Dissertations - 2010

GOOD AND POOR OUTCOMES FOLLOWING ADJUSTABLE GASTRIC BANDING: WHAT THE PATIENT'S FEEDBACK REVEALS

Flávia de Souza Scavone

Advisor: Profa. Dra. Denise G. Ramos
Keywords: bariatric surgery, adjustable gastric banding, AGB, analytical psychology, Jungian psychosomatic.

This study aims to observe the differences in the feedback of the patients who had good and poor outcomes following adjustable gastric banding (AGB). In-depth interviews were conducted with thirty patients (22 women), from 20 to 73 years old, who had AGB within the past 24 to 92 months. Patients were split into two groups of 15: good outcomes were considered percentage of excess weight loss (%EWL) > 40% and, poor outcomes %EWL less or equal to 40%. The answers were divided into categories. Statistical analysis was performed (Fischer's Exact Test and X² Test) to test the statistical differences between categories and groups ('p' less or equal 0,05). The significant results were qualitatively analyzed based on the theoretical guidelines of analytical psychology and the Jungian approach to psychosomatic illness. Analyzing differences among patients feedback, a relationship between psychological aspects and the outcomes of the AGB was observed. The decision to have AGB based on heath-related issues, psychological treatment, a better understanding of the use of food as a defense mechanism and the development of others strategies to deal with stress was related to good outcomes. Unrealistic expectations to the AGB outcomes, leaving treatment, conflictive relationship with medical team, stressful situations and high intake of sweets were related to poor outcomes. It was understood that the patients from the group with poor results had more difficulty elaborating on the many psychological aspects that are directly related to their eating behavior. This understanding suggests how important is to have psychological guidance after bariatric surgery to achieving good outcomes.