Does Post-operative Psychotherapy Contribute to Improved Comorbidities in Bariatric Patients with Borderline Personality Disorder Traits and Bulimia Tendencies? A Prospective Study.
Borderline personality disorder (BPD) and eating disorders may affect the outcomes of bariatric surgery. This study was aimed to evaluate the influence of a post-operative dialectical behavioral therapy (DBT) intervention on weight loss and comorbidities in a sample of comorbid obese Italian patients with BPD traits and bulimia tendencies who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB).



One hundred fifty-four LRYGB or LAGB patients showing BPD and bulimia traits and type II diabetes, hypertension, and/or sleep apnea (OSAS) voluntarily adhered to DBT (n = 72) or treatment as usual (n = 82) for 12 months after surgery. Total weight loss (%TWL) and remission/improvement of comorbidities were considered as outcomes. Differences between treatment groups and between LRYGB and LAGB subgroups were evaluated through Student's t test for TWL and chi-square test for comorbidities.



DBT was more effective than treatment as usual (TAU) in reducing weight loss (p < .001). Reduction of comorbidities was higher in patients treated with DBT, as for diabetes (p = .68), hypertension (p = .02), and OSAS (p = .03). LRYGB outcomes seem to be significantly better than those of LAGB, mainly in TAU group.



Our findings confirm the effectiveness of DBT in enhancing post-bariatric weight loss and reduction of comorbidities in patients showing BPD traits and bulimia tendencies. Further in-depth investigations and a longer follow-up are needed to strengthen these results.
Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina n. 40, 80133, Naples, Italy. francesca.galle@uniparthenope.it.
Francesca
F
Gallé
Evangelical Hospital "Villa Betania", Naples, Italy.
Pietro
P
Maida
Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina n. 40, 80133, Naples, Italy.
Assunta
A
Cirella
Evangelical Hospital "Villa Betania", Naples, Italy.
Elena
E
Giuliano
Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina n. 40, 80133, Naples, Italy.
Patrizia
P
Belfiore
Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina n. 40, 80133, Naples, Italy.
Giorgio
G
Liguori
D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D001521:Behavior Therapy / Q000379:methods*; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy*; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy; D005260:Female; D015390:Gastric Bypass / Q000523:psychology; D015391:Gastroplasty / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000523:psychology / Q000628:therapy; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery; D011182:Postoperative Care; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
Bariatric surgery; Borderline personality disorder; Bulimia; Diabetes; Dialectical behavioral therapy; Hypertension; OSAS