Effectiveness of a Cognitive Behavioral Therapy for Dysfunctional Eating among Patients Admitted for Bariatric Surgery: A Randomized Controlled Trial

Abstract

Objective. To examine whether cognitive behavioral therapy (CBT) alleviates dysfunctional eating (DE) patterns and symptoms of anxiety and depression in morbidly obese patients planned for bariatric surgery. Design and Methods. A total of 98 (68 females) patients with a mean (SD) age of 43 (10) years and BMI 43.5 (4.9) kg/m2 were randomly assigned to a CBT-group or a control group receiving usual care (i.e., nutritional support and education). The CBT-group received ten weekly intervention sessions. DE, anxiety, and depression were assessed by the TFEQ R-21 and HADS, respectively. Results. Compared with controls, the CBT-patients showed significantly less DE, affective symptoms, and a larger weight loss at follow-up. The effect sizes were large (DE-cognitive restraint, g = −.92, P ≤ .001; DE-uncontrolled eating, g = −.90, P ≤ .001), moderate (HADS-depression, g = −.73, P ≤ .001; DE-emotional eating, g = −.67, P ≤ .001; HADS-anxiety, g = −.62, P = .003), and low (BMI, g = −.24, P = .004). Conclusion. This study supports the use of CBT in helping patients preparing for bariatric surgery to reduce DE and to improve mental health. This clinical trial is registered with NCT01403558.

The Effect of Cognitive Behavioral Therapy on Depression and Obesity in Women with Polycystic Ovarian Syndrome: A Randomized Controlled Clinical Trial

“…In addition, in a study conducted on obese patients planned for bariatric surgery, in the intervention group compared with controls, the CBT-patients showed significantly less dysfunctional eating, less anxiety and depression symptoms, and a larger weight loss at follow-up (32). Based on the results obtained in the above-mentioned studies and the present study, it can be concluded that cognitive-behavioral therapy can play a significant role in reducing depression score and BMI in individuals and it is also better to use this therapy for all patients with mental diseases and obese patients.…”

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“…Hence avoiding such extreme measures in efforts to reduce osteoarthritis pain in obese cases seems highly recommended. To this end, the use of whole body mass impedance measures and the ability to examine local and general body fat distribution versus lean muscle mass, which can contribute to a high body mass index value along with periodic vitamin D assays, followed by long term carefully designed tailored multi pronged interventions as outlined by Janke et al 59 and Barlow, 60 as well as a focus on diet content, 61 stress control, 62 glucose control 63 and avoidance of reduced bone mineral density effects that can occur post weight loss 64 is highly recommended in this respect, as is careful attention to maximizing mental health through cognitive behavioral therapy 65,66 ( Figure 3) and behavioral therapy combined, 67,68 as well as overall health status, muscle and physical function through non pharmacologic approaches. 69,70 Finally ascertaining the cause of prevailing obesity and intervening accordingly in this respect is strongly advocated.…”

Clinical Practice Recommendations for the Management of Obesity in the United Arab Emirates

“…CBT is also used to treat eating disorder symptoms in high-risk situations, such as in pre- and post-bariatric surgery. Table 4[51] shows some interventions derived from a CBT modality that may benefit individuals suffering from obesity with or without severe psychological symptoms. This is by no means an exhaustive list of what the treatment entails.…”