Social Support

Evolution of WLS Social Support Groups

March 30, 2018

Social support following weight loss surgery (WLS) is essential to ensure long-term success by helping patients maintain behavioral changes. Research indicates that individuals who attend in-person support groups even tend to lose more weight. Nowadays, many patients are looking for convenient access to online support groups. Easy, quick access is the primary drive to join groups online. Information shared and presented this way, however, appears to be often inaccurate and biased.

WLS Social Support

Most patients who are considering WLS start their search on the Internet to learn about the operation and find answers to their questions before they contact a surgery center. A recent research showed that among WLS candidates, 81% used the Internet to find out more about surgical techniques and 72% were interested to learn more about the possible outcomes of the operation.

Unfortunately, not all the content is accurate on the web and even the personal stories often include a great deal of bias. A study examined the quality of information available on the Internet. Out of 30 websites, none were rated excellent, 2 were rated good, 4 were rated as fair and the remaining 22 were rated as poor. Another study found that Facebook is the preferred place for WLS patients to search for information (81%) followed by search engines (70%).

Connecting with individuals in a meaningful manner who shares an experience or goals can result in feeling less lonely and isolated.

Individuals often gain a sense of empowerment and control because they can talk honestly about their feelings and experiences. Traditionally, groups have met in person and members provided each other with various types of help, usually nonprofessional and nonmaterial, for a particular shared, usually difficult, interest/goal. The help may take the form of sharing information, listening to and relating to others' experiences, providing a sympathetic understanding and establishing social networks. Members with the similar experiences can come together to form a sense of community.

Online social media sites can limit and shape this experience. Social media, like Facebook, serves its members with uncensored content about topics like WLS. Social media sites function using a concept called a positive social feedback loop, such as “thumbs up” and “likes.”

Many individuals enjoy this positive feedback and consider them as encouragement. The more “likes” a post receives, encourages the individual to post more of the similar content. The sites also use mostly visual aids to support humans’ ability to process this information easier. This can influences what individuals share and how they present that information.

Most Frequently Asked Questions

In a recent study, multiple WLS Facebook accounts’ content was analyzed and it was found that the most frequently asked questions were related to nutrition “What protein supplement should I use?” and medical “What can I do to prevent hair loss?”

Expressing encouragement was included in about one-third of the posts “You will do great with your surgery!” On the other hand, concerns about body image issues “I am disgusted with my arm flaps” were mentioned 1%  and eating patterns “I thought my food addiction would go away” were mentioned only .5 % of the time.

Online support groups are a very popular way for patients to get support, ask questions, and give recommendations or to show personal results to other pre-op and post-surgical patients. Social media pages are also often used to seek medical or nutritional information/advice.

Patients in these groups also recommend products such as supplements and specific food items. A substantial amount of posts are documenting one’s weight loss progress. However, many posts project internalized stereotypical beliefs about weight and weight bias. As a result, the amount of real, emotional support is limited in online WLS social support groups.

Online platforms can also group individuals who share a common goal or experience. These groups can often inform and influence individuals without a check for accuracy. My recommendations for patients who seek support on social media sites are to:

  1. Inquire from multiple individuals and try to find a common thread rather than consider to take someone’s recommendation, even if it is based on their personal  (visible) current success.
  2. Find scientific journals, discuss your findings with professionals when you are seeking information about the surgery and its outcomes (surgeon/dietician/psychologist)
  3. Support groups are not just for individuals who are seeking support/answers. There is a profound benefit in helping others. Your success and struggles can help others to realize their mistakes or learn from yours. Consider sharing more about the emotional aspect of your journey that can’t be measured with a number on a scale or a smaller dress size.
  4. Finally, I highly recommend making an effort to find an in-person support group from time to time. If you could find one that is led by a professional your chances to receive information that is based on scientific research is greater. This could help you to overcome some of the limits of online social support networks.


  • Akbari K, Som R. Evaluating the quality of internet information for bariatric surgery. Obes. Surg. 2014; 24 (11): 2003-6.
  • Koball A, Jester D, Domoff A, et al. Examination of bariatric surgery Facebook support groups a content analysis Surgery for Obesity and Related Diseases. 2017 (13): 1369-75.
  • Orth WS, Madan AK, Taddeucci RJ, Coday M, Tichansky DS. Support group meeting attendance is associated with better weight loss Obes.Surg 2008; 18 (4):391-4.
  • Paolino L, Genser L, Fritsch S, et al. The web-surfing bariatric patient: the role of the internet in the decision-making process. Obes. Surg. 2015 Apr;25(4):738-43.


Zoltan Nabilek Psy.D.  (Dr.Z) is a licensed clinical psychologist guiding individuals to embrace habits that are more in line with their true self. Dr. Z is also helping individuals and couples to improve their relationships with each other, with food and their own bodies. He is a bariatric psychology expert that has been providing insight and guidance to hundreds of patients with interest in a healthy relationship with food and their body.