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Ogden J, Quirke-McFarlane S. Sabotage, Collusion, and Being a Feeder: Towards a New Model of Negative Social Support and Its Impact on Weight Management. Curr Obes Rep 2023:10.1007/s13679-023-00504-5. [PMID: 37280423 DOI: 10.1007/s13679-023-00504-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE OF REVIEW Whilst research indicates the positive impact of social support across a number of health domains, including weight management, not all social support is beneficial. RECENT FINDINGS This paper reviews the evidence for both positive and negative social support in the context of behavioural interventions and surgery for obesity. It then presents a new model of negative social support focusing on sabotage ('active and intentional undermining of another person's weight goals'), feeding behaviour ('explicit over feeding of someone when they are not hungry or wishing not to eat'), and collusion ('passive and benign negative social support to avoid conflict') which can be conceptualised within the context of relationships as systems and the mechanisms of homeostasis. There is increasing evidence for the negative impact of social support. This new model could form the basis of further research and the development of interventions for family, friends, and partners to maximise weight loss outcomes.
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Affiliation(s)
- Jane Ogden
- School of Psychology, University of Surrey, Guildford, GU2 7XH, Surrey, UK.
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Is body-contouring surgery a right for massive weight loss patients? A survey through the European Union National Health Systems. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-020-01779-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Background
Obesity is pandemic nowadays, and hanging skin with consequent functional and psychological impairments is a common price to pay for massive weight loss. Plastic surgery in postbariatric patients represents a fundamental step to regain possession of a positive self-image. The authors aimed to investigate how EU countries’ National Health System (NHS) behaves regarding reimbursements for body-contouring procedures after massive weight loss.
Methods
A 1-item survey was sent to contacts found on the NHS official Web sites of 27 EU countries. The question focused on postbariatric surgery practice and investigated the accessibility criteria for NHS coverage concerning body-contouring procedures after massive weight loss.
Results
Responses were collected between January 2020 and February 2020. Response rate was 65%, and access criteria to NHS coverage for postbariatric surgery presented great variation across EU countries. Only one country presented an NHS with no coverage for postbariatric surgeries.
Conclusions
Despite the conspicuous variability found among the EU NHS, none of them admit reimbursement in cases of merely aesthetic procedures: postbariatric patients need to display functional or health impairments due to the extensive weight loss. The results of the current study describe a complex situation among EU countries, but a common lead towards postbariatric patients’ care shows off. The ultimate goal of bariatric patient’s healing should be full restoration of physical and psychological well-being. NHS of EU countries are facing this increasing request in various ways, and more studies should be performed in order to understand which is the best approach.
Level of evidence: Not ratable.
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Köhler H, Kröger C, Watschke A, Gruner-Labitzke K, Böker C, Markov V. Changes in Patients' Relationship Satisfaction After Weight Loss Surgery: Results of a Study of Persons with Morbid Obesity and Their Relationship Satisfaction Before and 1 Year After Bariatric Surgery. Obes Surg 2021; 31:1431-1437. [PMID: 33403507 DOI: 10.1007/s11695-020-05147-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in relationship satisfaction (RS) is still limited. The present study examines whether a patient's RS changes after having bariatric surgery, in response to the surgery-induced weight loss. The predictive value of further variables such as age and sex are also investigated. METHODS A total of 145 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. RS was assessed with a reliable and valid short form of a standardized self-report measure, which was completed before, 6 months and 12 months after surgery. RESULTS Loss of excess weight at 6 and 12 months post-surgery was 49% and 66.3%, respectively. The repeated measures ANOVA for the factor "PFB-K" revealed a statistically significant effect, with F (2, 288) = 7.40, p = .001, and η2 = .05, and for the factor "BMI" with F (2, 288) = 505.99, p < .001, and η2 = .78. The highest mean RS score was observed 6 months post-surgery. Sex showed a statistical trend of influence on RS: F (1, 143) = 3.24, p = .074, and η2 = .022. At all three measurement points, men showed higher mean RS scores than women. CONCLUSION Bariatric surgery leads to significant weight loss and indicates an increase in RS. While a correlation with the amount of weight lost remains unclear, a trend was seen towards higher RS in subjects with higher weight loss. Men in particular reported higher RS.
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Affiliation(s)
- Hinrich Köhler
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Leipziger Str. 24, 38124, Braunschweig, Germany.
| | - Christoph Kröger
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
| | - Anna Watschke
- Department of Psychology, University of Braunschweig, Braunschweig, Germany
| | - Kerstin Gruner-Labitzke
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Leipziger Str. 24, 38124, Braunschweig, Germany
| | - Clara Böker
- Department of General, Visceral, Vascular, and Bariatric Surgery, Klinikum Nordstadt, Hannover, Germany
| | - Valentin Markov
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
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Conceição EM, Fernandes M, de Lourdes M, Pinto-Bastos A, Vaz AR, Ramalho S. Perceived social support before and after bariatric surgery: association with depression, problematic eating behaviors, and weight outcomes. Eat Weight Disord 2020; 25:679-692. [PMID: 30859467 DOI: 10.1007/s40519-019-00671-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/05/2019] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Engaging in a healthy lifestyle after bariatric surgery is essential to optimize and sustain weight loss in the long term. There is promising evidence that social support of patients who undergo bariatric surgery plays an important role in promoting a better quality of life and adherence to the required behavioral changes and medical appointments. This study sought to investigate: (a) if post-operative patients experience different levels of perceived social support compared to pre-operative patients; (b) correlations between perceived social support, depression, disordered eating, and weight outcomes; (c) if social support is a moderator between psychological distress, and disordered eating behavior and weight outcomes. METHODS A group of 65 patients assessed pre-surgery and another group of 65 patients assessed post-surgery (M = 26.12; SD 7.97 months since surgery) responded to a set of self-report measures assessing social support, eating disorder psychopathology, disordered eating, and depression. RESULTS Greater social support was associated with lower depression, emotional eating, weight and shape concerns, and greater weight loss in pre- and post-surgery groups. Social support was found to be a moderator between different psychological/weight variables but only for the post-surgery group: the relation between depression and eating disorder psychopathology or weight loss was significant for patients scoring medium to high level is social support; the relation between grazing and weight regain was significant for patients scoring medium to low levels of social support. CONCLUSIONS The associations found between perceived social support and depression, disordered eating and weight outcomes highlight the importance of considering and working with the social support network of patients undergoing bariatric surgery to optimize treatment outcomes. Level of Evidence Level III: case-control study.
