Abstract

PurposeWhile 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 MethodsQualitative 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.ResultsTwo 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.ConclusionTo 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.

Highlights

  • Bariatric surgery is an effective method for weight loss, less successful outcomes have been reported, including substantial weight regain

  • Apart from recurrence of medical risks, weight regain may have a negative impact on the quality of life (QoL) [1]

  • Weight regain seems to be especially common after gastric banding, but may occur regardless of surgical method [5]

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Summary

Introduction

Bariatric surgery is an effective method for weight loss, less successful outcomes have been reported, including substantial weight regain. Apart from recurrence of medical risks, weight regain may have a negative impact on the quality of life (QoL) [1]. One and a half to 2 years post-surgery, most patients have either stabilized their weight, or in some cases regained some weight [2]. Weight regain seems to be especially common after gastric banding, but may occur regardless of surgical method [5]. Many complex factors may contribute to the phenomenon of weight regain [6]. Bariatric surgery affects gut hormone levels and facilitate weight loss through increased satiety, resulting in a reduced intake of food [8]. The effect on hunger and satiety hormones vary

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