Portion perfection and Emotional Freedom Techniques to assist bariatric patients post surgery: A randomised control trial

Abstract

Background: Although significant health improvements are indicated from weight-loss following bariatric surgery, many individuals are unable to lose weight or maintain their weight-loss. The current study aimed to assess whether post-surgery care comprising Emotional Freedom Techniques (EFT), an emerging energy psychology intervention, combined with a behaviour-based nutrition and portion control eating plan in an online self-guided delivery would aid weight-loss and maintenance in bariatric patients. Methods: A 6-month randomised controlled parallel-group trial. Participants (N ¼ 343; aged 21-69 years; BMI !30 kg/m 2 ) had undergone bariatric surgery (12 þ months prior) and were randomly assigned to one of three treatment groups: Portion Perfection for Bariatric Patients (PPBP; n ¼ 109), PPBP combined with an eight-week online self-paced EFT treatment (n ¼ 107), and a treatment as usual (TAU) control (n ¼ 127). Participants completed measures of BMI, emotional eating, uncontrolled eating, food cravings, and self-esteem at 8-week posttreatment (n ¼ 158) and 6-month follow-up (n ¼ 109). Results: Mixed-design analyses of variances were conducted to examine the effect of the interventions on outcome measures (pre-intervention, 8-week post-intervention, and 6-month follow-up). Emotional eating decreased significantly from pre-intervention to post-intervention for the PPBP and PPBP with EFT groups, and at 6-month follow-up for the TAU group only. There were no statistically significant between-group differences in other outcome variables. However, at 6-months the PPBP with EFT group experienced the greatest improvements in emotional eating (-16.33%), uncontrolled eating (-9.36%), and self-esteem (þ4.43%), compared to PPBP only or TAU. Conclusion:The effect of EFT combined with the eating plan on psychological variables was largely inconsistent with prior research and discussion of how this may be optimised in future trials is discussed. Clinical trial registration: ACTRN12616001257459.

Are eHealth interventions for adults who are scheduled for or have undergone bariatric surgery as effective as usual care? A systematic review

“…Studies were conducted in Australia and New Zealand (n 5 4) [42][43][44][45], Canada (n 5 4) [46][47][48][49], Europe (n 5 3 studies, reported across 5 publications) [50][51][52][53][54], the United States (n 5 2 studies, reported across 3 publications) [55][56][57], and Korea (n 5 1) [58]. Among the studies, 10 were conducted as RCTs (reported across 13 publications) [43][44][45][46][47]49,[51][52][53][54][55][56][57], 3 were controlled before and after studies [42,48,50], and 1 was a quasi-experimental design [58]. The majority of the study settings were tertiary or public hospitals (n 5 8 studies, reported across 9 publications) [42][43][44][48][49][50]52,53,58].…”

“…The majority of the study settings were tertiary or public hospitals (n 5 8 studies, reported across 9 publications) [42][43][44][48][49][50]52,53,58]. Two were conducted in a medical or local center (reported across 4 publications) [51,[54][55][56], 1 in a public health service [47], 1 study was not sitespecific and recruited via social media [45], and 2 studies did not report the setting [46,57]. In all but 2 studies (reported across 3 publications) [51,54,58], the predominant patient sex was female.…”

“…The mean age ranged from 40 to 53 years. BMI at baseline (preoperative) ranged from 42 to 53 kg/m 2 and was not detailed in 3 studies [45,49,57]. Samples contained mostly mixed bariatric surgeries (n 5 6 studies, reported across 8 publications) [49][50][51][52][53][54][55]58], or laparoscopic sleeve gastrectomy (n 5 2) [44,57], along with waitlist samples in preoperative interventions (n 5 5) [42,43,46,47,56], and 2 not reporting detail [45,48].…”

“…Six interventions were delivered preoperatively [42,43,46,47,56,58], and Kalarchian et al [55] also delivered a postoperative intervention to the same sample. Four studies delivered the postoperative intervention without usual care [45,48,49,51,54], and 4 were in addition to usual care [44,50,52,53,57]. Across the interventions, modalities varied and included an online program or internet modules [42,47], telephone [46,49,55,56], text messages [43,44], videoconferencing [48,52,53], mobile application [57], and audiovisual media [58].…”

“…Across the interventions, modalities varied and included an online program or internet modules [42,47], telephone [46,49,55,56], text messages [43,44], videoconferencing [48,52,53], mobile application [57], and audiovisual media [58]. Three studies included a combination of modalities, with internet modules and telephone [51,54], wireless fidelity scales, emails, and telephone [50], and a combination of online treatment, weekly emails, and access to a private Facebook group [45]. Durations ranged from the minimum preoperative intervention of 2 weeks [58] to a maximum of 24 weeks [47].…”