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Objective To explore negative self‐evaluation following weight loss surgery (WLS). Methods In‐depth interviews were conducted with 11 women who had WLS. Thematic analysis was conducted through an iterative process, allowing categories and themes to emerge. To ensure rigor, two coders analyzed the data. Data were collected until thematic saturation was achieved. Results All participants reported health as the motivation for WLS. Overall sentiment regarding WLS was positive. However, negative self‐evaluation was reported and includes the following: (a) body‐image distortion; (b) body‐image dissatisfaction, including excessive skin; and (c) perceived stigma. Mitigating strategies include the following: (a) utilizing markers of progress to increase assimilation of a new identity as a thinner person, and (b) reflecting on the former self as a time of decreased quality of life. Implications for practice Nurse practitioners and other clinicians treat and counsel patients on obesity and obesity‐related morbidity, and may need to discuss WLS with patients who are either contemplating it or have already undergone it. The findings from the present study can provide clinicians insight into the possible psychological effects of WLS‐associated weight loss. Bringing possible negative self‐evaluative effects into open discussion can help optimize patient care and healthcare results.

Background and purpose Weight‐loss surgery (WLS) is a popular means toward achieving weight loss. Numerous studies report on the psychological and physical benefits of the procedure. Patients who have supportive others often demonstrate improved outcomes as compared to those who may not have support. The present study examines relationship maintenance activities that may contribute to a couple's positive adjustment following WLS, along with relational views that may modify and evolve as patients continue to lose weight. Method Eleven heterosexual couples in which the female had WLS participated in in‐depth, semistructured interviews. A deductive method of analysis was used to categorize relationship maintenance activities; an inductive method was used to examine relational views. Conclusions Six types of relationship maintenance activities proved beneficial following WLS: (1) openness, (2) assurances, (3) food/meals as shared tasks, (4) joint activities, (5) antisocial, and (6) affection. In describing their relational views, participants spoke to the increasing independence, confidence, and self‐focus of those who had had WLS. A persistent fat identity was also reported. Implications for practice The findings can provide advanced practice nurses and other clinicians additional insight into, and strategies to assist, couples who have experienced, or will experience, WLS within their relationship.

A field placement unit for undergraduate social work students in a typical American Indian off-reservation boarding school is discussed. The goals of the program were to help the school's students with their emotional, psychological, and social problems and to offer the interns experience in counseling American Indians.

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