A pilot randomized controlled trial of telephone-based cognitive behavioural therapy for preoperative bariatric surgery patients

Cassin, Stephanie E.; Sockalingam, Sanjeev; Du, Chau; Wnuk, Susan; Hawa, Raed; Parikh, Sagar V.

doi:10.1016/j.brat.2016.03.001

Cited by 48 publications

(107 citation statements)

References 33 publications

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“…Of the studies reviewed, 16 focused on preoperative interventions and 24 on post‐operative interventions . One study offered the intervention either before or after surgery, and three studies examined interventions delivered at time points both before and after surgery …”

Section: Resultsmentioning

confidence: 99%

“…Of the reviewed articles, 13 studies examined a cognitive‐behavioural intervention, and 13 examined behavioural modification techniques . Many selected studies examined a cognitive, cognitive‐behavioural, or behavioural modification intervention in conjunction with various other approaches, including motivational techniques, mindfulness‐based approaches, acceptance‐based treatments, dialectical behavioural therapy (DBT), virtual reality, dynamic guidance psychotherapy, exercise programmes, and meal delivery programmes …”

Section: Resultsmentioning

confidence: 99%

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Preoperative and post‐operative psychosocial interventions for bariatric surgery patients: A systematic review

2020

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Summary Psychosocial interventions are increasingly being utilized to help patients prepare for, and adjust to changes following, bariatric surgery in order to optimize psychosocial adjustment and weight loss. The current systematic review examined the impact of preoperative and post‐operative psychosocial interventions with a behavioural and/or cognitive focus on weight, dietary behaviours, eating pathology, lifestyle behaviours, and psychological functioning. A PsycINFO and Medline search of publications was conducted in March 2019. Two authors assessed retrieved titles and abstracts to determine topic relevance and rated the quality of included studies using a validated checklist. Forty‐four articles (representing 36 studies) met the study inclusion criteria. The current evidence is strongest for the impact of psychosocial interventions, particularly cognitive behavioural therapy, on eating behaviours (eg, binge eating and emotional eating) and psychological functioning (eg, quality of life, depression, and anxiety). The evidence for the impact of psychosocial interventions on weight loss, dietary behaviours (eg, dietary intake), and lifestyle behaviours (eg, physical activity) is relatively weak and mixed. Psychosocial interventions can improve eating pathology and psychosocial functioning among bariatric patients, and the optimal time to initiate treatment appears to be early in the post‐operative period before significant problematic eating behaviours and weight regain occur.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Preoperative and post‐operative psychosocial interventions for bariatric surgery patients: A systematic review

2020

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“…Cohen's d effect size was computed (.2 = small effect, .5 = medium effect, .8 = large effect) to report the magnitude of the Tele-CBT effect. One-year weight loss data was available for ten post-surgery Tele-CBT patients, and results were compared to ten patients who were randomized to pre-surgery Tele-CBT (n = 10) [12] using an independent t test.…”

Section: Discussionmentioning

confidence: 99%

“…This uncontrolled single-arm prospective pilot study was conducted as part of a larger pilot study on Tele-CBT [12]. Patients were informed about the study during the pre-surgical assessment process.…”

Section: Participantsmentioning

confidence: 99%

“…We used a previously developed 6-session Tele-CBT only intervention for bariatric surgery patients, which showed efficacy in reducing eating psychopathology and depressive symptoms prior to surgery in a randomized-controlled trial [11,12]. These previous studies did not focus on Tele-CBT feasibility and acceptability at 6 months post-surgery, which was the rationale for this study.…”

Section: Introductionmentioning

confidence: 99%

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A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery

et al. 2016

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Objective-This study aimed to determine the feasibility and preliminary efficacy of a postoperative telephone-based cognitive behavioral therapy intervention (Tele-CBT) in improving eating pathology and psychosocial functioning.Methods-Six-month post-operative bariatric surgery patients (n = 19) received six sessions of Tele-CBT. Study outcome variables included binge eating (BES), emotional eating (EES), depressive symptoms (PHQ-9), and anxiety symptoms (GAD-7).Results-Retention was 73.7 % post-intervention. Tele-CBT resulted in significant reductions in mean difference scores on BES, EES-Total, EES-Anxiety, EES-Anger, PHQ9, and GAD7. Tele-CBT patients experienced a mean weight loss of 8.62 ± 15.02 kg between 6-months post-surgery (pre-Tele-CBT) and 12-months post-surgery.Conclusions-These preliminary results suggest that post-surgery Tele-CBT is feasible and can improve post-surgery symptoms of psychopathology in this uncontrolled study, supporting the need for a randomized controlled trial.

