JMIR Publications

Background:

Morbid obesity (body mass index >40) has increased worldwide. The only long-term effective treatment for morbid obesity is bariatric surgery, with Roux-en-Y gastric bypass (RYGB) being the most commonly used, typically resulting in about 25% weight loss. Previous research shows that patients often have unrealistic expectations of surgery. The Internet is now the most widely-used source of healthcare information, and studies show that most RYGB patients have accessed information about the procedure online and wish to come into contact with others who have had the surgery. It has also been shown that many patients have unrealistic expectations about the surgery, despite being given accurate information by healthcare staff.

Objective:

The aim of the present study was to describe shared values, feelings, and thoughts among forum posters visiting a web-based forum for those considering and/or undergoing bariatric surgery.

Methods:

The study was conducted as a cross-sectional observation study using qualitative contents analysis. The material consisted of an online discussion forum thread about bariatric surgery, with 498 posts. These were copied into a separate document, read and re-read in a familiarization process. Data was then coded into meaningful sections and grouped into categories, illustrated with suitable excerpts.

Results:

The following categories emerged from the analysis: a new life - anticipating dramatic changes of body and mind; b) negotiating the system and playing the waiting game; c) a means to an end - managing the pre-operative diet; and d) managing the attitudes of others. The results showed that many posters described the process of bariatric surgery as a journey, riddled with roadblocks, setbacks and trials, but also with joy and great expectations of a new and better life. They struggled with the pre-operative weight loss diet, and many feared negative comments from their surroundings, but the posters provided constant emotional support, information and encouragement to each other in the discussion forum.

Conclusions:

The results show that the process of making a decision to undergo surgery, and navigating the healthcare system, the preoperative preparations and the reactions of friends and family, can be seen as a journey. As such, it is a process wraught with roadblocks, setbacks and struggles, during which the forum posters provide practical, emotional and social support for each other. Professionals who encounter this group should be aware of their need for support throughout the process, and investigate the possibility of both pre- and postoperative support groups, either online or face-to-face.