Andreu A, Jimenez A, Vidal J Bariatric support groups predicts long-term weight loss. Obes Surg. 2020; 30:(6)2118-2123

Bemanian M, Mæland S, Blomhoff R Emotional eating in relation to worries and psychological distress amid the COVID-19 pandemic: a population-based survey on adults in Norway. Int J Environ Res Public Health. 2020; 18:(1)

Bolier L, Haverman M, Westerhof GJ, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health. 2013; 13

Buckland NJ, Camidge D, Croden F Women with a low-satiety phenotype show impaired appetite control and greater resistance to weight loss. Br J Nutr. 2019; 122:(8)951-959

Busetto L, Bettini S, Makaronidis J, Roberts CA, Halford JCG, Batterham RL. Mechanisms of weight regain. Eur J Intern Med. 2021; 93:3-7

Chauvet-Gelinier JC, Roussot A, Cottenet J Depression and obesity, data from a national administrative database study: Geographic evidence for an epidemiological overlap. PLoS One. 2019; 14:(1)

Coulman KD, MacKichan F, Blazeby JM, Donovan JL, Owen-Smith A. Patients' experiences of life after bariatric surgery and follow-up care: a qualitative study. BMJ Open. 2020; 10:(2)

Dunn C, Haubenreiser M, Johnson M Mindfulness approaches and weight loss, weight maintenance, and weight regain. Curr Obes Rep. 2018; 7:(1)37-49

Forman EM, Manasse SM, Butryn ML, Crosby RD, Dallal DH, Crochiere RJ. Long-term follow-up of the mind your health project: acceptance-based versus standard behavioral treatment for obesity. Obesity (Silver Spring). 2019; 27:(4)565-571

Franja S, Wahl DR, Elliston KG, Ferguson SG. Comfort eating: an observational study of affect in the hours immediately before, and after, snacking. Br J Health Psychol. 2021; 26:(3)825-838

Gorlin EI, Lee J, Otto MW. A topographical map approach to representing treatment efficacy: a focus on positive psychology interventions. Cogn Behav Ther. 2018; 47:(1)34-42

Hamdouni H, Kliszczewicz B, Zouhal H, Rhibi F, Ben Salah FZ, Ben Abderrahman A. Effect of three fitness programs on strength, speed, flexibility and muscle power on sedentary subjects. J Sports Med Phys Fitness. 2022; 62:(1)25-38

Kouvelioti R, Vagenas G, Langley-Evans S. Effects of exercise and diet on weight loss maintenance in overweight and obese adults: a systematic review. J Sports Med Phys Fitness. 2014; 54:(4)456-74

McVay MA, Yancy WS, Bennett GG, Jung SH, Voils CI. Perceived barriers and facilitators of initiation of behavioral weight loss interventions among adults with obesity: a qualitative study. BMC Public Health. 2018; 18:(1)

Milaneschi Y, Simmons WK, van Rossum EFC, Penninx BW. Depression and obesity: evidence of shared biological mechanisms. Mol Psychiatry. 2019; 24:(1)18-33

Miller-Matero LR, Brescacin C, Clark SM, Troncone CL, Tobin ET. Why WAIT? Preliminary evaluation of the weight assistance and intervention techniques (WAIT) group. Psychol Health Med. 2019; 24:(9)1029-1037

Moffatt CJ, Gaskin R, Sykorova M Prevalence and risk factors for chronic edema in UK community nursing services. Lymphat Res Biol. 2019; 17:(2)147-154

NHS website. Obesity. 2019. (accessed 31 January 2021)

Nymo S, Coutinho SR, Rehfeld JF, Truby H, Kulseng B, Martins C. Physiological predictors of weight regain at 1-year follow-up in weight-reduced adults with obesity. Obesity (Silver Spring). 2019; 27:(6)925-931

Pirotta S, Joham A, Hochberg L Strategies to reduce attrition in weight loss interventions: a systematic review and meta-analysis. Obes Rev. 2019; 20:(10)1400-1412

Provan D. Body weight and the management of lymphoedema. Br J Community Nurs. 2019; 24:(12)576-579

Quinn DM, Puhl RM, Reinka MA. Trying again (and again): weight cycling and depressive symptoms in US adults. PLoS One. 2020; 15:(9)

Salemonsen E, Førland G, Saetre Hansen B, Holm AL. Beneficial self-management support and user involvement in Healthy Life Centres: a qualitative interview study in persons afflicted by overweight or obesity. Health Expect. 2020; 23:(5)1376-1386

Saul H, Gursul D. Group programmes for weight loss may be more effective than one-to-one sessions. BMJ. 2021; 375

Shantavasinkul PC, Omotosho P, Corsino L, Portenier D, Torquati A. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016; 12:(9)1640-1645

Sharifi N, Mahdavi R, Ebrahimi-Mameghani M. Perceived barriers to weight loss programs for overweight or obese women. Health Promot Perspect. 2013; 3:(1)11-22

Tolvanen L, Svensson Å, Hemmingsson E, Christenson A, Lagerros YT. Perceived and preferred social support in patients experiencing weight regain after bariatric surgery-a qualitative study. Obes Surg. 2021; 31:(3)1256-1264

van Baak MA, Mariman ECM. Mechanisms of weight regain after weight loss — the role of adipose tissue. Nat Rev Endocrinol. 2019; 15:(5)274-287

Yeung AY, Tadi P. Physiology, obesity neurohormonal appetite and satiety control.Treasure Island (FL): StatPearls Publishing; 2021

Running a weight-management programme with a psychological focus within a lymphoedema service

10 February 2022
11 min read
Volume 31 · Issue 3


Weight management and psychological health are intertwined. Patients in this context are often mindful of how to eat healthily and what they need to do to lose weight, but frequently self-sabotage, with external influences often impact any attempted weight-loss approach. Consequently, any form of lymphoedema management is also thwarted and vicious cycles between success and rebound occur. This article describes a 6-week weight-management programme that took place before the COVID-19 pandemic. The programme focused exclusively on the expectation that, if a patient's psychological health could be improved, weight reduction would occur as a result, and, in turn, any positive effects on adherence with lymphoedema treatments could be observed.

Lymphoedema services often support patients who are overweight or obese (Provan, 2019). Being overweight or obese are risk factors for the development of lymphoedema and can also be a complication in its management (Provan, 2019). In the UK, clinical efforts to help patients lose weight and keep this weight off have been found to be ineffective (Moffatt et al, 2019; Nymo et al, 2019; Busetto et al, 2021). Studies have indicated that a variety of strategies and approaches successfully lead to weight loss, but evidence shows that the majority of these patients then regain weight (Kouvelioti et al, 2014; Shantavasinkul et al, 2016; van Baak and Mariman, 2019). A common pattern for patients in the author's lymphoedema service is ‘yo-yo’ dieting—moving from one diet to the next, or one approach to the next, losing and then regaining weight. As a result, patients typically become highly demoralised, and this emotional state then sabotages possible future attempts to lose weight. In psychological terms, the experience of repeated failure, ie weight regain, has a serious negative impact on feelings of personal control, to say nothing of the adverse impact on self-esteem (Quinn et al, 2020).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content