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Patient Experiences of Weight Regain following Weight Loss Surgery: A Systemic Review

Regaining weight after losing it is common and not a sign of personal failure. It can help people understand how emotional triggers, stress, and slipping back into old habits—especially without ongoing support—can play a big role. As well as reminding people how important long-term support, like counselling or group programmes, really is and helping people feel more understood during their journey.

Patient Experiences of Weight Regain following Weight Loss Surgery: A Systemic Review

Matt Buckley, Dr Sophie Edwards, Prof Paul Gately

Introduction

Weight loss surgery (WLS) is seen as the most effective treatment for severe obesity, yet a significant amount of those having WLS will experience weight regain following WLS. This review will synthesise what is known of patients experience of weight regain (WR) following WLS to inform future research and practice to reduce WR and to support those with WR.

Methods

Inclusion criteria:

  • Adults (>18 years)
  • Weight loss surgery (any form of WLS accepted)
  • Definition and measure of weight regain (any definition of WR accepted
  • At least two years after WLS
  • Qualitative (any form of qualitative research accepted)

Each database was searched from the earliest possible date until 12th July 2022 with no filters using:

  • Allied and Complementary Medicine Database (AMED)
  • CINAHL Plus
  • MEDLINE
  • PsychInfo
  • PsychArticles
  • Embase

Studies were assessed using Critical Appraisal Skills Programme criteria (CASP, 2022) and synthesised using thematic synthesis methods proposed by Thomas and Harden (2008).

Results

Seven studies (57 participants) were included in the synthesis. All used semi-structured interviews, but the qualitative methods used by researchers did vary. There was an overrepresentation of females in the included studies compared to the number of those having WLS in the UK.

Two main themes were found from the synthesis: the neglected mind and social withdrawal. These themes were organised and explained through descriptive themes: emotional eating, other coping mechanisms, psychological support, adjusting to life with WLS, blame, social isolation and judgement from others.

Conclusion

The studies included some reporting issues. Other limitations related to potential variations in experience based on the type of WLS and participant demographics have yet to be explored in the evidence base.


Findings indicate that the influence of the mind is neglected, both by participants and those supporting participants with WLS. Further research is needed to establish how more psychological support can be implemented into the preparation and follow-up of WLS to reduce WR following WLS and support those experiencing WR. Blame and judgment from others lead to social withdrawal and need to be considered to best support patients post-WLS.

Key Points/Contributions

  • WR is experienced as an internal personal failure
  • Those experiencing WR withdraw socially based on unpleasant physical side effects of WLS and judgment from others
  • Psychological and emotional influences are present after WLS
  • For those experiencing WR, WLS was a physical intervention which neglected the influence of the mind
  • Research is needed to explore differences in the experience based on the amount of WR, type of WLS, and participant
    demographics
  • More research is needed to inform how practice will increase psychological support