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Contributing of Cognitive-Behavioral Therapy in the Context of Bariatric Surgery: a Review of the Literature

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Abstract

Bariatric surgery is the most effective treatment for obesity. Reported benefits include major weight loss, improvement in diseases associated with obesity, and better quality of life. Nevertheless, there is a long-term risk of deleterious physical and psychological effects: regained weight (30% of patients), depression, and body image dissatisfaction. The purpose of this review of the literature is to identify the contribution of cognitive-behavioral therapy (CBT) in the context of bariatric surgery. Eligible articles and published since 2003 were systematically searched in electronic databases (PsychoINFO, MEDLINE, PubMed and Academic Search). Among the 98 citations, eleven cross-sectional and longitudinal studies concerning bariatric surgery patients who participated in CBT programs fulfilled the inclusion criteria. The therapeutic efficacy of CBT was demonstrated in ten of the eleven studies. An improvement in eating behavior, comorbid psychological conditions, and body weight were reported in patients who participated in CBT group sessions before and/or after bariatric surgery. The beneficial effect of CBT in the context of bariatric surgery suggests interesting therapeutic perspectives. Further research is however needed to consolidate these early findings and to provide longitudinal follow-up data beyond 2 years post-surgery.

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References

  1. Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2006;35:93–9.

    Article  PubMed  Google Scholar 

  2. Mechanick JI, Kushner RF, Sugarman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and non-surgical support of the bariatric surgery patient. Obesity. 2009;17(Suppl. 1):S1–S70.

    PubMed  Google Scholar 

  3. World Health Organization. Obesity: preventing and managin the global epidemic. Report of a WHO consultation. WHO Technical Report Series. 2000;894:i–xii, 1–253.

  4. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  CAS  PubMed  Google Scholar 

  5. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  CAS  PubMed  Google Scholar 

  6. Angrisani L, Santonicola A, Lovino P, et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.

    Article  PubMed  Google Scholar 

  7. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.

    Article  PubMed  Google Scholar 

  8. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190. 215–357

    Article  CAS  PubMed  Google Scholar 

  9. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8(8):CD003641.

    Google Scholar 

  10. Benotti PN, Forse RA. The role of gastric surgery in the multidisciplinary management of severe obesity. Am J Surg. 1995;169:361–7.

    Article  CAS  PubMed  Google Scholar 

  11. Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31:1248–61.

    Article  CAS  Google Scholar 

  12. Shah M, Simha V, Garg A. Review : long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. JCEM. 2006;91(11):4223–31.

    Article  CAS  PubMed  Google Scholar 

  13. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4:640–6.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Josbeno DA, Kalarchian M, Sparto PJ, et al. Physical activity and physical function in individuals post-bariatric surgery. Obes Surg. 2011;21(8):1243–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.

    Article  PubMed  Google Scholar 

  17. Scholtz S, Bidlake L, Morgan J, et al. Long-term outcomes following laparoscopic adjustable gastric banding: postoperative psychological sequelae predict outcome at 5-year follow-up. Obes Surg. 2007;17(9):1220–5.

    Article  PubMed  Google Scholar 

  18. Jumbe S, Bartlett C, Jumbe SL, et al. The effectiveness of bariatric surgery on long term psychosocial quality of life–a systematic review. Obes Res Clin Pract. 2016;10(3):225–42.

    Article  PubMed  Google Scholar 

  19. Gordon K, King W, White G, et al. A prospective, longitudinal examination of suicidal ideation among bariatric surgery patients. Surg Obes Relat Dis. 2016;12(7):44–5.

    Article  Google Scholar 

  20. Geller S, Dahan S, Levy S, Goldzweig G, Hamdan S, Abu-Abeid S. Body image and emotional eating as predictors of psychological distress following bariatric surgery. Obes Surg. 2020;30(4):1417–1423.

  21. Fernandez SB, Folgueira C, Castelao C, et al. Peripheral signals mediate the beneficial effects of gastricsurgery in obesity. Gastroenterol Res Pract. 2015;2015:1–12.

    Google Scholar 

  22. Steinert RE, Feinle-Bisset C, Asarian L, et al. Ghrelin, CCK, GLP-1, and PYY (3–36): secretory controls and physiological roles in eating and glycemia in health, obesity, and after RYGB. Physiol Rev. 2017;97(1):411–63.

    Article  PubMed  Google Scholar 

  23. Dixon JB, Lambert EA, Lambert GW. Neuroendocrine adaptations to bariatric surgery. Mol Cell Endocrinol. 2015;418:143e–52e.

    Article  CAS  Google Scholar 

  24. Lean MEJ, Malkova D. Altered gut and adipose tissue hormones in overweight and obese individuals : cause or consequence ? Int J Obes. 2016;40(4):622–32.

    Article  CAS  Google Scholar 

  25. Moehlecke M, Canani LH, Silva LOJ, et al. Determinants of body weight regulation in humans. Arch Endocrinol Metab. 2016;60(2):152–62.

