Long-Term Efficacy of Telephone-Delivered CBT Post-Metabolic and Bariatric Surgery

Overview

This randomized controlled trial evaluated the long-term effects of telephone-delivered cognitive behavioral therapy (Tele-CBT) initiated 12 months after metabolic and bariatric surgery (MBS). Results at 18 months post-intervention demonstrated sustained improvements in disordered eating behaviors and psychological distress, although weight loss outcomes did not significantly differ from standard care.

Background

Metabolic and bariatric surgery is effective for severe obesity but maintaining weight loss long-term remains challenging, with many patients experiencing recurrent weight gain and psychological distress. Maladaptive eating behaviors and depression post-surgery are key factors contributing to suboptimal outcomes. Cognitive behavioral therapy has shown efficacy in improving psychological symptoms and disordered eating post-MBS, but access to in-person therapy is limited. Telephone-delivered CBT offers a remote alternative that may enhance long-term psychosocial outcomes.

Data Highlights

Key Findings

• Tele-CBT delivered at 12 months post-MBS leads to sustained reductions in binge eating, emotional eating, depressive, and anxiety symptoms up to 18 months follow-up.
• Despite psychological improvements, Tele-CBT did not produce significant differences in weight loss outcomes compared to standard care.
• The 12-month post-surgery timepoint is critical for intervention as maladaptive eating behaviors tend to re-emerge around this period.
• Telephone delivery of CBT overcomes barriers to access and provides effective remote psychosocial support for post-MBS patients.
• Psychosocial benefits of Tele-CBT may contribute to improved health-related quality of life even without additional weight loss.

Clinical Implications

Clinicians should consider integrating Tele-CBT into post-MBS care around 12 months after surgery to address psychological distress and disordered eating behaviors that threaten long-term success. Remote delivery increases accessibility and may enhance patient engagement. While Tele-CBT may not directly improve weight loss, its benefits on mental health and eating behaviors support its role in comprehensive post-surgical management.

Conclusion

Telephone-delivered CBT initiated one year after bariatric surgery provides durable improvements in psychological symptoms and disordered eating, highlighting its value as a scalable intervention to support long-term post-MBS outcomes. Further research is needed to explore strategies to translate these psychosocial gains into enhanced weight maintenance.

References

1. Author/Source/2023 -- A Randomized Controlled Study on the Efficacy of Telephone-Delivered Cognitive Behavioral Therapy for Post-Metabolic and Bariatric Surgery Patients