Psychological treatment approaches for improvement of maladaptive eating behaviors in bariatric surgery patients: A systematic review

Abstract

Introduction. Maladaptive eating behaviors (MEB) are highly prevalent among bariatric surgery patients and have been demonstrated to be important contributors for weight loss outcomes. A systematic review was conducted to evaluate the effectiveness of psychological treatment approaches on MEB in bariatric surgery patients. Materials and Methods. This systematic review was registered in PROSPERO. Literature review was performed in the databases PubMed, ScienceDirect, Cochrane Library, and Web of Science. We included studies published between January 1st 1990 and October 18th 2019, with pre- or postoperative psychological treatment approaches in bariatric surgery patients aimed to improve MEB. Results. A total of 15 studies met the inclusion criteria (eight RCT and seven pretest-posttest studies), 752 participants were identified, 80.3% were female and the average participant’s age was 46.1 years (SD ± 6.6). Follow-up period after intervention ranged from six weeks to 48 months. Five out of eight RCT reported a positive and significant effect (P <0.05) on MEB and four had medium to large effect size between the groups receiving psychotherapeutic interventions and the control group. Six out of seven pretest-posttest studies reported significant difference (P <0.05) on MEB and had small to large effect size after receiving psychotherapeutic interventions. Conclusion. Overall, the quality of the evidence ranged from low to moderate. Psychological treatments in bariatric surgery patients are inconsistent, though most results indicate improvement on MEB. Well-designed long-term studies and other approaches strategies are warranted to assess the long-term effects on MEB and weight loss in bariatric surgery patients.

Keywords

• maladaptive eating behaviors
• psychological treatment
• psychotherapeutic
• bariatric surgery
• systematic review