Support Groups and Behavioral Science

2018 ◽  
Author(s):  
Christina M. Rummell
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Substance Use ◽  
Behavioral Health ◽  
Support Groups ◽  
Behavioral Science ◽  
Weight Loss Surgery ◽  
Process Research ◽  
Health Interventions ◽  
Severely Obese

While a psychological evaluation is often a required part of a weight-loss surgery workup, providers are becoming aware of the need for behavioral health services during each phase of the surgery process. Research has documented a higher prevalence of psychiatric comorbidities in severely obese patient populations, with those who receive behavioral health interventions before surgery having better outcomes than those who do not. Common recommendations and interventions for pre- and postoperative behavioral health optimization are reviewed and discussed.Statistics indicate a greater lifetime prevalence of substance use disorders in weight-loss surgery patients than in the general population. Postoperative complications have been shown to result from substance abuse, making it one of the top-cited contraindications for surgery. Preliminary recommendations for assessing and addressing substance use in bariatric surgery candidates are discussed.

scholarly journals Bariatric Biosociality: Pushed Together, Pulled Apart

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989906
Author(s):  
Zoë C. Meleo-Erwin
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Loss Surgery ◽  
Structured Interviews ◽  
Severely Obese ◽  
History Of ◽  
Bariatric Patients ◽  
Provider Knowledge ◽  
Reconstructive Plastic Surgery ◽  
Reconstructive Plastic

This article explores the postoperative experiences of weight loss surgery patients. More specifically, it investigates why bariatric patients seek out and form connection to similarly situated others in online and in-person support forums. Based on a thematic analysis of 30 semi-structured interviews with individuals who have had bariatric surgery, it is argued that the experience of having been medically classified as obese or severely obese, a long history of failed dieting attempts, fears of future morbidity and mortality, and then undergoing bariatric surgery serve as an axis around which some individuals interact, create identity, and form community. The perceived lack of postoperative support from home bariatric clinics, inadequate provider knowledge about the particularities of bariatric bodies, and the fact that patients must “work with” their surgeries to avoid postoperative adverse events are additional drivers for the formation of such bariatric kinship. It is argued that Paul Rabinow’s concept of “biosociality” provides a helpful theoretical frame for understanding these processes. However, just as the aforementioned factors push bariatric patients together, tensions around the type of bariatric procedure undergone, the amount of weight loss, and economic access to reconstructive plastic surgery cause conflict, leading to the formation of subgroups within bariatric communities. It is argued that, ultimately, bariatric biosocialities are spaces in which bariatric patients collectively work to achieve normative health and aesthetic standards. However, these spaces also reflect highly complex, sometimes divergent and conflictual, and often ambivalent frameworks of understanding and experience.

scholarly journals The hamster wheel: a case study on embodied narrative identity and overcoming severe obesity

2021 ◽  
Author(s):  
Eli Natvik ◽  
Målfrid Råheim ◽  
Randi Sviland
Keyword(s):  
Weight Loss ◽  
Narrative Analysis ◽  
Life Story ◽  
Weight Loss Surgery ◽  
Sense Of Self ◽  
The Body ◽  
Long Run ◽  
Severely Obese ◽  
Eating Practices ◽  
And Control

AbstractBased in narrative phenomenology, this article describes an example of how lived time, self and bodily engagement with the social world intertwine, and how our sense of self develops. We explore this through the life story of a woman who lost weight through surgery in the 1970 s and has fought against her own body, food and eating ever since. Our narrative analysis of interviews, reflective notes and email correspondence disentangled two storylines illuminating paradoxes within this long-term weight loss process. Thea’s Medical Weight Narrative: From Severely Obese Child to Healthy Adult is her story in context of medicine and obesity treatment and expresses success and control. Thea’s Story: The Narrative of Fighting Weight is the experiential story, including concrete examples and quotes, highlighting bodily struggles and the inescapable ambiguity of being and having one’s body. The two storylines coexist and illuminate paradoxes within the weight loss surgery narrative, connected to meaningful life events and experiences, eating practices and relationships with important others. Surgery was experienced as lifesaving, yet the surgical transformation did not suffice, because it did not influence appetite or, desire for food in the long run. In the medical narrative of transforming the body by repair, a problematic relationship with food did not fit into the plot.

Weight loss surgery

2015 ◽  
Vol 97 (1) ◽  
pp. 45-45
Author(s):  
Jo Revill
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Loss Surgery ◽  
Love Affair

How our ongoing love affair with fad diet stories shapes the debate around bariatric surgery.

