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Published in: Obesity Surgery 11/2012

01-11-2012 | Review

Do Postoperative Psychotherapeutic Interventions and Support Groups Influence Weight Loss Following Bariatric Surgery? A Systematic Review and Meta-analysis of Randomized and Nonrandomized Trials

Authors: Nina N. Beck, Maja Johannsen, René K. Støving, Mimi Mehlsen, Robert Zachariae

Published in: Obesity Surgery | Issue 11/2012

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Abstract

Bariatric surgery is currently considered the most effective treatment of severe obesity, but considerable individual variations in weight loss results have been reported. We therefore conducted a systematic review and meta-analysis of studies investigating the effect of psychotherapeutic interventions and support groups on weight loss following bariatric surgery. A literature search was conducted in the databases PubMed and PsycINFO, identifying nine eligible studies reporting results of the effect of psychotherapeutic interventions and support groups on weight loss following bariatric surgery. The results revealed a statistically significant overall effect of both psychotherapeutic interventions and support groups on weight loss (pooled effect size correlation (ESr) = 0.18; p < 0.0001). When comparing the effect sizes of psychotherapeutic interventions and support groups, no difference was found (p = 0.51). Higher quality studies had smaller effect sizes (0.16) than studies with low quality scores (0.22), but the difference did not reach statistical significance (p = 0.26). Patients attending psychotherapeutic interventions or support groups in combination with bariatric surgery appeared to experience greater weight loss results than patients treated with bariatric surgery only. However, research in this area is characterized by a lack of methodological rigor, and it is recommended that future study designs include randomization and active attention control conditions.
Literature
1.
go back to reference Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25.PubMedCrossRef Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25.PubMedCrossRef
2.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef
3.
go back to reference Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMed Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMed
4.
go back to reference Angrisani L, Lorenzo M, Borrelli V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):127–32.PubMedCrossRef Angrisani L, Lorenzo M, Borrelli V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):127–32.PubMedCrossRef
5.
go back to reference Crowley N, Budak A, Byrne TK, et al. Patients who endorse more binge eating triggers before gastric bypass lose less weight at 6 months. Surg Obes Relat Dis. 2011;7(1):55–9.PubMedCrossRef Crowley N, Budak A, Byrne TK, et al. Patients who endorse more binge eating triggers before gastric bypass lose less weight at 6 months. Surg Obes Relat Dis. 2011;7(1):55–9.PubMedCrossRef
6.
go back to reference Kofman MD, Lent MR, Swencionis C. Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity. 2010;18(10):1938–43.PubMedCrossRef Kofman MD, Lent MR, Swencionis C. Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity. 2010;18(10):1938–43.PubMedCrossRef
7.
go back to reference Larsen J, van Ramshorst B, Geenen R, et al. Binge eating and its relationship to outcome after laparoscopic adjustable gastric banding. Obes Surg. 2004;14(8):1111–7.PubMedCrossRef Larsen J, van Ramshorst B, Geenen R, et al. Binge eating and its relationship to outcome after laparoscopic adjustable gastric banding. Obes Surg. 2004;14(8):1111–7.PubMedCrossRef
8.
go back to reference Kalarchian MA, Marcus MD, Levine MD, et al. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis. 2008;4(4):544–9.PubMedCrossRef Kalarchian MA, Marcus MD, Levine MD, et al. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis. 2008;4(4):544–9.PubMedCrossRef
9.
go back to reference De Panfilis C, Cero S, Torre M, et al. Utility of the temperament and character inventory (TCI) in outcome prediction of laparoscopic adjustable gastric banding: preliminary report. Obes Surg. 2006;16(7):842–7.PubMedCrossRef De Panfilis C, Cero S, Torre M, et al. Utility of the temperament and character inventory (TCI) in outcome prediction of laparoscopic adjustable gastric banding: preliminary report. Obes Surg. 2006;16(7):842–7.PubMedCrossRef
10.
