Feasibility and Clinical Usefulness of the Unified Protocol in Online Group Format for Bariatric Surgery Candidates: Study Protocol for a Multiple Baseline Experimental Design.

Alba Quilez-Orden,Vanesa Ferreres-Galán,Jorge Osma

doi:10.3390/ijerph17176155

Abstract

Obesity is currently becoming a serious global public health problem due to its high prevalence and continuous increase. This condition is associated with different physical and mental health problems. The presence of emotional disorders (anxiety, depression and related disorders) among candidates for bariatric surgery is very high and predicts worse physical and psychological results. The present study aims to explore the feasibility and clinical usefulness of the Unified Protocol, a transdiagnostic emotion regulation-based intervention, delivered in an online group format to patients with emotional disorder diagnosis or symptoms, who are waiting for bariatric surgery. We will conduct a pilot study with a repeated single-case experimental design (multiple baseline design) in a public mental health service. The sample will consist of 60 participants, who will be randomized to three baseline conditions: 8, 12 or 15 evaluation days before the intervention. Diagnostic criteria, symptomatology and body mass index are the primary outcome measures, and we will include affectivity, personality, quality of life, body image, eating behavior and surgical complications like secondary measures. An analysis of treatment satisfaction will be also performed. Assessment points will include pre-treatment, baseline, treatment, post-treatment, and follow-ups every three months until two years after post-treatment. The results obtained in this study may have important clinical, social and economic implications for public mental health.

Highlights

Obesity is a chronic disease characterised by an increase in body fatness, which is usually estimated by body mass index (BMI) calculated as measured body weight divided by measured height squared (m2 ) [1]
Despite the positive data on the effectiveness of the UP for the treatment of EDs in different health conditions, we have found no studies about its clinical utility to improve anxiety and depressive symptoms or EDs in patients with obesity who are waiting for Bariatric surgery (BS)
Based on the reviewed bibliography, the type of design of the present study, the proposed objectives and the characteristics of the intervention that will be carried out, we hope that the results will reveal the feasibility and clinical usefulness of the UP applied in an online group format, in a mental health setting of the national health system for candidates of BS who have at least one diagnosis of ED or emotional symptoms

Summary

Introduction

Obesity is a chronic disease characterised by an increase in body fatness, which is usually estimated by body mass index (BMI) calculated as measured body weight (kg) divided by measured height squared (m2 ) [1]. The causes of obesity are complex and multifactorial [1], and this condition is associated with different health problems, such as myocardial infarction, hypertension, stroke, dyslipidemia, diabetes mellitus, or obstructive sleep apnea [4,5,6]. All these alterations affect the quality of life and can disturb important areas of functioning (e.g., physical function, vitality, social functioning and emotional role) [7,8]. In addition to all of these complications, people with obesity experience significant

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