Background

Maladaptive eating behaviors (MEB) are highly prevalent among bariatric surgery patients leading to weight regain. Psychotherapy has shown inconsistent results. A systematic review was conducted to evaluate the effectiveness of pre or postoperative psychotherapeutic interventions on MEB pre or post-bariatric surgery.

Methods

The study was registered in PROSPERO. A comprehensive literature review was performed in the databases PubMed, ScienceDirect, Cochrane Library, and Web of Science. We included all the studies with pre or postoperative psychotherapeutic interventions in bariatric surgery patients aimed to improve MEB.

Results

14 studies met the inclusion criteria (7 RCT and 7 pre-posttest). A total of 691 participants were identified, 81% female and the average participant’s age was of 47.1 (SD ± 6.0). Follow-up period after intervention ranged from 6 weeks to 38 months. Five out of seven RCT reported a positive and significant effect (p <0.05) on MEB with psychotherapeutic interventions compared with the control group. Six out of seven pre-post-test studies reported significant difference (p <0.05) on MEB after receiving psychotherapeutic interventions. Although weight loss was reported in all studies that included weight measure, four (44%) out of nine studies reported significant weight loss difference. Overall, the quality of the evidence ranged from low to moderate.

Conclusions

Psychotherapeutic interventions in bariatric surgery patients are inconsistent, though most results indicate improvement on MEB. Significant positive effect on weight loss was reported in 44% of the studies. Well-designed long-term studies and other approach strategies are warranted to assess long-term effect on MEB and weight loss in bariatric surgery patients.