Title : The experience of weight regain after Bariatric Surgery: A phenomenological approach
Abstract:
Introduction: Bariatric surgery stands out as the most effective method in the long-term treatment of obesity, leading to significant remission of diseases associated with overweight. However, the results of the surgery are not always long lasting. It is estimated that 20% to 30% of the people who undergo the bariatric surgery will regain weight after the first two years.
Aim: To understand the experience of weight regain to people who were subjected to bariatric surgery.
Method: Qualitative research with a phenomenological approach, conducted in a public hospital of Sao Paulo. The sample was composed of 17 participants who presented weight regain after bariatric surgery. To collect the data, an open interview was used with the following guiding questions: How is it to you, to notice yourself gaining weight again? What do you believe is contributing to your weight gain? How do you deal with the weight regain? How do you see yourself in a few years, in relation to your body weight? The organization and analysis of the interviews were conducted following the steps recommended by scholars of the social phenomenology of Alfred Schütz.
Results: The typical action experienced by people with weight regain after bariatric surgery showed up as one that: assigns the weight regain to an emotional instability that leads them to difficulties in the control of eating behavior; states that stress, anxiety and loneliness contributes to weight regain; associates the recurrence of overweight to anatomical changes related to the surgery; expresses feelings of defeat, guilt and sadness; points out physical and mental consequences arising from the weight regain, fears gaining too much weight and losing control; report excessive alcohol consumption; has the expectation of controlling the weight gain in order to positively impact the quality of life, thus, requires multidisciplinary support for issues regarding weight regain; intend to undergo another bariatric surgery and a plastic surgery to improve self-esteem.
Conclusions: the findings illustrate how the phenomenon of weight regain is complex in its bio-psycho-emotional aspects and requires an individualized and qualified attention, welcoming of the subjective issues experienced by those who were submitted to a bariatric surgery and are going through a situation of weight regain. It is believed that the discussion on this research reinforces the need of the healthcare teams to invest on a follow-up of bariatric patients, based on an intersubjective relationship that respects and considers the other, sharing decisions and contributing to the patients becoming active in the production of their health and partners in the success of reaching and maintaining their desired weight.
Results of the present study show that in order to assist people who experience weight regain after bariatric surgery, members of the multidisciplinary team must deepen their knowledge, develop skills and abilities, exchange experiences and seek constant qualification in the various aspects involved, giving special attention to the subjective nature of the issues related to this theme.
This study demonstrates that the multidisciplinary team made up of doctors, nurses, psychologists and nutritionists among others, must be qualified in order to work with people with weight regain after bariatric surgery, offering instruments that will enable them to deal more adequately with their problems and thus preventing the recurrence of obesity. The intervention of the professionals must have a preventive and educational focus, guiding and accompanying the patients in every process - before and after the obesity surgery. It is emphasized the need of the team to deepen their knowledge, exchange experiences and seek constant qualification in the various aspects involved in bariatric surgery.
Faced with the complexity of weight regain after bariatric surgery, this study indicates that since the student's formation, educational actions should be incorporated that value the subjectivity of the person who experiences weight regain - the biomedical model focused only on disease does not contemplate this subjectivity. This research also highlight the need for reflection and critical judgment of professionals in order to provide support for the elaboration of concrete actions that can be implemented and which can contribute to the advancement of knowledge, the development of new research and to the quality of care provided.
