Evidence map›Paper›PMID 36268671›Full record

Trial reportThe International journal of eating disorders2022

Three- and five-year follow-up results of a randomized controlled trial on the effects of cognitive behavioral therapy before bariatric surgery.

Linda Paul, Colin van der Heiden, Daphne van Hoeken, Mathijs Deen, Ashley Vlijm, René Klaassen, L Ulas Biter, Hans W Hoek

Open access · hybridAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in The International journal of eating disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Emotional Eating Interventions for Adults Living With Overweight and Obesity: A Systematic Review and Meta-Analysis of Behaviour Change Techniques.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Linda PaulParnassia Psychiatric Institute, PsyQ, Department of Eating Disorders, Rotterdam, South Holland, The Netherlands.
Colin van der HeidenParnassia Psychiatric Institute, The Hague, South Holland, The Netherlands.ORCID 0000-0001-6486-974X
Daphne van HoekenParnassia Psychiatric Institute, The Hague, South Holland, The Netherlands.ORCID 0000-0003-2956-059X
Mathijs DeenParnassia Psychiatric Institute, The Hague, South Holland, The Netherlands.ORCID 0000-0002-3570-5524
Ashley VlijmParnassia Psychiatric Institute, The Hague, South Holland, The Netherlands.
René KlaassenDepartment of Bariatric Surgery, Maasstad Hospital, Rotterdam, South Holland, The Netherlands.
L Ulas BiterDepartment of Bariatric Surgery, Franciscus Hospital, Rotterdam, South Holland, The Netherlands.
Hans W HoekParnassia Psychiatric Institute, The Hague, South Holland, The Netherlands.ORCID 0000-0001-6353-5465
Parnassia Groep · NLLeiden University · NLMaasstad Ziekenhuis · NLSint Franciscus Gasthuis · NLUniversity Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveUp to 37% of bariatric surgery patients suffer from insufficient weight loss or weight regain and mental health symptoms in the longer term. Cognitive behavioral therapy (CBT) may be an effective adjunct intervention to optimize patients' psychological functioning and weight loss results. To examine the value of adding preoperative CBT to bariatric surgery, three- and five-year follow-up data are presented.

methodIn this multi-center randomized controlled trial (RCT; N = 130), a CBT group was compared to a treatment-as-usual (TAU) control group. Measurements were conducted at five time points: pretreatment (T0) and posttreatment/presurgery (T1) and at one- (T2; N = 120), three- (T3; N = 117), and five-year postsurgery (T4; N = 115). The intervention group received a 10-weeks, individual, preoperative CBT focused on self-monitoring, identifying triggers for disordered eating and goal setting for eating behavior and physical exercise, as well as postoperative lifestyle. Outcome measures included weight change, eating behavior, eating disorders, depression, quality of life (QoL), and overall psychological health.

resultsPreoperative CBT was not associated with better three- and five-year results than TAU regarding weight, dysfunctional eating behaviors, eating disorders, depression, overall psychological health, and QoL. DISCUSSION: Contrary to our hypothesis, three- and five-year postsurgery differences between groups regarding weight change and mental health were not significant.. Further exploration suggested that in both groups weight problems and depressive symptoms worsened at three and five-year follow-up. Future research should focus on long-term postoperative monitoring of weight and mood and on associated postoperative interventions and their specific timing. PUBLIC SIGNIFICANCE: After bariatric surgery, in the longer term weight problems re-occur in 30% of patients, which is probably partly related to psychopathology. We investigated whether cognitive behavior therapy (CBT) prior to bariatric surgery improved weight maintenance and mental health after surgery. Our study provided definite proof that preoperative CBT is not effective. Long-term postoperative monitoring and prompt psychological intervention after first signs of deterioration, are important to prevent further problems.

Indexed as

Bariatric SurgeryCognitive Behavioral TherapyHumansQuality of LifeWeight Lossbariatric surgerycognitive behavioral therapydepressioneating behavioreating disorderslong-term follow-upobesityquality of lifeweight changeweight loss

Identifiers

PMID36268671
PMCPMC10092022
OpenAlexW4307033037

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.