Friday, August 18, 2017

Peer-to-Peer: The role of online support for patients with obesity

Support group attendance and perceived levels of social support are associated with greater post-bariatric surgery weight loss.1,2 Unfortunately, geography and time constraints can limit participation. Therefore, online forums, Facebook groups, and tweetchats can serve to provide a sense of community while overcoming these limitations. Studies show online forums can be a useful resource for information and emotional support in obesity and bariatric surgery.3,4 The formats of online support have evolved over time from listservs to established communities such as Bariatric Pal and more recently Facebook groups and tweetchats. Some users choose to post anonymously while others share their identity and blog publicly about their experiences. While these forms of online support are shown to be beneficial, physicians may not regularly endorse their use.

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In our next #obsm chat, we will provide a forum for patients and health care practitioners to learn from patients and their loved ones on their personal online support experiences. Our goal is to help patients and physicians understand how online support groups can complement the care of patients with obesity, those considering bariatric surgery, and post-surgical patients. We will explore the utility, benefit, and potential pitfalls of online peer-to-peer support.


  1. What is the utility of online support for patients with #obesity and those considering #bariatricsurgery?
  2. What are the cons of online support in #obesity and #BariatricSurgery? Are there pitfalls to be aware of?
  3. What are the strengths and weaknesses of the different online platforms for people with #obesity and pre- and post- #bariatricsurgery support?
  4. Should physicians recommend online support to their patients? If so, which platforms are most useful?
  5. How do you predict (or hope) online support for those with #obesity and those undergoing #bariatricsurgery will evolve?

~The #obsm chat leadershipHeather Logghe, MD, Neil Floch, MD, Amir Ghaferi, MD, MS, Babak Moein, MD, and Arghavan Salles, MD, PhD

References:
4. Story Of Obesity Surgery - American Society for Metabolic and Bariatric Surgery. American Society for Metabolic and Bariatric Surgery. https://asmbs.org/resources/story-of-obesity-surgery. Accessed June 5, 2017.

Friday, July 7, 2017

#PlasticSurgery after #BariatricSurgery: Meeting Patients' Needs

Bariatric surgery often results in numerous health benefits, such as resolution or improvement of type 2 diabetes, hypertension, joint pain, and depression. However, the extreme and rapid weight loss after bariatric surgery may also lead to physical and emotional distress resulting from redundant, loose skin. These new skin folds require meticulous care; even so patients may suffer painful rashes and skin infections. The weight of the pendulous skin can prohibit exercise and normal daily activities. Excess skin on the upper arms, thighs, and abdomen can make it difficult to find proper fitting clothes. Patients may feel self-conscious of their atypical body contours and find the hanging skin a deterrent from their commitment to dietary changes, exercise, and continued weight loss maintenance.

“Post bariatric body contouring” is the term used for the multiple surgical procedures typically required to remove excess skin and reshape the contours of the breasts, abdomen, arms, and lower body. These procedures include the breast lift, tummy tuck, lower body and medial thigh lifts, and arm lift. Despite the medical and psychological indications for these procedures, they are largely uncovered by insurance companies. A recent study showed that after bariatric surgery, 75 percent of women and 68 percent of men were interested in plastic surgery, yet less than 6% of patients underwent any plastic surgery procedure. The failure of insurance companies to cover these medically indicated procedures results in patients either paying out of pocket or suffering the negative health and psychological consequences of the excess skin.