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

Abstract

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.

Patients’ views of long-term results of bariatric surgery for super-obesity: sustained effects, but continuing struggles

“…Some participants described how regulating their weight was much easier after MBS, while others continued to struggle with difficulty and associated this struggle with fear and feelings of failure. This is in line with findings in previous qualitative studies that patient narratives frequently contain control-related themes and that patients tend to blame themselves and talk of weight gain in terms of shame and failure [11,29]. However, the broad range of long-term weight loss after MBS is not fully understood; most studies suggest individual physiologic responses as the main determinant of this difference, rather than behaviors or compliance [30,31].…”

The Long-Term Association between Physical Activity and Weight Regain, Metabolic Risk Factors, Quality of Life and Sleep after Bariatric Surgery

“…For the purpose of this work, we considered the weight one year after surgery obtained in the EHR as the minimum postoperative weight. There is a considerable ongoing debate around this concept, namely, to establish the adequate threshold to predict surgery failure [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. In this work, we decided to opt for a conservative approach, namely that 5% of weight regain calculated by this formula was a sign of a significant weight regain.…”

Social Support for People with Morbid Obesity in a Bariatric Surgery Programme: A Qualitative Descriptive Study

“…Together with early support for patients who take part in a bariatric surgery programme, life-long, individualised support may be required to optimise the effects of bariatric surgery. Receiving follow-up visits from a multidisciplinary medical team or joining support groups may be beneficial in counteracting weight gain after bariatric surgery [ 55 ].…”