Weight Gain After Bariatric Surgery; What Patients Need to Avoid: A Qualitative Study

Introduction: Determinants of weight gain after bariatric surgery have not been sufficiently studied from the patients' perspective. Objective: The present qualitative study aims to identify these determinants and needs of patients to counteract them. Methods: Well after their surgery, in 2018 we interviewed 13 patients in France, with two focus groups: the success group ("SG") comprising patients who reached the desired weight, and the weight recidivism group ("WRG") comprising patients who had regained weight 2-12 years after surgery. Results: While SG patients were relatively satisfied but remained vigilant, WRG patients were lacking in confidence. Determinants of weight gain declared by patients were environmental, physiological, psychosocial, and lifestyle related; they were also impacted by the patient-physician relationship. We noted that WRG patients cited more external factors than did SG patients. Means to avoid weight gain were more psychological than physiological or environmental; when expressed, they were primarily associated with internal factors. Conclusion: This study highlights weight gain factors as seen from the patients' perspective. Educational sessions are predicated on identification of their means of avoiding weight gain. In this work, "locus of control" emerges as a key predictive factor of bariatric surgery success.