Abstract
BACKGROUND: Although bariatric surgery is associated with significant overall weight loss, many patients experience suboptimal outcomes. Our objective was to document the preliminary efficacy of a behavioral intervention for bariatric surgery patients with relatively poor long-term weight loss and to explore the factors related to outcome at an academic medical center in the United States. METHODS: Patients with a body mass index (BMI) ≥ 30 kg/m(2) who had undergone bariatric surgery ≥ 3 years before study entry and had <50% excess weight loss were enrolled. The participants were randomly assigned to a 6-month behavioral intervention or wait list control group. The assessments were conducted at baseline (before intervention) and 6 months (after intervention) and 12 months (6-mo follow-up). RESULTS: On average, the participants (n = 36) had undergone surgery 6.6 years before study entry. The average age was 52.5 ± 7.1 years, and the BMI was 43.1 ± 6.2 kg/m(2); most participants were women (75%) and white (88.9%). The intervention patients had a greater percentage of excess weight loss than did the wait list control group at 6 (6.6% ± 3.4% versus 1.6% ± 3.1%) and 12 (5.8% ± 3.5% versus .9% ± 3.2%) months. However, the differences were not significant and the results varied. The intervention patients with more depressive symptoms (P = .005) and less weight regain before study entry (P = .05) experienced a greater percentage of excess weight loss. CONCLUSION: Behavioral intervention holds promise in optimizing long-term weight control after bariatric surgery. More research is needed on when to initiate the intervention and to identify which patients will benefit from this type of approach.