Patients' strategies for eating after gastric bypass surgery: a qualitative study

There is considerable variation in the amount of weight patients lose after gastric bypass surgery, and this may be related to the way they adjust to the operation in their daily eating practices. Little is known about how this varies. On the basis of a qualitative research design, this study therefore explores how patients deal with gastric bypass surgery in their daily lives.

The study is based on interviews with 24 men and women in Denmark diagnosed with morbid obesity who have had, Roux-en-Y gastric bypass surgery. The interviews were transcribed, coded and analysed using 'grounded theory' methodology.

Three strategies used by patients to cope with postoperative changes were identified. In the first strategy, patients treat surgery as time-out, using the operation to facilitate a change in their ordinary habits of daily life, but not as a solution to overweight in itself. Patients adopting the second strategy of surgery as solution would expect their smaller stomach to hinder excess food intake automatically. The third strategy of abstaining was adopted by patients who were afraid to experience negative side effects, or who believed they might 'ruin the operation'.

Patients adjust to their postoperative condition in very different ways. The variation in the ways patients comprehend and cope with the operation and in its effects on their eating routines and practices needs to be further investigated and compared more systematically with the outcomes of the operation in terms of weight loss and overall well-being.