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Revamping Bariatric Surgery Support

Group: Providing optimal emotional care in

the weight loss and maintenance journey

Jenna Zemering

2016-2017

Preceptors: Elizabeth Newton, RD, CSOWM

and Shana Strange, MS, RD, CSOWM


ABSTRACT
Background
Research shows that regular attendance of a bariatric surgery support
groups is vital to weight loss surgery success, however, a knowledge gap
exists in regards to running a successful bariatric support group.
Purpose
The significance of this study was to improve the structure of the monthly
bariatric surgery support group held at The University of Virginia Health
system (UVA Health System).
Methods
UVA Health system bariatric support group members were surveyed in
January and February 2017 to see what they found to be most helpful about
the current support group. Data from the surveys was then used to select
three new topics to be carried out through February, March, and April 2017
support groups. Data from the surveys allowed for participant-focused topics,
handouts, and a meeting agenda for each selected topic. Post-topic feedback
surveys were distributed to the members in attendance in order to further
enhance the support group.
Results
Over the course of the 3 months, 16 out of 28 participants opted to fill out
the topic feedback survey. Data showed that 100% of participants felt
supported by the group, were happy with the main topic choice, reported
that they learned something from each group session, and felt they had
enough time for open discussion.
Conclusion
With structured meeting agendas, main topics based on participant feedback
requests, and encouraged participation, members will have a solid
foundation to continue on a successful wellness journey. More data is
needed from the various bariatric support groups around the world in order
to continue to provide the support and knowledge that this population needs.

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LITERATURE REVIEW

Overview of Bariatric Surgery


Currently, bariatric surgery remains the most effective intervention in treating obesity and its

associated comorbidities. Per the American Society for Metabolic and Bariatric Surgery, the

number of bariatric surgeries increased to 179,000 in 2013 with 34.2% of surgeries as Roux-en-Y

gastric bypass, 14% gastric banding, 42.1% gastric sleeve, 1% as duodenal switch, 6% as

revisional surgery and 2.7% classified as other.1 The goal of weight loss surgery is improved

health, reduced comorbidities, and increased quality of life resulting in restored health and

physical fitness. Unfortunately, as many as 50% of patients may regain a portion of their weight

back following surgery, and weight loss maintenance can be an ongoing challenge. Since the

long-term success of bariatric surgery relies on patients' ability to make sustained lifestyle

changes in nutrition and physical activity, the need to adopt a multidisciplinary approach and

seek ongoing support becomes imperative.2

The Purpose of Bariatric Support Groups

Support groups are groups of people with common experiences or concerns who provide each

other with encouragement, comfort, and advice. The importance of support groups has been well

studied for many different conditions, such as gamblers, alcoholics, and eating disorders.

However, a support group for bariatric surgery has not been well studied. Bariatric surgery

support groups are often led by registered dietitian nutritionists (RDNs) or other clinicians. They

are provided as part of most bariatric surgery programs, with the purpose of helping participants

achieve and maintain their goal weight. These programs are similarly recommended for patients

who may need help with adjusting to lifestyle. While the research for this group is limited,

anecdotal evidence can provide guidance and best practices in running effective support groups
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for these patients.

Weight loss surgery is thought of by some as a quick-fix method, but successful surgery is only

the beginning, and there should be no end to follow-up.3-5 After surgery, patients must learn to

deal with new self-images and old behavior patterns that may precipitate a return to the pre-

surgery status.3 Support group meetings are considered an integral part of success after bariatric

surgery, evidenced in part by a statically significant higher percent decrease in BMI than patients

who did not attend support group meetings.4 In April 2016, Tracy Martinez, Registered Nurse

and speaker at the Virginia Bariatric Society annual meeting, explained the purpose of support

groups is to bring people together focusing on similar issues, concerns, and goals.5 The support

that can be shared between someone who has been in the same situation can create strong

emotional bonds. Additionally, the significance for these individuals both pre-and post-operation

is to create social connections, help empower each other without judgment, and learn how to deal

with stress. Livhits et al6 conducted a systematic review of the association between greater

weight loss in the presence of social support. This review included bariatric procedures and a

spectrum of patient factors with potential relationship to weight loss outcomes using dates

between the years of 1988-2009. All 934 reviewed studies found a positive association between

post-operative support groups and weight loss, implying that support group attendance after

bariatric surgery is associated with greater post-operative weight loss.6 In a 2012 study, research

showed that patients attending psychotherapeutic interventions or support groups in combination

with bariatric surgery appeared to experience greater weight loss results than patients treated

with bariatric surgery only.7

An interdisciplinary team encouraging regular support groups, education, and continued health is

