Experiences and Perspectives of Racially Diverse Patients 5 Years Post-Bariatric Surgery: Qualitative Findings from the BELONG II Study

Laurel D Hansell; Clarissa W Hsu; Jessica M Mogk; Silvia R Paz; Darren D Moore; Mayra M Macias; Bhumi B Bhakta; Cecelia L Crawford; Debi Ellis; Cecilia Lopez; Tonce Jackson; Angela Borruso; Reggie Graves; Vincent Corralejo; Marlaine Figueroa Gray; Deborah R Young; Adam Drewnowski; Kristina H Lewis; Sameer B Murali; Karen J Coleman

doi:10.1007/s40615-025-02635-y

Experiences and Perspectives of Racially Diverse Patients 5 Years Post-Bariatric Surgery: Qualitative Findings from the BELONG II Study

J Racial Ethn Health Disparities. 2025 Oct 16:10.1007/s40615-025-02635-y. doi: 10.1007/s40615-025-02635-y. Online ahead of print.

Authors

Laurel D Hansell¹, Clarissa W Hsu², Jessica M Mogk², Silvia R Paz³, Darren D Moore⁴, Mayra M Macias³, Bhumi B Bhakta³, Cecelia L Crawford⁵, Debi Ellis³, Cecilia Lopez³, Tonce Jackson³, Angela Borruso³, Reggie Graves³, Vincent Corralejo³, Marlaine Figueroa Gray², Deborah R Young³, Adam Drewnowski⁶, Kristina H Lewis⁷, Sameer B Murali⁸, Karen J Coleman^{3

9}

Affiliations

¹ Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. laurel.d.hansell@kp.org.
² Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
³ Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
⁴ Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, IL, USA.
⁵ Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, CA, USA.
⁶ Center for Public Health Nutrition, University of Washington, Seattle, WA, USA.
⁷ Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
⁸ Center for Obesity Medicine & Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, TX, USA.
⁹ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.

Abstract

Introduction: Severe obesity and associated negative outcomes have increased in prevalence in America. Furthermore, people who identify as African American/Black (Black), Hispanic/Latine (Hispanic), Native Hawaiian/Pacific Islander (HPI), or American Indian/Alaskan Native (AIAN) suffer disproportionate impacts from obesity. Bariatric surgery is one of the most effective treatments for severe obesity. However, many patients with diverse ethnic backgrounds are less likely to receive bariatric surgery compared to their White counterparts, and when they do, they may have less weight loss and higher complication rates. This study seeks to describe the experiences of patients an average of 5 years after bariatric surgery.

Methods: Semi-structured qualitative interviews were conducted between September 2021 and March 2022 with participants who received bariatric surgery within a large integrated health system. Interviews aimed to understand the perspectives of patients from diverse racial and ethnic backgrounds regarding weight loss and regain. Interviews were audio-recorded and transcribed for thematic analysis.

Results: A total of 68 interviews were collected; 29% self-identified as Black, 29% as Hispanic, 15% as HPI or AIAN, and 27% as White; 53% were identified as women. In general, the experiences of the patients in this sample were very similar, with few differences between racial and ethnic groups. However, Black, Hispanic, HPI, and AIAN participants were more likely than White participants to express concerns about losing too much weight.

Discussion: This study highlights important implications for practice. Culturally relevant patient goals regarding weight loss should be incorporated into shared decision-making, and follow-up support should extend several years after surgery.

Keywords: Bariatric surgery; Qualitative; Racial and ethnic differences; Weight loss.

Abstract

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