The role of brief strategic therapy on the outcome of gastric banding.
BACKGROUND
The success of bariatric surgery can be measured in different ways and depends on many factors. The aim of this study was to assess if preoperative Brief Strategic Therapy (BST), a specific psychological support, can positively influence the results (weight loss, improvement in health status and quality of life, QOL) in the short- and long-term.


METHODS
500 patients who underwent laparoscopic adjustable gastric banding from 1996 to 1999 were evaluated both objectively (weight loss, health status) and subjectively (improvement in QOL and self-perception). We compared these results with those of a group of 145 patients treated with preoperative BST (6 sessions average). Patients were divided into 3 groups according to the percent of excess weight loss (< 40%, 40-60%, > 60%). The Moorehead-Ardelt QOL Questionnaire scoring was used. Individual interviews were conducted to understand emotional feelings and to evaluate the actual changes in the QOL and eating habits.


RESULTS
Patients treated preoperatively with BST had 46% excess weight loss (EWL) at 1 year which was significantlly different from patients non-treated (40% EWL). In the following years, treated patients showed better results, although not statistically significant. QOL improved objectively and subjectively


CONCLUSIONS
Preoperative BST gives a satisfactory result. In addition, good compliance preoperatively corrected eating habits that has been maintained through the years and is a good predictor of long-term success.
Caniato
Dorina
D
Department of Psychology, Strategic Therapy Center of Arezzo, Obesity Center, University of Padova, Italy. ffavret@tin.it
Skorjanec
Branka
B
D000293:Adolescent; D000328:Adult; D005260:Female; D015391:Gastroplasty / Q000379:methods / Q000523:psychology*; D006304:Health Status; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D011300:Preoperative Care / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss