Health  Vol.5 No.11 , November 2013
Patients’ perceptions, health and psychological changes with obesity treatment: Success and failure in a triangulation study
Abstract: The present study aims to understand changes in health problems, health complaints and coping strategies, during the obesity treatment process with qualitative and quantitative data. Thirty bariatric patients were interviewed before bariatric surgery and at a 12-month follow-up, and fulfilled self-report measures about health problems, health complaints and coping strategies before surgery, at 6-and 12-month follow-ups. Before surgery, failure cases differ from success on the conceptualization of obesity, However, there are no other differences between groups. At 6-and 12-month follow-ups, failure cases had the highest BMI, health problems and complaints and less % EWL than success cases. One year after the surgery, one in each three persons did not lose the expected weight, i.e., are failure cases. Before surgery, there are no differences between success and failure cases in the report of health problems, health complaints and coping strategies, but they have different conceptualizations of their obesity and treatment. One year after the surgery, success cases understood bariatric surgery as an important moment in their lives related to their expected results, whereas failures valued unexpected dimensions and still waiting for a miracle surgery without their personal commitment. Accordingly, it is necessary to consider life changes in the obesity treatment process.
Cite this paper: Silva, S. and Maia, Â. (2013) Patients’ perceptions, health and psychological changes with obesity treatment: Success and failure in a triangulation study. Health, 5, 1750-1759. doi: 10.4236/health.2013.511236.

[1]   WHO (2004) WHO-special issue-diet, nutrition and the prevention of chronic diseases. Scientific Background Papers of the Joint WHO/FAO Expert Consultation, Geneva.

[2]   Segal, A., Cardeal, M. and Cordás, T. (2002) Obesity: Psychosocial and psychiatric aspects. Revista de Psiquiatria Clínica, 29, 81-89.

[3]   Prochaska, J.O., Norcross, J.C., Fowler, J.L., Follick, M.J. and Abrams, D.B. (1992) Attendance and outcome in a work site weight control program: Processes and stages of change as process and predictor variables. Addictive Behaviors, 17, 35-45.

[4]   Fairbun, C. and Brownell K. (2002) Eating disorders and obesity. The Guilford Press, London.

[5]   Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M.D., Pories, W., Fahrbach, K., et al. (2004) Bariatric surgery: A systematic review and meta-analysis. JAMA, 292, 1724-1737.

[6]   Holzwarth, R., Huber, D., Majkrzak, A. and Tareen, B. (2002) Outcome of gastric bypass patients. Obesity Surgery, 12, 261-264.

[7]   Kaly, P., Orellana, S., Torrella, T., Takagishi, C., Saff-Koche, L. and Murr, M. (2008) Unrealistic weight loss expectations in candidates for bariatric surgery. Surgery for Obesity and Related Diseases, 4, 6-10.

[8]   Steinmann, W.C., Suttmoeller, K., Chitima-Matsiga, R., Nagam, N., Suttmoeller, N.R. and Halstenson, N.A. (2011) Bariatric surgery: 1-year weight loss outcomes in patients with bipolar and other psychiatric disorders. Obesity Surgery.

[9]   Kalarchian, M.A., Marcus, M.D., Wilson, G.T., Labouvie, E.W., Brolin, R.E. and LaMarca, L.B. (2002) Binge eating among gastric bypass patients at long-term follow-up. Obesity Surgery, 12, 270-275.

[10]   Horchner, R., Tuinebreijer, W. and Kelder, H. (2002) Eating patterns in morbidly obese patients before and after a gastric restrictive operation. Obesity Surgery, 12, 108-112.

[11]   Sjostrom, L., Narbro, K., Sjostrom, C., Karason, K., Larsson, B., Wedel, H., et al. (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. New England Journal of Medicine, 357, 741-752.

[12]   Ogden, J., Clementi, C., Aylwin, S. and Patel, A. (2005) Exploring the impact of obesity surgery on patients’ health status: A quantitative and qualitative study. Obesity Surgery, 15, 266-272.

[13]   Chantler, P. and Lakatta, E. (2009) Role of body size on cardiovascular function: Can we see the meat through the fat? Hypertension, 54, 459-461.

[14]   Lier, H., Biringer, E., Stubhaug, B., Eriksen, H.R. and Tangen, T. (2011) Psychiatric disorders and participation in preand postoperative counselling groups in bariatric surgery patients. Obesity Surgery, 21, 730-737.

[15]   Mitchell, J. and Zwaan, M. (2005) Bariatric surgery: A guide for mental health professional. Routledge, New York.

