title: A Pilot Study of an Acceptance-Based Behavioral Intervention for Weight Regain After Bariatric Surgery.
abstract: Tens of thousands of bariatric surgery patients each year experience sub-optimal weight loss, significant regain, or both. Weight regain can contribute to a worsening of weight-related co-morbidities, and for some, leads to secondary surgical procedures. Poor weight outcomes have been associated with decreased compliance to the recommended postoperative diet. Decreased compliance may be partially due to a lack of psychological skills necessary to engage in healthy eating behaviors over the long term, especially as the effects of surgery (on appetite, hunger, and desire for food) decrease. Many behavioral interventions do not sufficiently address these challenges and often have limited effectiveness. The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of a novel 10-week acceptance-based behavioral intervention to stop postoperative weight regain.
  
  
  
  A sample of bariatric surgery patients (n = 11) who regained at least 10 % of their maximum lost postoperative weight was recruited. All participants received the intervention, which emphasized psychological skills thought to be integral to successful weight control post-surgery.
  
  
  
  The intervention was shown to be feasible and acceptable, with 72 % retention and high mean rating (4.25 out of 5.00) of program satisfaction among completers. Weight regain was stopped, and even reversed, with a mean total body weight loss of 3.58 ± 3.02 % throughout the 10-week intervention. There were also significant improvements in eating-related and acceptance-related variables.
  
  
  
  These findings provide initial support for the use of a psychological acceptance-based intervention for weight regain in bariatric surgery patients.
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA. laur.bradley@gmail.com.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Bradley
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA, USA.
authors.forename: Evan M
authors.initials: EM
authors.lastname: Forman
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA, USA.
authors.forename: Stephanie G
authors.initials: SG
authors.lastname: Kerrigan
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA, USA.
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Butryn
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Herbert
authors.affiliation: Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
mesh_terms: D064869:Acceptance and Commitment Therapy; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000523:psychology*; D001521:Behavior Therapy; D015897:Comorbidity; D004435:Eating / Q000523:psychology; D005240:Feasibility Studies; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery*; D010349:Patient Compliance / Q000523:psychology; D010865:Pilot Projects; D011184:Postoperative Period; D012008:Recurrence; D015430:Weight Gain
keywords: Behavioral intervention; Postoperative weight regain