were accessing weight loss surgery in a specialist NHS obesity service in the south of England. Semi-structured interviews were completed with participants to explore their experiences of their weight loss surgery journey so far. Results: Six overarching themes were identified capturing what participants’ decisions to pursue weight loss surgery were grounded in, their experiences of specialist obesity services, their conceptualization of weight loss surgery, their hopes and expectations for life after surgery, the roles of family and friends within their weight loss surgery journey, and finally, participants’ plans and preparations for life thereafter. Discussion: The results highlighted the additional hopes which candidates hold for weight loss surgery, beyond weight loss and improvements in physical health. The complex nature of participants’ relationship with themselves, eating and weight was illustrated and how this impacts expectations and subsequent preparation for surgery. The clinical and theoretical implications are discussed, as well as future directions for research in this area.