Abstract
PurposeBariatric surgery is a successful obesity treatment; however, an estimated 1/5 of patients have regained more than 15% of their body weight 5 years post-surgery. To increase the understanding of patients who experienced weight regain after bariatric surgery, we conducted a qualitative study.Materials and MethodsWe recruited 16 adult participants (4 men, 12 women) at an obesity clinic in Stockholm, Sweden, 2018 to 2019, and performed semi-structured individual interviews. The transcribed recorded interview data was analyzed with thematic analysis.ResultsParticipants had undergone gastric bypass surgery on average 10 years prior to study and regained 36% (range 12 to 71%) of their weight from their nadir. Participants experienced challenges such as eating in social settings, loneliness, family difficulties, increases in appetite, and physical and mental health problems, which distracted them from weight management. Participants responded to weight regain with emotional distress, particularly with hopelessness, discouragement, shame, and frustration (theme: loss of control and focus). Nonetheless, participants experienced remaining benefits from the surgery, despite weight regain. Social support, self-care, and behavioral strategies were perceived as facilitators for weight management (theme: reducing the burden of weight management).ConclusionsWeight regain after bariatric surgery was perceived to be an unexpected and difficult experience that induced hopelessness, discouragement, shame, and frustration. Results indicate that internal and external circumstances such as psychosocial factors, changes in appetite, and physical and mental health problems may contribute to loss of control over weight. Social support, self-care, and behavioral strategies might facilitate long-term post-surgical weight management.Graphical abstract
Highlights
Compared to lifestyle interventions, bariatric surgery is superior for long-term weight loss maintenance and improvement in overall health and quality of life [1, 2]
The Longitudinal Assessment of Bariatric Surgery study (LABS) shows mean weight regain of about 4% after Roux-en-Y gastric bypass (RYGB) 3 to 7 years after surgery [5], while other studies e.g. from Sweden [6] and the Netherlands [4] report that 20 to 24% of patients have regained more than 15% of their body weight 5 years after RYGB or sleeve gastrectomy
Participants had the option of choosing the location of the interview, all interviews were conducted at the obesity clinic
Summary
Bariatric surgery is superior for long-term weight loss maintenance and improvement in overall health and quality of life [1, 2]. Weight loss after bariatric surgery varies between individuals [3]. Most patients regain some weight after their lowest weight has been reached [4]. Studies report large differences in the prevalence of weight regain in the bariatric. The Longitudinal Assessment of Bariatric Surgery study (LABS) shows mean weight regain of about 4% after Roux-en-Y gastric bypass (RYGB) 3 to 7 years after surgery [5], while other studies e.g. from Sweden [6] and the Netherlands [4] report that 20 to 24% of patients have regained more than 15% of their body weight 5 years after RYGB or sleeve gastrectomy. The exact prevalence of weight regain is difficult to estimate, since a definition for weight regain has not been established [4, 7]
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