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essential for successful outcomes post-surgery.8 As the number of weight loss surgeries continue

to increase due to the obesity epidemic, it becomes essential for this population to have access to

quality support groups. Support groups can help provide insight, perspective, and real world

experiences from those who have experienced surgery and now can share their viewpoint. Along

with validation, these groups provide education, motivation and a means of celebration. The

education piece of the support group is an opportunity for learning and reinforcing key concepts.

These groups also provide a sense of accountability, as falling back into unhealthy habits is not

uncommon and can become problematic. It has been recognized that the longer disparaging

habits go unchanged, the more difficult they become to modify.9 Making lifestyle changes is a

process that takes time and requires adherence. These support groups can provide patients with

helpful resources and a sense of community as they progress through their wellness journey.

The Role of the Facilitator in Support Groups

While research shows that support groups lead to greater success, these groups must be

appropriately planned, designed, and facilitated for all members to achieve their goals.

Anecdotally, the most successful groups are said to be dynamic, creative, and flexible.8 Effective

facilitation of a discussion involves the recognition and employment of different perspectives

and skills to create an inclusive environment. Therefore, it is necessary to consider the features of

effective discussion and conditions that promote small group interaction and engagement. 10

Meetings will often consist of a variety of people, likely at different stages of surgery and/or

recovery. Facilitators should know how to create an inclusive environment, keeping discussions

constructive and positive.9,10 In addition, they should encourage participation and can do so by

asking follow-up questions, combining initiation and probing questions, and encouraging

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participants to build on the comments of others.9,10 It is imperative for facilitators to understand

that participants may digress, leading the group session to go off agenda. Facilitators must learn a

delicate combination of control mixed with kindness as this sort of assertive caring will directly

address problems without insulting or offending members.9-11 Ultimately, enlisting well-trained,

qualified healthcare professionals can aid in keeping the group engaged and focused.

How to Structure a Bariatric Support Group Meeting

Variance and encouragement in support group meeting activities should be provided to promote

optimal learning.10 It is helpful to have a set agenda and schedule for the meetings that are easy

to follow. Structure in meetings allows participants to have certain predictable elements each

time, which can be reassuring to group members.11 Facilitators should be responsible for sending

out monthly reminders via email or phone to ensure participants have the correct date and time of

meetings and to guarantee active participation. The meeting should begin on time to encourage

participants to be prompt.10 A warm welcome from the facilitator sets the tone for acceptance and

comfort.11

The American Stroke Association has been running successful support groups since 1998. They

recommend grouping business items such as introductions, announcements, and a review of the

meeting goals as a supportive way to start the meeting.10 Setting the ground rules such as stating

that the group is confidential and a safe place should precede topic of the day discussions as it

will lead to a greater sense of comfort.10,11 Participants should be aware that support group is a

place where they will not be judged. They should be encouraged to engage in dialog about their

journeys, successes, and failures. Introductions and confidentiality could be followed up with a

message from the facilitator to encourage members to listen to each other, support each other,

