How to get back on track? Experiences of patients and healthcare professionals regarding weight recurrence and needs for an intervention after bariatric-metabolic surgery

Vera Voorwinde; Sahar Moukadem; Maartje M van Stralen; Ignace M C Janssen; Valerie M Monpellier; Ingrid H M Steenhuis

doi:10.1016/j.obpill.2023.100074

How to get back on track? Experiences of patients and healthcare professionals regarding weight recurrence and needs for an intervention after bariatric-metabolic surgery

Obes Pillars. 2023 Jun 8:7:100074. doi: 10.1016/j.obpill.2023.100074. eCollection 2023 Sep.

Authors

Vera Voorwinde^{1

2}, Sahar Moukadem², Maartje M van Stralen², Ignace M C Janssen¹, Valerie M Monpellier¹, Ingrid H M Steenhuis²

Affiliations

¹ Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis ter Heide, the Netherlands.
² VU University, Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.

Abstract

Background: Multidisciplinary lifestyle interventions are recommended as a first step in treating weight recurrence after bariatric-metabolic surgery (BMS). However, little is known about the experience of patients and healthcare professionals (HCP) with these interventions and how they should be tailored to the patients' needs. The aim of this study was to gain more insight into the experiences and needs of patients and HCP regarding weight recurrence after BMS and an intervention to get Back on Track. In addition, attitudes towards integrating e-Health into the care program were explored.

Methods: A qualitative process evaluation of an intervention for weight recurrence, the Back on Track (BoT), was conducted by means of in-depth interviews and focus groups with 19 stakeholders, including patients and HCP involved in BoT. Interviews were transcribed verbatim. Data were analyzed through thematic analysis.

Results: Patients and HCP reported a wide array of causes of weight recurrence. Patients found it difficult to decide when weight recurrence is problematic and when they should ask for help. Patients reported feeling like the exception and ashamed, therefore experiencing a high threshold to seek help. E-Health was seen as a promising way to improve tailoring, screening, autonomy for the patient, and accessible contact.

Conclusion: Patients should be adequately counselled on weight recurrence after BMS and the importance of intervening early. It is important to lower the threshold for seeking help. For example by offering more long-term standard care or by adding e-Health to the intervention.

Keywords: Bariatric-metabolic surgery; Behavior modification; Lifestyle intervention; Patient experience; Weight recurrence.