When is the best time to deliver behavioral intervention to bariatric surgery patients: before or after surgery?
Abstract
Background Many comprehensive bariatric surgery programs have implemented preoperative behavioral interventions for patients presenting with problematic eating behaviors in an effort to enhance postoperative weight loss and improve psychosocial adjustment. However, it is unknown whether these interventions are best delivered pre- or postoperatively. The purpose of this study was to determine when bariatric surgery patients are most receptive to a behavioral intervention, before or after surgery.Methods A total of 32 pre- and postoperative patients were referred to a 10-week intervention designed to reduce eating behaviors associated with postoperative weight gain (e.g., loss of control while eating, grazing). The sample was 78.1% female and 84.4% white, with an average age of 49.43 +/- 9.13 years and a body mass index of 44.22 +/- 6.48 kg/m(2). Of the 32 patients, 21 were referred preoperatively and 11 were referred postoperatively (5.63 +/- 2.91 months after surgery). These patients were tracked prospectively to determine whether pre- or postoperative patients were more likely to attend and complete the behavioral intervention.Results Compared with the preoperative patients, the postoperative patients were more likely to follow-up with their referral and initiate treatment [chi(2)(1) = 10.06, P = .002]. Of the postoperative patients, 100% attended the first intervention session compared with only 43% of preoperative patients. The postoperative patients also attended more intervention sessions [t(18) = 2.51, P = .02] and were more likely to complete the intervention [chi(2)(1) = 7.21, P = .007]. Only 14% of the preoperative referral patients completed the program compared with 91% of the postoperative patients.Conclusion Comprehensive bariatric surgery programs ought to consider balancing the needs of the preoperative patients presenting with maladaptive eating behavior with the likelihood of them participating in a behavioral intervention before surgery.
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Patients tend to overestimate the effect surgery will have on weight loss, despite being provided with information about the value of making and sustaining dietary and physical activity changes postoperatively.
“Qualitative studies have shown that patients tend to overestimate the effect surgery will have on weight loss, despite being provided with information about the value of making and sustaining dietary and physical activity changes postoperatively [7].”
From Preoperative predictors of adherence to dietary and physical activity recommendations and weight loss one year after surgery (2016) · cites this paper as [7]
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“Completion rates of behavioural modification therapy increased to 91%when performed post-operatively, compared to 14 % when done pre-operatively [35].”
MethodProject HELP: a Remotely Delivered Behavioral Intervention for Weight Regain after Bariatric Surgery
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BackgroundResultInfluentialLifestyle Intervention Favorably Affects Weight Loss and Maintenance Following Obesity Surgery
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“The results of this study would be enhanced by inclusion of behavioral intervention sessions preoperatively as well, although recent evidence suggests that preoperative patients may not be very receptive in participating in a behavioral intervention for maladaptive eating (44).”
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“There is some evidence that bariatric patients are more likely to attend a behavioral intervention after surgery than before surgery (3).”
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GUIDELINES FOR THE NUTRITIONAL MANAGEMENT OF BARIATRIC SURGERY PATIENTS: PRE- AND POST-OPERATIVELY
Kreider, R. (2010) · D-Scholarship@Pitt (University of Pittsburgh)
- Authors
- Leahey, T. M., Bond, D. S., Irwin, S. R., Crowther, J. H., & Wing, R. R.
- Affiliations
- Summa Health System (US)
- Brown University (US)
- Kent State University (US)
- Corresponding author
- Leahey, Tricia M.
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 5
- Issue
- 1
- Pages
- 99-102
- ISSN
- 1550-7289 (ISSN-L)
- OpenAlex
- W2015764960
- Cited by
- 46
- References
- 20
- Citations by year
- 2025: 1 · 2024: 4 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 6 · 2015: 5 · 2014: 3 · 2013: 3 · 2012: 4
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Surgery for Obesity and Related Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- bariatric surgery, behavioral interventions
- MeSH terms
- Behavior Therapy, Feeding Behavior, Female, Humans, Male, Middle Aged, Obesity, Morbid, Postoperative Care, Preoperative Care, Prospective Studies, Time Factors, Weight Loss, Chi-Square Distribution, Bariatric Surgery
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