Differential impact of bariatric surgery-induced weight loss on upper leg tissue composition in severely obese patients

2011 ◽  
Vol 35 (2) ◽  
pp. 188
Author(s):  
A. Auclair ◽  
J. Martin ◽  
M. Bastien ◽  
N. Bonneville ◽  
S. Marceau ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Obese Patients ◽  
Tissue Composition ◽  
Differential Impact ◽  
Severely Obese

Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Environmental Factors ◽  
Fast Food ◽  
Pediatric Obesity ◽  
Behavioral Interventions ◽  
Weight Loss Surgery ◽  
Pediatric Population ◽  
Nonalcoholic Fatty Liver ◽  
Sweetened Beverages

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues. Contributors to obesity are multifactorial, including genetic and environmental factors. Environmental factors associated with obesity include increased availability of inexpensive fast food, sugar-sweetened beverages, and high-fat and -sugar convenience foods; decreased exercise; and increased screen time. Treatment begins with behavioral interventions focusing on dietary modifications and increasing physical activity. Although medications to treat obesity are an area of increased interest, options in the pediatric population are limited. Currently, orlistat is the only FDA-approved option. For the treatment of severe obesity, bariatric surgery should be considered, based on age, weight, and associated comorbidities. Weight loss associated with surgery is robust and long-lasting and results in improvement in/resolution of multiple comorbidities. However, benefits should also be weighed against the long-term risks of vitamin deficiency. This review contains 73 references, 3 figures, and 3 tables. Key words: bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

scholarly journals Utilising a milk-based meal replacement programme in a bariatric patient with poorly controlled type 2 diabetes mellitus

2019 ◽  
Vol 2019 ◽  
Author(s):  
Michelle Maher ◽  
Mohammed Faraz Rafey ◽  
Helena Griffin ◽  
Katie Cunningham ◽  
Francis M Finucane
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Glycaemic Control ◽  
Severe Obesity ◽  
Meal Replacement ◽  
Agonist Therapy ◽  
Severely Obese ◽  
Skimmed Milk

Summary A 45-year-old man with poorly controlled type 2 diabetes (T2DM) (HbA1c 87 mmol/mol) despite 100 units of insulin per day and severe obesity (BMI 40.2 kg/m2) was referred for bariatric intervention. He declined bariatric surgery or GLP1 agonist therapy. Initially, his glycaemic control improved with dietary modification and better adherence to insulin therapy, but he gained weight. We started a low-energy liquid diet, with 2.2 L of semi-skimmed milk (equivalent to 1012 kcal) per day for 8 weeks (along with micronutrient, salt and fibre supplementation) followed by 16 weeks of phased reintroduction of a normal diet. His insulin was stopped within a week of starting this programme, and over 6 months, he lost 20.6 kg and his HbA1c normalised. However, 1 year later, despite further weight loss, his HbA1c deteriorated dramatically, requiring introduction of linagliptin and canagliflozin, with good response. Five years after initial presentation, his BMI remains elevated but improved at 35.5 kg/m2 and his glycaemic control is excellent with a HbA1c of 50 mmol/mol and he is off insulin therapy. Whether semi-skimmed milk is a safe, effective substrate for carefully selected patients with severe obesity complicated by T2DM remains to be determined. Such patients would need frequent monitoring by an experienced multidisciplinary team. Learning points: Meal replacement programmes are an emerging therapeutic strategy to allow severely obese type 2 diabetes patients to achieve clinically impactful weight loss. Using semi-skimmed milk as a meal replacement substrate might be less costly than commercially available programmes, but is likely to require intensive multidisciplinary bariatric clinical follow-up. For severely obese adults with poor diabetes control who decline bariatric surgery or GLP1 agonist therapy, a milk-based meal replacement programme may be an option. Milk-based meal replacement in patients with insulin requiring type 2 diabetes causes rapid and profound reductions in insulin requirements, so rigorous monitoring of glucose levels by patients and their clinicians is necessary. In carefully selected and adequately monitored patients, the response to oral antidiabetic medications may help to differentiate between absolute and relative insulin deficiency.

scholarly journals Readability of online patient-based information on bariatric surgery

2019 ◽  
Vol 9 (2) ◽  
pp. 156-160 ◽  
Author(s):  
Zoë Meleo-Erwin ◽  
Corey Basch ◽  
Joseph Fera ◽  
Danna Ethan ◽  
Philip Garcia
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Patient Education ◽  
Weight Loss Surgery ◽  
The Internet ◽  
Reading Levels ◽  
Web Based ◽  
Readability Score ◽  
Education Literature ◽  
Patient Comprehension

Background: Web-based patient education literature has been shown to be written at reading levels far above what is recommended. Little is known about the overall readability of current internet-based bariatric surgery information. The purpose of this study was to assess the readability of current bariatric material on the internet. Methods: The term "weight loss surgery" was searched using the Chrome browser on the first 15pages of URLs that appeared with content written in English. Using five readability measures, scores were generated using Readable.io for written content on a sample of 96 websites. Scores were sorted into the readability categories of "easy," "average," and "difficult." Results: Almost 93% of websites, both .com and .org, sampled received an unacceptable readability score on each assessment. Conclusion: Accurate and appropriate information about bariatric procedures is critical for patient comprehension and adherence to recommended protocols.

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