4.4 Article

Perceived and Preferred Social Support in Patients Experiencing Weight Regain After Bariatric Surgery-a Qualitative Study

Journal

OBESITY SURGERY
Volume 31, Issue 3, Pages 1256-1264

Publisher

SPRINGER
DOI: 10.1007/s11695-020-05128-5

Keywords

Interview; Metabolic surgery; Obesity; Support; Thematic analysis; Weight regain

Categories

Funding

  1. Karolinska Institute
  2. Stockholm County Council

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Although bariatric surgery shows successful weight loss outcomes, many patients experience weight regain. This qualitative study explores how patients with substantial weight regain after surgery perceive support from family, friends, and healthcare providers. The study found that patients often feel abandoned and struggle due to lack of support, and desired various forms of support including exercise, healthy eating, and access to healthcare professionals.
Purpose While bariatric surgery generally shows successful weight loss outcomes in patients with obesity, weight regain exists. The aim of this qualitative study was to improve understanding of how patients with substantial weight regain after bariatric surgery experienced the support from family, friends, and healthcare providers, and what kind of support they had preferred. Materials and Methods Qualitative data were collected from semi-structured interviews with 16 participants. Mean weight regain from surgery to interview was 36%. The transcribed interviews were analyzed with thematic analysis. Results Two main themes and seven sub-themes were formulated. The theme, A lonely struggle, illustrates patients' feelings of abandonment and struggle during weight regain due to lack of support or unfavorable treatment. Participants commonly blamed themselves for re-gaining weight, and shame made them reluctant to engage in social activities or seek medical care. The theme, Others as sources of compassion and control, covers what support they desired, as well as had perceived to be helpful. Exercising or eating healthy with others was appreciated and felt supportive. Pro-active healthcare support and access to dietitians, physiotherapists, and psychological support were desired. Conclusion To optimize the effect of bariatric surgery, support may need to be individualized and lifelong. Since shame and self-blame in patients with weight regain may hinder seeking professional help, care providers may need to initiate follow-up visits. Empathetic and non-judgmental support, access to multidisciplinary healthcare team, as well as peer-support groups may be beneficial to counteract weight regain post-bariatric surgery.

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