Year of Publication

2017

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Agriculture, Food and Environment

Department

Family Sciences

First Advisor

Dr. Nathan D. Wood

Abstract

Bariatric surgery, also known as weight loss surgery (WLS) is an intervention for individuals who are suffering from obesity and weight-related health complications which often accompany being 100 pounds or more overweight (Smith et al., 2011). Even though bariatric surgery has been shown to be a life-saving and life-enhancing operation, efforts to seek out surgery options, qualify and prepare for the procedure, recover from surgery, and then adapt new routines to support surgery are challenging not only for the patient, but also for the people with whom the patient spends the most time—their romantic partners (Applegate & Friedman, 2008; Bylund, Benzein, & Carina, 2013; Moore & Cooper, 2016; Sarwer, Dilks, & West-Smith, 2011).

This dissertation was a means to explore relational, food, and WLS success experiences that take place within couples when at least one person has had bariatric surgery. Comparisons between life before, during, and after WLS were discussed with focused attention given to relationship dynamics and daily food routines (Bocchieri, Meana, & Fisher, 2002). The couple’s definition of WLS success and the means by which they have been successful were launching points for more in-depth conversation. Data was generated through 2 interviews per couple (n = 11) with patients who met selection criteria for the study—committed long-term relationship and of the same residence for at least the past 5 years with at least 1 person having been successful with WLS. Success was defined by the WLS patient, however they had to be at least 2 years post-WLS, the critical time period where postoperative weight regain has been shown to occur, in order to participate (Magro et al., 2008; Ogden, Avenell, & Ellis, 2011; Pories et al., 2016). A thematic analysis with multiple rounds of coding was conducted after data saturation was met and couples indicated their agreeableness with results through a short, follow-up survey which also functioned as a form of member-checking.

Overall, couples’ relationship dynamics were characterized as secure and WLS gave them another way to give support, engage in teamwork, and ultimately become closer. Patients and spouses explained that they loved each other unconditionally, no matter what the patient weighed, and this had been the reality for their entire relationship. Thus, security was the theme for relationship dynamics with support, teamwork, and closer as subthemes. Spouses expressed their desire to help the WLS patient when it came to being open to change and then making necessary modifications in habits and lifestyle. The commitment to change happened before WLS and a mind-shift happened after WLS that enabled both people to adjust their thinking, consistently evaluate their routines, and continue to change their behaviors. As a result, commit and mind-shift were the themes and subsequent changes (diet, exercise, and mindsets) were the subthemes. A secure relationship and commitment to making “better choices” assisted the patient in experiencing WLS success and this meant that their spouse experienced success, too; “it’s our success together.” The theme for WLS success was follow-through and subthemes were results, comfort, happy, and freedom. Hope was also a by-product of success and it was the grand-theme of this study.

Digital Object Identifier (DOI)

https://doi.org/10.13023/ETD.2017.503

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