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and learn from each other.10 Following the introduction, discussion of the main topic should take

place. In closing of the meeting, participants should have time to set their own specific,

measurable, attainable, realistic, and time bound (SMART) goals for the next meeting. Being

specific in goal setting makes it easier to know when they have succeeded.12 The allotted meeting

time should allow for participants to mix and mingle with each other.9 Wrapping up the meeting

should be done with summary statements and final notes, and the meeting should end at the

stated time. Regardless of how much reassurance and education these participants are given,

some people will not return for various reasons such as hectic schedules, not feeling comfortable,

and level of priority for each individual. Therefore, an inspiring and upbeat sendoff will leave

members with a good impression and encourage them to return to the group.11-12

Support Group Topics

Protein

As the number of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgeries

continue to increase, a gain in knowledge into the prevalence of nutritional deficiencies will also

increase. While all macronutrients are important in the diet, protein becomes a key macronutrient

to discuss. 13-14 GBP and SG have comparable effects in terms of energy and food restriction and

subsequent risk of micronutrient and protein deficiencies in the first-year post bariatric surgery.13

A highly successful treatment for obesity requires adherence to special dietary

recommendations to ensure the achievement of weight loss and weight maintenance goals.

Protein is an essential part of the diet after surgery to assist in wound healing, muscle and skin

re-growth, cell repair, and preventing hair loss. 14-16 Research shows that patients consume

between 60-70 grams of protein per day. A protein-rich diet can lead to increased satiety,

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enhanced weight loss, and improved body composition. 14-15 The quality and composition of

protein sources are also important, particularly with respect to the quantity of leucine, which

helps to maintain muscle mass, and thus is particularly important for this patient population. 15

Participants should have the opportunity to discuss this topic in depth during support group in

order for them to share insights and ideas as to how they achieve their daily protein goals.

How to Read Food Labels

Following weight loss surgery, the capacity of the stomach will be reduced, resulting in a

reduced amount of hunger. As appetite intake is reduced, food choices and nutrient intake

become even more essential. It is well known that a quality diet is important for promoting

health and preventing chronic disorders.17 Part of that process entails properly reading food

labels and understanding which foods will optimize weight loss. Food label use can promote the

selection of healthier choice; however, food label use behavior can be affected by many factors.

Those who have received nutrition education are more likely to read labels.17 Moreover,

sufficient health literacy is a prerequisite to effectively using a food label to improve dietary

quality.17 If labels are read properly, they can be a useful tool to help patients make healthier food

choices, thus, this is another significant topic for support group discussion.

Exercise

Another topic that is useful for discussion at support group meetings is that of exercise. Evidence

shows that exercise following bariatric surgery appears to be associated with a decreased body

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mass index (BMI).16-18 Resistance training increases lean body mass and bone mineral density

while allowing for the ability to utilize more energy intake.16 While a combination of aerobic and

resistance training is optimal, the selected exercise should be readily available, enjoyable,

affordable, and easy to do. It has been demonstrated that weight regain is significantly less likely

to occur when physical activity is combined with any other weight reduction method.16-19 Patients

need to understand that any new exercise regimen should be started slowly and should gradually

increase in intensity as to avoid injury. Patients should see the benefits of physical activity as it is

directly associated with improved weight loss and decreased loose skin.16-19 Research has

suggested that RYGB patients who become active postoperatively achieve weight losses and

improvements that are greater than those experienced by patients who remain inactive.16-19 A

support group is an appropriate setting to help patients in defining how to get started on an

exercise regimen. While plans must be individualized, all patients should be encouraged to

incorporate 30-60 minutes of movement per day, 5 times per week. 16-19

Over 500,000 support groups exist in the United States.10 These groups have become a common

method of serving the needs of people who are experiencing problems in their lives because they

are both inexpensive and effective ways to aid people dealing with a variety of concerns. In a

support group, people can talk with like-minded individuals who truly understand what they're

going through leading to firsthand experience.10 It is central to remember that the heart and

power of the group comes from the involvement between members. Care must be taken to foster

and encourage members to express and share their feelings.12 Each month, The University of

Virginia Health System (UVA Health System) holds a support group meeting for preoperative

and postoperative weight loss surgery patients consisting of important topics while occasionally

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hosting guest speakers (psychologists, fitness instructors, physicians, etc.). The focus of this

group is to celebrate successes and recognizing strengths.11

PURPOSE

The significance of this study was to provide structure to the current monthly bariatric surgery

support group held at the UVA Health System. The revamped structure followed anecdotal

evidence based on studies of successful support groups using several different conditions.

