A Randomized-Controlled Trial Examining Telephone-Based Cognitive Behavioral Therapy for Patients After Metabolic and Bariatric Surgery: 18 Month Follow-up Results
Bibliographic record
Abstract
BACKGROUND: Telephone-based Cognitive Behavioral Therapy (Tele-CBT) has shown to reduce disordered eating and psychological distress after metabolic and bariatric surgery (MBS). However, it is currently unknown how Tele-CBT impacts outcomes long term, and if differences in weight loss trajectories following Tele-CBT emerge with a long-term follow-up. This study aimed to identify whether Tele-CBT remains effective at 18 months post-intervention for improving psychological distress and maladaptive eating, and mitigating recurrent weight gain. METHODS: This large, multisite randomized control trial was conducted at three hospital-based MBS programs in Ontario, Canada. Participants (n = 306) were randomized 1:1 to receive either Tele-CBT or standard MBS care. The primary outcome was percentage of total weight loss (%TWL). Secondary outcomes included disordered eating (Binge Eating Scale, Emotional Eating Scale) and psychological distress (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7). Linear mixed models assessed group-by-time interactions across five time points: baseline (1-year post-MBS), post-intervention, and 3-, 12-, and 18-month follow-ups. RESULTS: Tele-CBT resulted in significant post-intervention improvements in binge eating (MD = - 0.46, p < .001), emotional eating (MD = - 0.14, p = 0.01), anxiety (MD = - 0.40, p < .001), and depressive symptoms (MD = - 0.47, p < .001). These improvements were all sustained at 3 months post-intervention (p < .05) whereas only improvements for emotional eating were sustained at 12 months post-intervention (MD = - 0.15, p = 0.01). There were no significant differences in %TWL trajectories between the Tele-CBT and control groups. CONCLUSIONS: Tele-CBT provides psychological benefits, particularly in reducing emotional eating. Findings highlight the need for continued psychosocial support to sustain other psychological benefits and mitigate recurrent weight gain post-MBS and further research on optimizing intervention timing and duration. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03315247.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".