Shorter communicationA pilot randomized controlled trial of telephone-based cognitive behavioural therapy for preoperative bariatric surgery patients
Section snippets
Participants
Participants (N = 72) were adult bariatric surgery candidates recruited from a Canadian Bariatric Surgery Program. Exclusion criteria included current ineligibility for bariatric surgery, lack of computer access, or having significant language barriers, poorly controlled psychiatric illness or severe medical illness that would render Tele-CBT very difficult. Given the absence of clear pre-operative psychological predictors of bariatric surgery outcome (Livhits et al., 2012), participation was
Statistical analysis
All analyses were performed using SPSS Statistics for Windows (Version 18.0; SPSS, IBM Corp, Armonk, NY). Descriptive statistics including means, standard deviations, and frequency counts were calculated to describe participant characteristics. Independent t tests and chi-square were used to compare completers with dropouts, and to compare the Tele-CBT group with the Control group, on demographic variables and baseline clinical variables.
A 2 (Group: Tele-CBT vs. Control) x 2 (Time: baseline,
Results
Recruitment and Participant Flow. The CONSORT diagram is depicted in Fig. 1. Recruitment for the study occurred over a period of 9 months. Of 72 individuals screened for eligibility, 15 did not meet the study inclusion/exclusion criteria, and 10 chose to not participate. Of the remaining 47 participants who were randomly assigned to the Tele-CBT group (n = 23) or Control group (n = 24), 35 (74.5%) completed the post-treatment measures: 16 (70.0%) from the Tele-CBT Group and 19 (79.1%) from the
Discussion
The current pilot RCT found Tele-CBT to be a feasible intervention and efficacious in improving eating psychopathology and psychosocial functioning in pre-operative bariatric surgery patients. These findings are in line with previous research that has found CBT to be effective in improving disordered eating and affective symptoms in pre-operative bariatric surgery patients (Ashton et al., 2009, Gade et al., 2015). The RCT design of the current study permitted comparison with a standard
Conclusions
In summary, the current pilot RCT provided preliminary support that a 6-session pre-operative Tele-CBT intervention is feasible, and appears efficacious in improving eating psychopathology and depression immediately following the intervention. These pilot findings lend support to the growing body of literature demonstrating that CBT can be a helpful tool for bariatric surgery patients and provide an impetus to investigate other novel methods of treatment delivery to increase accessibility to
Author note
This research was supported by funding from the Canadian Institutes of Health Research (Grant #317877) and the Ontario Ministry of Health and Long Term Care. Dr. Stephanie Cassin and Dr. Sanjeev Sockalingam are both primary authors. Correspondence concerning this article should be addressed to Dr. Stephanie Cassin, Department of Psychology, Ryerson University, 350 Victoria St., Toronto, Ontario, Canada, M5B 2K3.
Acknowledgements
The authors would like to thank Dr. Sarah Royal for conducting Tele-CBT with a subset of the participants and Vincent Santiago for assisting with the manuscript.
References (33)
- et al.
Brief, four-session group CBT reduces binge eating behaviours among bariatric surgery candidates
Surgery for Obesity and Related Diseases
(2009) - et al.
Positive response to binge eating interventions enhances postoperative weight loss
Surgery for Obesity and Related Diseases
(2011) - et al.
Bari-active: a randomized controlled trial of a preoperative intervention to increase physical activity in bariatric surgery patients
Surgery for Obesity and Related Diseases
(2015) - et al.
Cognitive behavioural therapy for bariatric surgery patients: preliminary evidence for feasibility, acceptability, and effectiveness
Cognitive and Behavioural Practice
(2013) - et al.
The assessment of binge eating severity among obese persons
Addictive Behaviours
(1982) - et al.
Optimizing long-term weight control after bariatric surgery: a pilot study
Surgery for Obesity and Related Diseases
(2012) - et al.
Walking capacity of bariatric surgery candidates
Surgery for Obesity and Related Diseases
(2012) - et al.
Travel distance, age, and sex as factors in follow-up visit compliance in the post-gastric bypass population
Surgery for Obesity and Related Diseases
(2005) - et al.
Psychiatric disorders in bariatric surgery candidates. A review of the literature and results of a German prebariatric surgery sample
General Hospital Psychiatry
(2009) - et al.
Feasibility and acceptability of a telephone psychotherapy program for depressed adults treated in primary care
General Hospital Psychiatry
(2005)