go back to reference Ray EC, Nickels MW, Sayeed S, et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134(4):555–63. discussion 63-4.PubMedCrossRef Ray EC, Nickels MW, Sayeed S, et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134(4):555–63. discussion 63-4.PubMedCrossRef
11.
go back to reference Lanyon RI, Maxwell BM, Kraft AJ. Prediction of long-term outcome after gastric bypass surgery. Obes Surg. 2009;19(4):439–45.PubMedCrossRef Lanyon RI, Maxwell BM, Kraft AJ. Prediction of long-term outcome after gastric bypass surgery. Obes Surg. 2009;19(4):439–45.PubMedCrossRef
12.
go back to reference Kalarchian MA, Marcus MD. Management of the bariatric surgery patient: is there a role for the cognitive behavior therapist? Cognit Behav Pract. 2003;10(2):112–9.CrossRef Kalarchian MA, Marcus MD. Management of the bariatric surgery patient: is there a role for the cognitive behavior therapist? Cognit Behav Pract. 2003;10(2):112–9.CrossRef
13.
go back to reference Caniato D, Skorjanec B. The role of brief strategic therapy on the outcome of gastric banding. Obes Surg. 2002;12(5):666–71.PubMedCrossRef Caniato D, Skorjanec B. The role of brief strategic therapy on the outcome of gastric banding. Obes Surg. 2002;12(5):666–71.PubMedCrossRef
14.
go back to reference Livhits M, Mercado C, Yermilov I, et al. Is social support associated with greater weight loss after bariatric surgery?: a systematic review. Obes Rev. 2011;12(2):142–8.PubMedCrossRef Livhits M, Mercado C, Yermilov I, et al. Is social support associated with greater weight loss after bariatric surgery?: a systematic review. Obes Rev. 2011;12(2):142–8.PubMedCrossRef
15.
go back to reference Song Z, Reinhardt K, Buzdon M, et al. Association between support group attendance and weight loss after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(2):100–3.PubMedCrossRef Song Z, Reinhardt K, Buzdon M, et al. Association between support group attendance and weight loss after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(2):100–3.PubMedCrossRef
16.
go back to reference Orth WS, Madan AK, Taddeucci RJ, et al. Support group meeting attendance is associated with better weight loss. Obes Surg. 2008;18(4):391–4.PubMedCrossRef Orth WS, Madan AK, Taddeucci RJ, et al. Support group meeting attendance is associated with better weight loss. Obes Surg. 2008;18(4):391–4.PubMedCrossRef
17.
go back to reference Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–e34.PubMedCrossRef Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–e34.PubMedCrossRef
18.
go back to reference Gould JC, Beverstein G, Reinhardt S, et al. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surg Obes Relat Dis. 2007;3(6):627–30. discussion 30.PubMedCrossRef Gould JC, Beverstein G, Reinhardt S, et al. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surg Obes Relat Dis. 2007;3(6):627–30. discussion 30.PubMedCrossRef
19.
go back to reference Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.PubMedCrossRef Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.PubMedCrossRef
20.
go back to reference Pontiroli A, Fossati A, Vedani P, et al. Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients. Obes Surg. 2007;17(11):1492–7.PubMedCrossRef Pontiroli A, Fossati A, Vedani P, et al. Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients. Obes Surg. 2007;17(11):1492–7.PubMedCrossRef
21.
go back to reference Shen R, Dugay G, Rajaram K, et al. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg. 2004;14(4):514–9.PubMedCrossRef Shen R, Dugay G, Rajaram K, et al. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg. 2004;14(4):514–9.PubMedCrossRef
22.
go back to reference Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity (Silver Spring). 2009;17(5):996–1002.CrossRef Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity (Silver Spring). 2009;17(5):996–1002.CrossRef
23.
go back to reference Faria SL, de Oliveira Kelly E, Lins RD, et al. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20(2):135–9.PubMedCrossRef Faria SL, de Oliveira Kelly E, Lins RD, et al. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20(2):135–9.PubMedCrossRef
24.
go back to reference Shang E, Hasenberg T. Aerobic endurance training improves weight loss, body composition, and co-morbidities in patients after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2010;6(3):260–6.PubMedCrossRef Shang E, Hasenberg T. Aerobic endurance training improves weight loss, body composition, and co-morbidities in patients after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2010;6(3):260–6.PubMedCrossRef
25.
