Experiences and Perspectives of Racially Diverse Patients 5 Years Post-Bariatric Surgery: Qualitative Findings from the BELONG II Study.

Introduction: Severe obesity and associated negative outcomes have increased in prevalence in America. Furthermore, people who identify as African American/Black (Black), Hispanic/Latine (Hispanic), Native Hawaiian/Pacific Islander (HPI), or American Indian/Alaskan Native (AIAN) suffer disproportionate impacts from obesity. Bariatric surgery is one of the most effective treatments for severe obesity. However, many patients with diverse ethnic backgrounds are less likely to receive bariatric surgery compared to their White counterparts, and when they do, they may have less weight loss and higher complication rates. This study seeks to describe the experiences of patients an average of 5 years after bariatric surgery.

Methods: Semi-structured qualitative interviews were conducted between September 2021 and March 2022 with participants who received bariatric surgery within a large integrated health system. Interviews aimed to understand the perspectives of patients from diverse racial and ethnic backgrounds regarding weight loss and regain. Interviews were audio-recorded and transcribed for thematic analysis.

Results: A total of 68 interviews were collected; 29% self-identified as Black, 29% as Hispanic, 15% as HPI or AIAN, and 27% as White; 53% were identified as women. In general, the experiences of the patients in this sample were very similar, with few differences between racial and ethnic groups. However, Black, Hispanic, HPI, and AIAN participants were more likely than White participants to express concerns about losing too much weight.

Discussion: This study highlights important implications for practice. Culturally relevant patient goals regarding weight loss should be incorporated into shared decision-making, and follow-up support should extend several years after surgery.