‘The only chance of a normal weight life’: A qualitative analysis of online forum discussions about bariatric surgery

• Published in: PloS one Vol. 13; no. 10; p. e0206066
• Main Authors: Willmer, Mikaela, Salzmann-Erikson, Martin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 25.10.2018; Public Library of Science (PLoS)
• Subjects: adult; Anxieties; Anxiety; Bariatric surgery; Biology and Life Sciences; Body mass index; body weight; Body weight loss; Care and treatment; Clinical trials; Computer and Information Sciences; controlled study; Data analysis; Data processing; Diabetes; diet; Ethics; expectation; Families & family life; female; Gastric bypass; Gastrointestinal surgery; human; Human subjects; inget Strategiskt forskningsområde (SFO); Internet; interpersonal communication; male; Medicine and Health Sciences; Mental depression; Mental disorders; Methods; no Strategic Research Area (SFO); Obesity; observational study; Patients; preoperative evaluation; Qualitative analysis; Qualitative research; Quality of life; Risk factors; Social Sciences; Studies; Suicide bombings; support group; Support groups; Surgery; Systematic review; Weight control; Weight loss; Sweden
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0206066

The only effective weight loss treatment for severe obesity is bariatric surgery, with Roux-en-Y gastric bypass being the most common method. Patients often have unrealistic expectations of surgery and expect a "miracle cure" even though the procedure requires major lifelong lifestyle changes. Most patients access information about the procedure online, and come into contact with others who have had the surgery. The objective of this study was to describe shared values, feelings, and thoughts among visitors to a web-based forum for those undergoing bariatric surgery. In this cross-sectional observation study using qualitative contents analysis, the material consisted of an online discussion forum thread about bariatric surgery, with 498 posts. These were saved in a document, read and re-read. Through coding of meaningful units of text, themes were established. Four themes were constructed during data analysis: a) A new life-anticipating dramatic changes of body and mind; b) Negotiating the system and playing the waiting game; c) A means to an end-managing the pre-operative diet; and d) Managing the attitudes of others. Posters described the process of bariatric surgery as a journey, riddled with roadblocks, setbacks and trials, but also with joy and expectations of a new life. Professionals who encounter this group should be aware of their need for support throughout the process, and investigate the possibility of both pre- and postoperative support groups, either online or face-to-face. The results also show that the posters on the forum had very high, and often unrealistic, expectations on how the surgery would change their lives. It is important for those who encounter this group before surgery to be aware of this tendency and to take measures to ensure that patients undergo the surgery with realistic expectations.