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Obesity Surgery
Erschienen in: Obesity Surgery 3/2017

01.09.2016 | Original Contributions

Project HELP: a Remotely Delivered Behavioral Intervention for Weight Regain after Bariatric Surgery

verfasst von: Lauren E. Bradley, Evan M. Forman, Stephanie G. Kerrigan, Stephanie P. Goldstein, Meghan L. Butryn, J. Graham Thomas, James D. Herbert, David B. Sarwer

Erschienen in: Obesity Surgery | Ausgabe 3/2017

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Abstract

Background

Weight regain following bariatric surgery is common and potentially compromises the health benefits initially attained after surgery. Poor compliance to dietary and physical activity prescriptions is believed to be largely responsible for weight regain. Patients may benefit from developing specialized psychological skills necessary to engage in positive health behaviors over the long term. Unfortunately, patients often face challenges to physically returning to the bariatric surgery program for support in developing and maintaining these behaviors. Remotely delivered interventions, in contrast, can be conveniently delivered to the patient and have been found efficacious for a number of health problems, including obesity. To date, they have received little attention with bariatric surgery patients. The study aimed to evaluate a newly developed, remote acceptance-based behavioral intervention for postoperative weight regain.

Methods

Patients at least 1.5 years out from surgery who experienced postoperative weight regain were recruited to receive the 10-week intervention. Participants were assessed at baseline, mid-treatment, post-treatment, and at 3-month follow-up.

Results

Support for the intervention’s feasibility and acceptability was achieved, with 70 % retention among those who started the program and a high mean rating (4.7 out of 5.0) of program satisfaction among study completers. On average, weight regain was reversed with a mean weight loss of 5.1 ± 5.5 % throughout the intervention. This weight loss was maintained at 3-month follow-up. Significant improvements in eating-related and acceptance-based variables also were observed.