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Affiliation(s)
- Eva M Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal.
| | - Marta Fernandes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Ana R Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
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Lo Torto F, Marcasciano M, Frattaroli JM, Kaciulyte J, Mori FLR, Redi U, Casella D, Cigna E, Ribuffo D. Quality Assessment of Online Information on Body Contouring Surgery in Postbariatric Patient. Aesthetic Plast Surg 2020; 44:839-846. [PMID: 31712871 DOI: 10.1007/s00266-019-01535-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 10/31/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Nowadays, we have to face the fact that the Web represents one of the most important sources of information for patients. Postbariatric patients in particular are usually very motivated, and they are enthusiastic users of the Web as a source of information on the different types of surgery they could undergo after their weight loss in order to reshape and remodel their body thus regaining physical and functional wellness and dignity. The aim of the study was to assess information on the four most commonly performed postbariatric procedures worldwide, tummy tuck, breast, arm and thigh lift, with the same scale. METHODS Google and Yahoo have been probed for the keywords "Post bariatric Mastopexy OR breast lift" and "Post bariatric abdominoplasty OR tummy tuck" and "Post bariatric brachioplasty OR arm lift" and "post bariatric thigh lift". The first 50 hits were included, and the quality of information was evaluated with the expanded EQIP scale. RESULTS There was a critical lack of information about qualitative risks and side-effect description, treatment of potential complications, alert signs for the patient and precautions that the patient may take. Moreover, there was poor information about the sequence of the medical procedure, quantitative benefits and risks and quality of life issues after the procedure, and often, there were no other sources of information. CONCLUSIONS Due to the poor and not reliable information offered by the Web, health professionals should seek for a good communication practice with their patients. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Federico Lo Torto
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy.
| | - Marco Marcasciano
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Jacopo M Frattaroli
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Juste Kaciulyte
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Francesco L R Mori
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Ugo Redi
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Donato Casella
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Emanuele Cigna
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università degli Studi di Pisa, Pisa, Italy
| | - Diego Ribuffo
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
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Ofori A, Keeton J, Booker Q, Schneider B, McAdams C, Messiah SE. Socioecological factors associated with ethnic disparities in metabolic and bariatric surgery utilization: a qualitative study. Surg Obes Relat Dis 2020; 16:786-795. [PMID: 32139155 DOI: 10.1016/j.soard.2020.01.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/22/2020] [Accepted: 01/29/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) is a safe and effective treatment choice for severe obesity. Yet only approximately 50% of those referred to MBS complete the procedure. Studies show that racial minority groups are less likely than non-Hispanic whites to complete MBS despite having higher rates of severe obesity and co-morbidities. OBJECTIVES To conduct a qualitative study to determine facilitators and challenges to racially diverse patients completing MBS based on the 4 socioecological model domains (intrapersonal, interpersonal, organization/clinical interaction, and societal/environmental). SETTING One university-based surgery practice serving a racially diverse patient population. METHODS Focus groups and in-depth interviews were conducted (Spring 2019) among patients (n = 24, 70% female, 50% non-Hispanic black, 4% Hispanic) who completed MBS over the past year. Social support members were also included (n = 7). Grand tour questions were organized by the 4 socioecological model domains and within the context of MBS completion. Data were audio-recorded, transcribed, and coded. A thematic analysis combining a deductive and inductive approach was conducted. Codes were analyzed using Dedoose to identify themes/subthemes. RESULTS Ten themes and 15 subthemes were identified. Key intra- and interpersonal facilitators to MBS completion included social support systems, primary care physician support of MBS, co-morbidity resolution, discrimination experiences, and mobility improvements. Key community and environment themes associated with post-MBS sustained weight loss included community support groups and access to healthy foods and exercise facilities. No themes or subthemes varied by race. CONCLUSIONS Educating primary care physicians and social support networks about the benefits of MBS could improve utilization rates. MBS patients have a desire to have their communities provide resources to support their postoperative success.
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Affiliation(s)
- Ashley Ofori
- University of Texas Health Science Center at Houston, Dallas Campus, Dallas, Texas
| | - Juang Keeton
- University of Texas Health Science Center at Houston, Dallas Campus, Dallas, Texas
| | - Quiera Booker
- University of Texas Health Science Center at Houston, Dallas Campus, Dallas, Texas
| | - Benjamin Schneider
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Carrie McAdams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, Dallas Campus, Dallas, Texas.
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