One Year Later

This fall, Michigan surgeons gathered about 100 bariatric surgery patients into small focus groups roughly a year after their operations and asked about their new lives, expecting mostly enthusiastic reports. Yet responses were muted.

“From an outsider’s perspective — as someone who hasn’t had the operation — it is confusing,” Dr. Ghaferi said. “Why on earth wouldn’t you be ecstatic?”

There was a lot of talk about changed relationships. Some patients had divorced or separated from a spouse. Some said that a partner did not like the way they looked, or that their partner was still obese and jealous, or that the partner complained, “You’re not the person I married.”

Some believed that people would judge them for having had the surgery, so they kept the operation a secret.

Some did not like the way they looked. It was not enough weight loss, or they were not aware — although it had been part of their presurgery education sessions — that they would end up with big flaps of loose skin that could be gotten rid of only with extensive and expensive plastic surgery.

On the other side of the equation, patients raved about newfound energy and stamina, and the way joint and back pain disappeared. They loved tossing away medications for diabetes or high blood pressure.

Jessica and Keith, too, had mixed reactions.

A year after his surgery, Keith weighed 284 pounds, down from his starting weight of 377, but not at his projected weight of 230. It is increasingly unlikely that he will get there.