Conclusions

This pilot study provides initial support for the feasibility, acceptability, and preliminary efficacy of a remotely delivered acceptance-based behavioral intervention for postoperative weight regain.
Literatur
1.
Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed
2.
Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
3.
4.
Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.PubMedPubMedCentral
5.
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefPubMedPubMedCentral
6.
DiGiorgi M, Rosen DJ, Choi JJ, et al. Re-emergence of diabetes after gastric bypass in patients with mid- to long-term follow-up. Surg Obes Relat Dis. 2010;6(3):249–53.CrossRefPubMed
7.
Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.CrossRefPubMedPubMedCentral
8.
Sarwer DB, Dilks RJ, West-Smith L. Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis. 2011;7(5):644–51.CrossRefPubMed
9.
Colles SL, Dixon JB, O'Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity (Silver Spring). 2008;16(3):615–22.CrossRef
10.
Burgmer R, Grigutsch K, Zipfel S, et al. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg. 2005;15(5):684–91.CrossRefPubMed
11.
Mechanick JI, Youdim A, Jones DB, et al. 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;21(Suppl 1):S1–27.CrossRef
12.
Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.CrossRefPubMed
13.
Bradley LE, Sarwer DB, Forman EM, et al. A survey of bariatric surgery patients’ interest in postoperative interventions. Obes Surg. 2015.
14.
Stewart K, Olbrisch M, Bean M. Back on track: confronting post-surgical weight gain. Bariatric Nursing and Surgical Patient Care. 2010;5:179–85.CrossRef
15.
Harbottle L. Audit of nutritional and dietary outcomes of bariatric surgery patients. Obes Rev. 2011;12(3):198–204.CrossRefPubMed
16.
Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.CrossRefPubMed
17.
Rudolph A, Hilbert A. Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2013;14(4):292–302.CrossRefPubMed
18.
Forman EM, Herbert JD. New directions in cognitive behavior therapy: acceptance-based therapies. General principles and empirically supported techniques of cognitive behavior therapy. 2009;77-101.
19.
Forman EM, Butryn ML, Manasse SM, et al. Acceptance-based behavioral treatment for weight control: a review and future directions. Curr Opin Psychol. 2015;2:87–90.CrossRefPubMed
20.
Forman EM, Butryn ML. A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation. Appetite. 2015;84:171–80.CrossRefPubMed
21.
Hayes SC, Luoma JB, Bond FW, et al. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44(1):1–25.CrossRefPubMed
22.
Forman EM, Butryn ML, Hoffman KL, et al. An open trial of an acceptance-based behavioral intervention for weight loss. Cognitive and Behavioral Practice. 2009;16(2):223–35.CrossRef
23.
Forman EM, Butryn ML, Juarascio AS, et al. The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity. Obesity (Silver Spring). 2013;21(6):1119–26.CrossRef
24.
Forman EM, Butryn ML, Manasse SM. et al. Acceptance-based behavioral weight loss treatment outperforms standard BT: outcomes from the Mind Your Health study. Paper presented at the 37th Annual Meeting and Scientific Sessions of the Society for Behavioral Medicine; Washington, DC.; 2016, April.
25.
Niemeier HM, Leahey T, Palm Reed K, et al. An acceptance-based behavioral intervention for weight loss: a pilot study. Behav Ther. 2012;43(2):427–35.CrossRefPubMed
26.
Weineland S, Arvidsson D, Kakoulidis TP, et al. Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT. Obes Res Clin Pract. 2012;6(1):e1–e90.CrossRefPubMed
27.
Leahey TM, Crowther JH, Irwin SR. A cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients. Cognitive and Behavioral Practice. 2008;15(4):364–75.CrossRef
28.
Engstrom D. Eating mindfully and cultivating satisfaction: modifying eating patterns in a bariatric surgery patient. Bariatric Nursing and Surgical Patient Care. 2007;2(4):245–50.CrossRef
29.
Bradley LE, Forman EM, Kerrigan SG, et al. Sarwer DB. A pilot study of an acceptance-based behavioral intervention for weight regain after bariatric surgery. Obes Surg. 2016.
30.
Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity (Silver Spring). 2009;17(5):996–1002.CrossRef
31.
Gould JC, Beverstein G, Reinhardt S, et al. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surg Obes Relat Dis. 2007;3(6):627,30 .discussion 630CrossRef
32.
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(6):710–5.CrossRefPubMed
33.
Sarwer DB, Moore RH, Spitzer JC, et al. A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery. Surg Obes Relat Dis. 2012;8(5):561–8.CrossRefPubMed
34.
Jennings N, Boyle M, Mahawar K, et al. The relationship of distance from the surgical centre on attendance and weight loss after laparoscopic gastric bypass surgery in the United Kingdom. Clin Obes. 2013;3(6):180–4.CrossRefPubMed
35.
Lara MD, Baker MT, Larson CJ, et al. Travel distance, age, and sex as factors in follow-up visit compliance in the post-gastric bypass population. Surg Obes Relat Dis. 2005;1(1):17–21.CrossRefPubMed
36.
Sivagnanam P, Rhodes M. The importance of follow-up and distance from centre in weight loss after laparoscopic adjustable gastric banding. Surg Endosc. 2010;24(10):2432–8.CrossRefPubMed
37.
Thomas JG, Bond DS, Sarwer DB, et al. Technology for behavioral assessment and intervention in bariatric surgery. Surg Obes Relat Dis. 2011;7(4):548–57.CrossRefPubMedPubMedCentral
38.
Arem H, Irwin M. A review of web-based weight loss interventions in adults. Obes Rev. 2011;12(5):e236–43.CrossRefPubMed
39.
Tate DF, Jackvony EH, Wing RR. Effects of internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA. 2003;289(14):1833–6.CrossRefPubMed
40.
Nes AA, van Dulmen S, Eide E, et al. The development and feasibility of a web-based intervention with diaries and situational feedback via smartphone to support self-management in patients with diabetes type 2. Diabetes Res Clin Pract. 2012;97(3):385–93.CrossRefPubMed
41.
