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Development of a Group Therapy to Enhance Treatment Motivation and Decision Making in Severely Obese Patients with a Comorbid Mental Disorder

Obesity Surgery volume 21, pages 588–594 (2011)Cite this article

Abstract

Background

The prevalence rate of mental disorders in severely obese patients appears to be high. In the Department of Psychosomatic Medicine, Heidelberg, we established a short outpatient group intervention for severely obese patients with an affective, anxiety, and/or eating disorder who either are not able to make a clear decision for an intensive weight loss program or who have already decided to undergo bariatric surgery but are advised to attend a support group before surgery. The aim of the group intervention was to reduce depressive symptoms and, in indecisive patients, to enhance the motivation of the patients for engagement in further intensive treatment programs, including bariatric surgery.

Methods

Descriptive data of the first two intervention groups are provided. The treatment program and topics of the group sessions are explained. Time series analysis methods are used to investigate the development of a single patient during the intervention program.

Results

Initially, 16 patients joined the group program; ten of these attended the group therapy to completion. The remaining ten patients showed clinically relevant reduction in depression levels and improvement in mental quality of life. Results of the single-case time series analysis indicate that the temporal relationship between eating behavior and depression changed during treatment.

Conclusions

The group program, as outlined, could be a useful intervention for severely obese patients with comorbid depression, anxiety, or eating disorder. A gap in the health care system is thus bridged by this short intervention that can encourage further treatment decisions such as bariatric surgery.

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Acknowledgements

The study was supported by the “Kompetenznetz Adipositas (Competence Network of Obesity)”, research focus “Obesity and the GI tract,” funded by the Federal Ministry of Education and Research (grant number 01GI0853).

The authors would like to thank the participants who made this study possible. Thanks are also given to Lena Warrington for her perceptive editing services.

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Affiliations

  1. Department of Psychosomatic and General Internal Medicine, Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Beate Wild, Wolfgang Herzog, Daniela Wesche, Dorothea Niehoff & Bernhard Hain

  2. Department of General, Visceral, and Transplant Surgery, Medical University Hospital, Heidelberg, Germany

    Beat Müller

Authors
  1. Beate Wild
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  2. Wolfgang Herzog
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  3. Daniela Wesche
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  4. Dorothea Niehoff
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  5. Beat Müller
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  6. Bernhard Hain
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Correspondence to Beate Wild.

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Wild, B., Herzog, W., Wesche, D. et al. Development of a Group Therapy to Enhance Treatment Motivation and Decision Making in Severely Obese Patients with a Comorbid Mental Disorder. OBES SURG 21, 588–594 (2011). https://doi.org/10.1007/s11695-009-0025-2

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  • DOI: https://doi.org/10.1007/s11695-009-0025-2

Keywords

  • Severe obesity
  • Mental disorder
  • Group intervention
  • Depression
  • Bariatric surgery
  • Support group