Development of a group therapy to enhance treatment motivation and decision making in severely obese patients with a comorbid mental disorder.
BACKGROUND
The prevalence rate of mental disorders in severely obese patients appears to be high. In the Department of Psychosomatic Medicine, Heidelberg, we established a short outpatient group intervention for severely obese patients with an affective, anxiety, and/or eating disorder who either are not able to make a clear decision for an intensive weight loss program or who have already decided to undergo bariatric surgery but are advised to attend a support group before surgery. The aim of the group intervention was to reduce depressive symptoms and, in indecisive patients, to enhance the motivation of the patients for engagement in further intensive treatment programs, including bariatric surgery.


METHODS
Descriptive data of the first two intervention groups are provided. The treatment program and topics of the group sessions are explained. Time series analysis methods are used to investigate the development of a single patient during the intervention program.


RESULTS
Initially, 16 patients joined the group program; ten of these attended the group therapy to completion. The remaining ten patients showed clinically relevant reduction in depression levels and improvement in mental quality of life. Results of the single-case time series analysis indicate that the temporal relationship between eating behavior and depression changed during treatment.


CONCLUSIONS
The group program, as outlined, could be a useful intervention for severely obese patients with comorbid depression, anxiety, or eating disorder. A gap in the health care system is thus bridged by this short intervention that can encourage further treatment decisions such as bariatric surgery.
Wild
Beate
B
Department of Psychosomatic and General Internal Medicine, Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany, beate.wild@med.uni-heidelberg.de
Herzog
Wolfgang
W
Wesche
Daniela
D
Niehoff
Dorothea
D
Müller
Beat
B
Hain
Bernhard
B
D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003657:Decision Making; D003863:Depression / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D009042:Motivation; D009767:Obesity, Morbid / Q000453:epidemiology*; D011615:Psychotherapy, Group; D011788:Quality of Life; D012657:Self-Help Groups