title: Effectiveness of cognitive-behavioral therapy in morbidity obese candidates for bariatric surgery with and without binge eating disorder.
abstract: OBJECTIVE
  To analyze changes in the general and specific psychopathology of morbidly obese bariatric surgery (BS) candidates after cognitive behavioral therapy (CBT) and assess differences between patients with and without binge eating disorder (BED) and between patients with obesity grades III and IV, studying their influence on weight loss.
  
  
  METHODS
  110 consecutive morbidly obese BS candidates [77 females; aged 41 ± 9 yrs; body mass index 49.1 ± 9.0 kg/m²] entered a three-month CBT program (12 two-hour sessions) before BS. Participants were assessed with general and specific psychopathology tests pre- and post-CBT. Data were analyzed according to the degree of obesity and presence/ absence of BED.
  
  
  RESULTS
  At baseline, BED patients were more anxious and depressive with lower self-esteem and quality of life versus non-BED patients (p < 0.05) and were more concerned with food, weight and figure, felt greater hunger, fear and guilt, and were more influenced by contextual cues (p < 0.005). Post-CBT, these differences in self-esteem, depression, and eating disorders disappeared due to significant improvements in BED patients. No difference between OIII and OIV groups was found in any psychopathology test pre- or post-CBT. Multivariate analysis demonstrated that CBT was effective to treat psychological comorbidity regardless of the presence/ absence of BED or degree of obesity. At 1 yr post-CBT, weight loss versus baseline (before CTT) was > 10% in 61%, with no intergroup differences.
  
  
  CONCLUSIONS
  CBT is effective to treat psychological comorbidity in BS candidates, regardless of the presence of BED and degree of obesity.
authors.affiliation: Department of Surgery. Costa del Sol Hospital. Málaga.
authors.forename: V
authors.initials: V
authors.lastname: Abilés
authors.forename: S
authors.initials: S
authors.lastname: Rodríguez-Ruiz
authors.forename: J
authors.initials: J
authors.lastname: Abilés
authors.forename: A
authors.initials: A
authors.lastname: Obispo
authors.forename: N
authors.initials: N
authors.lastname: Gandara
authors.forename: V
authors.initials: V
authors.lastname: Luna
authors.forename: M C
authors.initials: MC
authors.lastname: Fernández-Santaella
mesh_terms: D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery; D056912:Binge-Eating Disorder / Q000150:complications; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult