Increasing Accessibility to Metabolic Bariatric Surgery: A Qualitative Study Based on In-Depth Interviews of Korean Adult Patients With Severe Obesity

J Metab Bariatr Surg. 2023 Dec;12(2):44-56. doi: 10.17476/jmbs.2023.12.2.44. Epub 2023 Nov 28.

Abstract

Purpose: After the initiation of national health insurance coverage in 2019, the number of metabolic bariatric surgeries (MBSs) in Korea has been increasing. Despite evidence regarding its efficacy, many candidates are hesitant regarding surgery for the treatment of severe obesity. This study interviewed patients who received MBS to further understand potential barriers and increase the accessibility of MBS.

Materials and methods: Eight interviewees who received MBS after 2019 participated. The interviews began in mid-July 2022 over approximately a month. Each one-on-one interview lasted a few hours and was done in person. The interviews were transcribed, and the results were analyzed based on grounded theory.

Results: This study focused on the quality of life before and after MBS. On a scale of 1 to 10, all patients had a high degree of satisfaction in quality of life after surgery (average score: 8.9, sleeve gastrectomy: 8.8, and bypass surgery: 9). Scores did not differ depending on procedure type, but factors that caused satisfaction and dissatisfaction were distributed differently between the 2 procedures.

Conclusion: Quality of life is significantly improved for patients undergoing MBS despite discomfort after surgery. Further promotion of the understanding of obesity as a chronic progressive disease is needed for both surgical candidates and the public to increase acceptance of MBS.

Keywords: Bariatric surgery; Metabolic surgery; Qualitative research; Quality of life; Roux-en-Y gastric bypass.