Skip to main content
Top
Published in: Obesity Surgery 3/2015

Open Access 01-03-2015 | Original Contributions

The Impact of Psychological Support on Weight Loss Post Weight Loss Surgery: a Randomised Control Trial

Authors: Jane Ogden, Amelia Hollywood, Christopher Pring

Published in: Obesity Surgery | Issue 3/2015

Login to get access

Abstract

Background

The purpose of the present study is to evaluate the impact of a health psychology-led bariatric rehabilitation service (BRS) on patient weight loss following bariatric surgery at 1 year.

Methods

A single-site open-randomised parallel group control trial based at St. Richard’s Hospital in Chichester in the UK. Patients (n = 162) were recruited immediately prior to Roux-en-Y gastric bypass and randomly allocated to receive either treatment as usual (n = 80) or the BRS (n = 82). The BRS involved three 50-min one-to-one sessions with a health psychologist and provided information, support and mentoring pre and post surgery addressing psychological issues such as dietary control, self esteem, coping and emotional eating. Weight loss was assessed at 1 year. The key outcome variable was BMI and change in BMI.

Results

Follow-up weight was available for 145 patients. Intention-to-treat analysis (n = 162) using last measured weights showed that mean change in BMI by 1 year post surgery was −16.49. There was no significant difference between the two groups (control group = −16.37, 95 % CI = 15.15–17.57; intervention = −16.6, 95 % CI = 15.42–17.81; η p 2 = 0.001). Similarly, explanatory analysis (n = 145) showed a mean change in BMI of −17.17. The difference between the two groups was not significant (control group = −16.9, 95 % CI = 15.78–18.18; intervention = −17.35, 95 % CI = 18.5–16.16; η p 2 = 0.001).

