Integrating psychological wellness into weight management education for long-term success: A formative evaluation of a pre-surgical preparation program

Background: In response to identified shortcomings in weight loss surgery preparation regimens, a large Northern California medical group developed “My True Body” (MTB), a 12-session group education program integrating nutrition and lifestyle education, a novel mind-body technique for reducing food cravings and stress, monthly weigh-ins, and discussion. The purpose of this study was to examine the effects of MTB participation on participants' beliefs and attitudes toward their ability to maintain healthy weight loss behaviors to inform a broader scale quantitative program evaluation. Methods: After obtaining informed consent, structured telephone interviews were conducted among women aged 36 to 65 years who completed MTB between April and December 2010. Interviews explored motivations for participation, advantages, disadvantages, and differentiating characteristics of MTB. Qualitative data analysis was performed using Atlas.ti to identify emergent themes. Results: Most study participants described psychological benefits, including better understanding of root causes of their current health status; taking stock and reshaping motivations and expectations for weight loss; and making healthier food choices. Most participants reported ongoing use of skills acquired in the program. Opinions were mixed regarding the value of group discussion. Many participants reported that they didn't know what to expect of MTB prior to participation. Conclusions: Exploration of psychological influences on food choices and integrating behavior modification training into pre-bariatric education programs appears to enhance most participants' post-program weight and stress management success, regardless of whether participants subsequently had weight loss surgery. Improvements to pre-program communication, administration, and scheduling logistics might improve overall participant experience.