title: Awakening: a qualitative study on maintaining weight loss after bariatric surgery.
abstract: OBJECTIVE
  To describe the experiences of adults who were successful in maintaining weight loss after bariatric surgery.
  
  
  BACKGROUND
  The majority of studies examine a homogenous demographic group of postbariatric surgical patients who have gone through initial weight loss, which occurs within the first 12-24 months post surgery. Maintenance of weight loss begins 24 months after bariatric surgery; however, there is a paucity of research examining experiences during this period. The lack of conclusive research related to interactions between intrapersonal, behavioural and environmental influences suggests a need to develop a better understanding of patients' experiences related to weight loss maintenance post bariatric surgery.
  
  
  METHODS
  Bandura's Social Cognitive Theory provided the framework for the semi-structured interviews for this qualitative descriptive study.
  
  
  METHODS
  In-person interviews with n = 14 participants who were able to maintain weight loss at least 24 months after a bariatric surgery.
  
  
  RESULTS
  Participants experienced an awakening and gained a new perspective on their life. They identified negative attitudes, influences and behaviours and modified their environment to support their desired healthy behaviour.
  
  
  CONCLUSIONS
  To maintain weight loss, an individual must seek out and be surrounded by positive family and peer support influences. Positive support may provide the opportunity for an individual to place personal health needs as a priority.
  
  
  CONCLUSIONS
  Therapeutic education and counselling for individuals, couples and families should occur during all phases of bariatric surgery. Communication techniques may empower clients to deflect negative comments and influences in a constructive manner. Support groups should accommodate the various phases of bariatric surgery. Clients should be prepared for how to work through emotions associated with weight fluctuations.
authors.affiliation: Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA.
authors.forename: Lori
authors.identifier: http://orcid.org/0000-0002-8553-0961
authors.initials: L
authors.lastname: Liebl
authors.affiliation: College of Nursing - Lincoln Division, University of Nebraska Medical Center (UNMC), Lincoln, NE, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Barnason
authors.affiliation: College of Nursing - Lincoln Division, University of Nebraska Medical Center (UNMC), Lincoln, NE, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Brage Hudson
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery*; D011184:Postoperative Period; D036301:Qualitative Research; D015431:Weight Loss
keywords: Social Cognitive Theory; addiction; bariatric surgery; lifestyle changes; long-term weight loss; obesity; qualitative; support; support groups; sustainable weight loss maintenance; weight recidivism