Long term patient perspectives following all types of bariatric surgery: A 19-year follow-up study

Bariatric surgery effectively treats severe obesity. However, long-term data on weight maintenance and patient well-being remain scarce. This study assessed patients' perspectives on their bariatric trajectory and outcomes of their historical and current status across multiple domains, irrespective of surgical procedure.

A retrospective cohort study was conducted among patients who were referred to the Department of Medical Psychology for bariatric screening between 1998 and 2004. Of the 547 referred patients, eligible participants received a survey after informed consent addressing weight outcomes, current eating patterns, dietary guidelines adherence, expectation fulfillment, satisfaction, and peer advice.

Sixty-two participants completed survey. Mean postoperative time since the initial surgery was 19 years (range 6-27). Mean preoperative weight decreased 33%, from 144.2 to 97.5 kg. Preoperative Body Mass Index decreased from 50.3 to 34.0 kg/m². Healthy postoperative behaviors included regular meals, portion control and control regarding snacking between meals. Unhealthy behaviors included evening snacking, alcohol consumption and binge eating. One third reported using vitamins never or sometimes. Participants reported diverse encountered barriers regarding eating, drinking, physical and psychological health and social functioning. Most would choose surgery again except those with expectation-outcome discrepancies or ongoing weight instability. Peer advice emphasized comprehensive preoperative education on all potential postoperative consequences from multiple sources.

After 19 years, weight loss, healthy eating and adherence to advice varied, yet most participants were satisfied regardless of weight loss or reoperation. We plea for lifelong follow-up care to optimize bariatric results regardless type of surgery.