Title : Relational support and early postoperative adjustment after Roux-en-Y gastric bypass: A qualitative study informed by social support theory
Abstract:
Introduction: After Roux-en-Y gastric bypass (RYGB), patients must quickly adapt to dietary changes, new bodily sensations, and several recommendations for daily life. These changes occur within family relationships and social networks, which may provide emotional, instrumental, informational, and appraisal support. However, support is not always experienced as helpful or appropriate. Social Support Theory offers a useful framework for understanding how different forms of support may influence recovery.
Objective: To explore how patients experienced relational support during the early postoperative period after RYGB and how different forms of support influenced emotional adjustment, nutritional care, health monitoring, and adherence to postoperative recommendations.
Methods: This qualitative study was conducted at a public university hospital in southeastern Brazil and reported according to the COREQ guidelines. it was part of a larger multimethod umbrella project. Patients with documented postoperative follow-up after RYGB were identified through clinical record review and invited to participate. Sixteen participants took part in remote, in-depth semi-structured interviews conducted between October 2025 and February 2026. The interviews were audio-recorded, transcribed verbatim, de-identified, and analyzed using reflexive thematic analysis. Social Support Theory guided the interpretation of the findings without restricting the analysis to predefined categories. The study was approved by the Research Ethics Committee of HUCAM (CAAE 59075722.7.0000.5071) and registered in ReBEC (RBR-26chs2g).
Results: Participants were mainly middle-aged women. Most were married or lived with family members, had low family income, and had severe obesity with related comorbidities before surgery. Four interconnected themes, reflecting the main functions of Social Support Theory, were identified: emotional support; instrumental support; informational and appraisal support; and support perceived as inadequate or misaligned with patients’ needs. Emotional support provided reassurance, encouragement, and a sense of being understood. Instrumental support included help with food preparation, household tasks, transportation, and postoperative routines. Informational and appraisal support helped participants understand bodily changes, monitor their health, assess their progress, and follow nutritional and behavioral recommendations. However, some interactions were described as controlling, dismissive, resistant, or inconsistent with patients’ needs.
Conclusion: Early adjustment after RYGB is influenced not only by patients’ own efforts, but also by the support they receive in daily life. Support may facilitate recovery, but it can also create tension when it is controlling or poorly matched to patients’ needs. Post-bariatric care should therefore consider both the availability and the quality of social support.
Keywords: Roux-en-Y Gastric Bypass; Bariatric Surgery; Postoperative Adjustment; Social Support; Social Support Theory; Qualitative Research
