Clinical Scorecard: Efficacy of Telephone-Delivered Cognitive Behavioral Therapy for Post-Metabolic and Bariatric Surgery Patients: 18-Month Follow-Up

At a Glance

Key Highlights

• Tele-CBT delivered at 12 months post-MBS improves disordered eating, depressive, and anxiety symptoms.
• Psychosocial benefits of Tele-CBT are sustained up to 18 months post-intervention.
• Weight loss outcomes did not significantly differ between Tele-CBT and standard care groups at follow-up.

Guideline-Based Recommendations

Diagnosis

• Assess for maladaptive eating behaviors (binge eating, emotional eating, loss-of-control eating) post-MBS.
• Screen for depressive and anxiety symptoms in post-MBS patients.

Management

• Implement Tele-CBT interventions around 12 months post-MBS to address emerging psychological and behavioral challenges.
• Provide routine psychosocial follow-up care with consideration for remote delivery methods to improve access.

Monitoring & Follow-up

• Monitor disordered eating behaviors and psychological distress longitudinally post-MBS, especially between 1 and 3 years.
• Evaluate weight trajectories and psychological symptoms at multiple time points post-intervention.

Risks

• Recognize that recurrent weight gain post-MBS is common and associated with psychological factors.
• Identify patients with active suicidal ideation or poorly controlled psychiatric conditions as ineligible for Tele-CBT without additional support.

Patient & Prescribing Data

Post-MBS adults at 12 months post-surgery with or without current psychological distress or disordered eating symptoms.

Tele-CBT is effective in reducing psychological distress and disordered eating behaviors but may not significantly impact weight loss outcomes over 18 months.

Clinical Best Practices

• Deliver psychosocial interventions such as CBT at approximately 12 months post-MBS when old maladaptive habits may resurface.
• Utilize telephone-based CBT to overcome barriers to in-person therapy including geographic and mobility limitations.
• Incorporate routine screening for psychological distress and disordered eating into post-MBS follow-up care.
• Educate patients on the importance of coping skills and behavioral strategies to maintain weight loss and psychological well-being.

References

• Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) cohort findings
• CONSORT Reporting Guidelines