Studies show that bariatric surgery, in combination with dietary and behavioral changes, is the most effective clinical intervention for patients with severe obesity. However, to maximize the benefits of the treatment, it is essential to take into account the bariatric patients’ experience, both pre- and post-surgery.
Holistic and long-term follow-up care that pays heed to the patient’s perspective is critical in this regard. Yet, the current guidelines mostly focus on surgical and metabolic outcomes and offer limited guidance on improving patients’ psychological and social wellbeing.
There are also very few long-term, randomized controlled trials on the subject. A recent study in the February 2020 volume of BMJ Open seeks to shed some light on the physical and psychosocial changes bariatric patients experience after surgery. Here is a summary of the researchers’ findings.
- Bariatric surgery can – and often does – have a multidimensional impact on patients’ lives.
- Unfortunately, not everyone’s post-surgery experience is positive.
- A well-thought-out, holistic, and long-term follow-up care program can help patients develop appropriate coping strategies and get the most value from their bariatric treatments.
What Are Some Common Experiences of Bariatric Patients Post-Surgery?
Bariatric surgery can affect all aspects of a patient’s life, including their physiology, mental health, lifestyle, and relationships.
Post-surgery, most bariatric patients report positive changes in their physical health, including significant weight loss, increased mobility and energy levels, improvement of symptoms such as joint pain, and reduced reliance on medications.
Some people, however, develop new health problems, such as:
- Brittle bones
- Cardiac issues
- Low blood pressure
- Menstrual problems
- Micronutrient deficiencies
Some of the patients interviewed for the BMJ Open study said that undergoing such a complex and difficult procedure only to replace one set of health implications with another has also had a markedly negative impact on their mental health.
Certain patients may also develop dumping syndrome (DS). DS is usually a desirable effect of surgery that produces instant gastric emptying by vomiting or diarrhea when the patient ingests too much or the wrong type of food. Sometimes, however, this can result in adverse side effects such as:
- Irregular heartbeat
- Gastrointestinal problems
- Food intolerances
- Poorly balanced diet
- Weight fluctuations
Bariatric surgery can have complex effects on patients’ mental health.
On the one hand, most patients report an improvement in their mobility levels and their ability to carry out daily activities, which can help them feel more independent, confident, and “normal.” Some people also experience an improved relationship with food post-surgery.
On the other hand, people with severe obesity are more likely to experience anxiety, depression, and disordered eating. Some patients struggle with body image issues after developing loose-hanging excess skin, or they may have a hard time switching to a healthier diet and creating new coping mechanisms to replace food. As a result, some go on to develop dependencies on alcohol or other substances.
A number of patients also report feeling “isolated” and “abandoned” by their healthcare providers. Some say their doctors ignored or did not handle their post-op complications properly, and many believe they did not receive enough guidance on adjusting to life after surgery in the long term.
Other factors that may contribute to the feelings of abandonment and isolation include long travel times to secondary care providers and receiving follow-up support only if the patient initiates the contact.
Some patients also feel that their primary care providers are not generally supportive of weight loss surgery and lack understanding of the long-term struggles of bariatric patients.
While many patients say they have received positive attention and compliments post-surgery, this may produce mixed emotions in some people who feel that their friends and family valued them less before their weight loss.
Unfortunately, some patients also become the targets of negative attention and new forms of social stigma and discrimination. This could be due to their changed looks (loose-hanging excess skin) or for having taken “the easy way out” instead of losing weight by exercising and eating clean.
Other patients report receiving negative attention from their families for eating smaller amounts of food. Some say they have experienced disruptions in their relationships and social life due to their “embarrassing” gastrointestinal symptoms.
5 Tips for Bariatric Journey Improvement
To improve your bariatric patients’ experience both pre- and post-surgery, consider the following strategies:
1. Provide Patients with the Right Information at the Right Time
The BMJ Open study shows that many patients do not believe their healthcare providers gave them enough information about adapting to life after the first few weeks post-surgery.
With this in mind, be sure to take the time to explain the long-term multidimensional impact of the treatment on the patient’s physical and mental health, relationships, and daily life. Discuss potential complications and side effects, strategies for developing better coping mechanisms, and tips for making exercise and a healthy diet a part of their daily life.
You may also share other patients’ testimonials and create informational materials for patients to read and watch in their own time similar to this video:
Preparing for Life After Bariatric Surgery
That said, you should also take care not to overwhelm patients with too much or too complex information. The key to success is providing them with the right information at the right time during their weight loss journeys.
2. Offer Open Appointments
To help your patients feel less abandoned and isolated, consider offering not just routine but also open post-surgery appointments. This can make follow-up care more flexible and accessible to some people. Moreover, research suggests a correlation between attendance at follow-up visits and better weight loss outcomes after surgery.
3. Maintain Direct Lines of Communication
Having at least one health professional available for patients to contact on an ad hoc basis can help reduce their sense of abandonment and isolation. This professional can be a physician as well as a nurse or specialist dietician. In addition, it is important to ensure that patients can contact your team via various contact methods, including by telephone, online, and face-to-face.
4. Refer Patients to Peer Support Groups
Peer groups can be a highly effective source of support. Yet, patient volunteers often run these groups with limited or no involvement from health professionals. Some patients also do not have access to or are unaware of such groups in their local areas.
To provide your bariatric patients with the best care possible, refer them to a peer support group as early in their treatment as possible. You may also consider getting involved with local groups to ensure that the information they disseminate is accurate and up to date.
5. Work with Patients’ Family Members
To better support your patients in developing mechanisms to cope with psychosocial challenges post-surgery, you should actively engage their family and close friends. Talk to them and provide them with detailed information about:
- Preoperative preparation
- Postoperative interventions
- The multidimensional impact of the surgery on a patient’s life
- Strategies to support someone going through a bariatric treatment
Bonus Tip: Use Technology to Improve Bariatric Patients’ Experience
Modern technological solutions like Wellbe’s Patient Enablement Platform allow you to create an automated guided workflow to actively engage patients at every stage of their weight loss journeys. This encourages them to be more proactive and helps them feel better informed and less isolated.
Click here to learn more and take the first step to improving your bariatric patients’ experience.