    Article  PubMed  Google Scholar 

  26. Baldassano S, Amato A, Mulè F. Influence of glucagonlike peptide 2 on energy homeostasis. Peptides. 2016;86:1–5.

    Article  CAS  PubMed  Google Scholar 

  27. Ogden J, Hollywood A, Pring C. The impact of psychological support on weight loss post weight loss surgery: a randomised control trial. Obes Surg. 2015;25(3):500–5.

    Article  PubMed  Google Scholar 

  28. Kaiser KA, Franks SF, Smith AB. Positive relationshipbetween support group attendance and one-year postoperative weightloss in gastric banding patients. Surg Obes Relat Dis. 2011;7:89–93.

    Article  PubMed  Google Scholar 

  29. Niazi M, Maleki AR, Talebpour M. Short-termoutcomes of laparoscopic gastricplication in morbidly obese patients: importance of postoperative follow-up. Obes Surg. 2013;23:87–92.

    Article  PubMed  Google Scholar 

  30. Rudolf A, Hilbert A. Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2013;14(4):292–302.

    Article  Google Scholar 

  31. Garaulet M, Pérez de Heredia F. Behavioural therapy in the treatment of obesity (I): new directions for clinical practice. Nutr Hosp. 2009;24(6):629–39.

    CAS  PubMed  Google Scholar 

  32. Hay P. A systematic review of evidence for psychological treatments in eating disorders: 2005–2012. Int J Eat Disord. 2013;46(5):462–9.

    Article  PubMed  Google Scholar 

  33. Mohr DC, Hart SL, Julian L, et al. Telephone-administered psychotherapy for depression. Arch Gen Psychiatry. 2005;62:1007–14.

    Article  PubMed  Google Scholar 

  34. Lovell K, Cox D, Haddock G, et al. Telephone administered cognitive behavior therapy for treatment of obsessive compulsive disorder: randomized controlled non inferiority trial. Br Med J. 2006;333(7574):883–6.

    Article  Google Scholar 

  35. King WC, Engel SG, Elder KA, et al. Walking capacity of bariatric surgery candidates. Surg Obes Relat Dis. 2012;8(1):48–59.

    Article  PubMed  Google Scholar 

  36. Golay A, Fossati M, Delétraz H, et al. Multidisciplinary approach to obesity treatement. Diabetes Obes Metab. 2003;5:274–9.

    Article  CAS  PubMed  Google Scholar 

  37. Moroshko I, Brennan L, O’Brien P. Predictors of attrition in bariatric after care: a systematic review of the literature. Obes Surg. 2012;22:1640–7.

    Article  PubMed  Google Scholar 

  38. Sala M, Haller DL, Laferrère B, et al. Predictors of attrition before and after bariatric surgery. Obes Surg. 2017;27:548–51.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Abiles V, Rodriguez-Ruiz S, Abiles J, et al. Effectiveness of cognitive behavioural therapy on weight loss after two years of bariatric surgery in morbidity obese patients. Nutr Hosp. 2013;28(5):1523–9.

    CAS  PubMed  Google Scholar 

  40. Ashton K, Drerup M, Windover A, et al. Brief, four-session group CBT reduces binge eating behaviors among bariatric surgery candidates. Surg Obes Relat Dis. 2009;5(3):257–62.

    Article  PubMed  Google Scholar 

  41. Beaulac J, Sandre D. Impact of a CBT psychotherapy group on post-operative bariatric patients. SpringerPlus. 2015;9(4):764

  42. Cassin SE, Sockalingam S, Wnuk S, et al. Cognitive behavioral therapy for bariatric surgery patients : preliminary evidence for feasibility, acceptability, and effectiveness. Cogn Behav Pract. 2013;20(4):529–43.

    Article  Google Scholar 

  43. Cassin SE, Sockalingam S, Du C, et al. A pilot randomized controlled trial of telephone- based cognitive behavioural therapy for preoperative bariatric surgery patients. Behav Res Ther. 2016;80:17–22.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Gade H, Hjelmesaeth J, Rosenvinge JH, et al. Effectiveness of a cognitive behavioral therapy for dysfunctional eating among patients admitted for bariatric surgery: a randomized controlled trial. J Obes. 2014;2014:127936.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Gade H, Friborg O, Rosenvinge JH, et al. The impact of a preoperative cognitive behavioural therapy (CBT) on dysfunctional eating behaviours, affective symptoms and body weight 1 year after bariatric surgery: a randomised controlled trial. Obes Surg. 2015;25(11):2112–9.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Himes SM, Grothe KB, Clark MM, et al. Stop regain: a pilot psychological intervention for bariatric patients experiencing weight regain. Obes Surg. 2015;25(5):922–7.

    Article  PubMed  Google Scholar 

  47. Hjelmesæth J, Rosenvinge JH, Gade H, et al. Effects of cognitive behavioral therapy on eating behaviors, affective symptoms, and weight loss after bariatric surgery: a randomized clinical trial. Obes Surg. 2019;29(1):61–9.

    Article  PubMed  Google Scholar 

  48. Kalarchian MA, Marcus MD, Courcoulas AP, et al. Preoperative lifestyle intervention in bariatric surgery: a randomized clinical trial. Surg Obes Relat Dis. 2016;12(1):180–7.