go back to reference Wolf DM, Lehman L, Quinlin R, et al. Effect of patient-centered care on patient satisfaction and quality of care. J Nurs Care Qua. 2008;23(4):316–21.CrossRef Wolf DM, Lehman L, Quinlin R, et al. Effect of patient-centered care on patient satisfaction and quality of care. J Nurs Care Qua. 2008;23(4):316–21.CrossRef
26.
go back to reference Marcus MD, Kalarchian MA, Courcoulas AP. Psychiatric evaluation and follow-up of bariatric surgery patients. AJ Psychiatry. 2009;166(3):285–91.CrossRef Marcus MD, Kalarchian MA, Courcoulas AP. Psychiatric evaluation and follow-up of bariatric surgery patients. AJ Psychiatry. 2009;166(3):285–91.CrossRef
27.
go back to reference Saunders R. Post-surgery group therapy for gastric bypass patients. Obes Surg. 2004;14(8):1128–31.PubMedCrossRef Saunders R. Post-surgery group therapy for gastric bypass patients. Obes Surg. 2004;14(8):1128–31.PubMedCrossRef
28.
go back to reference Andrews G. The post-surgical treatment of the bariatric patient: helping the patient succeed. Obes Surg. 1996;6(5):426–9.PubMedCrossRef Andrews G. The post-surgical treatment of the bariatric patient: helping the patient succeed. Obes Surg. 1996;6(5):426–9.PubMedCrossRef
29.
go back to reference Lind NA, Cigrang JA. Biofeedback-assisted relaxation, exposure, and cognitive-behavioral treatment of gastric bypass surgery related anxiety. Clin Case Stud. 2004;3(2):147–64.CrossRef Lind NA, Cigrang JA. Biofeedback-assisted relaxation, exposure, and cognitive-behavioral treatment of gastric bypass surgery related anxiety. Clin Case Stud. 2004;3(2):147–64.CrossRef
30.
go back to reference Wysoker A. The lived experience of choosing bariatric surgery to lose weight. J Am Psychiatr Nurses Assoc. 2005;11(1):26–34.CrossRef Wysoker A. The lived experience of choosing bariatric surgery to lose weight. J Am Psychiatr Nurses Assoc. 2005;11(1):26–34.CrossRef
31.
go back to reference 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(2):257–62.PubMedCrossRef 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(2):257–62.PubMedCrossRef
32.
go back to reference Boeka AG, Prentice-Dunn S, Lokken KL. Psychosocial predictors of intentions to comply with bariatric surgery guidelines. Psychol Health Med. 2010;15(2):188–97.PubMedCrossRef Boeka AG, Prentice-Dunn S, Lokken KL. Psychosocial predictors of intentions to comply with bariatric surgery guidelines. Psychol Health Med. 2010;15(2):188–97.PubMedCrossRef
33.
go back to reference Brandenburg D, Kotlowski R. Practice makes perfect? Patient response to a prebariatric surgery behavior modification program. Obes Surg. 2005;15(1):125–32.PubMedCrossRef Brandenburg D, Kotlowski R. Practice makes perfect? Patient response to a prebariatric surgery behavior modification program. Obes Surg. 2005;15(1):125–32.PubMedCrossRef
34.
go back to reference Leahey TM, Crowther JH, Irwin SR. A Cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients. Cognit Behav Pract. 2008;15(4):364–75.CrossRef Leahey TM, Crowther JH, Irwin SR. A Cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients. Cognit Behav Pract. 2008;15(4):364–75.CrossRef
35.
go back to reference Cowan Jr GS, Buffington CK, Cowan GS, et al. Assessment of the effects of a taped cognitive behavior message on postoperative complications (therapeutic suggestions under anesthesia). Obes Surg. 2001;11(5):589–93.PubMedCrossRef Cowan Jr GS, Buffington CK, Cowan GS, et al. Assessment of the effects of a taped cognitive behavior message on postoperative complications (therapeutic suggestions under anesthesia). Obes Surg. 2001;11(5):589–93.PubMedCrossRef
36.
go back to reference Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76(10):1139–42.PubMed Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76(10):1139–42.PubMed
37.
go back to reference Welch G, Wesolowski C, Zagarins S, et al. Evaluation of clinical outcomes for gastric bypass surgery: results from a comprehensive follow-up study. Obes Surg. 2011;21(1):18–28.PubMedCrossRef Welch G, Wesolowski C, Zagarins S, et al. Evaluation of clinical outcomes for gastric bypass surgery: results from a comprehensive follow-up study. Obes Surg. 2011;21(1):18–28.PubMedCrossRef
38.
go back to reference Hildebrandt SE. Effects of participation in bariatric support group after Roux-en-Y gastric bypass. Obes Surg. 1998;8(5):535–42.PubMedCrossRef Hildebrandt SE. Effects of participation in bariatric support group after Roux-en-Y gastric bypass. Obes Surg. 1998;8(5):535–42.PubMedCrossRef
39.
