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

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; ηp2 = 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; ηp2 = 0.001). Trial registration: ClinicalTrials.gov NCT01264120. 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.