The Impact of a Preoperative Cognitive Behavioural Therapy (CBT) on Dysfunctional Eating Behaviours, Affective Symptoms and Body Weight 1 Year after Bariatric Surgery: A Randomised Controlled Trial Comprehensive behavioral-motivational nutrition education improves depressive symptoms following bariatric surgery: a randomized, controlled trial of obese Hispanic Americans. Does cognitive behavioral therapy strengthen the effect of bariatric surgery for obesity? Design and methods of a randomized and controlled study. Employment Outcomes One Year after Bariatric Surgery: the Role of Patient and Psychosocial Factors National Surgical Quality Improvement Program analysis of bariatric operations: modifiable risk factors contribute to bariatric surgical adverse outcomes. Psychosocial predictors of intentions to comply with bariatric surgery guidelines The impact of a bariatric rehabilitation service on weight loss and psychological adjustment - study protocol When is the best time to deliver behavioral intervention to bariatric surgery patients: before or after surgery? Preoperative Lifestyle Intervention in Bariatric Surgery: Initial Results from a Randomized, Controlled Trial Exercise improves quality of life in bariatric surgery candidates: results from the Bari-Active trial. A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial. Psychological outcomes and predictors of initial weight loss outcomes among severely obese adolescents receiving laparoscopic adjustable gastric banding. Preoperative lifestyle intervention in bariatric surgery: a randomized clinical trial. A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery. Effects of a nursing intervention on quality of life outcomes in post-surgical women with gynecological cancers. The impact of preoperative counseling on postoperative treatment adherence in bariatric surgery patients: a randomized controlled trial. Psychoeducational support to post cardiac surgery heart failure patients and their partners--a randomised pilot study.
Background To examine whether a preoperative cognitive behavioural therapy ( CBT ) intervention exceeds usual care in the improvements of dysfunctional eating behaviours , mood , affective symptoms and body weight 1 year after bariatric surgery . Methods This is a 1-year follow-up of a single centre parallel-group r and omised controlled trial ( http:// clinical trials.gov/ct2/show/NCT01403558 ) . A total of 80 ( 55 females ) patients mean ( SD ) age 44 ( 10 ) years were included . The intervention group received 10 weeks of CBT prior to bariatric surgery , and the control group received nutritional support and education . Both groups were assessed at baseline ( T0 ) , post CBT intervention/preoperatively ( T1 ) , and 1 year postoperatively ( T2 ) . Using a mixed modelling statistical approach , we examined if the CBT group improved more across time than the control group . Results Our hypothesis was not supported as both groups had comparable improvements in all outcomes except for anxiety symptoms . Body weight declined by 30.2 % ( 37.3 kg ) in the CBT group and by 31.2 % ( 40.0 kg ) in the control group from baseline to follow-up , p = 0.82.There were statistically significant reductions in anxiety and depression symptoms in the CBT group between T0 and T1 and between T1 and T2 for depression only . However , in the control group , the anxiety score did not change significantly . The CBT group showed an earlier onset of improvements in all eating behaviours and affective symptoms than the control group . Conclusion The 10-week CBT intervention showed beneficial effects preoperatively , but the non-significant group differences postoperatively indicate a genuine effect of surgery OBJECTIVE To evaluate the effect of 2 post-bariatric support interventions on depressive symptoms of Hispanic Americans treated with gastric bypass for morbid or severe obesity . DESIGN / SETTING Prospect i ve r and omized , controlled trial conducted in a laparoscopic institution . PARTICIPANTS / INTERVENTIONS During the Phase 1 clinical trial ( from preoperative evaluation to 6 months after surgery ) , all participants received st and ard care . During Phase 2 ( 6 - 12 months after surgery ) , participants were r and omly assigned to receive either st and ard care ( n = 72 ) or comprehensive support ( n = 72 ) . Comprehensive group participants received 6 educational sessions focused on behavior change strategies and motivation with nutrition counseling . MAIN OUTCOME MEASURES Depression scores and weight change over time . ANALYSIS