Commitment or miracle?

Objective: Bariatric surgery has been indicated as an election treatment for morbid obesity although research has been controversial about the success of this procedure. This study tries to understand the factors contributing to the success and failure of bariatric surgery, comparing the expectations before surgery and the meaning assigned to this treatment, one year after bariatric surgery.
Method: 30 semi-structured interviews were carried out at the surgery moment and at 12 months follow-up and were analyzed through the Grounded Theory procedure.
Results: Before surgery, realistic expectations and perceptions of the process requirements seem to be fundamental to the commitment with the treatment and subsequent success of this intervention. Likewise, lifestyle changes and use of adequate coping strategies are important dimensions associated with success. On the other hand, in the failure cases, the presence of unrealistic expectations of weight loss and lack of awareness of the difficulties and requirements of the process are associated to the perception of the surgery as a miracle. Expectations about the treatment process are a central theme in the success and failure speeches, although the participants put themselves in the opposite poles of these categories. The presence of realistic expectations and awareness of the demands appear to contribute to the commitment and success of treatment. The failure, in turn, is associated with lack of commitment that does not allow the required lifestyle change and the expectation of a new miracle that would solve all the problems remains.
Conclusions: These results emphasize the need to rethink the whole process of bariatric surgery, reinforcing the importance of an evaluation that includes the beliefs, expectations and information, and psychological intervention before and after bariatric surgery.
Fundação para a Ciência e a Tecnologia (FCT)
Grant SFRH/BD/37069/2007