Weight Regain After Bariatric Surgery

Weight regain after bariatric surgery can be a concerning issue, often leading to a recurrence of obesity-related medical conditions and a decline in quality of life. Addressing this, a recent study published in the Journal of American Medical Association has highlighted the efficacy of telephone-based cognitive behavioral therapy (tele-CBT) in improving postoperative outcomes for bariatric surgery patients.

Study Overview

The Multisite Randomized Clinical Trial, conducted between February 2018 and December 2021 at three hospital-based bariatric surgery programs, involved 314 English-speaking adults who had undergone bariatric surgery one year prior. Patients with severe psychiatric illnesses or active suicidal ideation were excluded. The study aimed to determine the effectiveness of tele-CBT in enhancing weight loss, managing disordered eating, and reducing psychological distress.

Methodology

Participants were randomly assigned to two groups:

• The tele-CBT group
• The control group

The tele-CBT intervention comprised six one-hour weekly sessions, with an additional booster session one month later. Meanwhile, the control group received standard postoperative bariatric care.

Outcomes

The primary outcome assessed was the percentage of total weight loss, while secondary outcomes included measures of disordered eating and psychological distress:

• Disordered eating: Binge Eating Scale (BES) and Emotional Eating Scale (EES)
• Psychological distress: Patient Health Questionnaire-9 item scale (PHQ-9) and Generalized Anxiety Disorder-7 item scale (GAD-7)

Results

The results, analyzed in early 2023, revealed that the tele-CBT intervention did not significantly impact short-term weight loss outcomes. However, it showed substantial improvements in disordered eating and psychological distress across all time points compared to the control group. The tele-CBT participants exhibited notable decreases in BES, EES, PHQ-9, and GAD-7 scores, indicating positive changes in eating behavior and mental health.

Conclusion

This study's findings come at a critical juncture, as obesity rates continue to rise, and bariatric surgery remains an essential tool in managing severe obesity. By addressing psychological aspects and promoting healthier eating behaviors, tele-CBT shows promise in preventing weight regain and enhancing long-term weight management success.

Source

Sockalingam, S., Leung, S. E., Ma, C., Tomlinson, G., Hawa, R., Wnuk, S., Jackson, T., Urbach, D., Brown, J., Sandre, D., & Cassin, S. E. (2023). Efficacy of Telephone-Based Cognitive Behavioral Therapy for Weight Loss, Disordered Eating, and Psychological Distress After Bariatric Surgery. In JAMA Network Open (Vol. 6, Issue 8, p. e2327099). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.27099