Independent sample s t tests and regression analysis assessed relationships among depression scores and excess weight loss . RESULTS Participants receiving behavioral-motivational intervention scored significantly lower on Beck 's Depression Inventory question naire scores than those receiving st and ard care . For those with depressive symptoms at r and omization , 24 % of participants who received the comprehensive intervention reported no depressive symptoms at 12 months after surgery , compared with 6 % of those who received st and ard care ( P < .001 ) . Patients ' depressive mood improvement was significantly and positively associated with excess weight loss and attendance at educational sessions ( P < .001 ) . CONCLUSIONS AND IMPLICATION S Findings support the importance of post-bariatric comprehensive behavioral-motivational nutrition education for decreasing risk for depression and improving weight loss BACKGROUND ( Extreme ) obesity is a chronic harmful condition with high risk of medical comorbidities and negative social and emotional consequences . Bariatric surgery is an effective intervention for obesity , but approximately 20 to 30 % of the patients experience adverse outcomes after surgery and there is a need for augmentation of current treatment strategies . This study examines the added value of pre-operative cognitive behavioral therapy ( CBT ) focused on modification of thoughts and behaviors in terms of eating behavior and physical exercise as well as preparation for surgery and postoperative life style . We hypothesize that pre-operative CBT will result in better weight loss maintenance , reduction of maladaptive eating behavior and better adherence to postoperative lifestyle on the long term as compared to bariatric surgery alone . METHODS One hundred and twenty eight patients that are on a waiting list for bariatric surgery are r and omly assigned to the control or treatment condition . Patients in the treatment condition receive 10 sessions of CBT before surgery aim ed at modifying dysfunctional eating habits and behaviors and developing more rational weight and body-related beliefs in order to enable long term maintenance of a healthier lifestyle after surgery . Weight loss , eating behavior , eating disorders , depression , quality of life and psychological distress are assessed before and after treatment , as well as 1 , 3 , and 5 year following surgery Background Patients undergoing bariatric surgery  generally report improved work performance after this procedure ; however , previous research has been limited by a lack of st and ardized employment measures and a failure to account for the impact of psychiatric illness on employment outcomes . To address these limitations , this study aims to assess changes in patients ’ employment impairment and productivity 12 months post-surgery and to identify psychosocial predictors of change in employment outcomes . Methods A total of 164 patients underwent bariatric surgery between February 2010 and November 2012 in this prospect i ve cohort study . The primary outcome was a change in employment impairment ( EI ) as measured by total Lam Employment Absence and Productivity Scale ( LEAPS ) scores and changes in participants ’ job status category . Multiple linear regression models assessed whether baseline demographic or clinical factors , including a history of psychiatric illness and changes in depressive , anxiety and quality of life ( QOL ) symptoms , were associated with a change in LEAPS scores . Results Participants reported a significant reduction in EI post-surgery ( p < 0.0001 ) and improvement in work productivity ( p < 0.0001 ) 12 months after surgery . Only changes in depression ( confidence interval ( CI ) 0.46 , 0.76 , p < 0.0001 ) , anxiety ( CI 0.49 , 0.85 , p < 0.0001 ) and mental QOL ( CI −0.30 , −0.17 , p < 0.0001 ) were significant predictors of change in EI total scores . Logistic regression analysis did not identify significant predictors of change in participant job status . Conclusions Patients with pre-bariatric surgery psychiatric distress are more likely to report greater employment impairment and worse employment productivity pre-surgery . These patients also experience the greatest improvements in post-surgery employment functioning BACKGROUND The increase in obesity coupled with greater acceptance of the field of bariatric surgery has result ed in a substantial rise in the number of weight-loss operations . Because obese individuals are at high risk for surgical complications , concern about the safety of