The Dynamics of Surgical Support Group from a Longer-term Patient Perspective

Disclaimer: This blog post does not reflect the views of the OAC, the National Board of Directors or staff. Information contained in this blog post is not based on scientific research and has not been validated.

 In my last blog post, I told you that I, as a longer-term post-op, don’t always feel drawn to my surgical support group. But I realize that I only speak for myself. I don’t claim to speak for all longer-term post-ops through this blog series. But I had a hunch there were at least a few other people who feel the way I feel and those people deserve to have a voice!

So my first order of business was to give them one. I started by conducting an informal poll of longer-term post-ops. DISCLAIMER: this poll was by no means scientific and any results should be taken as anecdotal ones at best, but I must say the responses were interesting and some of them surprised me.

What’s a long-term post-op? And how do they feel about support group?

I’m sure there are debates going on in the bariatric professional community. For the average post-op it’s even more confusing because, as a person gets further out from surgery, they are more likely to stop participating in bariatric-specific groups. What that means for many post-ops who do participate in support mechanisms is that a post-op who is more than five years out who actively participates is a rare and wonderful thing!

For these reasons, I was fairly generous with my definition of a longer-term post op by asking people who were 18 months out or further to respond. A hundred people responded and here’s how those responses shook out:

      • 17% were 18-24 months post-op
      • 51% were 2-4 years post-op
      • 18% were 5-7 years post-op
      • 14% were 8+ years post-op

Of the respondents most (88%) shared their surgeon’s office has a support group, and a majority (67%) shared they attended at least one meeting. Further, most respondents (84%) said they thought bariatric support groups are important and beneficial.

When I asked about attendance, 17% said they attend very often, with only 16% reporting that they seldom attend, but most respondents (53%) used the question’s comment box. That’s where many people relayed that they don’t attend at all, and in subsequent answers, they explained why.

To be fair, many respondents shared they don’t attend their surgeon’s support group because of logistical difficulties. Their groups are located too far away, at a time that makes it difficult to attend or that they had surgery in a different state/country from where they live. But more than a few listed reasons that indication feelings of dissatisfaction with their surgical support group. It is those responses I’d like to focus on from here on out.

The Dynamics of Support Group: A Long-Term Patient’s Perspective

I’ve always found the social dynamic of groups of bariatric patients in general to be interesting for many reasons. A few of them are:

      • There is no common standard to which all bariatric practices are mandated to subscribe, only sets of recommendations by way of the American Society for Metabolic and Bariatric Surgery (ASMBS). This means if you put 10 post-ops together in a group from 10 different practices you are likely to hear about 10 different sets of rules!
      • The science and technology behind bariatric surgery is constantly changing. When I had surgery, gastric banding and gastric bypass were the two most common surgeries offered. Five years later, other surgeries, most notably the vertical sleeve gastrectomy (VSG), are becoming more common. Since this surgery, as a stand-alone, is relatively new to the scene the experiences of a VSG patient haven’t fully ingrained into weight-loss surgery patient culture. That is to say that there are certain things post-ops “know” about surgeries that are fairly common. Bypass patients can get dumping syndrome, for instance. Many gastric band patients report “PBs” or productive burps, a slang term for vomiting. These types of experiences are “WLS common knowledge.” While I think such knowledge is emerging about the VSG, there’s still a lot, socially, we don’t know about the surgery.
      • Anecdotally, I can say that I believe most people who take part in any support group — in person or online — tend to be newer post-ops.

Why are these things significant? To me, they are significant because many of the reasons I’ve heard for longer-term patients not attending group have a lot to do with these factors.

Because there is such variance in the post-op advice (or “rules” as we post-ops like to call them), and because of the human tendency to place the most trust in those we know, we sometimes come to each other’s experiences with a sense of incredulity.

Because the landscape of surgery types is changing, I believe that incredulity spills over into patient groups even at the same practice. When I go to group now there are many VSG patients. I’m simply not sure if my anatomical experiences are the same as theirs. This doesn’t usually create any hesitation in sharing experiences (at least not that I’ve seen), but it does mean that incredulity (or that “How is it that this happens to you and not me?”) can certainly be present even if you and another post-op of a different surgery type were operated on by the same bariatric surgeon.

And finally, because many of the attendees of bariatric support groups are newer post-ops, and because the experiences of newer post-ops and longer term post-ops differ (I’ll go into more detail about that in my next post), and because incredulity can exist between different surgical types, as well as “surgical ages” (time-elapsed post-surgery), sometimes long-term post-ops can feel alienated by the topics and resulting discussions at their surgical support group.

From the results of my survey, I identified three sentiments that I think illustrate this alienation well. I’ll discuss them in more detail in my next post!

In the meantime, if you’re a bariatric professional, weigh in! (Pun intended). Does your practice boast a high longer-term post-op attendance rate? And if you’re a longer-term post-op, weigh in! Do you still attend your surgeon’s support group?

About the Author
Nikki Massie is a professional writer based in Baltimore, Md. She underwent Roux-en-Y gastric bypass surgery in 2008. She also lives in Baltimore with her two daughters, dog and cat. To learn more about Nikki, please visit her blog

13 Comments for this Post
  • Kathleen
    October 17, 2013 at 5:58 pm

    I just past my 9 yr. Surgiversary and still attend my WLS support group. I had stopped going early on because I didn’t like our support group format at the time. It was based on the 12 – step program and I guess it made me feel uncomfortable. Unfortunately, during this time I had complications, etc. and began to have regain as a result. Feeling ashamed, and embarassed I turned to my old habits rather than reaching out to support group which I would have had I not quit going. I think this happens to alot of people. Thankfully, I started going back to support group about 5 yrs.ago and haven’t looked back. It keeps me accountable and by helping others, it helps me!!

