Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2013-0041
Trends in Psychiatry and Psychotherapy
Original Article

Weight regain among women after metabolic and bariatric surgery: a qualitative study in Brazil

Reganho de peso em mulheres após cirurgia metabólica e bariátrica: estudo qualitativo no Brasil

Ataliba de Carvalho Jr.; Egberto Ribeiro Turato; Elinton Adami Chaim; Ronis Magdaleno Jr.

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Abstract

INTRODUCTION: Due to the increased number of bariatric surgeries over the years, aspects contributing or hindering the achievement of outcomes, among them weight regain, have acquired increased significance. Psychological factors directly influence on this unwanted situation, but there are few studies and controversies about the degree of participation of these factors. We propose a qualitative investigation to analyze the meanings of weight regain after surgery among women and how these factors influence this outcome.METHOD: This study uses the clinical-qualitative method, by means of a semi-structured interview with open questions in an intentional sample, closed by saturation, with eight women who underwent surgery at the Bariatric Surgery Outpatient Clinic of Hospital das Clínicas, Universidade Estadual de Campinas (UNICAMP), in the state of São Paulo, Brazil.RESULTS: A feeling of defeat and failure emerges with weight regain, which contributes to social isolation; there is no regret, but gratitude for the surgery; among patients, there is a sense of feeling rejected greater than a rejection that actually exists.CONCLUSION: We found out the need for further qualitative studies that help the health team to better understand the dynamic psychological factors involved in the meaning of weight regain after bariatric surgery among women, in order to adopt appropriate conducts to deal with this problem.

Keywords

Obesity, bariatric surgery, weight regain, qualitative method, morbid obesity

Resumo

INTRODUÇÃO: Com o aumento do número de cirurgias bariátricas ao longo dos anos, têm chamado atenção os aspectos que contribuem ou impedem os resultados, entre eles o reganho de peso, mostram-se relevantes. Fatores psicológicos influenciam diretamente essa situação indesejada, mas há poucos estudos e controvérsias sobre o grau de participação desses fatores. Nós propomos uma investigação qualitativa para analisar os significados do reganho de peso depois da cirurgia para mulheres e como esses fatores influenciam esse resultado.MÉTODO: Este estudo usa o método clínico-qualitativo, por meio de entrevista semiestruturada com questões abertas em uma amostra intencional, fechada por saturação, com oito mulheres operadas no ambulatório de cirurgia bariátrica do Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP), no estado de São Paulo.RESULTADOS: Um sentimento de derrota e fracasso surge com o reganho de peso, que colabora para o isolamento social; não há arrependimento, mas gratidão pela cirurgia; entre as pacientes, há uma ideia de sentir-se rejeitada maior que uma rejeição que existe de fato.CONCLUSÃO: Constatamos a necessidade de novos estudos qualitativos que auxiliem a equipe de saúde a entender melhor os fatores psicológicos dinâmicos envolvidos no significado do reganho de peso após a cirurgia bariátrica entre as mulheres para adotar condutas adequadas para lidar com esse problema.

Palavras-chave

Obesidade, cirurgia bariátrica, reganho de peso, método qualitativo, obesidade mórbida

References

Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg.. 2004;14:1157-64.

Obesity and overweight. 2013.

Ferreira VA, Magalhaes R. Obesidade no Brasil: tendências atuais. Rev Port Sau Pub. 2006;24:71-81.

Monteiro CA, Conde WL, Popkin BM. Income-specific trends in obesity in Brazil: 1975-2003. Am J Public Health. 2007;97:1808-12.

Buchwald H. Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis. 2005;1:371-81.

Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg. 2009;19:1605-11.

Hsu LK, Benotti PN, Dwyer J, Roberts SB, Saltzman E, Shikora S. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60:338-46.

Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648-51.

Dymek MP, le Grange D, Neven K, Alverdy J. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg. 2001;11:32-9.

Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res. 2002;52:155-65.

Byrne S, Cooper Z, Fairburn C. Weight maintenance and relapse in obesity: a qualitative study. Int J Obes Relat Metab Disord. 2003;27:955-62.

Elfhag K, Rössner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev. 2005;6:67-85.

Dziurowicz-Kozlowska AH, Wierzbicki Z, Lisik W, Wasiak D, Kosieradzki M. The objective of psychological evaluation in the process of qualifying candidates for bariatric surgery. Obes Surg. 2006;16:196-202.

Magdaleno Jr. R, Chaim EA, Turato ER. Características psicológicas de pacientes submetidos a cirurgia bariátrica. Rev Psiquiatr RS.. 2009;31:73-8.

Magdaleno Jr. R, Chaim EA, Turato ER. Surgical treatment of obesity: some considerations on the transformations of the eating impulse. Rev Latinoam Psicopat Fund.. 2010;13:425-40.

Benotti PN, Forse RA. The role of gastric surgery in the multidisciplinary management of severe obesity. Am J Surg. 1995;169:361-7.

