Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada.
Bariatric Surgical Assessment Clinic, Regina Qu'Appelle Health Region, Regina, SK, Canada.
Obes Surg. 2019 Jan;29(1):252-261. doi: 10.1007/s11695-018-3515-2.
Bariatric surgery is the most effective treatment for morbid obesity, yet 20 to 30% of such patients regain weight approximately 2 years post-surgery. A psychological intervention adjunctive to bariatric surgery that addresses eating pathology often observed in bariatric populations may improve outcomes. In the present study, a brief, adapted DBT-ST group for bariatric surgical candidates was evaluated as an adjunctive intervention to bariatric surgery in the pre-surgical period to reduce eating pathology and clinical impairment.
Participants included 95 bariatric surgery candidates, with 50 candidates in the DBT-ST plus treatment as usual (TAU) group and 45 candidates in the TAU (i.e., comparison) group. Participants completed measures of eating pathology at three time points (i.e., T = pre-DBT-ST program; T = post-DBT-ST program; T = 4 months post-DBT-ST; comparable time points employed for TAU group). Average wait time for surgery following the pre-surgical program was approximately 2 to 4 months.
A series of 2 (group: DBT-ST + TAU versus TAU) × 3 (assessment time: T, T, and T) mixed-model ANOVAs were completed. Participants in the DBT-ST plus TAU group showed significant reductions in binge eating, emotional eating, global eating pathology, and clinical impairment related to eating difficulties over time in comparison to TAU.
Findings demonstrated that a brief DBT-ST group integrated as an adjunctive intervention to TAU in a bariatric pre-surgical program could aid in addressing eating pathology. Bariatric participants in a DBT-ST plus TAU group may be on a better weight loss trajectory than those who only receive TAU.
减重手术是治疗病态肥胖最有效的方法，但约有 20%至 30%的患者在手术后 2 年内体重会反弹。在减重手术的基础上增加针对减重人群中常见进食障碍的心理干预可能会改善治疗效果。本研究中，评估了一种针对减重手术候选者的简短、适应性 DBT-ST 团体作为减重手术的辅助治疗，以在术前阶段减少进食障碍和临床障碍。
研究对象包括 95 名减重手术候选者，其中 50 名参与者进入 DBT-ST 加治疗（TAU）组，45 名参与者进入 TAU（即对照组）。参与者在三个时间点完成进食障碍评估（T=DBT-ST 项目前；T=DBT-ST 项目后；T=DBT-ST 项目后 4 个月；TAU 组采用相同时间点）。接受术前项目治疗后，患者的平均手术等待时间约为 2 至 4 个月。
进行了一系列 2（组：DBT-ST+TAU 与 TAU）×3（评估时间：T、T 和 T）混合模型方差分析。与 TAU 组相比，DBT-ST 加 TAU 组的参与者在一段时间内，暴食、情绪性进食、整体进食障碍和与进食困难相关的临床障碍都显著减少。
研究结果表明，将简短的 DBT-ST 团体作为减重术前 TAU 的辅助治疗，可以帮助解决进食障碍问题。与仅接受 TAU 的患者相比，接受 DBT-ST 加 TAU 治疗的减重患者可能会走上更好的减重轨迹。