go back to reference Papalazarou A, Yannakoulia M, Kavouras SA, et al. Lifestyle intervention favorably affects weight loss and maintenance following obesity surgery. Obesity (Silver Spring). 2010;18(7):1348–53.CrossRef Papalazarou A, Yannakoulia M, Kavouras SA, et al. Lifestyle intervention favorably affects weight loss and maintenance following obesity surgery. Obesity (Silver Spring). 2010;18(7):1348–53.CrossRef
40.
go back to reference 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.CrossRef 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.CrossRef
41.
go back to reference Ashton K, Heinberg L, Windover A, et al. Positive response to binge eating intervention enhances postoperative weight loss. Surg Obes Relat Dis. 2011;7(3):315–20.PubMedCrossRef Ashton K, Heinberg L, Windover A, et al. Positive response to binge eating intervention enhances postoperative weight loss. Surg Obes Relat Dis. 2011;7(3):315–20.PubMedCrossRef
42.
go back to reference Nicolai A, Ippoliti C, Petrelli MD. Laparoscopic adjustable gastric banding: essential role of psychological support. Obes Surg. 2002;12(6):857–63.PubMedCrossRef Nicolai A, Ippoliti C, Petrelli MD. Laparoscopic adjustable gastric banding: essential role of psychological support. Obes Surg. 2002;12(6):857–63.PubMedCrossRef
43.
go back to reference Elakkary E, Elhorr A, Aziz F, et al. Do support groups play a role in weight loss after laparoscopic adjustable gastric banding? Obes Surg. 2006;16(3):331–4.PubMedCrossRef Elakkary E, Elhorr A, Aziz F, et al. Do support groups play a role in weight loss after laparoscopic adjustable gastric banding? Obes Surg. 2006;16(3):331–4.PubMedCrossRef
44.
go back to reference Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.PubMedCrossRef Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.PubMedCrossRef
45.
go back to reference Sterne JAC, Egger M, Moher D. Addressing reporting biases. In: Higgins JPT, Green S (eds.). Cochrane handbook for systematic reviews of intervention. Version 5.0.1. The Cochrane Collaboration, 2008, Chapter 10.46. Sterne JAC, Egger M, Moher D. Addressing reporting biases. In: Higgins JPT, Green S (eds.). Cochrane handbook for systematic reviews of intervention. Version 5.0.1. The Cochrane Collaboration, 2008, Chapter 10.46.
46.
go back to reference Poole C, Greenland S. Random-effects meta-analyses are not always conservative. Am J Epidemiol. 1999;150(5):469–75.PubMedCrossRef Poole C, Greenland S. Random-effects meta-analyses are not always conservative. Am J Epidemiol. 1999;150(5):469–75.PubMedCrossRef
47.
go back to reference Rosenthal R, Rubin DB. r equivalent: a simple effect size indicator. Psychol Methods. 2003;8(4):492–6.PubMedCrossRef Rosenthal R, Rubin DB. r equivalent: a simple effect size indicator. Psychol Methods. 2003;8(4):492–6.PubMedCrossRef
48.
go back to reference Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.PubMedCrossRef Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.PubMedCrossRef
49.
go back to reference Rosenthal R. The file drawer problem and tolerance for null results. PsyB. 1979;86(3):638–41. Rosenthal R. The file drawer problem and tolerance for null results. PsyB. 1979;86(3):638–41.
50.
go back to reference Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988.
51.
go back to reference Rosenthal R. Writing meta-analytic reviews. Psychol Bull. 1995;118(2):183–92.CrossRef Rosenthal R. Writing meta-analytic reviews. Psychol Bull. 1995;118(2):183–92.CrossRef
52.
go back to reference Hedges LV, Pigott TD. The power of statistical tests for moderators in meta-analysis. Psychol Meth. 2004;9(4):426–45.CrossRef Hedges LV, Pigott TD. The power of statistical tests for moderators in meta-analysis. Psychol Meth. 2004;9(4):426–45.CrossRef
53.
go back to reference Herpertz S, Kielmann R, Wolf AM, et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12(10):1554–69.PubMedCrossRef Herpertz S, Kielmann R, Wolf AM, et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12(10):1554–69.PubMedCrossRef
54.
go back to reference Biertho L, Steffen R, Ricklin T et al. Laporascopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg; 197(4):536-545. Biertho L, Steffen R, Ricklin T et al. Laporascopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg; 197(4):536-545.
Metadata
Title
Do Postoperative Psychotherapeutic Interventions and Support Groups Influence Weight Loss Following Bariatric Surgery? A Systematic Review and Meta-analysis of Randomized and Nonrandomized Trials
Authors
Nina N. Beck
Maja Johannsen
René K. Støving
Mimi Mehlsen
Robert Zachariae
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 11/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0739-4

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