EXPERIENCE OF WEIGHT LOSS AMONG YOUNG ADULTS WHO UNDERWENT BARIATRIC SURGERY AS ADOLESCENTS: A MIXED-METHODS APPROACH

Purpose: In response to rising obesity rates among U.S. adolescents, bariatric surgery has gained acceptance when behavioral treatments fail. Adolescents must make voluntary and involuntary lifestyle modifications after surgery. The qualitative aspects of these changes have not been fully explored. This study aimed to describe the weight loss journey (quality of life, successes, challenges) among young adults who underwent bariatric surgery approximately 10 years ago. Methods: A convergent, parallel mixed methods (QUALITATIVE-quantitative) design was used. Participants were recruited through a pediatric hospital's bariatric program registry. Semi-structured phone interviews were conducted and independently coded to identify initial codes within pre-determined categories (e.g. eating habits, physical activity, social relationships) and to allow for the emergence of new themes. Thematic analysis guided the overall approach; data was triangulated through peer-debriefing with each coding cycle, use of thick descriptions, and analytic memos. Qualitative findings were integrated with the quantitative results from the RAND 36-item Short Form Survey (SF-36), Body Quality of Life (QoL), Transition Readiness Assessment Questionnaire (TRAQ) and medical chart data (e.g. pre-surgical BMI and comorbidities) to describe the adolescent experience. Results: Twenty-two participants completed the surveys (16 females, 6 males), followed by optional phone interviews (n=20). The median participant age was 25 years (range 19-30), with the median age at surgery 17 years (range 14-19), and percentage of weight loss since surgery 22.6% (range 5.8%-58.0%). The following themes emerged from the qualitative findings: a second chance at life, body image adjustment, growing up, and continual challenges. Participants conveyed that surgery had increased mobility and sociability, and that they had avoided or reversed more life-threatening comorbidities. Those with greater percentages of weight loss since surgery communicated routine exercise goals compared to participants whose physical activity were embedded in job duties or daily living. Participants iterated that mothers were instrumental in developing healthy weight-loss behaviors. Common challenges included forced portion control to avoid physical discomfort after eating, the desire to remove excess skin that remained after surgery, and barriers associated with COVID-19 social distancing measures. The SF-36 scores in this sample excee