title: Optimizing long-term weight control after bariatric surgery: a pilot study.
abstract: BACKGROUND
  Although bariatric surgery is associated with significant overall weight loss, many patients experience suboptimal outcomes. Our objective was to document the preliminary efficacy of a behavioral intervention for bariatric surgery patients with relatively poor long-term weight loss and to explore the factors related to outcome at an academic medical center in the United States.
  
  
  METHODS
  Patients with a body mass index (BMI) ≥ 30 kg/m(2) who had undergone bariatric surgery ≥ 3 years before study entry and had <50% excess weight loss were enrolled. The participants were randomly assigned to a 6-month behavioral intervention or wait list control group. The assessments were conducted at baseline (before intervention) and 6 months (after intervention) and 12 months (6-mo follow-up).
  
  
  RESULTS
  On average, the participants (n = 36) had undergone surgery 6.6 years before study entry. The average age was 52.5 ± 7.1 years, and the BMI was 43.1 ± 6.2 kg/m(2); most participants were women (75%) and white (88.9%). The intervention patients had a greater percentage of excess weight loss than did the wait list control group at 6 (6.6% ± 3.4% versus 1.6% ± 3.1%) and 12 (5.8% ± 3.5% versus .9% ± 3.2%) months. However, the differences were not significant and the results varied. The intervention patients with more depressive symptoms (P = .005) and less weight regain before study entry (P = .05) experienced a greater percentage of excess weight loss.
  
  
  CONCLUSIONS
  Behavioral intervention holds promise in optimizing long-term weight control after bariatric surgery. More research is needed on when to initiate the intervention and to identify which patients will benefit from this type of approach.
authors: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. kalarchianma@upmc.edu
authors: Melissa A
authors: MA
authors: Kalarchian
authors: Marsha D
authors: MD
authors: Marcus
authors: Anita P
authors: AP
authors: Courcoulas
authors: Yu
authors: Y
authors: Cheng
authors: Michele D
authors: MD
authors: Levine
authors: Deborah
authors: D
authors: Josbeno
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D040242:Risk Reduction Behavior; D055502:Secondary Prevention; D016896:Treatment Outcome; D015431:Weight Loss