Buhrman M, Skoglund A, Husell J, et al. Guided internet-delivered acceptance and commitment therapy for chronic pain patients: a randomized controlled trial. Behav Res Ther. 2013;51(6):307–15.CrossRefPubMed
42.
Bricker JB, Mann SL, Marek PM, et al. Telephone-delivered acceptance and commitment therapy for adult smoking cessation: a feasibility study. Nicotine Tob Res. 2010;12(4):454–8.CrossRefPubMed
43.
Goetter EM, Herbert JD, Forman EM, et al. An open trial of videoconference-mediated exposure and ritual prevention for obsessive-compulsive disorder. J Anxiety Disord. 2014;28(5):460–2.CrossRefPubMed
44.
Yuen EK, Herbert JD, Forman EM, et al. Treatment of social anxiety disorder using online virtual environments in second life. Behav Ther. 2013;44(1):51–61.CrossRefPubMed
45.
Yuen EK, Herbert JD, Forman EM, et al. Acceptance based behavior therapy for social anxiety disorder through videoconferencing. J Anxiety Disord. 2013;27(4):389–97.CrossRefPubMed
46.
Carlbring P, Hagglund M, Luthstrom A, et al. Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial. J Affect Disord. 2013;148(2–3):331–7.CrossRefPubMed
47.
Hesser H, Gustafsson T, Lunden C, et al. A randomized controlled trial of internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. J Consult Clin Psychol. 2012;80(4):649–61.CrossRefPubMed
48.
Weineland S, Hayes SC, Dahl J. Psychological flexibility and the gains of acceptance-based treatment for post-bariatric surgery: six-month follow-up and a test of the underlying model. Clin Obes. 2012;2(1–2):15–24.CrossRefPubMed
49.
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry. 2004;65(2):267–72.CrossRef
50.
Weineland SM, Bradley LE. Using acceptance and mindfulness approaches to enhance outcomes from bariatric surgery. In: Haynos AF, Forman EM, Butryn ML, Lillis J, editors. Mindfulness and acceptance for treating eating disorders and weight concerns: evidence-based interventions. Oakland: New Harbinger Publications; 2016.
51.
Tate DF, Jackvony EH, Wing RR. A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an internet weight loss program. Arch Intern Med. 2006;166(15):1620–5.CrossRefPubMed
52.
Livhits M, Mercado C, Yermilov I, et al. Is social support associated with greater weight loss after bariatric surgery?: a systematic review. Obes Rev. 2011;12(2):142–8.CrossRefPubMed
53.
54.
Burke LE, Conroy MB, Sereika SM, et al. The effect of electronic self-monitoring on weight loss and dietary intake: a randomized behavioral weight loss trial. Obesity (Silver Spring). 2011;19(2):338–44.CrossRef
55.
56.
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16(4):363–70.PubMed
57.
White MA, Kalarchian MA, Masheb RM, et al. Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry. 2010;71(2):175–84.CrossRefPubMed
58.
Mond JM, Hay PJ, Rodgers B, et al. Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behav Res Ther. 2004;42(5):551–67.CrossRefPubMed
59.
Stunkard AJ, Messick S. Eating inventory manual. New York: Psychological Corporation; 1998.
60.
Cappelleri JC, Bushmakin AG, Gerber RA, et al. Psychometric analysis of the Three-Factor Eating Questionnaire-R21: results from a large diverse sample of obese and non-obese participants. Int J Obes. 2009;33(6):611–20.CrossRef
61.
Foster GD, Wadden TA, Swain RM, et al. The eating inventory in obese women: clinical correlates and relationship to weight loss. Int J Obes Relat Metab Disord. 1998;22(8):778–85.CrossRefPubMed
62.
Arnow B, Kenardy J, Agras WS. The Emotional Eating Scale: the development of a measure to assess coping with negative affect by eating. Int J Eat Disord. 1995;18(1):79–90.CrossRefPubMed
63.
Conceicao EM, Mitchell JE, Engel SG, et al. What is “grazing”? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surg Obes Relat Dis. 2014;10(5):973–82.CrossRefPubMed
64.
Cepeda-Benito A, Gleaves DH, Williams TL, Erath SA. The development and validation of the state and trait food-cravingsquestionnaires. Behav Ther. 2001;31(1):151–73.
65.
Crowley NM, LePage ML, Goldman RL, et al. The Food Craving Questionnaire-Trait in a bariatric surgery seeking population and ability to predict post-surgery weight loss at six months. Eat Behav. 2012;13(4):366–70.CrossRefPubMed
66.
Paffenbarger Jr RS, Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol. 1978;108(3):161–75.PubMed
67.
Cardaciotto L, Herbert JD, Forman EM, et al. The assessment of present-moment awareness and acceptance: the Philadelphia Mindfulness Scale. Assessment. 2008;15(2):204–23.CrossRefPubMed
68.
Juarascio A, Forman E, Timko CA, et al. The development and validation of the food craving acceptance and action questionnaire (FAAQ). Eat Behav. 2011;12(3):182–7.CrossRefPubMed
69.
Forman EM, Herbert JD, Juarascio AS, et al. The Drexel Defusion Scale: a new measure of experiential distancing. Journal of Contextual Behavioral Science. 2012;1(1):55–65.CrossRef
70.
Butryn ML, Arigo D, Raggio GA, et al. Measuring the ability to tolerate activity-related discomfort: initial validation of the Physical Activity Acceptance Questionnaire (PAAQ). J Phys Act Health. 2015;12(5):717–6.CrossRefPubMed
71.
Goetter EM, Herbert JD, Forman EM, et al. Delivering exposure and ritual prevention for obsessive–compulsive disorder via videoconference: clinical considerations and recommendations. Journal of Obsessive-Compulsive and Related Disorders. 2013;2(2):137–45.CrossRef
72.
Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102–38.CrossRefPubMed
73.
Leahey TM, Bond DS, Irwin SR, et al. When is the best time to deliver behavioral intervention to bariatric surgery patients: before or after surgery? Surg Obes Relat Dis. 2009;5(1):99–102.CrossRefPubMed
Metadaten
Titel
Project HELP: a Remotely Delivered Behavioral Intervention for Weight Regain after Bariatric Surgery
verfasst von
Lauren E. Bradley
Evan M. Forman
Stephanie G. Kerrigan
Stephanie P. Goldstein
Meghan L. Butryn
J. Graham Thomas
James D. Herbert
David B. Sarwer
Publikationsdatum
01.09.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 3/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2337-3

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