Psychic Resistances in Loss of Weight by Patients in Preparation for a Bariatric Surgery : a Qualitative Research

Abstract

Background: Medical care are developed to combat obesity such as bariatric surgery. In spite of the existence of many therapeutic education programs, a significant number of therapeutic failures are observed with patients, because of presence of psychic resistances that prevent them for adopting behaviors in favor of the loss of weight. This research is focused on the psychic resistances in the loss of weight and attempts to highlight the emotional, cognitive and behavioral processes which explained the origin of these resistances. Methods: Population : Four patients with obesity (average : 40,5 years). Methodology: qualitative approach. Data collection: semi-structured interviews. Data analysis : using IPA and clinical analysis. Finding: - Most of patients lived traumatic experiences. To defend themselves against the psychic tensions, they adopt a compulsive consumption of food ; - The patients associate their eating habits with the family model ; - Their feeling to exist become intensified by consuming food ; - Submit to a conflict in the Ego, these patients are urged to adopt behaviors sometimes in favour, sometimes against a loss of weight. Discussion : This research allow us to consider that these defensive and identity functions are at the origin of the psychic resistances in the loss of weight. A therapeutic education, which would consider these elements related to the subjectivity of patients, could constitute an interesting way for the care of patients in preparation for a bariatric surgery and to decrease the incidence of therapeutic failures.