180 Does Preoperative Cognitive Behavioural Therapy Improve Postoperative Weight Loss Outcomes in Patients Undergoing Bariatric Surgery? a Systematic Review and Meta-Analysis
J Hughes, R Hughes, A Musbahi, G Kourounis- Surgery
Abstract
Aim
Bariatric surgery is an effective intervention in treating obesity. However, some patients experience weight regain or early weight stabilisation. It is thought that psychological comorbidity may contribute to this. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) to determine if preoperative cognitive behavioural therapy (CBT) would improve weight loss outcomes in patients scheduled for bariatric surgery.
Method
Medline, PsychINFO, Scopus and EMBASE were searched from their origin to 20th March 2022 for articles comparing preoperative CBT to standard care. Primary outcome was weight loss at least 1 year postoperatively. This review was registered on PROSPERO (CRD42022326336).
Results
Of 144 articles, 2 met inclusion criteria. They included a total of 187 patients randomised between CBT (n = 95) and control (n = 92). One paper included 1 year follow up whilst the other included 1 and 4 year follow up. Our random-effects meta-analysis found no significant difference in weight loss outcomes between the two groups at 1 year, p = 0.43. There was high heterogeneity between the studies, I2 = 90%.
Conclusions
Currently, RCTs do not show a significant difference in postoperative weight loss between CBT and control groups although case specific CBT may still be beneficial. Our study was limited by few eligible studies and high heterogeneity between the studies. One study also demonstrated selection bias by excluding patients who had previously undergone psychotherapy from the analysis.