Patients' explanations for unsuccessful weight loss after laparoscopic adjustable gastric banding (LAGB).

Abstract

OBJECTIVE: Not all morbidly obese patients attain sufficient weight loss after laparoscopic adjustable gastric banding (LAGB). We examined patients' explanations for unsuccessful weight loss and self-awareness regarding food intake. METHODS: Interviews with 11 patients (10 female/1 male; mean age 46 years) with unsuccessful weight loss were transcribed and analyzed with the MAXqda2 program. RESULTS: Interviewees were disappointed with the postoperative outcome. Some showed no awareness of their own role, while others were inefficacious to continue the actions needed to maintain weight loss, especially during times of stress. Typical statements that distinguished interviewees were: 'It didn't work out', 'I don't care anymore', 'I know I have to do it', 'I know I can do it'. CONCLUSION: Some patients with unsuccessful weight loss after LAGB are insufficiently aware that their own effort is needed to maintain weight loss. Others have self-awareness, but find it difficult to turn awareness into action. PRACTICE IMPLICATIONS: This group could perhaps be helped by tailoring postoperative guidance to the stage of change of an individual patient. Counseling could include increasing awareness of the need to self-control eating and offering assistance to turn intentions into action and to deal with stress, emotions and physical problems.