bariatric procedures exists . Earlier investigations of the clinical features associated with surgical complications have produced conflicting results . We sought to identify risk factors for surgical complications in a large , nationally representative population of US veterans . STUDY DESIGN We analyzed data  on bariatric procedures performed at 12 Veterans ' Affairs medical centers approved to perform weight-loss operations between 1998 and 2004 . Detailed pre- , intra- , and postoperative information and longterm mortality data were prospect ively collected using the National Surgical Quality Improvement Program methodology . We used multivariable logistic regression to identify clinical features associated with postoperative complications . RESULTS Among 575 bariatric patients assessed between 1998 and 2004 , 74 % were men with a mean age of 51 years . Thirty-day mortality was 1.4 % . Overall complication rate was 19.7 % . Of those with complications , one-half were of considerable clinical importance , as they were associated with prolonged length of stay . Clinical features that were predictive of adverse events in our multivariable analyses were superobesity , weight>350 pounds , and smoking . A more than 20 pack-year history of smoking was also associated with difficulty in weaning from a ventilator postoperatively . CONCLUSIONS We identified smoking and superobesity as preoperative risk factors associated with postoperative complications . Future studies should examine the effect of preoperative weight loss and smoking cessation on bariatric procedure outcomes An increasing body of research suggests that many patients have difficulty adopting the eating guidelines after weight-loss surgery , thereby reducing the long-term success of the procedure . Given such difficulties , it is possible that the typical preoperative education regarding post-surgical eating behavior guidelines is ineffective in motivating some individuals to comply . Presently , no accurate predictors of intentions to comply with post-bariatric surgery guidelines have been identified . In the present pilot study , a psychosocial intervention based on protection motivation theory ( PMT ) was presented to patients undergoing bariatric surgery .  PMT is a well-established preventive health model that has been utilized in a variety of health domains . Participants for this study were recruited before undergoing bariatric surgery , and were r and omly assigned to one of two groups : PMT group vs. control . In addition to routine messages from the bariatric surgeon , participants in the PMT group received an intervention based in PMT that focused on the importance of adhering to post-surgical eating behavior guidelines and how best to adhere to these guidelines . Participants in the control group received st and ard of care information from the bariatric surgeon . Results indicated that the PMT intervention did not have a significant impact . However , follow-up analyses revealed that two aspects of PMT , perceived self-efficacy and perceived threat of not following the guidelines , predicted patients ' intentions to comply with post-surgical guidelines . Findings are discussed in terms of the method ological compromises that result ed from the applied research setting as well as promising avenues for future investigation Background Bariatric surgery is currently the most effective form of obesity management for those whose BMI is greater than 40 ( or 35 with co morbidities ) . A minority of patients , however , either do not show the desired loss of excess weight or show weight regain by follow up . Research highlights some of the reasons for this variability , most of which centres on the absence of any psychological support with patients describing how although surgery fixes their body , psychological issues relating to dietary control , self esteem , coping and emotional eating remain neglected . The present study aims to evaluate the impact of a health psychology led bariatric rehabilitation service ( BRS ) on patient health outcomes . The bariatric rehabilitation service will provide information , support and mentoring pre and post surgery and will address psychological issues such as dietary control , self esteem , coping and emotional eating . The package reflects the rehabilitation services now common place for patients post heart attack and stroke which have been shown to improve patient health outcomes . Methods / Design The study is a r and omised control trial and patients will be allocated to receive either usual