Negotiating control: patients' experiences of unsuccessful weight-loss surgery.

Interviews were carried out with 10 men and women who had undergone weight-loss surgery (WLS) up to 10 years ago and felt that it had failed. Seven had had a further successful procedure. Data were analysed using Interpretative Phenomenological Analysis. Weight regain following surgery was explained in terms of either the mechanics of the operation or with participants describing ways to 'cheat' as food continued to be used for emotional regulation. Everyone spoke of how surgery neglected their mind. Following the second successful surgery, participants described changes in both their eating behaviour and cognitions emphasising how their mind had been brought 'in gear' through the investment of two invasive procedures. Transcending all accounts was the mind/body relationship and the issue of control with attributions for both failed and successful surgery shifting from the self to the surgical mechanism as the participants negotiated the pathway between self-blame and responsibility and utilised conflicting frameworks in which the mind and body were either divided or united. Whereas failed surgery is characterised by a battle for control, successful surgery involves handing control over to their restricted stomachs or considering WLS as a tool to be worked with.