Nutritional behaviors and adaptation before and after metabolic bariatric surgery: a qualitative study based on patient experiences.

BACKGROUND: Although metabolic bariatric surgery is an effective treatment for obesity, qualitative evidence exploring patients' experiences across both pre- and post-operative periods remains limited. This study aimed to examine patients' decision-making experiences, nutritional behaviors, and perceptions of nursing care throughout this process. METHODS: This qualitative descriptive study included individuals who had undergone metabolic bariatric surgery at least 12 months previously at a private hospital in Türkiye. Data were collected through focus group discussions (FGDs) followed by individual semi-structured interviews (ISIs) to obtain both shared and in-depth individual perspectives. All FGDs and ISIs were audio-recorded and transcribed verbatim. The FGD and ISI data were initially analyzed separately using inductive qualitative content analysis and subsequently compared and integrated during the later stages of analysis. Codes were grouped into categories, subthemes, and overarching themes through an iterative coding process. The coding process was independently reviewed by a second qualitative researcher, and discrepancies were resolved through consensus. RESULTS: Five main themes emerged: decision-making for surgery, preoperative dietary habits, post-operative nutritional strategies, postoperative challenges, and information sharing. Participants reported that physical, psychological, and social factors influenced their decision to undergo surgery. Preoperatively, high-calorie and irregular eating patterns were common, whereas post-operative adaptation involved portion control, slow eating, and meal planning. Early postoperative challenges included physical symptoms, difficulties with dietary adherence, and limited social support. Structured education and regular nursing counseling were found to enhance patients' confidence and facilitate adaptation. CONCLUSION: Metabolic bariatric surgery represents a comprehensive care process requiring physical, behavioral, psychological, and social adaptation throughout the surgical journey. The findings highlight the importance of structured nursing support, including individualized education, psychosocial guidance, and long-term follow-up, to facilitate patients' adaptation after surgery.