title: Body image concerns amongst massive weight loss patients.
abstract: OBJECTIVE
  To explore body image matters amongst patients following massive weight loss.
  
  
  BACKGROUND
  In contemporary health care, a growing number of morbidly obese patients are seeking surgical solutions such as bariatric surgery or in other cases engaging with radical lifestyle changes. Massive weight loss can leave patients with a huge excess of lax overstretched skin that in some cases can trigger major body image dissatisfaction or depression. There is a scarcity of research about the needs of this group of patients and this is important for nursing practice.
  
  
  METHODS
  A qualitative design using in-depth interviews was employed.
  
  
  METHODS
  Twenty white adults (18 women and two men) were recruited retrospectively amongst patients who had massive weight loss by undergoing bariatric surgery or radical lifestyle changes, aged 29-63 years. All of the participants gave signed informed consent. Face-to-face in-depth interviews were conducted and transcribed verbatim. The data were analysed using thematic analysis.
  
  
  RESULTS
  One core theme focusing on body image ugliness and three associated subthemes were identified: the subthemes included feeling socially marginalised, feeling depressed and sexual and intimacy difficulties.
  
  
  CONCLUSIONS
  Body image matters are hugely significant and appear to have a lasting effect on emotional well-being and function, contributing to psychological distress and social isolation. Greater sensitivity is required in enabling patients to work through emotional isolation and shame that has been a part of their childhood. Furthermore more, treatments need to be accessible to this growing patient population such as reconstructive surgery.
  
  
  CONCLUSIONS
  Nurses who care for massive weight loss patients need to be mindful of their psychodynamic needs and be non-judgemental and accepting. Moreover, nurses need to be aware of treatment options and be able to assess body image matters and implement quality care for this particular patient group including body image acceptance programmes and support groups.
authors.affiliation: School of Healthcare, University of Leeds, Leeds, UK. j.gilmartin@leeds.ac.uk
authors.forename: Jo
authors.initials: J
authors.lastname: Gilmartin
mesh_terms: D000328:Adult; D001828:Body Image; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery; D012189:Retrospective Studies; D015431:Weight Loss