Abstract
Background
Weight regain following sleeve gastrectomy is an increasingly recognised and important problem. Similar to other centres, we have noticed an association between the onset of weight regain and discharge from the bariatric service. We aimed to elucidate this further from the patient perspective.
Methods
Patients at least 2 years from sleeve gastrectomy, who had experienced weight regain, were invited to participate in a focus group discussion. Participants were asked to complete a demographic survey and discussions were audio-recorded. Transcripts underwent content analysis using an inductive approach.
Results
Thirty-eight participants participated in one of seven focus group discussions. The majority of participants were female, European and satisfied with the surgery and follow-up care. Participants described positive and negative aspects of the surgery, their follow-up care and causes of weight regain. Important emergent themes included the desire for more support, that is delivered within the overarching principles of providing individualised, specialised care by providers that maintain good rapport and assist in maintaining motivation. Furthermore, this follow-up support may be delivered in non-traditional ways rather than conventional face-to-face consultations.
Conclusion
Explorative focus group discussions in a group of patients who had regained weight following sleeve gastrectomy revealed a desire for more support after discharge from the bariatric service.
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References
Sarela AI, Dexter SP, O’Kane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results. Surg Obes Relat Dis. 2012;8(6):679–84.
Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.
Lemanu DP, Singh PP, Rahman H, et al. Five-year results after laparoscopic sleeve gastrectomy: a prospective study. Surg Obes Relat Dis. 2015;11(3):518–24.
Jimenez A, Casamitjana R, Flores L, et al. Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256(6):1023–9.
Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–33.
Kushner RF, Sorensen KW. Prevention of weight regain following bariatric surgery. Current Obesity Reports. 2015;4(2):198–206.
Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.
Ferguson S, Al-Rehany L, Tang C, et al. Self-reported causes of weight gain: among prebariatric surgery patients. Can J Diet Pract Res. 2013;74(4):189–92.
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surg Obes Relat Dis. 2013;9(2):159–91.
National Institute for Health and Clinical Evidence. Specifying a bariatric surgical service for the treatment of people with severe obesity. 2012. [updated 2 March 2012; cited 2015 7 July 2015]; Available from: http://www.nice.org.uk/proxy/?sourceurl=http://www.nice.org.uk/usingguidance/commissioningguides/bariatric/specifyingabariatricsurgicalservice.jsp.
Beck NN, Johannsen M, Stoving RK, et al. Do postoperative psychotherapeutic interventions and support groups influence weight loss following bariatric surgery? A systematic review and meta-analysis of randomized and nonrandomized trials. Obes Surg. 2012;22(11):1790–7.
Ogden J, Hollywood A, Pring C. The impact of psychological support on weight loss post weight loss surgery: a randomised control trial. Obes Surg. 2015;25(3):500–5.
Hollywood A, Ogden J, Pring C. The impact of psychological support on psychological outcomes and patients’ experiences of the bariatric service 1 and 2 years after bariatric surgery. J Obes Bariatrics. 2015;2(1):7.
Keren D, Matter I, Rainis T, et al. Getting the most from the sleeve: the importance of post-operative follow-up. Obes Surg. 2011;21(12):1887–93. Epub 2011 August 2.
Keren D, Matter I, Lavy A. Lifestyle modification parallels to sleeve success. Obes Surg. 2014;24(5):735–40.
Shaw RJ, Bosworth HB, Silva SS, et al. Mobile health messages help sustain recent weight loss. Am J Med. 2013;126(11):1002–9.
Lemanu DP. Optimising the bariatric perioperative journey [thesis]. Auckland: The University of Auckland; 2014.
Lauti M, Gormack S, Thomas J, Morrow J, Rahman H, MacCormick A. What does the excised stomach from sleeve gastrectomy tell us? Obes Surg. 2016;26(4):839–42.
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Conflict of Interest
This study was conducted whilst the first author held a Health Research Council of New Zealand Clinical Research Training Fellowship (15/008). She was also awarded a Jamieson Scholarship from the Obesity Surgery Society of Australia and New Zealand (OSSANZ) to support her travel to Vienna to present this work at IFSO15.
The senior author had a speaking honorarium with Covidien, holds Lottery Health Research and Auckland Medical Research Foundation grants for other research projects.
The remaining authors have no conflicts to declare.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
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Lauti, M., Stevenson, S., Hill, A.G. et al. Patient Perspectives About Follow-Up Care and Weight Regain Following Sleeve Gastrectomy. OBES SURG 26, 2724–2731 (2016). https://doi.org/10.1007/s11695-016-2178-0
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DOI: https://doi.org/10.1007/s11695-016-2178-0