Metabolic Surgery Supporting Aftercare via Group-Intervention (MeSSAGES): study protocol of a randomised controlled trial

IntroductionObesity is a constantly rising and cost-intensive medical issue worldwide. Severe obesity often needs surgery to promote weight loss, but due to the rapid therapeutic success after the surgery, many patients lack the awareness of the need to consistently maintain the postoperative care. However, therapeutic success and psychological well-being can be increased through group interventions and social support of the group members. Therefore, aftercare via group intervention is a promising approach. In this prospective randomised controlled study, the self-efficacy in a social media-based interactive, psychoeducational intervention is to be tested.Methods and analysisThe intervention group will complete a social media-supported group intervention for 6 weeks with weekly postings of educative contents and the possibility to exchange in groups via anonymous avatars. The control group will receive treatment as usual (TAU) after the obesity surgery as recommended in the German S3-guidelines Obesity Surgery and Metabolic Surgery. We will examine the effectiveness of a social media-supported intervention group, and therefore, the change in self-efficacy expectation. For the primary outcome, we will perform a mixed analysis of variance with time as the within-subject factor (times of measurement T0–T4) and the group assignment as the between-subject factor (intervention +TAU vs TAU group).Ethics and disseminationThe study was approved by the Medical Association North Rhine (Ärztekammer Nordrhein, 2020031) and the patient enrolment will begin in July 2021.Trial registration numberDRKS00018089.

Bariatric surgery

This chapter discusses the anaesthetic management of obesity surgery (bariatric surgery). It begins with an introduction to obesity surgery; risk scoring; indications for when obesity surgery should be offered. Surgical procedures covered include intragastric balloon insertion and removal; gastric banding; gastric bypass, and sleeve gastrectomy.

Generalized Anxiety as a Risk Factor for Dysfunctional Eating Behavior after Obesity Surgery during the COVID-19 Pandemic

Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for obesity surgery), while 142 (55.46%) had already undergone surgery. Participants who underwent surgery were compared to participants that did not yet undergo surgery in terms of mental burden (depression and anxiety), as well as safety and eating behavior. Further moderation analyses attempted to identify risk factors for increased COVID-19-related dysfunctional eating behavior after surgery. Results: Participants who underwent surgery showed generally lower levels of depression and general anxiety on a trend level. Moderation analyses suggested that people with high levels of generalized anxiety actually show more dysfunctional COVID-19-specific eating behavior after obesity surgery. Conclusion: On a trend level, obesity surgery appears to attenuate symptoms of generalized anxiety and depression. Yet, surgery patients with high levels of generalized anxiety exhibit even higher levels of dysfunctional eating during the COVID-19 pandemic. It is therefore particularly important to support people at risk.

Thinking with attachments: Appreciating a generative analytic

Much current work in Science and Technology Studies inflects knowing with care. Analyses of the ethos of objectivity, and of the practices by which objectivity is crafted, have shown that knowing and caring cannot be thought apart from each other. Using case studies from our own work we analyse how, in the sociotechnical relationships that we study, knowing and caring are entangled through ‘attachments’. We appreciate – both in the sense of valuing or respecting and in the sense of evaluating or assessing – how the notion of ‘attachment’ invites re-imagining relations between the social and the technical, between knowers and objects known, and between sociotechnical work and the affective sensibilities that enable, and are brought to life by, such work. Our respective ethnographic engagements with dog-human relations, obesity surgery and dementia care demonstrate that it is agents’ diverse and shifting attachments to technologies and techniques that shape the ways in which bodies, knowledge and practices form. The affects that arise in this process, or so we claim in neo-pragmatist fashion, are not preconditions to, but rather the result of such practices of attachment; rather than a prerequisite, they are an effect of the work of attaching itself. Thinking with attachments recognizes how techno-scientific work builds and shapes passions, aesthetics and sensory experience, allowing us to trace how varied sensibilities to what constitutes ‘the good’ come to be and come to matter in practices of relating between humans, animals and things.

The Cyberball task in people after obesity surgery: preliminary evaluation of cognitive effects of social inclusion and exclusion with a laboratory task

Background Social cognition and temperamental and interpretative styles could play a role in the outcome of bariatric surgery. This study aims to assess preliminary evidence about how obesity surgery patients evaluate social inclusion and exclusion through a ball-tossing game called Cyberball, looking at the influence of early maladaptive schemas. Methods Thirty-four patients with a history of obesity surgery interventions and 44 controls were recruited for this study. A psychological evaluation was performed before and after the Cyberball task with self-report questionnaires. Results In the ostracism condition, significant differences were seen across all the patients’ fundamental psychological needs with less perceived ostracization (p = 0.001) even if they recognized less interaction via fewer ball tosses than controls. Moreover, the ostracism paradigm resulted in patients experiencing a higher urge to binge (p = 0.010) and a higher urge to restrain (p = 0.012) than controls. Looking at differences due to the Cyberball paradigm applied, clear differences emerged only between controls subgroups at the specific self-report scales applied, corroborating the reduced perception of the exclusion. As evidenced by the schema domains, the study found a connection between the impaired limits-schema domain and the drive to binge. Conclusion The results show that obesity surgery patients reported different effects of the Cyberball task than controls. Different possible interpretations are discussed, and future directions for studies are exposed, both for the evaluation of social interactions effects and in the assessment of the role of specific cognitive schemas. Level of evidence Level III: evidence obtained from well-designed cohort or case–control analytic studies.