A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial.
OBJECTIVE
This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery.


METHODS
Randomized, controlled pilot trial.


METHODS
Beth Israel Deaconess Medical Center, Boston, MA, USA.


METHODS
Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention.


METHODS
Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted.


RESULTS
Attendance was excellent (6 of 9 patients attended ≥7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (-4.9±13.7 in mindfulness vs. 6.2±28.4 in standard, p for between-group difference=0.03) but not weight. We also observed a significant increase in HbA1C (0.34±0.38 vs. -0.06±0.31, p=0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews.


CONCLUSIONS
This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population.


BACKGROUND
ClinicalTrials.gov identifier NCT02603601.
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States. Electronic address: sachacko@bidmc.harvard.edu.
Sara A
SA
Chacko
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
Gloria Y
GY
Yeh
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
Roger B
RB
Davis
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
Christina C
CC
Wee
D050110:Bariatric Surgery / Q000379:methods; D001835:Body Weight / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D010865:Pilot Projects; D061217:Weight Reduction Programs / Q000379:methods*
Bariatric surgery; Mindfulness; Obesity; Weight
Behav Res Ther. 2001 May;39(5):499-511
11341247
J Health Soc Behav. 1983 Dec;24(4):385-96
6668417
Ann Behav Med. 2009 Feb;37(1):58-69
19252962
Obes Surg. 2004 Nov-Dec;14(10):1402-5
15603659
Obes Surg. 2010 Mar;20(3):349-56
19554382
JAMA Intern Med. 2014 Mar;174(3):357-68
24395196
Am J Epidemiol. 1985 Jan;121(1):91-106
3964995
Appetite. 2009 Apr;52(2):396-404
19101598
Complement Ther Med. 2010 Dec;18(6):260-4
21130363
Int J Behav Med. 1997;4(1):92-100
16250744
Emotion. 2010 Feb;10(1):83-91
20141305
J Health Psychol. 1999 May;4(3):357-63
22021603
Am J Surg. 2002 Dec;184(6B):9S-16S
12527344
Obes Res Clin Pract. 2012 Jan-Mar;6(1):e1-e90
24331170
Int J Obes Relat Metab Disord. 2000 Dec;24(12):1715-25
11126230
Psychosom Med. 1998 May-Jun;60(3):338-46
9625222
Nutr Res. 2012 Jun;32(6):413-20
22749177
Obes Res. 2001 Feb;9(2):102-11
11316344
J Clin Psychol. 2013 Jan;69(1):28-44
23070875
J Consult Clin Psychol. 1991 Oct;59(5):739-44
1955608
Psychosom Med. 2015 Jan;77(1):59-67
25490697
Gen Hosp Psychiatry. 1982 Apr;4(1):33-47
7042457
Obesity (Silver Spring). 2013 Jun;21(6):1119-26
23666772
J Nutr Educ Behav. 2012 Jan-Feb;44(1):22-8
22243980
Obes Rev. 2003 Nov;4(4):213-27
14649372
Psychoneuroendocrinology. 2012 Jul;37(7):917-28
22169588
Behav Ther. 2012 Jun;43(2):427-35
22440077
J Gen Intern Med. 2013 Feb;28(2):231-8
22956443
Eat Disord. 2011 Jan-Feb;19(1):49-61
21181579
Health Educ Behav. 2014 Apr;41(2):145-54
23855018
Am J Med Sci. 2006 Apr;331(4):201-6
16617235
Surg Obes Relat Dis. 2005 May-Jun;1(3):371-81
16925250
Eat Behav. 2014 Apr;15(2):197-204
24854804
Addict Behav. 1982;7(1):47-55
7080884