Obesity Surgery, 12, 781-788 © FD-Communications Inc. Obesity Surgery, 12, 2002 781 Background: Attempts to understand postoperative psychosocial changes in the lives of individuals who have undergone gastric bypass surgery for morbid obesity have 1) been guided by constructs emanat- ing from the assumptions of researchers, and 2) have resulted in fragmented conclusions that cata- logue changes without theoretically integrating them. Materials and Methods: Using unstructured and semi-structured interviews and in-depth focus groups, 31 patients were asked in an open-ended fashion about the ways, if any, in which gastric bypass surgery had affected their lives. Grounded theory methodology was utilized in order to identify emergent themes and their interrelations, and build a meaningful, comprehensive theory of life after gas- tric bypass. Results: Patients’ report of a rebirth/transforma- tion was identified as the core process of the theory. The changes marking this process were clearly con- ceptualized in dichotomous terms comparing pre to postsurgical life. Patients reported changes that they regarded as unequivocally positive, a number of which had not been previously reported in the litera- ture. Unique to this particular study was the finding of numerous life changes that generated tension and posed challenges in various aspects of patients’ lives. Conclusion: The grounded theory proposes that the extent to which patients successfully negotiate tension-generating changes may be a major deter- minant in the long-term outcome of gastric bypass, both weight loss and psychosocial adjustment. Key words: Gastric bypass, bariatric surgery, morbid obesity, quality of life, qualitative, grounded theory Introduction The medical research on obesity surgery is rich and elaborate, showing that surgery is generally effec- tive in producing dramatic weight loss and reduc- tion of obesity-related comorbidities. What still remains unclear is the extent of the psychosocial impact of surgery and the ways in which these psy- chosocial outcomes are related to the ability to maintain weight loss. 1,2 Formulating a thorough theoretical conception of the ways in which patients’ lives are impacted by surgery is challeng- ing, if not impossible, when one examines the existing psychosocial outcome literature. 1 The vast majority of studies have utilized quantitative mea- sures in an attempt to assess what researchers assumed to be the constructs associated with psy- chosocial outcome of surgery. These assessment measures typically do not allow for a heterogeneity of patient responses and thus increase the likeli- hood that the patients’ experience is only partially conveyed and understood. What remains are frag- mented conclusions that have compartmentalized isolated psychosocial changes without theoreti- cally integrating them. 1 The present study attempted to reconstruct our understanding of the psychosocial phenomena associated with gastric bypass surgery, inducted directly from the patients’ point of view. Qualitative methodology was utilized in order to: 1) provide the richness of detail currently missing from the literature; 2) escape researcher assump- tions/biases about potential outcomes (positive and negative), and; 3) guide the relevance of future quantitative outcome studies and intervention plans. In formulating a grounded theory of the psy- Perceived Psychosocial Outcomes of Gastric Bypass Surgery: A Qualitative Study Lindsey E. Bocchieri, MA; 1 Marta Meana, PhD; 1 Barry L. Fisher, MD 2 1 Department of Psychology, University of Nevada, Las Vegas; 2 Department of Surgery, University of Nevada School of Medicine, LasVegas, NV, USA Reprint requests to: Dr. Marta Meana, Department of Psychology, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 455030, Las Vegas, NV 89154-5030, USA Fax: (702) 895-0195; e-mail: meana@unlv.edu