care or the bariatric rehabilitation service pre and post bariatric surgery . Follow up measures of weight loss and psychological issues will be taken at baseline ( 2 weeks preoperatively ) , 3 , 6 and 12 months postoperatively . The contents of the bariatric service and the follow up measures are based on previous pilot work and have been developed further by the research team working closely with two patient support groups ( BOSPA & WLSinfo ) . This study will take place in St Richard 's Hospital in Chichester in the UK . Discussion It is predicted that a bariatric rehabilitation service will improve weight loss following surgery and will also facilitate changes in other psychological variables such as quality of life , dietary control , self esteem , coping and emotional eating . This also has cost implication s for the NHS and other healthcare providers as improved effectiveness of bariatric surgery reduces the health costs of obese patients in the longer term . Trial registration Clinical Trials.gov NCT01264120 BACKGROUND Many comprehensive bariatric surgery programs have implemented preoperative behavioral interventions for patients presenting with problematic eating behaviors in an effort to enhance postoperative weight loss and improve psychosocial adjustment . However , it is unknown whether these interventions are best delivered pre- or postoperatively . The purpose of this study was to determine when bariatric surgery patients are most receptive to a behavioral intervention , before or after surgery . METHODS A total of 32 pre- and postoperative patients were referred to a 10-week intervention design ed to reduce eating behaviors associated with postoperative weight gain ( e.g. ,  loss  of control while eating , grazing )  . The sample was 78.1 % female and 84.4 % white , with an average age of 49.43 + /- 9.13 years and a body mass index of 44.22 + /- 6.48 kg/m(2 ) . Of the 32 patients , 21 were referred preoperatively and 11 were referred postoperatively ( 5.63 + /- 2.91 months after surgery ) . These patients were tracked prospect ively to determine whether pre- or postoperative patients were more likely to attend and complete the behavioral intervention . RESULTS Compared with the preoperative patients , the postoperative patients were more likely to follow-up with their referral and initiate treatment [ chi(2)(1 ) = 10.06 , P = .002 ] . Of the postoperative patients , 100 % attended the first intervention session  compared with only 43 % of preoperative patients . The postoperative patients also attended more intervention sessions [ t(18 ) = 2.51 , P = .02 ] and were more likely to complete the intervention [ chi(2)(1 ) = 7.21 , P = .007 ] . Only 14 % of the preoperative referral patients completed the program compared with 91 % of the postoperative patients . CONCLUSION Comprehensive bariatric surgery programs ought to consider balancing the needs of the preoperative patients presenting with maladaptive eating behavior with the likelihood of them participating in a behavioral intervention before surgery OBJECTIVE To document preoperative outcomes of a behavioral lifestyle intervention delivered to patients prior to bariatric surgery in comparison to treatment as usual ( insurance-m and ated physician supervised diet ) . DESIGN AND METHODS After completing a baseline assessment , c and i date s for surgery were r and omized to a 6-month , evidence -informed , manualized lifestyle intervention ( LIFESTYLE , n = 121 ) or to preoperative care as usual ( USUAL CARE , n = 119 ) . At 6 months , 187 participants remained c and i date s for bariatric surgery and were included in the analyses . RESULTS LIFESTYLE participants  lost significantly more weight than those receiving USUAL CARE [ 8.3 ± 7.8 kg vs. 3.3 ± 5.5 kg , F(1,183 ) = 23.6 , P < 0.0001 ] , with an effect size of 0.72 . Additionally , logistic regression modeling indicated that LIFESTYLE patients were significantly more likely to lose at least 5 % of initial body weight than those in USUAL CARE [ OR ( 95 % CI ) = 2.94 ( 1.253 , 6.903 ) ] , as were participants who were heavier [ OR ( 95 % CI ) = 1.07 ( 1.001 - 1.14 ) for each unit increase in BMI ] or with larger improvements in eating behaviors [ OR ( 95 % CI ) = 1.1 ( 1.049 , 1.145 ) for each unit increase on the Eating Behavior Inventory ) . CONCLUSIONS A behavioral lifestyle intervention for severely overweight individuals leads to clinical ly significant weight loss prior to bariatric surgery . Post-surgery follow-up will allow us to examine the impact of the preoperative intervention on postoperative outcomes OBJECTIVE To examine the impact of a pre-bariatric surgery physical activity intervention ( PAI ) , design ed to increase bout-related ( ≥10 min ) moderate to vigorous PA ( MVPA ) , on health-related quality of life ( HRQoL ) . METHODS Analyses included 75 adult participants ( 86.7 % female ; BMI = 45.0 ± 6.5 kg m(-2 ) ) who were r and omly assigned to 6 weeks of PAI ( n = 40 ) or st and ard pre-surgical care ( SC ; n = 35 ) .  