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BMC Obes. 2018 Dec 3;5:38. doi: 10.1186/s40608-018-0215-3. eCollection 2018.

Understanding the psychosocial impact of weight loss following bariatric surgery: a qualitative study.

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Ann Arbor VA Health System, Ann Arbor, MI USA.
2Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, Building 16, Room 16-278C, Ann Arbor, MI 48109-2800 USA.
3Department of Surgery, University of Michigan, Ann Arbor, MI USA.
4Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, MI USA.
Contributed equally



Bariatric surgery leads to changes in mental health, quality of life and social functioning, yet these outcomes differ among individuals. In this study, we explore patients' psychosocial experiences following bariatric surgery and elucidate the individual-level factors that may drive variation in psychosocial outcomes.


Eleven semi-structured focus groups with Michigan Bariatric Surgery Collaborative (MBSC) patients (n = 77). Interviews were audio recorded, transcribed verbatim, and analyzed using a grounded theory approach. Data on participant demographic characteristics were abstracted from the MBSC clinical registry.


Most focus group participants were female (89%), white (64%), and married (65%). We identified three major themes: (1) change in self-perception; (2) change in perception by others; and (3) change in relationships. Each theme includes 3 sub-themes, demonstrating a range of positive and negative psychosocial experiences. For example, weight loss led to increased self-confidence among many participants while others described a loss of self-identity. Some noted improved relationships with family or friends while others experienced worsening or even loss of relationships due to perceived jealousy.


Weight loss following bariatric surgery leads to complex changes in self-perception and inter-personal relationships, which may be proximal mediators of commonly assessed mental health outcomes such as depression. Individuals considering bariatric surgery may benefit from anticipatory guidance about these diverse experiences, and post-surgical longitudinal monitoring should include evaluation for adverse psychosocial events.


Obesity; Psychosocial; Weight loss surgery

Conflict of interest statement

This study was approved by the University of Michigan Institutional Review Board. All participants signed an informed consent document.Not applicable.None.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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