A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial

Abstract

Objective This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery. Design Randomized, controlled pilot trial. Setting Beth Israel Deaconess Medical Center, Boston, MA, USA. Interventions Bariatric patients 1–5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention. Main outcome measures Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted. Results Attendance was excellent (6 of 9 patients attended ≥ 7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (−4.9 ± 13.7 in mindfulness vs. 6.2 ± 28.4 in standard, p for between-group difference = 0.03) but not weight. We also observed a significant increase in HbA1C (0.34 ± 0.38 vs. −0.06 ± 0.31, p = 0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews. Conclusions This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population.

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

“…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 …”

“…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 …”

“…Of the selected studies, 24 conducted group‐based interventions, and 16 conducted the interventions individually . Galle et al offered participants DBT, which included both individual and group therapy components .…”

“…The psychosocial interventions examined in the selected studies included a wide range of therapeutic strategies. The most common strategies employed across studies included psychoeducation, self‐monitoring, goal setting, mechanical/normalized eating, stimulus control, cognitive restructuring, addressing ambivalence, problem solving, using reinforcements,…”

“…Thirty studies offered the psychosocial intervention in person . Thirteen studies utilized a combination of delivery methods, primarily in the form of in‐person interventions supplemented by telephone coaching calls .…”