PAI received 6 individual weekly counseling sessions to increase walking exercise . Participants wore an objective PA monitor for 7 days and completed the SF-36 Health Survey  at baseline and post-intervention to evaluate bout-related MVPA and HRQoL changes , respectively . RESULTS PAI increased bout-related MVPA from baseline to post-intervention ( 4.4 ± 5.5 to 21.0 ± 21.4 min day(-1 ) ) versus no change ( 7.9 ± 16.6 to 7.6 ± 11.5 min day(-1 ) ) for SC ( P = 0.001 ) . PAI reported greater improvements than SC on all SF-36 physical and mental scales ( P < 0.05 ) , except role-emotional . In PAI , better baseline scores on the physical function and general health scales predicted greater bout-related MVPA increases ( P < 0.05 ) , and greater bout-related MVPA increases were associated with greater post-intervention improvements on the physical function , bodily pain , and general health scales ( P < 0.05 ) . CONCLUSIONS Increasing PA preoperatively improves physical and mental HRQoL in bariatric surgery c and i date s. Future studies should examine whether this effect improves surgical safety , weight loss outcomes , and postoperative OBJECTIVE This study aim ed to develop and test a novel mindfulness-based intervention ( MBI ) design ed to control weight after bariatric surgery . DESIGN R and omized , controlled pilot trial . SETTING Beth Israel Deaconess Medical Center , Boston , MA , USA . INTERVENTIONS Bariatric patients 1 - 5 years post-surgery ( n=18 ) were r and omized to receive a 10-week MBI or a st and ard intervention . MAIN OUTCOME MEASURES Primary outcomes were feasibility and acceptability of the MBI . Secondary outcomes included changes in weight , eating behaviors , psychosocial outcomes , and metabolic and inflammatory biomarkers . Qualitative exit interviews were conducted post-intervention . Major themes were coded and extracted . RESULTS Attendance was excellent ( 6 of 9 patients attended ≥7 of 10 classes ) . Patients reported high satisfaction and overall benefit of the MBI . The intervention was effective in reducing emotional eating at 6 months ( -4.9±13.7 in mindfulness vs. 6.2±28.4 in st and ard , p for between-group difference=0.03 ) but not weight . We also observed a significant increase in HbA1C ( 0.34±0.38 vs. -0.06±0.31 , p=0.03 ) . Objective measures suggested trends of an increase in perceived stress and symptoms of depression , although patients reported reduced stress reactivity , improved eating behaviors , and a desire for continued mindfulness-based support in qualitative interviews . CONCLUSIONS This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating , although it did not improve weight or glycemic control in the short term . Longer-term studies of mindfulness-based approaches may be warranted in this population . CLINICAL TRIAL REGISTRATION Clinical Trials.gov identifier NCT02603601 OBJECTIVE Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery . The role of mental health providers in this population is not well defined , and the selection of c and i date s is often the result of clinical judgment alone . The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric b and ing ( LAGB )  by ( 1 ) examining changes in depressive symptoms and quality of life in the year following surgery ; ( 2 ) evaluating the interaction between patterns of change in depression , quality of life , and weight postsurgery ; and ( 3 ) identifying presurgical psychological predictors of initial weight change . METHOD Participants were 101 severely obese adolescents aged 14 to 18 years receiving LAGB at the Center for Adolescent Bariatric Surgery at the Morgan Stanley Children 's Hospital of New York Presbyterian/Columbia University Medical Center between August 2006 and December 2009 . Measures of height , weight , depressive symptoms , and quality of life were obtained in the first year following surgery . Changes in the Beck Depression Inventory ( BDI ) , Pediatric Quality of Life Inventory ( PedsQL ) , and body mass index were analyzed using latent growth curve modeling . RESULTS Short-term changes in psychiatric