Background

Though surgical interventions are effective in treating patients with severe obesity, approximately 50% will experience weight regain within the first 1.5-2 years. Pilot studies looking at a telephone-based cognitive behavioural therapy (Tele-CBT) for bariatric surgery patients have shown high levels of treatment satisfaction and improvements in eating pathology and psychological distress. Building off these studies, this large multisite randomized controlled trial study aimed to examine whether Tele-CBT delivered at 1-year post-surgery is efficacious in optimizing weight loss and improving physical and psychosocial functioning up to 3-years post-surgery.

Methods

Participants were recruited from three Ontario Bariatric Centres of Excellence and randomized 1:1 to receive Tele-CBT or standard bariatric care. As part of this preliminary analysis, outcomes of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Emotional Eating Scale (EES), and Binge Eating Scale (BES) were measured at baseline, immediately post-intervention, and 3-months post-intervention. Linear mixed models were used to test the effect of intervention group, time, and group-by-time interaction for each outcome.

Results

306 patients were included in the intention-to-treat analysis. Mean (SD) age of participants was 47.55 (9.98) years and 83.6% were female. There were significant decreases in mean GAD-7 (p < 0.001), PHQ-9 (p < 0.001), EES-Total (p < 0.001), and BES (p < 0.001) scores for the Tele-CBT group immediately post-intervention and 3-month follow-up when compared to baseline and the control group.

Conclusions

This large Tele-CBT trial clearly demonstrates that this intervention is effective for improving psychological distress and disordered eating for patients 1-year post-operative bariatric surgery.