Overall, the goal was to produce a pioneering support group meeting outline that was creative,

flexible, and dynamic. Generating an innovative template for future support group meetings will

stimulate more interactive group sessions with specific topics to meet patient needs. Surveying

patients to find out what they are most interested in doing/discussing at group meeting is what

provided the basis to revamping the structure.

PROJECT METHODS

The dietetic intern worked with the UVA Health System bariatric surgery dietitians to develop an

initial feedback survey for support group participants. The initial survey (See Appendix A) was

distributed to participants during the January 2017 support group, was sent out via email, and

was featured in the February 2017 support group newsletter. Data from the survey was used to

determine three topics for the February, March, and April 2017 support group meetings.

The methods of project evaluation were carried out via confidential, post-topic feedback surveys

(See Appendix B), which was created by the dietetic intern and the UVA Health System bariatric

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surgery dietitians. These surveys were distrubuted after each revamped lesson plan in February,

March, and April 2017. All participants were encouraged to respond to the survey and they were

made aware that their feedback would further enhance the UVA Health System bariatric support

group.

RESULTS

Support Group Initial Feedback Results

Fourteen participants filled out the initial feedback survey (See Appendix A) that was distributed

between the months of January and February 2017. Twenty-nine percent of these participants

were first time participants; 29% attended 1-3 times in the past year; 29% attended 3-6 times in

the past year; and 7% attended greater than 6 times in the past year. Approximately 64% of the

participants felt welcomed at the meetings. Fifty-seven percent felt supported by the group, and

36% of participants reported enough time was provided for mingling and sharing during the

group session. The data from the surveys allowed for creative, participant-focused topics,

handouts and a meeting agenda for each selected topic. Given the participant feedback, the

revised meeting agenda (See Appendix C, D, and E) included allotted time for mixing and

mingling, question and answer, and goal setting.

Participants stated that the most helpful discussions thus far were on protein intake, exercise,

snacking, and stress reduction. When asked what guest speakers they were interested in hearing

from, five said personal trainer; four said plastic surgeon; and one said motivational speaker.

Participants were asked what topics they were most interested in hearing about for future support

group classes and were given several options to choose from. Exercise was the topic of choice

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with vitamins/minerals, snacking, protein intake, hormone changes, carbohydrates, and food

logging/tracking to follow (See Appendix F). With the data from the feedback survey as well as

taking into account recent topics used in group, the topics of protein, food logging, and exercise

were taught over the 3 month period.

Support group participants were asked for open and honest opinions about what they would

change about the current support group. While many were first time participants, the other group

members discussed the possibility of mentoring with another support group member; and many

discussed they would change the timing of the meetings. A mentoring relationship pairs group

participants together through the physical, emotional and spiritual components involved in

weight loss. The goal is for both partners to have a sense of accountability, confidence, and the

motivation necessary to achieve his/her goals. Currently, meetings take place the 3rd Tuesday of

every month, alternating between afternoon and evening time slots. Many of the participants

expressed interest in meeting more frequently and not alternating between afternoon and evening

time slots. When asked how the support group could be improved, participants mentioned

updating inspirational stories on the website; others said it was great as is; and many went into

detail about the timing of the meetings (more days, different hours, different day of the week,

etc.). As for the open comments and feedback section, members were thankful for having the

group stating, I am so thankful for this group. It is so helpful! Thanks for having this group.

Support Group Topic Feedback Results


A total of approximately 15 participants attended February 2017 group, 3 participants attended

March 2017 group, and 9 participants attended the April 2017 support group meeting, resulting

in a total of 28 participants over the 3 month period. All participants were asked to fill out a topic

feedback form (See Appendix B) to provide the group facilitators with their opinions on how we

can further enhance the UVA Health System bariatric support group meetings. Of the 28

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participants, 16 people opted to provide feedback. All participants reported feeling supported by

the group and felt safe sharing their questions and concerns during the group meetings. One

hundred percent of the participants felt the main topic was appropriate, and said they learned

something during the one-hour group session. Ninety-four percent of the participants stated that

they would share the information that they learned with their family, friends, and/or support

system. One hundred percent of the participants felt they had enough time for questions and

answers; 88% felt that they had enough time for mingling with peers; and 75% of the participants

utilized the allotted time to set goals for themselves. Participants were again asked what topics

they are most interested in hearing about for future support group classes. Exercise was the top

choice followed by snacking, food logging/tracking, stress reduction, and carbohydrates (See

Appendix G).

