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

Abstract

Summary Psychosocial interventions are increasingly being utilized to help patients prepare for, and adjust to changes following, bariatric surgery in order to optimize psychosocial adjustment and weight loss. The current systematic review examined the impact of preoperative and post‐operative psychosocial interventions with a behavioural and/or cognitive focus on weight, dietary behaviours, eating pathology, lifestyle behaviours, and psychological functioning. A PsycINFO and Medline search of publications was conducted in March 2019. Two authors assessed retrieved titles and abstracts to determine topic relevance and rated the quality of included studies using a validated checklist. Forty‐four articles (representing 36 studies) met the study inclusion criteria. The current evidence is strongest for the impact of psychosocial interventions, particularly cognitive behavioural therapy, on eating behaviours (eg, binge eating and emotional eating) and psychological functioning (eg, quality of life, depression, and anxiety). The evidence for the impact of psychosocial interventions on weight loss, dietary behaviours (eg, dietary intake), and lifestyle behaviours (eg, physical activity) is relatively weak and mixed. Psychosocial interventions can improve eating pathology and psychosocial functioning among bariatric patients, and the optimal time to initiate treatment appears to be early in the post‐operative period before significant problematic eating behaviours and weight regain occur.

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

“…These results add to the findings of a systematic review of pre-and postoperative psychosocial interventions for bariatric surgery patients [57]. The authors report strongest evidence for the impact of psychosocial interventions, CBT in particular, on eating behaviors and psychological functioning.…”

Impact of COVID‐19 stay‐at‐home orders on weight‐related behaviours among patients with obesity

“…Xenaki et al showed that enrolling patients in a stress management program led to significantly reductions in BMI and improved depression and anxiety scores 30 . Although this was a small study, larger systemic reviews have also shown benefits of psychosocial interventions on eating pathology of binge eating/uncontrolled eating, uncontrolled eating, emotional eating and quality of life 31 . These types of interventions may help mitigate the increase in behaviours promoting weight gain during this stressful time.…”

The Impact of Coronavirus Disease 2019 on Bariatric Surgery: Redefining Psychosocial Care

“…Telemedicine‐delivered care has been shown to result in weight loss and psychosocial outcomes comparable to those of in‐person bariatric care (11). Remotely delivered CBT by telephone or videoconferencing is effective in improving binge eating, emotional eating, depression, and anxiety among bariatric patients (12). Rapid implementation of telemedicine requires integration with existing electronic health records, policies to ensure use of secure modalities, consideration of privacy, patient safety protocols (e.g., remote management of suicidal ideation), cost analysis, and clinician training on both the technology and ability to deliver patient‐centered care using telemedicine.…”