A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 45
PATHOLOGY PERSPECTIVES
letter describing how you work and the
primary goals in your massage therapy
sessions can open this dialogue, as you invite
the team to share any questions or concerns.
The abdominal area will be sore for
quite some time—several weeks or more—
so side-lying or semi-supine may be the
best table position for your client who is
recently postbariatric surgery. Elevating
the legs can also help with any extremity
swelling. Because of the abdominal digestive
revision, the lymphatic pathways will be
going through a rerouting process, and
some fluid backup can be expected. As
the person rapidly sheds their presurgery
weight, skin changes can be expected,
especially in texture and elasticity.
Excess skin is a by-product of the weight
loss, so strokes like long-drag Swedish
effleurage may need extra lubrication.
Some patients will go through follow-
up body-contouring surgery to remove
excess skin, and this requires different
accommodations for massage therapy.
It's hard to foresee where and what
kind of massage will best suit a person
who has been through bariatric surgery.
One predictable challenge is how
posture changes as the weight comes
off. Overweight people are likely to have
back pain, along with neck and shoulder
pain. They may also have foot issues like
plantar fasciitis or flat feet that persist
after weight loss. Other physical symptoms
will vary, and it is the practitioner's job
to address these on a case-by-case basis.
Massage therapists can contribute to a
positive outcome by developing a long-term
focused treatment plan that supports the
physical transformation of their bariatric
client. While Lisa went through her rapid,
and then more manageable, weight loss,
massage helped her get in touch with
changing postural needs and encouraged
a positive self-image. It was—and is—an
important part of her recovery process.
In conclusion, when a person who has
had bariatric surgery makes an appointment
for massage therapy, we need to anticipate
certain needs. We also need to be flexible
and teachable: our clients will know
much more about their situation than
we can. When we engage our clients in
teaching us, and work together to design
their perfect session, we invite them to
long-term self-care with massage. This
is a wonderful gift for all of our clients,
especially those who, like people who
have chosen bariatric surgery, are deeply
invested in their own well-being.
Notes
1. Susanne A. Fogger and Teena M. McGuinness,
"The Relationship Between Addictions and Bariatric
Surgery for Nurses in Recovery," Perspectives in
Psychiatric Care 48, no. 1 (February 18, 2011): 10–15,
https://doi.org/10.1111/j.1744-6163.2010.00298.x.
2. Jules R. Altfas, "Prevalence of Attention Deficit/
Hyperactivity Disorder among Adults in Obesity
Resources
American Society for Metabolic and Bariatric Surgery. "Bariatric Surgery Misconceptions."
Accessed June 5, 2018. www.asmbs.org/patients/bariatric-surgery-misconceptions.
American Society for Metabolic and Bariatric Surgery. "Bariatric Surgery Procedures."
Accessed June 11, 2018. www.asmbs.org/patients/bariatric-surgery-procedures.
Bond, D. S. et al. "Weight-Loss Maintenance in Successful Weight Losers: Surgical vs Non-
Surgical Methods." International Journal of Obesity 33, no. 1 (January 2009): 173–80. https://
doi.org/10.1038/ijo.2008.256.
Gloy, Viktoria L. et al. "Bariatric Surgery versus Non-Surgical Treatment for Obesity: A
Systematic Review and Meta-Analysis of Randomised Controlled Trials." BMJ 347 (October
22, 2013): f5934. https://doi.org/10.1136/bmj.f5934.
Kahan, S. "Quick Takes: What You Need to Know About The 5 FDA-Approved Obesity Drugs."
Medscape. March 2, 2017. www.medscape.com/viewarticle/876411.
MarketResearch.com. "U.S. Weight Loss Market Worth $66 Billion." December 20, 2017. www.
prnewswire.com/news-releases/us-weight-loss-market-worth-66-billion-300573968.html.
Semedo, Daniela. "In Morbidly Obese, New Non-Surgical Approach May Be an Option."
Obesity News Today. December 7, 2015. www.obesitynewstoday.com/2015/12/07/morbidly-
obese-new-non-surgical-approach-may-option.
Shayani, V. "Gastric Balloon — 14 Ways It Will Affect You." Bariatric Surgery Source. Last
updated May 24, 2018. Accessed June 11, 2018. www.bariatric-surgery-source.com/gastric-
balloon.html.
Weiss, Clifford R. et al. "Clinical Safety of Bariatric Arterial Embolization: Preliminary Results of
the BEAT Obesity Trial." Radiology 283, no. 2 (May 2017): 598–608. https://doi.org/10.1148/
radiol.2016160914.
Treatment," BMC Psychiatry 2 (September 13,
2002): 9, https://doi.org/10.1186/1471-244X-2-9.
3. Susanne A. Fogger and Tenna M. McGuiness,
"The Relationship Between Addictions and
Bariatric Surgery for Nurses in Recovery."
Ruth Werner is a former massage therapist,
a writer, and an NCBTMB-approved continuing
education provider. She wrote A Massage
Therapist's Guide to Pathology (available at
BooksofDiscovery.com), now in its sixth edition,
which is used in massage schools worldwide.
Werner is available at www.ruthwerner.com or
wernerworkshops@ruthwerner.com.
