An exploration of psychological support throughout the bariatric surgery journey : expectations versus reality

Rowland, Hannah and Staniford, Leanne and Charsley, Jo (2025) An exploration of psychological support throughout the bariatric surgery journey : expectations versus reality. PhD thesis, Lancaster University.

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Abstract

This thesis explored individuals’ experiences following bariatric surgery and consists of a systemic literature review, empirical paper and critical appraisal. The systematic literature review used a meta-ethnographic approach to synthesis the data from 11 qualitative studies, which explored the experiences described by individuals who reported or engaged in disordered or non-normative restrictive eating behaviours following bariatric surgery. Four themes were generated: ‘When monitoring becomes compulsion,’ ‘Striving for success: The burden of fear,’ ‘A fragmented self: The emotional toll of surgery,’ and ‘Scrutinised and isolated: The social cost of transformation.’ The clinical implications of the synthesised data is explored within this paper. The empirical paper aimed to explore individuals’ experiences of recovery and psychological support at least three years post-surgery, to explore the longer-term psychological implications of bariatric surgery and the potential psychological support that could be helpful. Qualitative data from six semi-structured interviews was analysed utilising reflexive thematic analysis. Six themes were generated: ‘Are individuals actually providing informed consent? The role of unrealistic expectations and insufficient communication’, ‘navigating bariatric surgery recovery, it’s not an “easy way out”’, ‘the conveyor belt of inadequate support’, ‘the psychological impact of surgery, a life-long and profound struggle’, ‘the crucial role of a bariatric psychologist in navigating recovery’ and ‘recommendations for a holistic bariatric surgery support pathway’. The clinical implications of the experiences shared are discussed within this paper. The final paper is a critical appraisal of the above papers, where comparisons are made between the findings from the systemic literature view and empirical paper. Reflections are provided surrounding the research and decision making process, alongside a critical analysis of the research project. Recommendations for future research are explored.