symptoms and weight were analyzed using latent growth curve modeling . Significant changes in total BDI ( βslope = -0.885 , SE = 0.279 , P < .01 ; βquadratic = 0.054 , SE = 0.021 , P < .001 ) and PedsQL ( βslope = -0.885 , SE = 0.279 , P < .001 ) scores were observed following LAGB , and comparable postoperative changes between psychosocial variables and body mass index were also noted ( BDI : covariance [ COV ] = 0.21 , SE = 0.06 , P < .001 ; PedsQL : COV = -0.41 , SE = 0.10 , P < .01 ) . Two variables ( family conflict/loss of control eating ) were found to be significant predictors of weight change over the year following surgery ( P < .05 ) . CONCLUSIONS Adolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB , and measures of preoperative binge eating and family conflict affected postsurgery body mass index among youth . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01045499 BACKGROUND Studies on the impact of presurgery weight loss and lifestyle preparation on outcomes following bariatric surgery are needed . OBJECTIVE To evaluate whether a presurgery behavioral lifestyle intervention improves weight loss through a 24-month postsurgery period . SETTING Bariatric Center of Excellence at a large , urban medical center . METHODS C and i date s for bariatric surgery were r and omized to a 6-month behavioral lifestyle intervention or to 6 months of usual presurgical care . The lifestyle intervention consisted of 8 weekly face-to-face sessions , followed by 16 weeks of face-to-face and telephone sessions before surgery ; the intervention also included 3 monthly telephone contacts after surgery . Assessment s were conducted 6 , 12 , and 24 months after surgery . RESULTS Participants who underwent surgery ( n = 143 ) were 90.2 % female and 86.7 % White . Average age was 44.9 years , and average body mass index was 47.5 kg/m(2 ) at study enrollment . At follow-up , 131 ( 91.6 % ) , 126 ( 88.1 % ) , 117 ( 81.8 % ) patients participated in the 6- , 12- , and 24-month assessment s , respectively . Percent weight loss from study enrollment to 6 and 12 months after surgery was comparable for both groups , but at 24 months after surgery , the lifestyle group had significantly smaller percent weight loss compared with the usual care group ( 26.5 % versus 29.5 % , respectively , P = .02 ) . CONCLUSIONS Presurgery lifestyle intervention did not improve weight loss at 24 months after surgery . The findings from this study raise questions about the utility and timing of adjunctive lifestyle interventions for bariatric surgery patients BACKGROUND Bariatric surgery is a powerful treatment of severe obesity . During the past several years , a greater appreciation for the need for multidisciplinary care to optimize outcomes has developed , and a number of studies have been started to examine the role of postoperative interventions used in combination with surgery . The purpose of the present study was to investigate the hypothesis that the provision of postoperative dietary counseling , delivered by a registered dietitian , would lead to greater weight loss and more positive improvements in dietary intake and eating behavior compared with st and ard postoperative care . The study was performed at an academic medical center . METHODS Eighty-four individuals who underwent bariatric surgery were r and omly assigned to receive either dietary counseling or st and ard postoperative care for the first 4 months after surgery . The participants completed measures of macronutrient intake and eating behavior at baseline and 2 , 4 , 6 , 12 , 18 , and 24 months after surgery . RESULTS The patients who received dietary counseling achieved greater weight loss than those who received st and ard postoperative care that did not involve this counseling , although this difference did not reach statistical significance . Patients in the dietary counseling arm did report significant changes in several eating behaviors believed to be important to successful long-term weight maintenance . CONCLUSION The results of our pilot study provide some support for the efficacy of early postoperative dietary counseling to improve outcomes after bariatric surgery OBJECTIVE Women with gynecological cancers have reported poor health-related quality of life ( QOL ) , with complex physical and psychological needs post-surgery and during chemotherapy treatment . There are no studies reporting interventions addressing these needs post-hospital discharge in this population . METHODS Patients were r and omized into two groups . The intervention