Background: Bariatric surgery is the most effective treatment for patients with obesity and type 2 diabetes (T2DM), inducing profound metabolic changes associated with improvements in glycaemic control. In spite of the recognition of the physiological changes associated with bariatric surgery, what remains underappreciated is the patient experience of surgery to treat T2DM. Objectives: This study explored the patient experience with regard to motivations, expectations and outcomes, including remission and relapse of diabetes. Methods: An in-depth qualitative approach was adopted, encompassing semi-structured interviews with patients (n=17) living with obesity and T2DM both pre- and postsurgery. Interpretive thematic analysis identified emergent themes using a grounded approach. Results: Analysis revealed a number of themes throughout the interviews which included motivations and perceived benefits of surgery, obesity stigma and its impact on self-worth as well as perceptions of remission or relapse and the implications for sense of control. Conclusions: The motivation for undergoing bariatric surgery was driven by health concerns, namely T2DM and the desire to reduce the risk of developing diabetes-related complications. Patients highlighted social and self-stigmatisation associated with obesity and T2DM, leading to feelings of shame and an inability to seek support from family or healthcare professionals. Stigmatisation created a sense of failure and feeling of guilt for having T2DM. As a result, patients felt responsible for maintaining disease remission postoperatively and regarded the need for medication as a sign of treatment failure.
Bibliographical noteFunding Information:
Author Carel W le Roux reports receiving honoraria from NovoNordisk, EliLily, Johnson and Johnson, Sanofi Aventis, Astra Zenica, Janssen, Bristol-Meyers Squibb, Boehringer-Ingelheim, and a research grant from AnaBio and is a shareholder in Keyron. CWlR is also on the advisory board for NovoNordisk and GI Dynamics.
Open Access funding provided by the IReL Consortium. Alexis Sudlow has received a Royal College of Surgeons (England) Research Fellowship grant to support this research.
© 2021, The Author(s).
- Bariatric surgery
- Patient-centred care
- Type 2 diabetes mellitus