Kalarchian MA, Marcus MD, Wilson GT, Labouvie EW, Brolin RE, LaMarca LB. Binge eating among gastric bypass patients at long-term follow-up. Obes Surg. 2002;12:270-5.

Glinski J, Wetzler S, Goodman E. The psychology of gastric bypass surgery. Obes Surg. 2001;11:581-8.

Bauchowitz AU, Gonder-Frederick LA, Olbrisch ME, Azarbad L, Ryee MY, Woodson M. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med. 2005;67:825-32.

McGuire MT, Wing RR, Klem ML, Lang W, Hill JO. What predicts weight regain in a group of successful weight losers. J Consult Clin Psychol. 1999;67:177-85.

Odom J, Zalesin KC, Washington TL, Miller WW, Hakmeh B, Zaremba DL. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20:349-56.

Groven KS, Råheim M, Engelsrud G. "My quality of life is worse compared to my earlier life": living with chronic problems after weight loss surgery. Int J Qual Stud Health Well-being.. 2010;5.

Natvik E, Gjengedal E, Raheim M. Totally changed, yet still the same: patients' lived experiences 5 years beyond bariatric surgery. Qual Health Res. 2013;23:1202-14.

Sugerman HJ, Kellum JM, Engle KM, Wolfe L, Starkey JV, Birkenhauer R. Gastric bypass for treating severe obesity. Am J Clin Nutr. 1992;55:560S-6S.

Myers VH, Adams CE, Barbera BL, Brantley PJ. Medical and psychosocial outcomes of laparoscopic Roux-en-Y gastric bypass: cross-sectional findings at 4-year follow-up. Obes Surg. 2012;22:230-9.

Ogden J, Sian A, Ellis G. Negotiating control: patients' experiences of unsuccessful weight-loss surgery. Psychol Health.. 2006;21:273-93.

Ogden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: A qualitative study. Psychol Health. 2006;21:273-93.

Turato ER. Tratado da Metodologia da Pesquisa Clínico-Qualitativa: construção teórico-epistemológica, discussão comparada e aplicação nas áreas da saúde e humanas. 2010.

Denzin NK, Lincoln YS. The SAGE handbook of qualitative research. 2005.

Minayo MCS. O desafio do conhecimento-pesquisa qualitativa em saúde. 2010.

Morse JM, Field PA. Qualitative research methods for health professionals. 1995.

Patton MQ. Qualitative evaluation and research methods. 1990.

Fontanella BJ, Campos CJ, Turato ER. Data collection in clinical-qualitative research: use of non-directed interviews with open-ended questions by health professionals. Rev Lat Am Enfermagem. 2006;14:812-20.

Shamblin JR, Shamblin WR. Bariatric surgery should be more widely accepted. South Med J. 1987;80:861-5.

Powers PS, Rosemurgy A, Boyd F, Perez A. Outcome of gastric restriction procedures: weight, psychiatric diagnoses, and satisfaction. Obes Surg. 1997;7:471-7.

Fontanella BJB, Ricas J, Turato ER. Amostragem por saturação em pesquisas qualitativas em saúde: contribuições teóricas. Cad Saúde Pública. 2008;24:17-27.

Bardin L. Análise de conteúdo. 2009.

van Hout GC, Boekestein P, Fortuin FA, Pelle AJ, van Heck GL. Psychosocial functioning following bariatric surgery. Obes Surg. 2006;16:787-94.

van Hout GC, Fortuin FA, Pelle AJ, van Heck GL. Psychosocial functioning, personality, and body image following vertical banded gastroplasty. Obes Surg. 2008;18:115-20.

Magdaleno Jr R, Chaim EA, Turato ER. Understanding the life experiences of Brazilian women after bariatric surgery: a qualitative study. Obes Surg. 2010;20:1086-9.

Magdaleno Jr R, Chaim EA, Pareja JC, Turato ER. The psychology of bariatric patient: what replaces obesity? A qualitative research with Brazilian women. Obes Surg. 2011;21:336-9.

de Zwaan M, Lancaster KL, Mitchell JE, Howell LM, Monson N, Roerig JL. Health-related quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg. 2002;12:773-80.

Maddi SR, Fox SR, Khoshaba DM, Harvey RH, Lu JL, Persico M. Reduction in psychopathology following bariatric surgery for morbid obesity. Obes Surg. 2001;11:680-5.

Curtis C, Davis C. A qualitative study of binge eating and obesity from an addiction perspective. Eat Disord. 2014;22:19-32.

Eichen DM, Lent MR, Goldbacher E, Foster GD. Exploration of "food addiction" in overweight and obese treatment-seeking adults. Appetite. 2013;67:22-4.

Pretlow RA. Addiction to highly pleasurable food as a cause of the childhood obesity epidemic: a qualitative Internet study. Eat Disord. 2011;19:295-307.

Sinha R, Jastreboff AM. Stress as a common risk factor for obesity and addiction. Biol Psychiatry. 2013;73:827-35.

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