Conclusions

Psychological support pre and post bariatric surgery had no impact on weight loss as measured by BMI and change in BMI by 1 year. It is argued that psychological support should be targeted to patients who start to demonstrate weight regain at a later stage.
Trial registration: ClinicalTrials.gov NCT01264120.
Literature
1.
go back to reference 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;13:41.CrossRef 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;13:41.CrossRef
2.
go back to reference Sjostrom L, Nabro K, Sjostrom CD. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed Sjostrom L, Nabro K, Sjostrom CD. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed
3.
go back to reference Nguyen NT, Silver M, Robinson M, et al. Result of a national audit of bariatric surgery performed at academic centers. A 2004 University Health System Consortium Benchmarking Project. Arch Surg. 2006;141:445–50.CrossRefPubMed Nguyen NT, Silver M, Robinson M, et al. Result of a national audit of bariatric surgery performed at academic centers. A 2004 University Health System Consortium Benchmarking Project. Arch Surg. 2006;141:445–50.CrossRefPubMed
4.
go back to reference Courcoulas AP, Christian NJ, Belle SH, et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.PubMedCentralPubMed Courcoulas AP, Christian NJ, Belle SH, et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.PubMedCentralPubMed
5.
go back to reference Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health related quality of life (HRQL) and eating behaviour after gastric surgery for severe obesity. Int J Obes (Lond). 1998;22:113–26.CrossRef Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health related quality of life (HRQL) and eating behaviour after gastric surgery for severe obesity. Int J Obes (Lond). 1998;22:113–26.CrossRef
6.
go back to reference O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.CrossRefPubMed O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.CrossRefPubMed
7.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMed
8.
go back to reference Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.CrossRefPubMed Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.CrossRefPubMed
9.
go back to reference Ogden J, Clementi C, Aylwin S, et al. Exploring the impact of obesity surgery on patient’s health status: a quantitative and qualitative study. Obes Surg. 2005;15:266–72.CrossRefPubMed Ogden J, Clementi C, Aylwin S, et al. Exploring the impact of obesity surgery on patient’s health status: a quantitative and qualitative study. Obes Surg. 2005;15:266–72.CrossRefPubMed
10.
go back to reference Ogden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health. 2006;21:273–93.CrossRefPubMed Ogden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health. 2006;21:273–93.CrossRefPubMed
11.
go back to reference Ogden J, Avenell S, Ellis G. Negotiating control: patients’ experiences of unsuccessful weight-loss surgery. Psychol Health. 2011;26:949–64.CrossRefPubMed Ogden J, Avenell S, Ellis G. Negotiating control: patients’ experiences of unsuccessful weight-loss surgery. Psychol Health. 2011;26:949–64.CrossRefPubMed
12.
go back to reference Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res. 2002;52:155–65.CrossRefPubMed Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res. 2002;52:155–65.CrossRefPubMed
13.
go back to reference Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20:249–56.CrossRef Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20:249–56.CrossRef
14.
go back to reference Semanscin-Doerr DA, Windover A, Ashton K, et al. Mood disorders in laparoscopic sleeve gastrectomy patients: does it affect early weight loss? Surg Obes Relat Dis. 2010;6:191–6.CrossRefPubMed Semanscin-Doerr DA, Windover A, Ashton K, et al. Mood disorders in laparoscopic sleeve gastrectomy patients: does it affect early weight loss? Surg Obes Relat Dis. 2010;6:191–6.CrossRefPubMed
15.
go back to reference Saltzman E, Anderson W, Apovian CM, et al. Criteria for patient selection and multidisciplinary evaluation and treatment of the weight loss surgery patient. Obes Res. 2005;13:234–43.CrossRefPubMed Saltzman E, Anderson W, Apovian CM, et al. Criteria for patient selection and multidisciplinary evaluation and treatment of the weight loss surgery patient. Obes Res. 2005;13:234–43.CrossRefPubMed
16.
go back to reference Heinberg LJ. Comment on: optimizing long-term weight control after bariatric surgery: a pilot study. Surg Obes Relat Dis. 2012;8:715–6.CrossRefPubMed Heinberg LJ. Comment on: optimizing long-term weight control after bariatric surgery: a pilot study. Surg Obes Relat Dis. 2012;8:715–6.CrossRefPubMed
17.
go back to reference Henrickson HC, Ashton KR, Windover AK, et al. Psychological considerations for bariatric surgery among older adults. Obes Surg. 2009;19:211–6.CrossRefPubMed Henrickson HC, Ashton KR, Windover AK, et al. Psychological considerations for bariatric surgery among older adults. Obes Surg. 2009;19:211–6.CrossRefPubMed
18.
go back to reference Kalarchian MA, Marcus MD, Courcoulas AP, et al. Preoperative lifestyle intervention in bariatric surgery: initial results from a randomized, controlled trial. Obesity (Silver Spring). 2013;21:254–60.CrossRef Kalarchian MA, Marcus MD, Courcoulas AP, et al. Preoperative lifestyle intervention in bariatric surgery: initial results from a randomized, controlled trial. Obesity (Silver Spring). 2013;21:254–60.CrossRef
19.
go back to reference Kalarchian MA, Marcus MD, Courcoulas AP, et al. Optimizing long-term weight control after bariatric surgery: a pilot study. Surg Obes Relat Dis. 2012;8:710–5.CrossRefPubMedCentralPubMed Kalarchian MA, Marcus MD, Courcoulas AP, et al. Optimizing long-term weight control after bariatric surgery: a pilot study. Surg Obes Relat Dis. 2012;8:710–5.CrossRefPubMedCentralPubMed
21.
go back to reference Mechanick JI, Youdim A, Jones DB, et al. American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient-2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013 Mar;21 Suppl 1:S1-27. Mechanick JI, Youdim A, Jones DB, et al. American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient-2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013 Mar;21 Suppl 1:S1-27.
22.
go back to reference Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med. 2001;345:892–902.CrossRefPubMed Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med. 2001;345:892–902.CrossRefPubMed
23.
go back to reference Petrie KJ, Cameron LD, Ellis CJ, et al. Changing illness perceptions after myocardial infarction: an early intervention randomized controlled trial. Psychosom Med. 2002;64:580–6.CrossRefPubMed Petrie KJ, Cameron LD, Ellis CJ, et al. Changing illness perceptions after myocardial infarction: an early intervention randomized controlled trial. Psychosom Med. 2002;64:580–6.CrossRefPubMed
Metadata
Title
The Impact of Psychological Support on Weight Loss Post Weight Loss Surgery: a Randomised Control Trial
Authors
Jane Ogden
Amelia Hollywood
Christopher Pring
Publication date
01-03-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1428-2

Other articles of this Issue 3/2015

Obesity Surgery 3/2015 Go to the issue