Committee Spotlight

Published in February 2014 Issue             

An Interview with Chair, Dr. Stephen Ritz and

Co-Chair, Kellie Armstrong, RN

The mission of the ASMBS Integrated Health Support Group committee is to promote the development of support groups in the care of bariatric surgical patients. Through the development and distribution of resources, including a support group leader manual, the seven-member committee is helping nurses, bariatric coordinators and support group leaders meet the needs of their patients.

Stephen Ritz, MD

Kellie Armstrong, RN

connect recently interviewed Committee Chair, Stephen Ritz, PhD, Licensed Psychologist at Decatur Psychotherapy Group and its Co-Chair, Kellie Armstrong, RN, MS, CBN, Bariatric Surgery Program Coordinator at the Center for Bariatric Surgery, RI and Miriam Hospitals, about support groups and the critical role they play in patient care.

connect: How and why was the IH Support Group Committee established? Why was it important to create its own committee?

The committee was formed to define, refine and expand our understanding of the support group concept to better meet patient and support group leader needs. It was the view of the Integrated Health Executive Committee that members of the committee have significant support group leader experience, and that by doing so, the ASMBS might best respond to the range of needs of support group leaders and patients alike. We wanted to provide leadership in this important area of patient care.

connect: What is the current charge of the committee? What is its scope? What are the committee’s goals for 2014?

Specifically, the current charges of the committee include:

  1. To optimize the support group experience spanning all phases of the bariatric surgery journey for the patient and their personal support systems.

  2. To optimize bariatric surgery programs and their affiliated personnel’s ability to provide competent and meaningful support group services.

  3. To provide strategies and resources to encourage, increase and retain support group membership and attendance.

  4. To promote the importance and value of the bariatric surgery support group.

Our goals for 2014 include the completion of the Updated and Revised ASMBS Support Group Leader Manual and to pilot user friendly needs assessment surveys for bariatric surgery support group facilitators and support group attendees. Over the longer term, we hope to develop ASMBS policies and protocols for evidence-based and best practices with regard to the development and facilitation of bariatric surgery support groups and to develop an ASMBS Community Standard for program support group facilitators.

connect: How have bariatric support groups evolved over the years? How have they improved? What still needs to improve about the utilization of support groups?

We believe they have evolved and become much more common. Just 20 years ago, you rarely heard of a support group for a bariatric surgical patient. It’s really only been in the last 12 to 14 years that we have seen a real emergence of support groups. Many groups were started by patients themselves and as they grew and developed, they become an official part of the bariatric surgery programs that they are associated with, and with that they were able to get some more resources.

connect: Do most bariatric programs have support groups? Has the number increased or decreased over the years? What is the trend?

In order to be an accredited center you need to provide at least one support group led by a licensed healthcare professional, so we believe that they have increased in numbers, if not by frequency as well. The Center for Bariatric Surgery, RI and Miriam Hospitals usually has four support groups a month. Two post op and one men’s only, and then there is a big monthly group where the pre op’s are required to attend (at least two sessions prior to surgery) and everyone else is welcome to come as well.

connect: Do you think the quality of support groups is consistent throughout the country? Do most follow “best practices"?

There are certainly some great programs out there, but there is great variability with regard to content, scope and format, as well as knowledge base of facilitators. We hope to change that by providing a best practices resource guide that could help make the support group experience more consistent.

connect: What are best practices in support groups? Is there a science to it?

Currently there is no one set of “best practices”. It varies by the type of surgery, male vs. female; age of patients, location, patient education level and several other factors, including who is leading the support group, i.e, patient, healthcare worker social worker, Psych, RD, RN, etc.

connect: What is the most significant evidence that provides the justification for support groups?

This is an area that research is needed. We all know support groups help improve patient outcomes from our own experience. It’s now time to document it through data publication. The available research has shown that patients who attend more support groups (five+ on average) experience significantly more weight loss during the first year after bariatric surgery. Unfortunately, there are no studies that have assessed support group attendance and weight loss outcomes beyond one-year, post-op.

connect: What do you think about online support groups in bariatric, is this a good idea? Are many programs adopting this practice?

Many groups have begun to adopt the practice. It certainly seems better to have a support group online than to not have one at all. It could also help inspire greater attendance by patients who can participate from the comfort of their own home. It could also save on room and travel costs and have a positive impact on long-term patient retention and optimal post-surgery weight loss maintenance. There is also the expectation that programs that have varied support group options are well positioned to serve patient needs, both pre and post-operatively.

However, we need to be careful about eliminating human contact altogether. It’s important for people to see each other and make a personal connection in that way. A combination of online and offline offerings may be best. This is an area we will be watching.

connect: What are the three most important things that the entire ASMBS membership should understand about support groups and the IH committee?

  1. Support groups help with retention of patients and follow up in the long term.

  2. Support groups help the patients stay on track.

  3. Our goal is to provide a living document to help bariatric surgery programs care and support their patients at the highest level possible.