title: Analyzing the Effects of Psychotherapy on Weight Loss after Laparoscopic Gastric Bypass or Laparoscopic Adjustable Gastric Banding in Patients with Borderline Personality Disorder: A Prospective Study.
abstract: OBJECTIVE
  Personality disorders are frequently associated with eating disorders in obese patients and may negatively affect weight loss and maintenance after bariatric surgery. This non-randomized study aimed to assess the effects of different psychotherapeutic interventions on weight loss in a sample of patients with borderline personality disorder who underwent laparoscopic gastric bypass or laparoscopic adjustable gastric banding.
  
  
  METHODS
  A total of 153 bariatric patients meeting borderline personality disorder criteria were chosen voluntarily and consecutively to undergo an interpersonal individual treatment (n = 50), a dialectical behavioral group treatment (n = 50), or treatment as usual (n = 53) for a year after surgery. Their body mass index was measured before and at the end of each treatment.
  
  
  CONCLUSIONS
  A total of 12 patients (7.8%) dropped out of the study. Significantly higher body mass index reductions were registered in both experimental groups (-14.2 and -9.4 kg/m2, respectively) compared with the treatment as usual group (-2.1 kg/m2; p < 0.01). Treated patients who underwent laparoscopic gastric bypass (total n = 94) showed better outcomes than those who underwent laparoscopic adjustable gastric banding (total n = 45), while no differences were observed in untreated patients. This study demonstrates the role of pre-operative psychological assessment and post-operative psychotherapeutic support in improving weight loss among bariatric patients with borderline personality disorder. A randomized controlled trial is needed to confirm these preliminary findings.
authors.affiliation: 1 Department of Movement Sciences and Wellbeing, University of Naples "Parthenope," Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Gallé
authors.affiliation: 1 Department of Movement Sciences and Wellbeing, University of Naples "Parthenope," Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cirella
authors.affiliation: 2 Evangelical Hospital "Villa Betania," Naples, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Salzano
authors.affiliation: 3 Department of Sciences and Technologies, University of Naples "Parthenope," Naples, Italy.
authors.forename: V Di
authors.initials: VD
authors.lastname: Onofrio
authors.affiliation: 1 Department of Movement Sciences and Wellbeing, University of Naples "Parthenope," Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Belfiore
authors.affiliation: 1 Department of Movement Sciences and Wellbeing, University of Naples "Parthenope," Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Liguori
mesh_terms: D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000150:complications / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D011613:Psychotherapy; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Bariatric surgery; borderline personality disorder; dialectical behavioral therapy; interpersonal therapy; weight loss