Navigating barriers and facilitators to lifestyle changes after bariatric surgery among Emirati adolescents: a qualitative study

Abstract

Adolescent obesity is a major public health concern, with bariatric surgery emerging as an effective treatment option. However, little is known about adolescents' long-term adherence to healthy behaviors after surgery, especially in non-Western settings. This qualitative interview study explored lifestyle challenges faced and enablers experienced by adolescents who had undergone bariatric surgery at least one year before the interview, addressing a research gap. Semi-structured interviews were conducted with 15 adolescents (12-19 years) who had undergone bariatric surgery (sleeve gastrectomy: 86.6%; Roux-en-Y gastric bypass: 13.2%) more than a year ago, using the social-ecological model (SEM) to guide data collection and interpretation. The interviews revealed five key themes: Motivations for bariatric surgery, post-surgery barriers to regular physical activity, enablers for overcoming post-surgery challenges, post-bariatric surgery lifestyle change strategies, and suggestions for overcoming post-surgery challenges. Barriers to regular physical activity included family and academic responsibilities, as well as environmental, psychological, and medical factors. Health challenges were more difficult to manage than food or physical activity. Support from healthcare teams played a crucial role in overcoming post-bariatric surgery challenges, especially those related to diet and medication adherence. Participants recommended adapting lifestyle changes and consulting health professionals to overcome post-bariatric surgery challenges.

Keywords: United Arab Emirates; adolescent; bariatric surgery; diet; exercise; qualitative; social environment.

Figure 1

Participant flow chart.

Figure 2

Barriers and facilitators of lifestyle factors among adolescents ≥1 year post–bariatric surgery, classified according to the social-ecological model.