Does cognitive behavioral therapy strengthen the effect of bariatric surgery for obesity? Design and methods of a randomized and controlled study

Paul, Linda; Rongen, Sofie van; Hoeken, Daphne van; Deen, Mathijs; Klaassen, René A.; Biter, L. Ulas; Hoek, Hans W.; Heiden, Colin van der

doi:10.1016/j.cct.2015.04.001

Cited by 17 publications

(17 citation statements)

References 47 publications

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“…At pretreatment, scores on the Eating Disorders Examination-Questionnaire (EDE-Q) were elevated for all subscales, indicating eating disorder pathology [8]. At post treatment, dietary restraint and eating concerns were no longer present, whereas shape concerns and weight concerns showed a relevant decrease.…”

Section: Resultsmentioning

confidence: 99%

“…Whether this also prevents relapse and weight regain is currently under investigation [8], but it is expected that adding on CBT can contribute to optimizing weight loss results as well as psychological functioning and adjustment after bariatric surgery.…”

Section: Resultsmentioning

confidence: 99%

“…In this protocol patients receive 10 sessions of CBT focused on nutritional and activity management (session 1-4), cognitive restructuring and self-control (session [5][6][7][8] and relapse prevention strategies and preparation for the period after surgery (session 9-10). See Table 1 for an overview of the interventions in the 10 sessions.…”

Section: Introductionmentioning

confidence: 99%

“…A randomized clinical trial with long-term follow-up examining the added value of preoperative CBT for bariatric surgery patients is currently being conducted [8]. The CBT treatment described in the case illustration was carried out within this context.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Behavior Therapy Procedure Prior To Bariatric Surgery

Paul¹,

Cvd²,

Lu³

et al. 2017

J Obes Weight Loss Ther

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Although bariatric surgery is an effective treatment for morbid obesity, approximately 20-30% of the patients stabilize premature in weight loss or regain weight post surgically. Adherence to post-surgical diets and permanent changes in life style concerning eating habits and physical exercise are supposed to be important factors for successful weight loss on the long term. A preoperative cognitive behavior therapy (CBT) protocol has been developed, based on treatment protocols for eating disorders and obesity and modified for bariatric surgery patients. This 10 session treatment is focused on modification of thinking and behavior in terms of eating habits and physical activity. This procedure is promising as illustrated by a case study.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cognitive Behavior Therapy Procedure Prior To Bariatric Surgery

Paul¹,

Cvd²,

Lu³

et al. 2017

J Obes Weight Loss Ther

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show abstract

“…The current RCT aimed to investigate the added value of 10 sessions of CBT prior to bariatric surgery compared to the standard preparation/treatment-as-usual (TAU) procedure in the hospital for long-term maintenance of weight loss and psychological well-being [33]. For the completed 1-year follow-up, it was hypothesized that preoperative CBT aimed at improving eating behavior and mental health resulted in a greater reduction of maladaptive eating behavior, depressive symptoms and psychological distress, as well as increased QoL, as compared to the control group.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Behavioral Therapy Versus Usual Care Before Bariatric Surgery: One-Year Follow-Up Results of a Randomized Controlled Trial

et al. 2020

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Background Although early results of bariatric surgery are beneficial for most patients, some patients regain weight later. Cognitive behavioral therapy (CBT) has been suggested as a way to improve patients’ psychological health and maintaining weight loss in the longer term. The added value of preoperative CBT to bariatric surgery was examined. Pre- and posttreatment and 1-year follow-up data are presented. Methods In a multi-center randomized controlled trial, CBT was compared to a treatment-as-usual (TAU) control group. Measurements were conducted pre- and posttreatment/pre-surgery (T0 and T1) and at 1-year post-surgery (T2). Patients in the intervention group received 10 individual, weekly sessions of preoperative CBT focused on modifying thoughts and behaviors regarding eating behavior, physical exercise, and postoperative life style. Outcome measures included weight change, eating behavior, eating disorders, depression, quality of life, and overall psychological health. Results Though no significant differences between conditions were found per time point, in the CBT, condition scores on external eating, emotional eating, depressive symptoms, and psychological distress decreased significantly more over time between pre- (T0) and posttreatment (T1) pre-surgery compared to TAU. No significant time x condition differences were found at 1-year post-surgery (T2). Conclusions Compared to TAU, preoperative CBT showed beneficial effects on eating behavior and psychological symptoms only from pretreatment to posttreatment/pre-surgery, but not from pre-surgery to 1-year post-surgery. Preoperative CBT does not seem to contribute to better long-term outcomes post-surgery. Recent studies suggest that the optimal time to initiate psychological treatment may be early in the postoperative period, before significant weight regain has occurred. Trial Registration https://www.trialregister.nl Identifier: Trial NL3960.

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