Support group participants were asked what they would change about the current support group.

Many responded that they were happy with the group by stating, I enjoy the groups; excellent

meeting today; I really like the group; I wouldnt change anything; I have enjoyed all the

meetings; I love it; I appreciate this support group; it has been very helpful. A few participants

discussed the timing of the meetings, including number of meetings per month, longer duration,

times/dates, and incorporating morning/evening time slots. When asked how the service we are

trying to provide can be improved, participants stated, Unsure; I love it; nothing; and at this

time I have no suggestions. Support group participants were asked to provide additional

comments and feedback, to which they responded Great topic and information; had enough time

before and after group to mingle with peers; I LOVE these classes; and look forward to them!

DISCUSSION

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Initial Feedback Survey

Surveying UVA Health Systems bariatric support group participants on topics they found most

helpful and would like to learn more about, assisted in the assembly of the lesson plans for the

February, March, and April 2017. The feedback provided vital information in what the

participants are most interested in doing and discussing during the allotted monthly, one-hour

group meetings. This information was taken into consideration when improving the structure of

the UVA Health Systems bariatric support group.

Meeting Agenda
Evidence showed that structure in the meetings allowed participants to have certain predictable

elements each time, which can be reassuring to group members. Therefore, lesson plan agendas

were made for the February, March, and April 2017 support group meetings. Data from the initial

feedback survey showed that only 36% of participants felt that they had enough time for visiting

and sharing during the one-hour session. Given the data from the feedback surveys, ground rules

were set at the beginning of each class by stating the group is confidential and a safe place. After

the topic of the day was mentioned, each participant introduced themselves and told the group

the type of surgery they had or intend to have, followed by an ice breaker question based on the

topic of the month. The introduction portion was part of the meeting agenda in order to help the

participants feel welcomed, to engage members about their journeys, and to allow participants to

feel a sense of comfort amongst the other members and group facilitators.

Meeting Topics

After the introduction portion of the meeting, the agenda focused on the main topic discussion

for the month. The topics participants were most interested in hearing about were exercise,

snacking, vitamins and minerals, protein intake and carbohydrates. Given the data received in the

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survey, facilitators selected protein intake, how to read food labels/food logging, and exercise.

Several participants commented in the survey that they were interested in having a personal

trainer as a guest speaker. UVA Health System bariatric dietitians and a dietetic intern, who is a

certified personal trainer, led the sessions.

Protein was the selected topic for February 2017s support group meeting. The agenda for the

meeting can be found in Appendix C. Participants were provided a handout on healthy high

protein snack ideas and how to select the appropriate protein supplement. At the end of the class,

participants were able to taste test bars discussed during the session.

The lesson plan on reading a food label was created and was discussed during the March 2017

support group. This lesson included a visually appealing handout that discussed the basics of

how to read the nutrition facts label and the changes being implemented to the nutrition facts

label. The component of food logging and tracking was added to this discussion, as it can help

participants stay on trajectory with meeting their estimated nutritional needs.

The lesson plan for April 2017 focused on exercise. In the initial feedback survey (Appendix A),

57% of the participants indicated they were interested in a 5 minute stretch session.Given the

feedback, a 5-minute stretch session was conducted at the beginning of the meeting. The lesson

plan included a handout explaining why exercise is important, tips for long-term success, and

appropriate exercise duration. The lesson plan had a strong focus on choosing exercise that is

enjoyable while being creative with the physical activity. Additionally, a thorough discussion on

the difference between physical activity and exercise was provided. Participants were given

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supplemental handouts to take home which included visual aids for full body workouts and

stretching.

