Experiences of food and relationships after bariatric surgery: an interpretative phenomenological analysis

Introduction: Two particular areas which appear to create psycho-social tension following bariatric surgery are changes to food use and relationship dynamics. Food and eating are known to play significant roles within interpersonal relationships; however such roles after surgery are largely underreported. This study therefore aimed to explore participants’ experiences of the roles of food and eating within the context of their interpersonal relationships, following bariatric surgery, along with how people might manage these experiences.
Method: A qualitative design was used, comprising semi-structured interviews with a homogenous sample of seven adult participants, recruited from a local bariatric support group. Interviews were recorded, transcribed verbatim and analysed using an Interpretive Phenomenological Analysis (IPA), in order to generate themes based on participants’ lived experience.
Results: There were three overarching master themes that emerged following the analysis of data: ‘Disruption to usual social eating’, ‘Food as a creator of conflict’ and ‘Food as a connector’. Disruption to usual social eating was characterised by a sense of embarrassment due to physical illness after eating. Such disruptions acted as a cue for change, with some embracing this and others resisting it. Either way there was a sense that participants tried to make the best of their new situation in a way that worked for them. The second and third master themes of conflict and connection existed on a continuum and were dependent upon the impact of and reactions to disruption. Hence, food could assume the role of being a source of conflict or a connector within relationships. Tools which seemed particularly important for managing experiences linked to this continuum were showing pride in the changes, facilitating communication through the use of humour and using food as a gift.
Discussion: The findings were consistent with literature around food being closely linked to emotion and a source of maintaining identities/social bonds. Prior to surgery it may be useful for services to offer systemic assessments for prospective patients and significant others, so that the disruption to social eating and modified roles of food can be adequately prepared for. Other group based interventions may also be considered such as programmes with a mindfulness component; these may provide people who typically resolve emotional and social distress by turning to/using food, with alternative coping skills.