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Background <p>Telephone-based Cognitive Behavioral Therapy (Tele-CBT) has shown to reduce disordered eating and psychological distress after metabolic and bariatric surgery (MBS). However, it is currently unknown how Tele-CBT impacts outcomes long term, and if differences in weight loss trajectories following Tele-CBT emerge with a long-term follow-up. This study aimed to identify whether Tele-CBT remains effective at 18 months post-intervention for improving psychological distress and maladaptive eating, and mitigating recurrent weight gain.</p> Methods <p>This large, multisite randomized control trial was conducted at three hospital-based MBS programs in Ontario, Canada. Participants (<i>n</i> = 306) were randomized 1:1 to receive either Tele-CBT or standard MBS care. The primary outcome was percentage of total weight loss (%TWL). Secondary outcomes included disordered eating (Binge Eating Scale, Emotional Eating Scale) and psychological distress (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7). Linear mixed models assessed group-by-time interactions across five time points: baseline (1-year post-MBS), post-intervention, and 3-, 12-, and 18-month follow-ups.</p> Results <p>Tele-CBT resulted in significant post-intervention improvements in binge eating (<i>MD</i> = − 0.46, <i>p</i> &lt; .001), emotional eating (<i>MD</i> = − 0.14, <i>p</i> = 0.01), anxiety (<i>MD</i> = − 0.40, <i>p</i> &lt; .001), and depressive symptoms (<i>MD</i> = − 0.47, <i>p</i> &lt; .001). These improvements were all sustained at 3 months post-intervention (<i>p</i> &lt; .05) whereas only improvements for emotional eating were sustained at 12 months post-intervention (<i>MD</i> = − 0.15, <i>p</i> = 0.01). There were no significant differences in %TWL trajectories between the Tele-CBT and control groups.</p> Conclusions <p>Tele-CBT provides psychological benefits, particularly in reducing emotional eating. Findings highlight the need for continued psychosocial support to sustain other psychological benefits and mitigate recurrent weight gain post-MBS and further research on optimizing intervention timing and duration.</p> Trial Registration <p><b>ClinicalTrials.gov Identifier:</b> NCT03315247.</p>

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A Randomized-Controlled Trial Examining Telephone-Based Cognitive Behavioral Therapy for Patients After Metabolic and Bariatric Surgery: 18 Month Follow-up Results

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月1日

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  • Stephanie E. Cassin,
  • Katey E. Park,
  • Samantha E. Leung,
  • Clement Ma,
  • George Tomlinson,
  • Raed Hawa,
  • Susan Wnuk,
  • Timothy Jackson,
  • David Urbach,
  • Allan Okrainec,
  • Jennifer Brown,
  • Daniella Sandre,
  • Sanjeev Sockalingam

摘要

Background

Telephone-based Cognitive Behavioral Therapy (Tele-CBT) has shown to reduce disordered eating and psychological distress after metabolic and bariatric surgery (MBS). However, it is currently unknown how Tele-CBT impacts outcomes long term, and if differences in weight loss trajectories following Tele-CBT emerge with a long-term follow-up. This study aimed to identify whether Tele-CBT remains effective at 18 months post-intervention for improving psychological distress and maladaptive eating, and mitigating recurrent weight gain.

Methods

This large, multisite randomized control trial was conducted at three hospital-based MBS programs in Ontario, Canada. Participants (n = 306) were randomized 1:1 to receive either Tele-CBT or standard MBS care. The primary outcome was percentage of total weight loss (%TWL). Secondary outcomes included disordered eating (Binge Eating Scale, Emotional Eating Scale) and psychological distress (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7). Linear mixed models assessed group-by-time interactions across five time points: baseline (1-year post-MBS), post-intervention, and 3-, 12-, and 18-month follow-ups.

Results

Tele-CBT resulted in significant post-intervention improvements in binge eating (MD = − 0.46, p < .001), emotional eating (MD = − 0.14, p = 0.01), anxiety (MD = − 0.40, p < .001), and depressive symptoms (MD = − 0.47, p < .001). These improvements were all sustained at 3 months post-intervention (p < .05) whereas only improvements for emotional eating were sustained at 12 months post-intervention (MD = − 0.15, p = 0.01). There were no significant differences in %TWL trajectories between the Tele-CBT and control groups.

Conclusions

Tele-CBT provides psychological benefits, particularly in reducing emotional eating. Findings highlight the need for continued psychosocial support to sustain other psychological benefits and mitigate recurrent weight gain post-MBS and further research on optimizing intervention timing and duration.

Trial Registration

ClinicalTrials.gov Identifier: NCT03315247.