SMART Goal Setting

In closing of the meeting, time was allotted to set individual, specific, measurable, attainable,

realistic, and time-bound (SMART) goals for the next meeting. Printed color copies were

distributed for members to fill out to make it easier to know when they have succeeded. This was

scheduled at the end of the meeting in order to inspire an upbeat sendoff and encourage

participants to return to the group with their progress updates.

Encouraging Participation
With trained and motivated group facilitators, everyone within the group should feel a sense of

welcome, comfort, and support; group members should also feel safe to share their opinions and

experience. Each member was encouraged to participate in group activities, both for their own

advantage and for the benefit of the group as a whole. Plenty of opportunities were provided for

participants to engage in open discussion, share their insights, and discuss any questions or

concerns.

Several changes were made to the support group structure over the last couple of months.

Monthly raffles were added that included at least two winners per month. The facilitators

supplied samples related to topic material, in addition to providing bariatric supplement samples,

protein powder samples, and multivitamins. Patients were also given educational materials and

resources to help them succeed.

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A couple of participants mentioned in their feedback form the topic of mentoring with another

support group member. Mentoring aids in peer support, with the goal of making healthy lifestyle

changes and achieving long-term weight loss goals. In light of this, time was built into the

meeting agenda to encourage participants to exchange contact information, mingle with each

other, and build relationships with other members.

Feedback Topic Survey

The data from the feedback survey showed 100% of the participants felt supported by the group

vs. 57% prior to changing the structure of the support group. One hundred percent of the

participants were happy with the main topic choice, and 100% reported they learned something

from each group session over the past 3 months. One hundred percent of the participants felt they

had enough time for the question and answer period, and 88% felt that they had enough time for

mingling vs. the 36% taken from the initial feedback survey. Given the vast list of patient

interests, the three topics selected resulted in 100% of the participants feeling the main topic was

appropriate and 94% stating they will be sharing the information they learned with their friends,

family, and/or support system. Lastly, 75% of the participants began setting specific, measurable,

attainable, realistic, and time bound (SMART) goals to focus on until the next monthly meeting.

SUMMARY AND CONCLUSION

A study of the facilitation of bariatric surgery support groups has not previously been conducted.

However, this information remains a vital part of most bariatric surgery programs as it aids in

achieving a healthy lifestyle. The purpose of support groups is to bring people together and

discuss similar issues, concerns, and goals during both the pre-and-post-operation periods of

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bariatric surgery. While recent studies have shown that patients who regularly attend bariatric

support group meetings lose more weight and are more successful in maintaining their weight

loss, there was a gap in the knowledge of how to run a bariatric support group effectively.

This study has several limitations. First, sample sizes were small and included only 14

participants in the initial feedback survey and 16 participants in the feedback topic survey.

Participation in these groups greatly varied by the time and date of meetings, resulting in

responses coming from a variety of members for example, those who attended greater than six

times a year vs. first time attendees. Given the low response rate, it should be noted that

responses were subject to self-reporting bias, as intended in the study design. Participants often

had a limited time to respond to the survey, as they were collected after the group meeting. For

this reason, some answers were left blank and others illegible. Many of the participants were first

time participants to the group and were, therefore, unable to answer some of the questions

appropriately, while some participants opted not to fill out the feedback forms. This information

is limited to the UVA Health Systems bariatric support group and may not be generalizable to

various bariatric support groups around the world.

Utilizing the collected data, the bariatric dietitians at UVA Health System hope to obtain further

research on the structure of bariatric support groups. Given the information on participant

requests for future topics, the UVA Health System bariatric support group intends to address the

topics of snacking, vitamins and minerals, hormonal changes, and maintaining weight loss. UVA

Health System bariatric dietitians expect to provide guest speakers in the upcoming meetings,

including, plastic surgeons and motivational speakers. The participants of the bariatric support

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group will be polled for their best availability to fix the timing issues voiced by many and to

enhance attendance from those who cannot currently make it to group. The support group at

UVA Health System will begin to gather data from bariatric support groups at other surgical

centers in order to continue to enhance participant satisfaction. Support group dietitians at UVA

Health System aim to share the data with others to help them in the process of creating

successful support groups.

