Abstract
BackgroundTo examine whether a preoperative cognitive behavioural therapy (CBT) intervention exceeds usual care in the improvements of dysfunctional eating behaviours, mood, affective symptoms and body weight 1 year after bariatric surgery.MethodsThis is a 1-year follow-up of a single centre parallel-group randomised controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). A total of 80 (55 females) patients mean (SD) age 44 (10) years were included. The intervention group received 10 weeks of CBT prior to bariatric surgery, and the control group received nutritional support and education. Both groups were assessed at baseline (T0), post CBT intervention/preoperatively (T1), and 1 year postoperatively (T2). Using a mixed modelling statistical approach, we examined if the CBT group improved more across time than the control group.ResultsOur hypothesis was not supported as both groups had comparable improvements in all outcomes except for anxiety symptoms. Body weight declined by 30.2 % (37.3 kg) in the CBT group and by 31.2 % (40.0 kg) in the control group from baseline to follow-up, p = 0.82.There were statistically significant reductions in anxiety and depression symptoms in the CBT group between T0 and T1 and between T1 and T2 for depression only. However, in the control group, the anxiety score did not change significantly. The CBT group showed an earlier onset of improvements in all eating behaviours and affective symptoms than the control group.ConclusionThe 10-week CBT intervention showed beneficial effects preoperatively, but the non-significant group differences postoperatively indicate a genuine effect of surgery.
Highlights
In patients with extreme obesity undergoing bariatric surgery, there is a high rate of dysfunctional eating behaviours (DE) both prior to [1,2,3,4,5] and after surgery [5,6,7]
The cognitive behavioural therapy (CBT) group showed an earlier onset of improvements in all eating behaviours and affective symptoms than the control group
The 10-week CBT intervention showed beneficial effects preoperatively, but the non-significant group differences postoperatively indicate a genuine effect of surgery
Summary
In patients with extreme obesity undergoing bariatric surgery, there is a high rate of dysfunctional eating behaviours (DE) (i.e. emotional eating, uncontrolled eating and cognitive restraint) both prior to [1,2,3,4,5] and after surgery [5,6,7]. Five sub-groups with different patterns of weight loss were identified. These patterns showed a variability of weight changes starting at 6 months postoperatively. To examine whether a preoperative cognitive behavioural therapy (CBT) intervention exceeds usual care in the improvements of dysfunctional eating behaviours, mood, affective symptoms and body weight 1 year after bariatric surgery
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