Randomized Controlled Trial of Treatments for Loss‐of‐Control Eating Following Bariatric Surgery. Issue 4 (10th March 2021)

• Record Type: Journal Article
• Authors: Grilo, Carlos M.; Ivezaj, Valentina; Duffy, Andrew J.; Gueorguieva, Ralitza
• Is Part Of: Obesity. Volume 29:Issue 4(2021)
• Page Start: 689
• Page End: 697
• Publication Date: 2021-03-10
• Subjects: Obesity -- Periodicals; 616.398005
• DOI: 10.1002/oby.23124
• Languages: English
• ISSNs: 1930-7381

Abstract

Abstract : Objective: Loss‐of‐control (LOC) eating postoperatively is a consistent predictor of suboptimal longer‐term bariatric surgery outcomes. This randomized controlled trial examined the effectiveness of two guided self‐help treatments (cognitive behavioral therapy [gshCBT] and behavioral weight loss [gshBWL]) compared with a control (CON) for reducing LOC eating and weight. Methods: A total of 140 patients with recurrent LOC eating approximately 6 months after bariatric surgery were randomly assigned (5:5:2 ratio) to one of three conditions: gshCBT ( n = 56), gshBWL ( n = 60), or CON ( n = 24). Three‐month treatments were delivered by trained allied health clinicians to increase generalizability to bariatric surgery settings. Independent assessments were performed by doctoral research‐clinicians using established interviews/measures; posttreatment outcomes were obtained for 89% of patients. Results: Mixed models revealed significant improvements for LOC eating frequency and weight loss but no significant differences between treatments; race neither predicted (main effect) nor moderated (interaction effect) treatment outcomes. Intent‐to‐treat categorical analyses of abstinence from LOC eating (30% for gshCBT, 27% for gshBWL, 38% for CON) and proportion attaining 5% weight loss (20%, 22%, 17%) revealed no significant differences between treatments; non‐White participants had a higher proportion achieving LOC eating abstinence but a lower proportion attaining 5% weight loss compared with White participants. Conclusions: In this 12‐week randomized controlled trial following bariatric surgery, significant LOC eating reductions and weight loss did not differ significantly between treatments. Race was associated with posttreatment categorical outcomes.