As the number of weight loss surgeries continue to increase, it is essential for this population to

have access to quality support groups. More data on facilitating support groups for bariatric

patients is needed in order to continue to provide the support and knowledge that this population

needs. With structured meeting agendas, main topics based on participant feedback, and

encouraged participation, members will have a solid foundation to continue on a successful

wellness journey.

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Appendix A

Support Group Initial Feedback Form


Although doing this is voluntary, your answers to these questions will help our program
understand and improve the services we provide. We do not ask for your name.
Your answers are confidential and very important to us. Please respond honestly.

1 Approximately how many times have you been to this support group in the last
year?

___ 0 ___ 1 ___ 2 5 ___ 6 10 ___ More than 10

2 Do you feel welcomed at our meetings?

____Yes ____No____ Sometimes ____ Not Applicable

3 Do you feel supported by the group?

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____Yes ____No____ Sometimes ____ Not Applicable

4 Is there enough time for visiting and sharing during the group session?

____Yes ____No____ Sometimes ____ Not Applicable

5 Would you be interested in a 5-minute stretch session during class?

____Yes ____No____ Maybe

6 The most helpful discussions thus far have been? (Circle all the apply)

A. Protein intake

B. Reading food labels

C. Exercise

D. Hormone changes

E. Water intake

F. Snacking

G. Food logging/tracking

H. Exercise

I. Vitamins and minerals

J. Stress reduction

K. Fats

L. Carbohydrates

7 Other (list as many as youd like) _______________________________

8 What speakers and topics did you find most useful?


________________________________________________________________________

9 What kind of guest speakers are you interested in hearing from? List All. For
example: Surgeon, personal trainer.
________________________________________________________________________

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10 What topics are you most interested in hearing about for future classes? (Circle all
that apply)

A. Protein intake

B. Reading food labels

C. Exercise

D. Hormone changes

E. Water intake

F. Snacking

G. Food logging/tracking

H. Vitamins and minerals

I. Stress reduction

J. Fats

K. Carbohydrates

L. Other (list as many as youd like) _______________________________

11 What would you change about the current support group?

_____________________________________________________________________

12 How can we improve the service we are trying to provide?

______________________________________________________________________

Comments/Feedback:

______________________________________________________________________

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Appendix B

Support Group Topic Evaluation Form

Although doing this is voluntary, your answers to these questions will help our program
understand and improve the services we provide. We do not ask for your name.
Your answers are confidential and very important to us. Please respond honestly.

1. Did you feel supported by the group?

____Yes ____No____ Sometimes ____ Not Applicable

2. Did you feel safe sharing your questions/concerns during the group session?

____Yes ____No____ Not Applicable

3. Did you feel the main topic was appropriate?

____Yes ____No____ Not Applicable

4. Did you learn anything from this group session?

____Yes ____No____ Not Applicable

5. Will you share the information you learned with your friends/family/support
system?

____Yes ____No____ Not Applicable

6. Did you feel you had enough time for question and answers?

____Yes ____No____ Not Applicable

7. Did you utilize the provided time to set goals for yourself?

____Yes ____No____ Sometimes ____ Not Applicable

8. Did you have enough time for mingling with peers during the group session?

____Yes ____No____ Sometimes ____ Not Applicable

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9. What topics are you most interested in hearing about for future classes? (Circle all
that apply)

A. Hormone changes

B. Water intake

C. Snacking

D. Food logging/tracking

E. Exercise

F. Protein intake

G. Vitamins and minerals

H. Stress reduction

I. Fats

J. Carbohydrates

K. Other (list as many as youd like) _______________________________

10. What would you change about the current support group?

________________________________________________________________________

11. How can we improve the service we are trying to provide?

________________________________________________________________________

Comments/Feedback:

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Appendix C

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Appendix D

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Appendix E

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Appendix F

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Data from the initial feedback survey question, What topics are you
most interested in hearing about for future classes? (Check all that
apply)

Appendix G

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Data from the topic feedback survey question, What topics are you
most interested in hearing about for future classes? (Check all that
apply)

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