Patient experiences of a bariatric group programme for managing obesity: A qualitative interview study

Mark Tarrant*, Sammyh S. Khan, Claire V. Farrow, Pooja Shah, Mark Daly, Katarina Kos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

<jats:sec><jats:title>Objectives</jats:title><jats:p>People with obesity experience a range of physical and psychological ill‐health outcomes. This study examined patients’ experiences of a group‐based programme for the management of morbid obesity delivered within the <jats:styled-content style="fixed-case">UK</jats:styled-content> National Health Service. The focus of the study was on the emerging dynamic of the group and patients’ perceptions of its impact on health outcomes.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A qualitative interview study was conducted and involved patients recruited from a Tier 3 bariatric service in South West England. Verbatim transcripts were analysed using thematic analysis.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Twenty patients (12 females) with a <jats:styled-content style="fixed-case">BMI</jats:styled-content> ≥ 35 kg/m<jats:sup>2</jats:sup> participated in a semi‐structured one‐to‐one interview. Participants had been registered with the bariatric service for at least 6 months. None of the participants had had bariatric surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Most participants felt that they had benefited from participating in the group programme and talked about the group as a resource for lifestyle change. Participants’ narratives centred on the emergence of a sense of self based upon their participation in the group: establishing <jats:italic>psychological connections</jats:italic> to other patients, or shared social identity, was regarded as a key mechanism through which the programme's <jats:italic>educational material</jats:italic> was accessed, and underpinned the experience of <jats:italic>social support</jats:italic> within the group. Through interaction with other patients, involving the sharing of personal experiences and challenges, participants came to experience their weight ‘problem’ through a collective lens that they felt empowered them to initiate and sustain <jats:italic>individual lifestyle change</jats:italic>.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>Bariatric care groups have the potential to support lifestyle change and weight loss and may help address the psychological needs of patients. Nurturing a sense of shared social identity amongst patients with morbid obesity should be a core aim of the care pathway and may provide the foundation for successful translation of dietetic content in group programmes.</jats:p></jats:sec><jats:sec><jats:label /><jats:p> <jats:boxed-text content-type="box" position="anchor"><jats:caption><jats:title>Statement of contribution</jats:title></jats:caption><jats:p> <jats:italic> <jats:bold>What is already known on this subject?</jats:bold> </jats:italic> </jats:p><jats:p> <jats:list list-type="bullet"> <jats:list-item><jats:p>Services for people with obesity who require specialist care are often supported by group‐based bariatric programmes.</jats:p></jats:list-item> <jats:list-item><jats:p>There are no specific guidelines for the organization of bariatric groups beyond the recommendation for lifestyle interventions delivered by a multidisciplinary care team.</jats:p></jats:list-item> <jats:list-item><jats:p>Research with other health conditions suggests that the psychological connections formed between participants in bariatric programmes may play an important role in structuring programme effectiveness.</jats:p></jats:list-item> </jats:list> </jats:p><jats:p> <jats:italic> <jats:bold>What does this study add?</jats:bold> </jats:italic> </jats:p><jats:p> <jats:list list-type="bullet"> <jats:list-item><jats:p>Establishing psychological connections with other patients underpins bariatric patients’ group experience.</jats:p></jats:list-item> <jats:list-item><jats:p>Shared social identity structures behaviour change in patients on bariatric programmes.</jats:p></jats:list-item> <jats:list-item><jats:p>Nurturing shared social identity should be a core aim of the bariatric care pathway.</jats:p></jats:list-item> </jats:list> </jats:p></jats:boxed-text> </jats:p></jats:sec>
Original languageEnglish
Pages (from-to)77-93
Number of pages0
JournalBritish Journal of Health Psychology
Volume22
Issue number1
Early online date17 Nov 2016
DOIs
Publication statusPublished - Feb 2017

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