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The Experiences and Perceptions of Behavioral Factors That Contribute to Successful Weight Loss in Male Bariatric Patients

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The Experiences and Perceptions of Behavioral Factors That Contribute to Successful Weight Loss in Male Bariatric Patients Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2017 THE EXPERIENCES AND PERCEPTIONS OF BEHAVIORAL FACTORS THAT CONTRIBUTE TO SUCCESSFUL WEIGHT LOSS IN MALE BARIATRIC PATIENTS Stephen P. Sowulewski Follow this and additional works at: https://scholarscompass.vcu.edu/etd Part of the Other Medicine and Health Sciences Commons © The Author Downloaded from https://scholarscompass.vcu.edu/etd/4674 This Dissertation is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. © Stephen P. Sowulewski 2016 All Rights Reserved THE EXPERIENCES AND PERCEPTIONS OF BEHAVIORAL FACTORS THAT CONTRIBUTE TO SUCCESSFUL WEIGHT LOSS IN MALE BARIATRIC PATIENTS A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. by Stephen P. Sowulewski B.S., Exercise Science, Lake Superior State University, 1997 M.A., Health Promotion, Central Michigan University, 2003 Director: Lisa M. Abrams, Ph.D. Associate Professor and Chair Department of Foundations of Education School of Education Virginia Commonwealth University Richmond, Virginia January, 2017 ii Acknowledgment This dissertation marks the end of a long journey that has proven to test my inner resolve through patience and determination. I would like to thank my parents, Steve and Stephanie Sowulewski, for their unyielding support and their tireless efforts in urging me to stay focused on the ultimate goal of finishing this degree. I am truly grateful for the assistance and guidance provided by Dr. Lisa Abrams, Dr. Beverly Warren, Dr. Tracey Gendron, and Dr. Ron Evans who served as my committee members. I would also like to thank my dear friend, Ms. Deb Thompson, who has been steadfast in her support of my completion of the Ph.D. Lastly, I would like to thank Ms. Jill Meador, the Bariatric Program Coordinator, and her colleagues Dr. Guilherme and Mr. Luke Wolfe in the surgical practice at VCU Health System for their help with patient recruitment. iii Table of Contents List of Tables ................................................................................................................................ vi Abstract ......................................................................................................................................... vii 1. Introduction ............................................................................................................................... 1 Background for the Study ................................................................................................. 1 Overview of the Study ...................................................................................................... 2 Overview of the Literature ................................................................................................ 3 Eating Behaviors ........................................................................................................ 3 Physical Activity ........................................................................................................ 4 Support Group Attendance ........................................................................................ 4 Postoperative Physician Follow-up ........................................................................... 5 Rationale and Significance for the Study.......................................................................... 6 Statement of the Problem .................................................................................................. 7 Design and Methods ......................................................................................................... 8 Participants ........................................................................................................................ 8 Data Collection Procedures ............................................................................................... 9 Data Analysis .................................................................................................................... 9 Definition of Terms........................................................................................................ 10 2. Review of Literature .............................................................................................................. 12 Health Ramifications of Obesity .................................................................................... 13 Lifestyle Approaches to Weight Management: Eating Behaviors ................................. 13 Lifestyle Approaches to Weight Management: Physical Activity ................................. 14 Lifestyle Approaches to Weight Management: Behavior Modification ........................ 15 Lifestyle Approaches to Weight Management: Pharmacotherapy ................................ 16 Bariatric Surgery ............................................................................................................ 17 Types of Surgeries .................................................................................................. 18 Patient Selection ..................................................................................................... 19 Preoperative Weight Status ..................................................................................... 19 Bariatric Research Involving Males ............................................................................... 20 Eating Behaviors Pre and Postop ................................................................................... 23 Physical Activity ............................................................................................................ 27 Preoperative Physical Activity ............................................................................... 28 Postoperative Physical Activity in Gastric Bypass Patients ................................... 29 iv Postoperative Physical Activity in LAGB Patients ................................................ 30 Frequency, Intensity, and Time of Physical Activity ............................................. 30 Support Group Attendance ............................................................................................ 33 Postoperative Physician Visits ....................................................................................... 36 Summary ........................................................................................................................ 39 3. Methodology .......................................................................................................................... 43 Study Design .................................................................................................................. 43 Participants and Recruitment ......................................................................................... 45 Recruitment Procedures ................................................................................................. 46 Data Collection .............................................................................................................. 46 Instrument Development and Pilot ......................................................................... 46 Full Study Collection Procedures ........................................................................... 49 Data Analysis ................................................................................................................. 50 First Cycle Codes .................................................................................................... 50 Second Cycle Codes ............................................................................................... 51 Strategies for Ensuring Credibility in Qualitative Research .......................................... 51 Field Journaling ...................................................................................................... 55 Memos .................................................................................................................... 56 Delimitations .................................................................................................................. 56 Institutional Review Board Statement ........................................................................... 57 4. Findings ................................................................................................................................ 58 Introduction .................................................................................................................... 58 Presurgery ...................................................................................................................... 61 Quality of Life ........................................................................................................ 61 Locus of Control ..................................................................................................... 62 Unhealthy Choices .................................................................................................. 65 Physical State .......................................................................................................... 66 Affect .....................................................................................................................
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