    Article  PubMed  Google Scholar 

  49. Lier HO, Biringer E, Stubhaug B, et al. The impact of preoperative counseling on postoperative treatment adherence in bariatric surgery patients: a randomized controlled trial. Patient Educ Couns. 2012;87(3):336–42.

    Article  PubMed  Google Scholar 

  50. Bray G. Medical consequences of obesity. J Clin Endocrinol Metab. 2004;89:2583–9.

    Article  CAS  PubMed  Google Scholar 

  51. Cash TF, Counts B, Huffine CE. Current and vestigial effects of overweight among women: fear of fat, attitudinal body image, and eating behaviors. J Psychopathol Behav Assess. 1990;12:157–67.

    Article  Google Scholar 

  52. Schwartz MB, Brownell K. Obesity and body image. Body Image. 2004;1(1):43–56.

    Article  PubMed  Google Scholar 

  53. Johnson F, Wardle J. Dietary restraint, body dissatisfaction, and psychologicaldistress: a prospective analysis. J Abnorm Psychol. 2005;114(1):119–25.

    Article  PubMed  Google Scholar 

  54. Stice E, Shaw HE. Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosom Res. 2002;53(5):985–93.

    Article  PubMed  Google Scholar 

  55. Hsu LKG, Benotti P, Dwyer L, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60:338–46.

    Article  CAS  PubMed  Google Scholar 

  56. Ortega J, Fernadez-Canet R, et al. Predictors of psychological symptoms in morbidly obese patients after gastric bypass surgery. Surg Obes Relat Dis. 2012;8(6):770–6.

    Article  PubMed  Google Scholar 

  57. Thonney B, Pataky Z, Badel S, et al. The relationship between weight loss and psychosocial functioning among bariatric surgery patients. Am J Surg. 2010;199:183–8.

    Article  PubMed  Google Scholar 

  58. Tucker JA, Samo JA, Rand CSW, et al. Behavioral interventions to promote adaptive eating behavior and lifestyle changes following surgery for obesity : results of a two-year outcome evaluation. Int J Eat Disord. 1991;10(6):689–98.

    Article  Google Scholar 

  59. Orth WS, Madan AK, Taddeucci RJ, et al. Support group meeting attendance is associated with better weightloss. Obes Surg. 2008;18(4):391–4.

    Article  PubMed  Google Scholar 

  60. Song Z, Reinhardt K, Buzdon M, et al. Association between support group attendance and weightlossafter Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(2):100–3.

    Article  PubMed  Google Scholar 

  61. Herpertz S, Kielmann R, Wolf AM, et al. Do psychosocial variables predictweightloss or mental health after obesity surgery ?A systematic reviews. Obes Res. 2004;12(10):1554–69.

    Article  CAS  PubMed  Google Scholar 

  62. Fairburn C, Beglin S. Assessment of eatingdisorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16:363–70.

    Article  CAS  PubMed  Google Scholar 

  63. Wheeler E, Prettyman A, Lenhard MJ, et al. Adherence to out patient program post operative appointments after bariatric surgery. Surg Obes Relat Dis. 2008;4:515–20.

    Article  PubMed  Google Scholar 

  64. Leahey TM, Bond DS, Irwin SR, et al. When is the best time to deliver behavioral intervention to bariatric surgery patients: before or after surgery? Surg Obes Relat Dis. 2009;5:99–102.

    Article  PubMed  Google Scholar 

  65. White MA, Kalarchian MA, Masheb RM, et al. Loss of control over eating predicts outcomes in bariatric surgery: a prospective 24-monrh follow-up study. J Clin Psychiatry. 2010;71(2):175–84.

    Article  PubMed  Google Scholar 

  66. Dayan D, Kuriansky J, Abu-Abeid S. Weight regain following roux-en-Y gastric bypass : etiology and surgical treatment. Isr Med Assoc J. 2019;12(21):823–8.

    Google Scholar 

  67. Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weightloss after gastric bypass. Am Surg. 2010;76:1139–42.

    Article  PubMed  Google Scholar 

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Acknowledgments

This region did not exercise any editorial direction or censorship on any part of this manuscript. The authors thank the Endocrinology service of Saint Philibert Hospital Center for its help for this study.

Funding

C. Cheroutre received financial support for her work from Region “Hauts de France”.

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Authors and Affiliations

  1. PSITEC - Psychologie : Interactions Temps Émotions Cognition, Univ. Lille, ULR 4072, 59000, Lille, France

    Cynthia Cheroutre, Alain Guerrien & Amélie Rousseau

  2. Endocrinology Department,, Lille Catholic Hospitals, 59000, Lille, France

    Cynthia Cheroutre

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  1. Cynthia Cheroutre
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  2. Alain Guerrien
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Correspondence to Cynthia Cheroutre.

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Cheroutre, C., Guerrien, A. & Rousseau, A. Contributing of Cognitive-Behavioral Therapy in the Context of Bariatric Surgery: a Review of the Literature. OBES SURG 30, 3154–3166 (2020). https://doi.org/10.1007/s11695-020-04627-9

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