Perspectives of adolescents with severe obesity on social Media in Preparation for weight-loss surgery: a qualitative study

Elizabeth Prout Parks,Darra D Finnerty,Gaby Cordero,Noel N Williams,Kristoffel R Dumon,Jennifer Panganiban,David B Sarwer,Rosemary Frasso,Chanelle Bishop-Gilyard,Colleen M Tewksbury,Douglas L Hill

doi:10.1186/s12887-020-1992-7

Abstract

BackgroundCurrently the most effective treatment for severe obesity in adolescents is weight-loss surgery coupled with lifestyle behavior change. In preparation for weight-loss surgery, adolescents are required to make changes to eating and activity habits (lifestyle changes) to promote long term success. Social media support groups, which are popular among adolescents, have the potential to augment preoperative lifestyle changes. The purpose of this study was to qualitatively assess the perceived role of social media as a support tool for weight-loss, and to identify motivators and constraints to lifestyle changes and social media use in adolescents preparing for weight-loss surgery.MethodsThematic analysis of social media comments from 13 (3 male, 10 female) adolescents aged 16 ± 1.3 years with a body mass index (BMI) 45 ± 7.3 kg/m2 enrolled in a weight-management program preparing for bariatric surgery and who participated in a 12-week pilot social media intervention was performed. Participants commented on moderator posts and videos of nutrition, physical activity, and motivation that were shared three to four times per week. Social media comments were coded using NVivo 11.0 to identify recurrent themes and subthemes.Results1) Social media provided accountability, emotional support, and shared behavioral strategies. 2) Motivators for lifestyle changes included family support, personal goals, and non-scale victories. 3) Challenges included negative peers, challenges with planning and tracking, and time constraints.ConclusionAdolescents considering bariatric surgery identified social media as a tool for social support and reinforcement of strategies for successful behavior change. Important motivators and challenges to lifestyle changes were identified.

Highlights

The most effective treatment for severe obesity in adolescents is weight-loss surgery coupled with lifestyle behavior change
Bariatric surgery coupled with lifestyle behavior change has documented weight-loss achievements of 30% and significant improvements in glycemic control, cardiovascular disease risk compared with 5% or less with lifestyle interventions alone for the treatment for severe obesity in adults and adolescents [2,3,4,5,6]
The objectives of this study were to utilize qualitative methods to: 1) assess the perceived role of social media as a support tool for weight-loss, and 2) identify motivators and constraints to lifestyle changes in adolescents with severe obesity preparing for weight-loss surgery

Summary

Introduction

The most effective treatment for severe obesity in adolescents is weight-loss surgery coupled with lifestyle behavior change. Bariatric surgery coupled with lifestyle behavior change has documented weight-loss achievements of 30% and significant improvements in glycemic control, cardiovascular disease risk compared with 5% or less with lifestyle interventions alone for the treatment for severe obesity in adults and adolescents [2,3,4,5,6]. Preliminary data suggests that capitalizing on adolescent use of social media for peer support may be a method to promote engagement, meet health goals, and potentially enhance patient retention in a medical weight management preoperative program [9, 14,15,16]. Preoperative assessment with adolescents preparing for bariatric surgery may be an ideal time period to leverage this tool

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