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Efficacy of Telephone-Based Cognitive Behavioral Therapy for Weight Loss, Disordered Eating, and Psychological Distress After Bariatric Surgery

Sockalingam

Leung

et al. 2023

JAMA Netw Open

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ImportanceWeight regain after bariatric surgery is associated with recurrence of obesity-related medical comorbidities and deterioration in quality of life. Developing efficacious psychosocial interventions that target risk factors, prevent weight regain, and improve mental health is imperative.ObjectiveTo determine the efficacy of a telephone-based cognitive behavioral therapy (tele-CBT) intervention at 1 year after bariatric surgery in improving weight loss, disordered eating, and psychological distress.Design, Setting, and ParticipantsThis multisite randomized clinical trial was conducted at 3 hospital-based bariatric surgery programs, with recruitment between February 2018 and December 2021. Eligibility for participation was assessed among 314 adults at 1 year after bariatric surgery who were fluent in English and had access to a telephone and the internet. Patients with active suicidal ideation or poorly controlled severe psychiatric illness were excluded. Primary and secondary outcome measures were assessed at baseline (1 year after surgery), after the intervention (approximately 15 months after surgery), and at 3-month follow-up (approximately 18 months after surgery). Data were analyzed from January to February 2023.InterventionsThe tele-CBT intervention consisted of 6 weekly 1-hour sessions and a seventh booster session 1 month later. The control group received standard postoperative bariatric care.Main Outcomes and MeasuresThe primary outcome was postoperative percentage total weight loss. Secondary outcomes were disordered eating (Binge Eating Scale [BES] and Emotional Eating Scale [EES]) and psychological distress (Patient Health Questionnaire-9 item scale [PHQ-9] and Generalized Anxiety Disorder-7 item scale [GAD-7]). The hypotheses and data-analytic plan were developed prior to data collection.ResultsAmong 306 patients 1 year after bariatric surgery (255 females [83.3%]; mean [SD] age, 47.55 [9.98] years), there were 152 patients in the tele-CBT group and 154 patients in the control group. The group by time interaction for percentage total weight loss was not significant (F1,160.61 = 2.09; P = .15). However, there were significant interactions for mean BES (F2,527.32 = 18.73; P &lt; .001), EES total (F2,530.67 = 10.83; P &lt; .001), PHQ-9 (F2,529.93 = 17.74; P &lt; .001), and GAD-7 (F2,535.16 = 15.29; P &lt; .001) scores between the tele-CBT group and control group across all times.Conclusions and RelevanceThis study found that tele-CBT delivered at 1 year after surgery resulted in no change in short-term weight outcomes but improved disordered eating and psychological distress. The impact of these psychosocial improvements on longer-term weight outcomes is currently being examined as part of this longitudinal multisite randomized clinical trial.Trial RegistrationClinicalTrials.gov Identifier: NCT03315247

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A pilot randomized controlled trial of telephone-based cognitive behavioural therapy for preoperative bariatric surgery patients

Abstract: Tele-CBT holds promise as a brief intervention for improving eating psychopathology and depression in bariatric surgery candidates.

Cited by 48 publications

References 33 publications

Preoperative and post‐operative psychosocial interventions for bariatric surgery patients: A systematic review

Preoperative and post‐operative psychosocial interventions for bariatric surgery patients: A systematic review

A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery

Efficacy of Telephone-Based Cognitive Behavioral Therapy for Weight Loss, Disordered Eating, and Psychological Distress After Bariatric Surgery

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