    • Nikki Massie
      October 18, 2013 at 2:34 pm

      It’s interesting you said that because I’m going to speak on part of your experience in the next post. I heard from many longer-term post-ops that regain made them hesitant to participate in support group. But I’m glad you’ve found it a helpful tool for getting back on track! Thanks for your comment!

  • Midge
    October 18, 2013 at 9:17 am

    This is such a great article! I want to get a hard copy of it to show my doctors at my hospital-based support group for their practice! The dietician is also interested in what you have to say, Nikki! I am a member of OAC and find your articles invaluable…….I am the one who started this support group for the surgeons at my local hospital. Like you say, I have the usual assortment of surery types. The group is 18 months old, with me as the sole long term post op at 10 years. Any helpful info I can receive regarding this topic is greatly appreciated. I will continue to follow the series. Thank you for this great contribution. I want my new support group to grow and I want to minimize the negative issues that may affect future attendance.

    • Nikki Massie
      October 18, 2013 at 2:35 pm

      Thanks for the feedback! You’ll want to pay attention especially to the last blog post in this 4-part series (this is the 2nd one). In it I’m going to talk about some support groups I’ve experienced with high attendance by longer-term patients. I’ve asked them what keeps them coming back to group and I plan to share!

      • Midge
        October 18, 2013 at 8:03 pm

        Thank you! I look forward to what follows from you!

  • Lois
    October 24, 2013 at 5:59 pm

    I’m three years into my diet journey.. Best gift to myself.. As for the support group meeting, I could not live without it!!! my doctors offered a meeting every Monday night in different areas surrounding their office. If I have to miss mine, I can attend another during the month.. We have pre- and post- in our meetings.. We are a great group of people coming together monthly to support each other.

    • Nikki Massie
      October 28, 2013 at 2:32 pm

      I love hearing about groups that work! How do you decide on topics and make sure everyone’s experiences are recognized and discussed. There’s probably much to be learned from your group!

  • Shana
    October 24, 2013 at 8:06 pm

    I’m over 5 years out now. After the first 12 months, the surgeon’s support group no longer met my needs. I started my own. We have a fairly consistent group of longer term post-ops and I believe that’s because we have created the network we need to be successful. Recently, some newer post-ops have become involved. I greatly appreciate their fresh energy and success to go alongside our veteran experience.

    • Nikki Massie
      October 28, 2013 at 2:30 pm

      Hi Shana,

      I’m interested to know what about your surgical group no longer met your needs? And what does this group provide that does? I think it’s great that you found a source of support that’s right for you. But I’d also love if your great example could help surgical support groups improve!

  • Tom Bilcze (@Beariatric)
    October 28, 2013 at 1:48 pm

    Nikki, I am a regular attendee at my local WLS support group. I find many long-term post-ops drop out because of the program. Ours is targeted to the new post-ops. The topics rotate on a yearly basis covering the must-cover topics that new post-ops need. I understand that. Luckily, the nutritionist that coordinates ours is savvy enough to vary the program somewhat to encourage a wider audience.

    I see the value a long term person brings to the group. People like to see how people have progressed after surgery. They need to see the struggles that are ahead. A newly post-op group would paint a very rosy picture. This coming year, my nutritionist asked for program topics and is going to do one I suggested. I suggested a panel of long-term post-ops with 1 person who is a stellar success, a person who is struggling and a person who struggled and then found success again. I think this type of panel will give people a sense of how diverse life after bariatric surgery is. On another note, I personally believe people who attend support groups are much more successful in what they seek to achieve. Those who are absent find themselves isolated and in trouble. Also, our long-lerm post-ops started our own support group to meet our specific needs. — tom

    • Nikki Massie
      October 28, 2013 at 2:28 pm

      Great observations!

      My next post will go over some of that in detail so I don’t want to give too much away, but my theory, after speaking with a lot of people, is that it isn’t so much that the particular topics presented by a lot of groups are more or less relevant to one group or another but that newer post-ops and longer-term post-ops approach those topics from different places and that must be recognized. Take eating for instance. Many newer post-ops struggle to get enough food and protein so a conversation on eating is likely to revolve around those facts. But that conversation might not be meaningful to a longer-term post-op who has a larger eating capacity and whose struggles include avoiding temptation and overeating. So I think the things you’ve outlined are very important in that regard. How do we get those voices in the conversation? One of my biggest suggestions (which will appear as a part of my final post) is exactly what you proposed! Engage longer-term post-ops as a resource and a source of realistic experience. But that can’t be the end of it in my opinion! We are there for support too and if all we’re ever asked to do is give support, that can make going to group a drag. I also think there should be an effort to make sure aspects of the given topic are relevant. Sometimes all it takes is asking longer-term post-ops what they think and are going through and make sure some of those points get discussed. But I have learned SO much in doing this blog series. I could probably write 10 more installments but I’ll spare you all. :)

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  • Kelly
    October 29, 2013 at 10:17 am

    I would guess some people don’t attend the support groups at their surgeons’ offices because some of those groups don’t provide much support. Instead, they provide a forum for representatives from vitamin companies to come in and try to sell their products. I find that pretty offensive.

    I would also guess some people don’t attend because some groups are facilitated by nutritionists that aren’t even familiar with the ASMBS guidelines and tell patients things like “Flintstones are good vitamins to take after WLS” and “Carbonated beverages will stretch your pouch.”

    I do participate in a weekly peer-facilitated support group and I find it very helpful. We actually focus on supporting each other.

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