group received 6 months of specialized care by an Advanced Practice Nurse ( APN ) ; in addition , women with high distress were evaluated and monitored by a psychiatric consultation-liaison nurse ( PCLN ) . The attention control group was assisted with symptom management by a research assistant . The effects of the 6-month intervention were evaluated using self-report question naires at baseline ( 24 - 48 h after surgery ) , 1 , 3 , and 6 months post- surgery . QOL assessment s included the Center for Epidemiological Studies -Depression Scale , the ambiguity subscale of the Mishel Uncertainty in Illness Scale , the Symptom Distress Scale , and the Short-Form Health Survey ( SF-12 ) . The sample for the longitudinal analysis included 123 who completed QOL outcome measures  across three occasions post-surgery . RESULTS The APN intervention result ed in significantly less uncertainty than the attention control intervention 6 months after surgery . When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group , the sub-group had significantly less uncertainty , less symptom distress , and better SF-12 mental and physical QOL over time . CONCLUSION Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect OBJECTIVE To assess if attendance to a preoperative counseling program improved weight loss or adherence to treatment guidelines in patients who underwent bariatric surgery . METHODS One-hundred-forty-one patients were included in the study . Sixty-nine percent chose to participate in the counseling groups . They were r and omized to a Treatment group and a Control group . Thirty-one percent chose not to participate in the counseling . However , they gave their consent to assessment before and after surgery ( Reference group ) . RESULTS One year after bariatric surgery , 88 % had a weight loss of ≥ 50 % EWL , 37 % reported more than 30 min of physical activity daily , 74 % had 5 - 7 meals daily , and 87 % took recommended vitamins . There were no differences in weight loss , eating habits , or physical exercise between the Treatment group , the Control group and the Reference group one year after surgery . CONCLUSION Preoperative group counseling did not increase treatment adherence to recommended life-style changes . PRACTICE IMPLICATION S In accordance with findings in the present study , it is not reasonable to offer a preoperative counseling program for all patients undergoing bariatric surgery . Further research should focus on developing and evaluating programs for postsurgical follow-up , and identifying patients that are in need for more comprehensive treatment programs OBJECTIVES Postoperative heart failure is a serious complication that changes the lives of both the person who is critically ill and family in many ways . The purpose of this study was to evaluate the effects of an intervention in postoperative heart failure patient-partner dyads regarding health , symptoms of depression and perceived control . RESEARCH METHODOLOGY / DESIGN Pilot study with a r and omised controlled design evaluating psychosocial support and education from an interdisciplinary team . SETTING Patients with postoperative heart failure and their partners . MAIN OUTCOME MEASURES SF-36 , Beck Depression Inventory , Perceived Control at baseline , 3 and 12 months . RESULTS A total of 42 patient-partner completed baseline assessment . Partners in the intervention group increased health in the role emotional and mental health dimensions and patients increased health in vitality , social function and mental health dimensions compared with the control group . Patients ' perceived control improved significantly in the intervention group over time . CONCLUSION Psychoeducational support to post cardiac surgery heart failure dyads improved health in both patients and partners at short term follow-up and improved patients ' perceived control at both short and long-term follow-up . Psychoeducational support appears to be a promising intervention but the results need to be confirmed in larger studies
Preoperative and post-operative intensive interventions improved symptoms of depression and anxiety , quality of life , diastolic blood pressure , and resting heart rate but not lipids or glycaemic measures .
This systematic review and meta- analysis of intervention studies aims to evaluate the effect of preoperative and /or post-operative support for adults who elect bariatric surgery delivered by a multidisciplinary team ( MDT )  on post-operative body composition , mental health , co-morbidities , quality of life , and side effects .