[16]   Dodsworth, A., Warren-Forward, H. and Baines, S. (2010) Changes in eating behavior after laparoscopic adjustable gastric banding: A systematic review of the literature. Obesity Surgery, 20, 1579-1593.

[17]   Fischer, S., Chen, E., Katterman, S., Roerhig, M., Bochierri-Ricciardi, L., Munoz, D., et al. (2007) Emotional eating in a morbidly obese bariatric surgery-seeking population. Obesity Surgery, 17, 778-784.

[18]   Delin, C., McK Watts, J. and Bassett, D. (1995) An exploration of the outcomes of gastric bypass surgery for morbid obesity: Patient characteristics and indices of success. Obesity Surgery, 5, 159-170.

[19]   Van Gemert, W., Severeijins, R., Greve, J., Groenman, N. and Soeters, P. (1998) Psychological functioning of morbidly obese patients after surgical treatment.

[20]   Engstrom, M., Wiklund, M., Olsén, M., Lonroth, H. and Forserg, A. (2011) The meaning of awaiting bariatric surgery due to morbid obesity. The Open Nursing Journal, 1-8.

[21]   Patton, M.Q. (1990) Qualitative evaluation and research methods. 2nd Edition, Sage Publications Inc., Thousand Oaks.

[22]   Nakkash, R., Afifi Soweid, R.A., Nehlawi, M.T., ShediacRizkallah, M.C., Hajjar, T.A. and Khogali, M. (2003) The development of a feasible community-specific cardiovascular disease prevention program: Triangulation of methods and sources. Health Education & Behavior, 30, 723-739.

[23]   Silva, S. and Maia, A. (2008) Socio-demographic questionnaire.

[24]   McIntyre, T., McIntyre, S. and Redondo, S. (1999) Portuguese version of ways of coping questionnaire.

[25]   Parkes, K. (1984) Locus of control, cognitive appraisal, and coping in stressful episodes. Journal of Personality and Social Psychology, 46, 655-668.

[26]   De Haes, J., Van Knippenberg, F. and Neijt, J. (1990) Measuring psychological and physical distress in cancer patients: Structure and application of the Rotterdam Symptom Checklist. British Journal of Cancer, 62, 1034-1038.

[27]   McIntyre, T. and Gameiro, J. (1997) Portuguese version of Rotterdam Symptoms Checklist (RSCL).

[28]   Silva, S. and Maia, A. (2007) Self report diseases checklist.

[29]   Silva, S. and Maia, A. (2012) Obesity and treatment meanings in bariatric surgery candidates: A qualitative study. Obesity Surgery, 22, 1714-1722.

[30]   Silva, S. and Maia, A. (2013) Patients’ experiences after bariatric surgery: A qualitative study at 12-month follow-up. Clinical Obesity.

[31]   Strauss, A.C. and Corbin, J.M. (1990) Basics of qualitative research: Grounded theory procedures and techniques. 2nd Edition, Sage Publications, Inc., Thousand Oaks.

[32]   Corbin, J.M. and Strauss, A.C. (2007) Basics of qualitative research: Techniques and procedures for developing grounded theory. 3rd Edition, Sage Publications, Inc., Thousand Oaks.

[33]   Richards, P.L. (2009) Handling qualitative data: A practical guide. 2nd Edition, Sage Publications Ltd, Thousand Oaks.

[34]   Silva, S. and Maia, A. Psychological and health comorbilities before and after bariatric surgery: A longitudinal study.

[35]   Torgerson, J. and Sjostrom, L. (2001) The swedish obese subjects (SOS) study—Rationale and results. International Journal of Obesity and Related Metabolic Disorders, 25, S2-S4.

[36]   Kitsantas, A. (2000) The role of self-regulation strategies and self-efficacy perceptions in successful weight loss maintenance. Psychology & Health, 15, 811.

[37]   Ogden, J., Clementi, C. and Aylwin, S. (2006) The impact of obesity surgery and the paradox of control: A qualitative study. Psychology & Health, 21, 273.

[38]   Horwath, C.C. (1999) Applying the transtheoretical model to eating behaviour change: Challenges and opportunities. Nutrition Research Reviews, 12, 281-317.

[39]   Prochaska, J.O., DiClemente, C.C. and Norcross, J.C. (1992) In search of how people change. Applications to addictive behaviors. American Psychologist, 47, 1102-1114.

[40]   Kinzl, J.F. (2010) Morbid obesity: Significance of psychological treatment after bariatric surgery. Eating and Weight Disorders, 15, e275-e280.