Becoming ex-obese: narrations about identity changes before and after the experience of the bariatric surgery

Abstract

Aims and objectives: This exploratory research investigates obese patients' beliefs and expectations before and one year after bariatric surgery. Changes and resistance to change in the identity system, in the perception of the body, in relationships and in the quality of life were of particular interest.

Background: Although bariatric surgery represents a promising treatment for obesity, nevertheless, it is still under utilised. This may be because, either the intervention is not always easily accessible or because very little is known about its psychological implications.

Design: Open answers provided by participants were analysed through discourse analysis.

Methods: A semi-structured interview about the exchanges in self-representations through time was administered to 30 Italian women, 15 of whom were obese before surgery and 15 were ex-obese, one year after surgery.

Results: The research shows that those participants who have already been operated on are generally satisfied with the results obtained; however, they faced considerable difficulties in adapting their identity to their new body. Participants reported that even one year after surgery they still thought, behaved and related to others as though they were still obese, and only after a change in awareness did they become able to realise they are now ex-obese.

Conclusions: This paper contributes to the understanding of the unrealistic expectations of patients before surgery compared with the real changes in their lives, as well the difficulties they still faced one year later. More studies in evaluating how bariatric patients live with this long-term condition are recommended to foster patient-centered care.

Relevance to clinical practice: Health professionals should also help people to face the difficulties of the postsurgery period, which are linked to the acceptance of the new body and of the new emerging self-image in relationships with others.

Keywords: narrative; obesity surgery; postoperative care; psychological well-being; qualitative approaches.